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# The forensic exam after sexual violence

- Procedure

The clinical and forensic exam of a victim of sexual violence: emergency care first, consent, account, full exam and evidence collection.

Updated Nov 5, 2026

## Key points

- Sexual violence is a medical emergency: triage priority I within the first 72 hours (protocol of Resolution 459 of 2012).
- Informed consent for each procedure; the victim may choose the examiner's sex if the service allows (Law 1257, art. 8).
- A normal genital exam does not rule out sexual violence.
- Children under three are not interviewed directly in the clinical history (protocol of Resolution 459).
- Record whether the victim washed, changed clothes, urinated or used tampons after the event: it changes what can be found.

## What it is

In Colombia every victim of sexual violence is treated as a medical emergency, and health care and the forensic exam go together: the same encounter must treat, protect and preserve the evidence. The protocol adopted by Resolution 459 of 2012 of the Ministry of Health sets the steps of comprehensive care and refers to the INMLCF technical regulation for the forensic part. The victim has the right to give or refuse informed consent and, where possible, to choose the sex of the examiner (Law 1257 of 2008, art. 8). The exam is victim-centred and trauma-informed: explain each step, ask permission, do not judge and do not re-victimise.

## What to document

- Date and time of the event and of the exam, and the time elapsed: it changes interpretation and the samples possible.
- Consent or refusal for each procedure, and who was present.
- The account in the victim's own words, in quotation marks, without reinterpreting it.
- General, extragenital, genital and anal findings, normal and abnormal.
- Samples collected, labelled and handed over under chain of custody.
- Treatments offered and accepted, referrals, notification and the authority informed.

## How it is done

- Stabilise: assess threats to life and treat urgent injuries before any paperwork.
- Explain the victim's rights and obtain written informed consent for care and for the forensic exam.
- Ensure privacy and a companion if the victim wishes; offer a choice of the examiner's sex.
- Record the free, spontaneous account, using open questions and no leading questions.
- Note what happened after the event: washing, changing clothes, urination, defecation, vomiting, tampon or pad use.
- Do the general head-to-toe exam, then the genital and anal exam, explaining each step and asking permission.
- Describe and locate each injury on diagrams; collect forensic samples following the INMLCF technical regulation.
- Order the protocol's tests and ensure prophylaxis, emergency contraception and mental health care.
- Activate the protection and justice pathway, notify the case and schedule follow-up.

## Next step: what to do and document

- Treat in the emergency department without barriers, without demanding a police report or insurance, and stabilise first.
- Apply the protocol of Resolution 459 of 2012 and, for the forensic part, the INMLCF technical regulation that the protocol cites.
- Hand the samples over under chain of custody to the judicial police or the INMLCF.
- Activate protection (ICBF if under 18; family commissioner if an adult woman) and, at the same time, justice (Fiscalía or judicial police).
- Notify the case to the public health surveillance system and schedule follow-up visits.
- Official text checked on 2026-11-05 at minsalud.gov.co and funcionpublica.gov.co.

## Common mistakes

- Sending the victim elsewhere without care, or demanding a police report or insurance before treating.
- Concluding there was no sexual violence because the genital exam is normal.
- Repeating interviews that re-victimise; forensic interviews of children are done by trained professionals.
- Collecting samples without consent, without labels or without chain of custody.

## Test yourself

Think of the answer, then tap the question to see it.

## What triage priority does a victim of sexual violence seen within the first 72 hours have?

Priority I, under the protocol of Resolution 459 of 2012. After 72 hours it may be priority II, unless there are signs of high risk to life or health.

## What rights does Law 1257 of 2008 give the victim regarding the medico-legal exam for sexual violence?

To give informed consent and to choose the sex of the examiner, within what the service can offer (art. 8, item d).

## Does a normal genital exam rule out sexual violence?

No. Many victims have no genital injuries; the absence of findings does not exclude the event.

## Why ask whether the victim bathed or changed clothes?

Because those actions reduce the evidence that can be recovered, and they must be recorded to interpret the findings.

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## Elsewhere in DurgiPedia

- [Informed consent: elements and how to obtain it](https://durgical.com/en/medical-ethics/informed-consent-elements-and-how-to-obtain-it/)
- [Mandatory reporting: public health, violence and abuse](https://durgical.com/en/medical-ethics/mandatory-reporting-public-health-violence-and-abuse/)

## Connections

## Related 4

- [Sexual violence: samples and evidence](https://durgical.com/en/forensic-medicine/sexual-violence-samples-and-evidence/)
- [Resolution 459 of 2012: the health-care protocol for sexual violence](https://durgical.com/en/forensic-medicine/resolution-459-of-2012-the-health-care-protocol-for-sexual-violence/)
- [Chain of custody (cadena de custodia) in the hospital or rural post](https://durgical.com/en/forensic-medicine/chain-of-custody-in-the-hospital-or-rural-post/)
- [Drug-facilitated sexual assault and robbery](https://durgical.com/en/forensic-medicine/drug-facilitated-sexual-assault-and-robbery/)

## Related conditions 1

- [Sexual violence (care of the survivor)](https://durgical.com/en/conditions/sexual-violence/)

[← All of forensic medicine](https://durgical.com/en/forensic-medicine/)

Educational content on forensic and legal medicine; not legal advice and no substitute for the technical guides of Colombia's National Institute of Legal Medicine and Forensic Sciences. Laws change: each page links the official text and says when it was last checked. For a real case, follow the guide in force and ask the competent authority.

Sources: [Resolución 459 de 2012, Protocolo y Modelo de Atención Integral en Salud para Víctimas de Violencia Sexual](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/Resolucion-0459-de-2012.PDF) (Ministerio de Salud y Protección Social, 2012); [Ley 1257 de 2008, violencia y discriminación contra las mujeres (art. 8)](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=34054) (Función Pública, Gestor Normativo, 2008); [Ley 906 de 2004, Código de Procedimiento Penal (art. 250)](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=14787) (Función Pública, Gestor Normativo, 2004).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/forensic-medicine/the-forensic-exam-after-sexual-violence/