Sexual Assault and the Adolescent

Rape is a significant and serious crime in our society. The Uniform Crime Report for 1991 published by the US Department of Justice listed over 100 000 reported rapes nationwide, but this report excluded statutory rape, rape against men, and unreported sexual assaults.1 The National Victim Center estimates that almost 700 000 women are raped each year, and that 61% of the rape victims are under the age of 18.2 The American Academy of Pediatrics last published a policy statement on rape and the adolescent in 1988,3 and in 1991 the Committee on Child Abuse and Neglect addressed the evaluation of the sexually abused child.4 Current definitions of rape, new data on date rape and acquaintance rape, and new suggested protocols for rape management mandate an updated knowledge base for the pediatrician who may need to care for the patient who has been sexually assaulted. Sexual assault in childhood and adolescence includes incest, acquaintance rape, and stranger rape. As incest has been discussed in the statement on childhood sexual abuse,4 this statement will focus on a discussion of stranger and acquaintance rape. DEFINITIONS There is often confusion among legal definitions, medical terminology, and lay usage of terms related to sexual assault. Rape has historically been defined under standard common law as "the unlawful carnal knowledge of a woman by a man, forcible and against her will, or without her consent."5 In general, the ability to consent to an act is an essential concept in defining sexual assault. Current legal and medical definitions are included in Tables 1 and 2.