Adults/Adolescents

Adolescent: “Adolescents” are defined in this protocol as children under 18 years of age, who have reached puberty. “While the physical developmental level of these patients” is similar to that of an adult and “must be taken into account when performing the exam, these patients should otherwise be treated as adolescents rather than children” (DoJ, 2013, p. 14).

Adult: “Person who is not a child” (Texas Family Code §101.003), adult who is older than 18 years of age.

Adult patients (18–64 years of age) who do not have a disability may choose to be treated by basic forensically trained medical professionalsFor the purposes of this protocol, a basic forensically trained medical professional is defined as a licensed medical professional (registered nurse, nurse practitioner, physician’s assistant or physician) who has taken a minimum two hours or more of education on forensic evidence collection, but less than the didactic and clinical requirements obtained by specially trained medical forensic professionals, and who cares for patients who report sexual assault or when there is a concern that sexual assault occurred (Texas Board of Nursing, 2013, Rule 216.3(d)(1); Texas Medical Board, 2018, Rule... More or be treated in SAFE-ready facilities (Texas Health and Safety Code §323.0015). Adult patients who experience sexual assault have the right to receive a medical forensic assessment at the hospital where they present. The examination includes evidence collection, if doing so within 120 hours of the assault. Adolescent patients should be seen by specially trained medical forensic professionals (such as SAMFEs, SANEs, or child abuse pediatricians).

A facility is defined as SAFE-ready by Texas Health and Safety Code §323.001 “if the facility notifies the department (Department of State Health Services) that the facility employs or contracts with a sexual assault forensic examiner or uses a telemedicine system of sexual assault forensic examiners to provide consultation to a licensed nurse or physician when conducting a sexual assault medical forensic examination.”

Texas Department of State Health Services (2018) defines a SAFE-ready facility as one with certified SANEs “or a physician with specialized training to conduct a medical forensic examination of a sexual assault survivor” (Texas Department of State Health Services, 2018).

Consider offering an assessment regardless of:

• When the assault occurred (or was thought to have occurred), and
• What the patient stated occurred. Sometimes patients may only disclose a small portion of what occurred. Highly trained SANEs, specially trained medical forensic professionalsA licensed medical professional (registered nurse, nurse practitioner, physician’s assistant or physician) who has completed forensic education and clinical requirements that meets or exceeds the Department of Justice recommended standards outlined in “A National Protocol for Sexual Assault Medical Forensic Examinations - Adults/Adolescents Second Edition,” and/or the minimum standards required for certification as outlined by the Texas Attorney General in "Initial SANE certification guide," which includes:
  • Adult/adolescent patient
  • 40 hours of didactic education that me... More have the expertise and training to establish trust with patients who have experienced trauma and ask questions appropriate to obtaining a history.

Complete medical forensic assessment examinations can elicit:

• Additional medical findings,
• Patient’s history of new or additional information,
• Information regarding sexually transmitted diseases, or
• The presence of other victims.

Additional References:

• National protocol for sexual assault medical forensic examinations: Adult/adolescents, 2nd ed. (2013)
• National best practices for sexual assault kits: A multidisciplinary approach (2017)
• The biological evidence preservation handbook: Best practices for evidence handlers (2013)