Female victims of sexual assault with dark skin are less likely than females with light skin to have their injuries identified, documented, and treated, leaving them disadvantaged in both the healthcare and criminal justice system, according to a new study published in the November issue of The American Journal of Emergency Medicine. 

 According to the National Crime Victimization Survey, black women have higher rape/sexual assault cases than white women, and one of the main reasons women do not report sexual victimization is "lack of [physical] proof" that an incident occurred.

 "This finding is novel and important with respect both to clinical assessment and the decisions made within the criminal justice process," said Penn Nursing professor Marilyn Sommers, PhD, RN, the principal investigator of the study.

 Dr. Sommers' study, in which 120 black and white volunteers underwent a forensic examination after consensual sexual intercourse, found:

• 55 percent of the sample suffered at least one, post-sex external genital injury (such as a tear, abrasion, redness, or swelling), with injuries identified 68 percent of the time in white women but only 43 percent of the time in black women. Significant disparities were only evident for external genitalia (as opposed to the internal genitalia or anus).
• Nearly three times the number of injuries to the external genitalia were identified in white women.
• The effects of race/ethnicity on injury detection became insignificant when skin color values were added to a model that predicts the occurrence of external genitalia injury, demonstrating the spurious relationship between race/ethnicity and injury prevalence.

 "The novel findings from this study have clinical ramifications for those performing forensic sexual assault exams," said Dr. Sommers. "Practitioners need to increase their vigilance when examining individuals with dark skin to ensure all injuries are identified, treated, and documented."