Purpose: Patients reporting gang rape are rare in comparison to those with other forms of sexual abuse, and there is little research focused on adolescent victims. The primary aim of this study was to describe contextual events, abuse experiences and disclosure processes for adolescents who presented to a hospital-based Child Advocacy Center (CAC) for medical evaluation and evidentiary collection as indicated after gang rape.
Methods: This study used a retrospective mixed-methods design in which in-depth forensic interviews of gang-raped adolescents, together with physical examinations and lab results, informed researchers’ analyses and findings (N¼32). We identified individuals’ demographic, health, psychological and lifestyle characteristics in an effort to identify common experiences and themes, to aid providers in their evaluation of gang-raped adolescents presenting at Emergency Departments or CACs. Analyses focused on revelations about the abuse contexts, trauma responses, and unique challenges in forensic interviews from this type of event. Reports of acute and non-acute physical exam findings and colposcopic results conducted by experienced medical providers were also included.
Results: Patients were age 12 to 17 years (mean,14 years), with 16% White, 8% African American, 44% Asian, and 12% Hispanic/Mexican. Acute presentation was rare (n ¼ 3). Of the 19 teens who allowed a video colposcopic exam, 6 had a complete healed transaction of their hymen, which was consistent with their reports of vaginal pain and bleeding. Remembering physical symptoms and questioning what had happened to their clothes were the two most common elements reported about the assault. Unlike single offender assaults, gang rape is witnessed by others, including people victims had thought they could trust; victims consistently reported feeling let down by those who could have helped or intervened but didn’t, and felt they had no choice but to give in to a bad situation. Among patients who completed the UCLA PTSD Screening Index, 89% reported symptoms consistent with PTSD. More than half reported self-harm behaviors: 58% were cutting, and 63% reported suicidal ideation. While no victims reported guns or other weapons, nearly all victims (n ¼ 31) reported offenders gave them alcohol disguised as something else and/or in extreme doses, to the point of dangerous biological effects; most mentioned vomiting or blacking out. Patients were rarely able describe offenders or witnesses, which made any police investigations resource intensive.
Conclusions: While relatively rare, gang rape is a type of severe sexual assault experience, with a significant risk factor for deleterious health outcomes that require on-going health care. Alcohol is a common weapon used by offenders, and causes details of the event to be difficult for victims to remember and report in order receive needed physical and mental health care. It is imperative for professionals to be knowledgeable about multiple perpetrator rape so that they can effectively diagnose, treat and support victims.
Sources of Support: Children’s Hospitals and Clinics of Minnesota Educational and Research Committee, and the Canadian Institutes of Health Research.
All abstracts published in the Journal of Adolescent Health for the SAHM 2014 Conference can be found here, through your university library’s membership.