The medical forensic sexual assault examination can document findings, if any, of injury to the external and internal genitalia. But injury itself is not definitive for sexual assault; the types, quality, or location of injury do not necessarily allow SANEs to differentiate injury from assault from injury from consensual sex. The majority of anogenital injuries identified on exams are nonspecific, meaning they could have been caused by either consensual or non-consensual contact.

On occasion, the SANE may note injuries difficult to ascribe to consensual contact, such as deeply seated lacerations in the vaginal vault, or extensive injury requiring surgical repair. But even then, the SANE, who must have been qualified as an expert, can only comment on whether or not the injuries are consistent with the patient’s account of the assault.

Research is ongoing with volunteer heterosexual couples who are examined shortly after consensual vaginal-penile intercourse to determine whether and where they have tears, bruising, or other genital injury, and to compare these findings with data from injury patterns recorded for women subjected to non-consensual vaginal-penile penetration.