The term adult sexual assault, as used in this section, applies to all such offenses (sexual assault is a criminal act) against persons who are 18 years of age and over, and not married to the alleged perpetrator. Sexual assault against children under the age of 18, and those incidents that occur within a marital relationship should be referred to the Family Advocacy Program and should be handled as child sexual abuse or spouse abuse (OPNAVINST 1752.2 and BUMEDINST 6320.70). Sexual harassment is covered by SECNAVINST 5300.26.

The assessment of sexual abuse is a complex process involving many professionals including law enforcement, a family advocacy representative (FAR), and medical personnel. Coordination of the assessment is often difficult and confusing. Navy instructions direct family advocacy representatives (FAR) to take the lead role. The FAR is always the first person to contact in a sexual abuse case as mandated by Navy instruction. Most state statutes also require reporting to civilian authorities.

All victims of sexual assault will be given as much credibility as a victim of any other crime: they shall be considered a victim of sexual assault when any type of sex is forced on her or him through any type of coercion, violent or otherwise, they shall be considered a victim of sexual assault, regardless of her/his behavior at the time of the sexual assault (e.g. fraternization, underage drinking, etc.), and they shall be considered a victim of sexual assault regardless of the assailant's relationship with the victim (e.g., boyfriend, acquaintance, co-worker, etc.).

Role of the Physician

The medical officer must ensure appropriate law enforcement and command notifications are made depending upon jurisdiction and per OPNAVINST 1752.1. This should include providing the victim with options concerning her/his involvement with investigative/legal personnel and possible consequences as outlined in OPNAVINST 1752.1.

The primary role of the physician is to meet the needs of the victim and to observe, describe, collect, and record findings. All victims of sexual assault will be treated with fairness and respect. All medical personnel will ensure the sensitive, coordinated, and effective management of sexual assault cases, including access to a victim advocate program and appropriate counseling. Sensitivity to the victim's emotional state is critical. Explain the availability of victim advocacy services and notify the on-call victim advocate, if desired by the victim.

The medical officer will conduct a medical examination and gather physical evidence as soon as possible, (if the assault occurred within 72 hours of the visit), paying particular attention to victim sensitivity and privacy. Allow the victim to receive medical care and emotional support and / or stabilization before detailed investigative interviews. A victim's written consent is necessary for all medical procedures. This is contained within the sexual assault kit. Sexual assault cases must be managed in compliance with SECNAVINST 5520.3. If the assault occurred more than 72 hours before the visit, the sexual assault kit does not need to be utilized; however a physical exam should be conducted and appropriate medical care provided to address pregnancy prevention (emergency contraception, STDs treatments, etc.), as well as counseling services.

Collection of physical evidence is not required in all cases of sexual assault, such as the case of a patient presenting for psychological assistance several days post-assault. These individuals should be referred for appropriate mental health counseling and should still be offered a physical exam and medical care.