{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:57:28Z","timestamp":1781153848653,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100019168","name":"Starship Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019168","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To describe anogenital examination findings in a large cohort seen for child sexual abuse concerns, with findings classified following current international guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of records of the Starship Children's Hospital child protection team for all children and adolescents (0\u201317\u2009years) seen over 20\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 4443 children and adolescents were seen, of whom 3942 (89%) were female. The age distribution was bimodal, with a small peak in childhood and a larger peak in adolescence. Anogenital examination occurred in 2975 (67%), more often in those &lt;\u20098\u2009years (1197\/1394, 86%) compared to those 8\u2009years and older (1778\/3049, 58%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001. The proportion examined declined steadily, from 93% in 1999 to 54% in 2018. 2263 examinations (76%) were normal, 425 (14%) had findings unrelated to sexual abuse and 287 (10%) had abnormal findings possibly related to sexual abuse. Of 1426 examined at Tanner Stage 1, 41 (3%) had abnormal findings, compared to 246\/1549 (16%) at Tanner Stages 2\u20135. Of 16 pregnant adolescents examined, 2 (13%) had anogenital findings of previous trauma. In adolescents examined acutely where semen was observed on Gram stain, 8\/17 (47%) had anogenital findings of acute trauma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The cohort seen for sexual abuse concerns has changed over 20\u2009years, becoming increasingly adolescent. This has resulted in a decrease in the proportion examined and an increase in the rate of abnormal findings. Anogenital examinations are often normal in pregnancy or with semen present, reinforcing the international consensus that normal does not mean nothing happened.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70374","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:36:06Z","timestamp":1775630166000},"page":"1008-1015","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medical Findings in 2975 Examinations for Child Sexual Abuse: A Retrospective Review"],"prefix":"10.1111","volume":"62","author":[{"given":"Patrick","family":"Kelly","sequence":"first","affiliation":[{"name":"Te Puaruruhau (Child Protection Team), Starship Child Health, Health New Zealand Te Toka Tumai  Auckland New Zealand"},{"name":"Department of Paediatrics: Child and Youth Health Faculty of Medical &amp; Health Sciences, Waipapa Taumata Rau, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wallace","sequence":"additional","affiliation":[{"name":"Te Puaruruhau (Child Protection Team), Starship Child Health, Health New Zealand Te Toka Tumai  Auckland New Zealand"},{"name":"Marinoto Child and Youth Mental Health Services, Health New Zealand Waitemat\u0101  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Reed","sequence":"additional","affiliation":[{"name":"Reed NZ Ltd.  Rotorua New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)00311\u20103"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2007.02.009"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2024.107183"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51870"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579422001146"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.52922\/sp09784"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0145-2134(89)90003-3"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0145\u20102134(93)90011\u2010s"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.94.3.310"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2023.106283"},{"key":"e_1_2_12_12_1","volume-title":"Physical Signs of Child Sexual Abuse (The Purple Book): An Evidence\u2010Based Review and Guidance for Best Practice","author":"Royal College of Paediatrics and Child Health","year":"2024"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0145\u20102134(02)00339\u20103"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013\u20101741"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2016.05.001"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2017.10.006"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2005.11.002"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101754.2006.00808.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2023.106272"},{"key":"e_1_2_12_20_1","unstructured":"Mana Mokopuna\u2014Children's Commissioner \u201cVictims of Sexual Violence (Strengthening Legal Protections) Legislation Bill \u201dSubmission to the Justice Committee Wellington New Zealand 2023."},{"key":"e_1_2_12_21_1","unstructured":"G.Lardies \u201cWhere Did the Age of Consent Come From and How Does It Work Today? \u201d2023 https:\/\/thespinoff.co.nz\/society\/12\u201009\u20102023\/where\u2010did\u2010the\u2010age\u2010of\u2010consent\u2010come\u2010from\u2010and\u2010how\u2010does\u2010it\u2010work\u2010today."},{"key":"e_1_2_12_22_1","unstructured":"YouthLaw \u201cSex & Relationships Consent \u201dAuckland New Zealand: YouthLaw 2026 https:\/\/youthlaw.co.nz\/rights\/sex\u2010relationships\/consent\/."},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101754.1995.tb00813.x"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo\u20102025\u2010003653"},{"key":"e_1_2_12_25_1","unstructured":"The Ray E. 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