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Sexual offences in forensic medicine

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Sexual Offences in Forensic Medicine

Sexual offences in forensic medicine are divided into natural and unnatural sexual offences. The forensic physician's role is to examine victims and accused, collect evidence, document findings, and provide expert opinion in court - not to determine whether the legal offence occurred (that is a judicial determination).

Classification

A. Natural Sexual Offences

Rape (the most important)
Incest

B. Unnatural Sexual Offences (under Section 377 IPC)

Sodomy (buggery)
Buccal coitus
Tribadism
Bestiality

RAPE

Legal Definition (Indian Law - IPC Section 375)

A man commits rape if he has sexual intercourse with a woman:

Against her will
Without her consent
With consent obtained by putting her or someone she cares for in fear of death/hurt
With consent obtained by impersonation of her husband
With consent when she is of unsound mind or intoxicated
With or without consent if she is under 18 years of age
When she is unable to communicate consent

Penetration is sufficient - emission is immaterial. Even the slightest penetration constitutes rape.

Consent

Evidence of lack of consent includes:

Any evidence of fraud
Administration of drugs or drinks
Evidence of threat or force
Signs of struggle
Physical disproportion between parties
Impersonation (while she is asleep, drunk, hypnotized, or mentally defective)

Examination of the Rape Victim

General Procedure

Examination should be done only with a requisition from the investigating police officer or Magistrate - the court/police cannot force a woman to be examined against her will
Written, witnessed consent must be obtained from the victim (or her parents if under 12 or of unsound mind), covering: examination, specimen collection, photography, treatment, and information release to police
The victim must be identified by the escorting police constable
All preliminary demographic data (name, age, marital status, time/date/place of examination) must be recorded
The victim is examined in the presence of a third person, preferably a female nurse or female relative
Examination must be carried out without delay - minor injuries fade rapidly, vulval swelling may disappear within hours, and spermatozoa motility diminishes over time

History to be Recorded

A thorough history includes:

Whether she knows the accused
Whether food/drink was offered prior (affecting consciousness)
Date, time and place of alleged offence
Location (inside/outside, weather)
Number of assailants
Alcohol or drugs involved
Details of struggle/resistance and injuries sustained
Exact relative positions of parties
Type and number of sexual acts
Use of condoms or lubricants
Whether ejaculation occurred and where
Bleeding from vagina
Events after assault: changed clothing, bathed, douched, urinated, etc.
Recent consensual intercourse (in married women)
Previous sexual history, menses, VD, pregnancies

Physical Examination

General:

General demeanor (distressed, calm, shocked, intoxicated, agitated)
Elevated pulse (emotional stress or major trauma)
Gait - guarded gait with legs apart if in pain
Signs of alcohol or drug influence (collect blood and urine)
Height, weight, physical development

General injuries (signs of struggle):

Abrasions/bruises on mouth, neck, inner thighs, wrists (restraint marks)
Torn clothing, disheveled appearance
Bite marks, scratches
Injuries inconsistent with consensual sex suggest force

Genital findings (hymen):

Condition	Findings
Virgin	Hymen intact initially; fresh tears indicate recent forced entry
Woman used to intercourse	Hymen completely absent or only tags remain; no injury may be present even after complete penetration - absence of injury does not exclude rape
Older/atrophic women	Extensive vaginal lacerations even with moderate force due to senile atrophy
Children	Usually few/no signs of general violence; contusions of inner thighs, labia; hymen may be intact as adult penis cannot fully penetrate; redness and tenderness of vulva

Typical genital injuries:

Fresh lacerations of the hymen (at 6 o'clock position most commonly)
Lacerations of vaginal mucosa, posterior fourchette, perineum
Bruising of labia majora and minora
Contusions on inner aspects of thighs
Vaginal vault tears (right > left, in deflorate women)

Key point: Injuries from rape in women used to intercourse usually disappear in 3-4 days. In cases of significant violence, signs may persist longer.

