Male Victims of Rape: An Observational Study over Four Years in Paris, France
Abstract
:1. Introduction
2. Materials and Methods
2.1. Presentation of the Department of Forensic Medicine and of a Forensic Consultation
2.2. Study Methodology
2.3. Statistical Analyses
2.4. Ethical Standards
3. Results
3.1. Study Population
3.2. Characteristics of the Victims
- Age at the time of the assault
- •
- Vulnerabilities
- -
- A social or economic vulnerability linked to the reported living condition for 18 victims (9.0%),
- -
- A psychological vulnerability for 17 victims (8.5%): three victims were hospitalized in a psychiatric department at the time of the assault, four were living in a specialized center due to a mental pathology, and the files of 10 victims mentioned a psychological vulnerability (Down’s syndrome, Alzheimer’s, etc.).
- •
- Usual treatments
- -
- Psychiatric medications were reported by 43 patients (21.5%). Psychiatric medication intake was not associated with a suspected DFSA (p = 0.1568) or with alcohol or illicit substance consumption before the assault (p = 0.1193 and p = 0.2217, respectively).
- -
- Endocrine medications linked to sexual reassignment were reported by 8 patients (4.0%).
- -
- Anti-retroviral treatment not related to the assault was reported by 29 patients (14.5%), 15 in connection with positive HIV status (7.5%) and 14 with HIV pre-exposure prophylaxis (PREP, 7.0%).
- •
- Opportunistic DFSA
- -
- Alcohol use was reported by 107 patients (53.5%). The quantity was specified in 89 files. The average reported consumption was 61.8 g of pure alcohol (median 60 g [40–80]).
- -
- Illicit substance use was reported by 49 patients (24.5%). These patients reported a median of one illicit substance (excluding alcohol) [1;1]. These were mainly cannabis (16.5%), cocaine (3.0%), 3-methylmethcathinone (3MMC) (2.5%), gamma-hydroxybutyric acid (GHB) or gamma-butyrolactone (GBL) (1.5%), 3,4-methylenedioxymethamphetamine (MDMA) (1.5%), poppers (1.0%), and diverted psychoactive drugs (pregabalin 1.0%, clonazepam 0.5%). One patient reported taking methamphetamines (0.5%) and another reported alpha-pyrrolidinopentiophenone (alpha-PVP, known as “flakka”, 0.5%). Illicit substances other than cannabis were reported to have been voluntarily consumed in the context of chem-sex or slam-sex by 14 patients (7.0%).
3.3. Characteristics of the Assault
- Location
- Type
- -
- Of the 126 patients who reported a rape, 73 (57.9%) reported a single act and 53 (42.1%) reported several acts. The acts reported were most often anal penetrations committed on the victim (108/126; 85.7%). They were most frequently penile (77/126; 65.9%) or digital (25/126; 19.8%). Six victims reported a rape with objects (6/126; 4.7%). Penile oral penetration of the victim was reported in more than one-third of cases (46/126; 36.5%). Victims less frequently reported being forced to perform penile penetration on the assailant (oral 10/126—7.9% or anal 3/126—2.4%).
- -
- For the 74 patients suspecting a rape, amnesia was mostly related to a proactive or opportunistic DFSA (62/74; 83%). Rape was suspected upon awakening, with several interrelated elements of concern: report of theft of valuables (29/74; 39%), physical injuries (24/74; 32%), patient awakening in an unusual place (22/74; 30%), or patient awakening naked in the company of another person (30/74; 41%). In ten cases, a possible assault could not be specified because of a state of psychological vulnerability of the patient (10/74; 14%; autism, psychiatric pathologies, mental retardation, etc.). For these cases, the circumstances were reported by the family or care takers. Finally, in two cases, the circumstances could not be specified because of a head injury resulting in loss of consciousness (2/74; 3%).
