Sexual violence is a significant health, social, and legal problem in the United States. The U.S. Department of Justice, Office on Violence Against Women (OVW) strives to support communities across the country in their efforts to implement an effective response to victims of sexual violence. The medical forensic examination is an integral component of this response. It is designed to address victims’ health care needs and promote their safety and healing. In addition, forensic evidence collected during the examination—information gathered during the medical history, documentation of exam findings, and forensic samples, if potentially available—can help facilitate case investigation and prosecution of perpetrators of sexual violence. Success in meeting these objectives depends not only on the skills and knowledge of the health care providers conducting the examination, but also the coordinated efforts of all disciplines involved in the response to victims.

With successful medical forensic care as a goal, OVW released the National Protocol for Sexual Assault Medical Forensic Examinations—Adults/Adolescents in 2004 and a second edition in 2013.[1] It was evident during protocol development that the medical forensic care of adult and adolescent victims should be addressed separately from younger child victims, as considerable variations in approaches exist with these populations. OVW is pleased to now offer the National Protocol for Sexual Abuse Medical Forensic Examinations—Pediatric, which focuses on prepubescent children (see “Use of Terms” on page 8 for an explanation of terms used in this protocol).

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[1]The 2004 adult/adolescent protocol was developed under the direction of the U.S. Attorney General pursuant to the Violence Against Women Act (VAWA) of 2000. The statutory requirement can be found in Section 1405 of the VAWA of 2000, Public Law 106-386. The 2nd edition of this protocol is available at The VAWA requirement also mandated the development of a national recommended training standard for health care professionals performing these examinations, as well as training for health care students. The National Training Standards for Sexual Assault Medical Forensic Examiners 2nd Edition was updated in 2018 and is available at