Evidence Collection - SAFE Kit / PERK Kit

The SAFE (Sexual Assault Forensic Evidence) kit or PERK (Physical Evidence Recovery Kit) is used to systematically collect and preserve trace evidence. The objectives are:

Confirm allegations
Establish a link between victim and scene
Establish a link between victim and assailant (Locard's exchange principle)

Specimens to collect from victim:

Specimen	Details
Hair	10 hairs cut from different head locations; pubic hair combings; avulsed pubic hair; any loose foreign hair
Fingernail scrapings	For blood/tissue from accused (from scratching)
Seminal stains	Swabs from introitus, perineum, vagina (low + high), cervical os; UV lamp reveals seminal soiling
Blood	5 mL plain for grouping; 5 mL EDTA for DNA profile; 5 mL NaF/K-oxalate for alcohol/drugs/VD
Urine	NaF tube for alcohol/drug screening
Saliva	For secretor grouping
Swabs	From all surfaces that were kissed, licked, sucked, or bitten
Clothing	All worn items

Semen analysis:

Swabs taken before digital vaginal examination
Sperm motility: lost within 1-6 hours in vagina; non-motile sperm recoverable up to 24 hours
Cervical canal yields best results for delayed examination (>48 hrs)
Seminal stains fluoresce under UV/Wood's lamp
Acid phosphatase test used on swabs
Matted pubic hair should be cut away entirely and preserved

Examination of the Accused

Findings to look for:

Abrasions, scratches, bite marks (from victim's resistance)
Injuries to penis (indicating forced intercourse)
Blood grouping and DNA sampling
Seminal stains on clothing
Pubic hair for comparison with victim
STI/VD status

In court, the physician should never state whether rape has occurred - that is a legal conclusion. The examiner testifies only to their examination findings and what those findings are consistent with.

Findings Related to Time of Assault

Spermatozoa: Motile sperm within 1-6 hours; non-motile recoverable up to 24 hours in vagina
VD/STIs: Useful in determining time of sexual assault
Wounds: Age of injury correlated with alleged time of assault

POCSO Act (Protection of Children from Sexual Offences)

Special legislation protecting children from sexual offences
For a rape charge against a boy, his age must be >7 years
New amendments include IPC Sections 376AB, 376DA, 376DB (aggravated rape of minors)
No anticipatory bail to accused of raping girls under 16 years
Investigation must be completed within 3 months of FIR

Unnatural Sexual Offences (Section 377 IPC)

Defined as sexual intercourse "against the order of nature" with any man, woman, or animal. Penetration is sufficient; emission is immaterial.

Note: Consensual sexual activity between adult homosexuals is no longer a crime in India following the Supreme Court ruling (Navtej Singh Johar v. Union of India, 2018).

Sodomy (Buggery)

Anal intercourse between:

Two males (homosexual sodomy)
Male and female (heterosexual sodomy)

Terminology:

Gerontophilia - passive agent is an adult
Paederasty - passive agent is a young boy (catamite)
Active agent - the one who performs the act
Passive agent - the one on whom the act is performed

Examination of the Passive Agent:

Funnel-shaped anus with gaping
Loss of anal rugae
Relaxation of sphincter ani
Fissures and scars around anus
Bruising or lacerations of anal margin in acute cases

Examination of Active Agent:

Injuries on penis (abrasions, bite marks)
Fecal matter or blood on penis

Other Unnatural Offences

Buccal coitus - oral-genital contact; semen in oral cavity, genital injuries may be found
Tribadism - simulated coitus between two females
Bestiality - sexual intercourse with an animal
All require psychiatric assessment alongside forensic medical examination

One Stop Centre (OSC)

The Ministry of Women and Child Welfare has established One Stop Centres at all district hospitals across India, providing medical, legal, and social support to adult and child victims during and after investigation.

Sources:

Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, Chapters 27-28
The Essentials of Forensic Medicine and Toxicology, 36th Edition (2026), Chapter on Sexual Offences

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