- Associated theft
- Associated physical violence
- Threat or use of a weapon
- Suspicion of proactive DFSA
3.4. Characteristics of the Assailant
3.5. Characteristics of the Forensic Examination
- Time between the assault and the forensic examination
- Extragenital findings
- Anogenital findings
- Samples for judicial purposes
- Management of the infectious risk
3.6. Aggravating Circumstances
3.7. Characteristics of the Victims and the Assaults According to the Victim’s Vulnerability
3.8. Characteristics of the Victims and the Assaults According to the Victim’s Memory of the Assault
3.9. Characteristics of the Victims and the Assaults According to the Assailant’s Status
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Aggravating Circumstance | Number of Victims (%) |
---|---|
Act resulting in permanent mutilation or disability | 2 (1.0) |
Act committed on a minor of 15 years old | not included in the study |
Physical/psychological vulnerability of the victim | 17 (8.5) |
Economic/social vulnerability of the victim | 18 (9.0) |
Act committed by an ascendant/person in authority | 1 (0.5) |
Act committed by a person who abuses authority * | 6 (3.0) |
Act committed by several persons | 28 (14.0) |
Act committed with the use or threat of a weapon | 4 (2.0) |
Contact with the perpetrator through (…) an electronic communication network | not included in the study |
Act committed in conjunction with one or more other rapes committed on other victims | 0 (0.0) |
Act committed by a spouse | 4 (2.0) |
Act committed by a person acting in a state of obvious intoxication or under the influence of drugs | not included in the study |
Act committed on a person engaged in prostitution | 14 (7.0) |
Minor present at time of offence | 0 (0.0) |
Proactive DFSA | Suspicion: 82 (41.0) ** |
Vulnerable n = 32 Number (%) | Non Vulnerable n = 168 Number (%) | p | |
---|---|---|---|
Victim | |||
Median age (years) | 25.93 | 26.98 | 0.5280 |
Psychiatric medication | 17 (55) | 35 (20.8) | 0.0001 |
Alcohol use before the assault | 9 (29) | 70 (41.7) | 0.1509 |
Psychoactive substance use before the assault | 12 (38) | 37 (22.0) | 0.0621 |
Initial medical examination | 13 (41) | 65 (38.7) | 0.9371 |
Median delay between the assault and the forensic examination (days) | 1 day | 1 day | 0.9110 |
Extragenital lesions | 9 (28) | 71 (42.3) | 0.1346 |
Anogenital lesions | 3 (9) | 41 (24.4) | 0.0381 |
Assault | |||
Number of assailants (mean) | 1 (3) | 1 (0.6) | 0.3199 |
Previously known assailant | 13 (41) | 18 (10.7) | 0.0001 |
Place of assault | |||
Assailant’s home | 3 (9) | 28 (16.7) | 0.3242 |
Victim’s home/place of living | 15 (47) | 30 (17.9) | 0.0002 |
Public place | 4 (13) | 38 (22.6) | 0.2232 |
Type of assault | |||
Cannot recall any assault | 13 (41) | 61 (36.3) | 0.6431 |
Anal penetration of the victim | 16 (50) | 82 (48.8) | 0.9017 |
Oral penetration of the victim | 8 (25) | 39 (23.2) | 0.8272 |
Penetration of the assailant | 22 (69) | 11 (6.5) | 0.9501 |
Physical violence | 6 (19) | 58 (34.5) | 0.0796 |
Theft | 1 (3) | 35 (20.8) | 0.0169 |
Suspicion of proactive DFSA | 5 (16) | 77 (45.8) | 0.0015 |
Patient Reporting a Rape n = 126 Number (%) | Total Amnesia n = 74 Number (%) | p | ||
