The purpose of this project was to evaluate the transhymenal diameter measurement from a somewhat different perspective, specifically from within a population of children referred for examinations for suspected sexual molestation. The main question, therefore, became, "Is the horizontal transhymenal diameter of prepubertal girls, with definitive evidence of penetration trauma to the genitalia, significantly different from that of alleged victims who show no definitive physical signs of acute or chronic penetration trauma to genital tissues?"
Upper limit of "normal" transhymenal diameters as included in the Informational Guide to the California Medical Protocol for the Examination of Sexual Assault and Child Sexual Molestation Victims:
Infancy to 2y: 4mm
2-5y: 5mm
6-9y: 9mm
10y to puberty: 15mm
The graphs below summarize the results of horizontal transhymenal measurements using the supine labial separation technique among prepubertal girls selected by the presence or absence of definitive physical signs of genital trauma. Girls with no definitive signs of trauma (negative examinations) demonstrated a mean transhymenal diameter of 2.3 mm (average age, 5.0 years). Prepubertal girls whose examinations revealed the presence of definitive physical signs of genital trauma (positive examinations) exhibited a mean horizontal transhymenal measurement of 9.0 mm (average age, 6.2 years). Despite correcting for the difference in average age of the 2 populations, the difference in mean transhymenal diameter was highly significant
When compared with the results of other investigators' transhymenal measurements for prepubertal girls selected for nonabuse, the girls with negative examinations in this study exhibited similar values. For example, in the age group of 5 to 8 years, this study population of girls with negative examinations exhibited a mean transhymenal diameter of 3.3 mm compared with the mean of 4.2 mm of the study population of McCann et al. This supports the perspective that the population with negative examinations is a valid and reliable representation of "normal" genital anatomy.
http://archfami.ama-assn.org/cgi/content/full/8/5/403
Any wonder why expert after expert concluded that Jonbenet was a victim of chronic sexual abuse?
Upper limit of "normal" transhymenal diameters as included in the Informational Guide to the California Medical Protocol for the Examination of Sexual Assault and Child Sexual Molestation Victims:
Infancy to 2y: 4mm
2-5y: 5mm
6-9y: 9mm
10y to puberty: 15mm
The graphs below summarize the results of horizontal transhymenal measurements using the supine labial separation technique among prepubertal girls selected by the presence or absence of definitive physical signs of genital trauma. Girls with no definitive signs of trauma (negative examinations) demonstrated a mean transhymenal diameter of 2.3 mm (average age, 5.0 years). Prepubertal girls whose examinations revealed the presence of definitive physical signs of genital trauma (positive examinations) exhibited a mean horizontal transhymenal measurement of 9.0 mm (average age, 6.2 years). Despite correcting for the difference in average age of the 2 populations, the difference in mean transhymenal diameter was highly significant
When compared with the results of other investigators' transhymenal measurements for prepubertal girls selected for nonabuse, the girls with negative examinations in this study exhibited similar values. For example, in the age group of 5 to 8 years, this study population of girls with negative examinations exhibited a mean transhymenal diameter of 3.3 mm compared with the mean of 4.2 mm of the study population of McCann et al. This supports the perspective that the population with negative examinations is a valid and reliable representation of "normal" genital anatomy.
http://archfami.ama-assn.org/cgi/content/full/8/5/403
Any wonder why expert after expert concluded that Jonbenet was a victim of chronic sexual abuse?