The medical forensic sexual assault assessment with evidence collection for men and 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). More boys may be different from an assessment for a female. Examiners should consider discussing that a physical response to sexual stimulation does not indicate consent.

Barriers that may prevent male survivors from disclosing sexual assault:

• Societal stigma related to the sexual assault of a male as largely overlooked, ignored or regarded as a joke.
• Fear of blame, disbelief, or other negative reactions.
• Patients may question their sexual identity post–sexual assault.
• Fear of being judged because an erection and/or ejaculation was experienced during the sexual assault.
• Fear of embarrassment of examination in a hospital setting.
• Fear of being ridiculed.
• Cultural myth that when an adult“Person who is not a child” (Texas Family Code §101.003). More encourages an adolescent to engage in sexual activity, the child is considered “lucky” to be having sex with an older individual.

Treatment

• Immediate, gender-sensitive treatment for the male will have a positive impact and may decrease the long-term effects of the sexual assault.
• Provide access to comprehensive care:
  • Timely medical forensic care and treatment of injuries and psychological assessment, if indicated.
  • Crisis intervention.
  • Option for medical forensic sexual assault examination and evidence collection.
  • Prophylactic treatment for STIs.
  • Counseling for HIV PEP.
• Provide referrals to the community for ongoing treatment and support for the following:
  • Crisis counseling and supportive counseling.
  • Ongoing assessment for healing of injuries.
  • Ongoing documentation of injury healing.
  • Repeat STI testing.