---|---|---|---|---|
Victim | ||||
Median age (years) | 24.67 | 28.52 | 0.0045 | |
Psychiatric medication | 33 (26.2) | 19 (26) | 0.9361 | |
Vulnerability | 19 (15.1) | 13 (18) | 0.6431 | |
Alcohol use before the assault | 49 (38.9) | 58 (78) | <0.0001 | |
Psychoactive substance use before the assault | 17 (13.5) | 32 (43) | <0.0001 | |
Initial medical examination | 50 (39.7) | 28 (38) | 0.7962 | |
Median delay between the assault and the forensic examination (days) | 1 day | 1 day | 0.8205 | |
Extragenital lesions | 54 (42.9) | 26 (35) | 0.2818 | |
Anogenital lesions | 34 (27.0) | 6 (8) | 0.0001 | |
Chem-sex | 6 (4.8) | 8 (11) | 0.1055 | |
Assault | ||||
Number of assailants (mean) | 1.25 | 1.8 | 0.0049 | |
Previously known assailant | 23 (18.3) | 8 (11) | 0.1602 | |
Place of the assault | ||||
Assailant’s home | 22 (17.5) | 9 (12) | 0.3175 | |
Victim’s home/place of living | 31 (24.6) | 14 (19) | 0.3527 | |
Public place | 36 (28.6) | 6 (8) | 0.0006 | |
Unknown place | 0 (0.0) | 35 (47) | <0.0001 | |
Physical violence | 64 (50.8) | 0 (0) | <0.0001 | |
Theft | 7 (5.6) | 29 (39) | <0.0001 | |
Suspicion of proactive DFSA | 20 (15.9) | 62 (84) | <0.0001 |
Known Assailant n = 31 Number (%) | Previously Unknown Assailant n = 96 Number (%) | p | ||
---|---|---|---|---|
Victim | ||||
Median age (years) | 26.7 | 25.5 | 0.8699 | |
Psychiatric medication | 21 (68) | 12 (13) | <0.0001 | |
Vulnerability | 13 (42) | 11 (11) | 0.0002 | |
Alcohol use before the assault | 12 (39) | 45 (47) | 0.4268 | |
Psychoactive substance use before the assault | 11 (35) | 21 (22) | 0.1292 | |
Initial medical examination | 9 (29) | 43 (45) | 0.0411 | |
Median delay between the assault and the forensic examination (days) | 1 day | 1 day | 0.2945 | |
Extragenital lesions | 7 (23) | 42 (44) | 0.0055 | |
Anogenital lesions | 1 (3) | 35 (36) | 0.0004 | |
Chem-sex | 0 (0) | 9 (9) | 0.0770 | |
Assault | ||||
Number of assailants (mean) | 1.2 | 1.4 | 0.7958 | |
Place of the assault | ||||
Assailant’s home | 5 (16) | 24 (25) | 0.3063 | |
Victim’s home/place of living | 20 (65) | 17 (18) | <0.0001 | |
Public place | 1 (3) | 30 (31) | 0.0016 | |
Physical violence | 7 (23) | 47 (49) | 0.0098 | |
Theft | 0 (0) | 13 (14) | 0.0306 | |
Suspicion of proactive DFSA | 6 (19) | 32 (33) | 0.1395 |
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Liautard, M.; Deguette, C.; Alcaraz, E.; Diot, H.; Vasseur, P.; Gorgiard, C.; Dufayet, L. Male Victims of Rape: An Observational Study over Four Years in Paris, France. Int. J. Environ. Res. Public Health 2022, 19, 13909. https://doi.org/10.3390/ijerph192113909
Liautard M, Deguette C, Alcaraz E, Diot H, Vasseur P, Gorgiard C, Dufayet L. Male Victims of Rape: An Observational Study over Four Years in Paris, France. International Journal of Environmental Research and Public Health. 2022; 19(21):13909. https://doi.org/10.3390/ijerph192113909
Chicago/Turabian StyleLiautard, Marc, Céline Deguette, Elizabeth Alcaraz, Hélène Diot, Patricia Vasseur, Charlotte Gorgiard, and Laurène Dufayet. 2022. "Male Victims of Rape: An Observational Study over Four Years in Paris, France" International Journal of Environmental Research and Public Health 19, no. 21: 13909. https://doi.org/10.3390/ijerph192113909