Sexual assault reporting: a retrospective study on care provided in gynaecology emergency care settings after sexual assault.

Abstract

Objective: To assess the characteristics of all people reporting sexual assault at the obstetrics and gynaecology emergency departments of Geneva University Hospitals (HUG) and Lausanne University Hospitals (CHUV) between 2018 and 2021.

Methods: Retrospective analysis of medicolegal reports for all people reporting sexual assault at the obstetrics and gynaecology emergency departments of HUG and CHUV between 2018 and 2021. Included: cisgender women, non-binary, queer persons, transgender men with a vulva and vagina and transgender women, regardless of sexual orientation, aged at least 14 years old. Excluded: Children and adolescents <14, cisgender men and trans men with a penis (who usually do not consult obstetrics and gynaecology emergency departments after a sexual assault) and recurrent patients with more than three sexual assaults reported at a participating centre within the study period (the first three assaults were included). During the study period, the two regional university hospitals used the same forensic sexual assault reporting forms, which allows a uniform description of the sociodemographic and clinical characteristics of patients reporting sexual assault as well as the characteristics of the sexual assault itself.

Key findings: Of the 962 sexual assault records during the 48-month study, 740 were retained for the analysis. Median age of victims: 24 years (interquartile range: 19 to 33 years; range: 14 to 93 years). On weekend days, the number of assaults was twice as high as on weekdays (45% of all sexual assaults took place during the weekend, on either a Saturday or Sunday). During the summer, the monthly number of assaults was increased by half. The summer months had the highest number of consultations (34%). 58% of victims reported knowing their assaulter, 28% did not, and due to amnesia, 14% did not know whether they knew their attacker or not. 24% of the patients were unable to recall or specify which types of penetration they were subjected to (if any), because of amnesia. 67% of patients reported vaginal penetration, 17% anal and 21% oral. 63% of victims reported some type of substance use (alcohol, drugs) prior to the assault. The police or public prosecutor ordered 40% of the sexual assault medicolegal examinations, while 60% of the victims came to the emergency department seeking care on their own. 56% of assaults take place at someone's home (victim's home, assailant's home, friend/family member's home, couple's home). 83% of patients were examined within 72 hours of the sexual assault. Ano-genital injuries were found in 28% of patients who underwent a gynaecological exam (n = 705). 21% of patients who underwent a gynaecological exam and reported anal penetration presented with anal injury. 28% of patients who underwent a gynaecological exam and reported vaginal penetration presented with genital injury.

Conclusions and recommendations: Such data can inform the general population as well as actors working in this field, including legislators, about the use of services after sexual assault, prevention and health education strategies and how to improve services for people who are sexually assaulted. There is no countrywide observatory of persons consulting for sexual assault in Swiss hospitals. We aim to create a national observatory that can inform prevention, care and education campaigns against sexual assault and its consequences for both men and women.