Rape and the Adolescent

In recent years the problem of rape and sexual abuse of young persons has begun to receive appropriate medical attention. Nearly 50% of reported rape victims are adolescents^1,2 Whereas the vast majority of offenses involve girls, the incidence of sexual assaults on young males also appears to be increasing.

Although community resources may vary considerably, most metropolitan areas now have special programs or facilities to assist the victims of sexual assault. Such assistance usually includes advice as to the management of the acute crisis as well as guidelines for the collection of evidence and the preparation for trial should legal action follow. Because so many of the victims are adolescents, they are being seen with increasing frequency in pediatric emergency rooms.

The adolescent who is forcibly assaulted may display a wide range of behaviors, such as hysterical crying or giggling, agitation, feelings of degradation, anger and rage, helplessness, nervousness, and rapid mood swings. Alternatively, the adolescent may appear calm and controlled, masking internal turmoil. She is often angry, confused, and filled with self-blame. In cases of forcible assault, longterm sequelae such as fears, nightmares, and sleep disturbances, disturbed peer and sexual relationships, and psychosomatic complaints may develop. Some fear retaliation from their attacker and develop ritualistic behavior as a defense. Some believe their bodies to be permanently damaged, and may even fear death as a consequence of the violent act they have experienced.

For the victim, the circumstances of the initial medical evaluation may be frightening and stressful. Police interrogation, repeated questioning by health professionals, and the physical examination itself all have the potential to add to the trauma of the sexual assault.