Why women don't report sexual assault to the police: the influence of psychosocial variables and traumatic injury.

The purpose of this study was to identify the variables that acutely influence reporting practices in female sexual assault victims presenting to an urban clinic or Emergency Department. We conducted a cross-sectional survey of consecutive female victims during an 18-month study period. Patient demographics, assault characteristics, and injury patterns were recorded in all eligible patients using a standardized classification system. At the completion of the forensic examination, victims were asked to complete a psychosocial questionnaire designed to determine specific reasons why women reported or did not report their sexual assault to police. During the study period, 424 women were eligible to participate in the study; 318 (75%) reported the sexual assault to police. One hundred six (25%) did not file a police report, but consented to a medical-legal examination. Women not reporting sexual assault were typically employed, had a history of recent alcohol or drug use, a known assailant, and prolonged time intervals between the assault and forensic evaluation (p < 0.001). There were no differences in the extent of non-genital injuries or anogenital injuries between the two groups. Thirty-six percent (152/424) of the eligible population agreed to complete the questionnaire. Only three of the 20 psychosocial variables examined were found to be significantly different in women not reporting sexual assault compared to reporters. The reasons for not reporting were primarily environmental factors (prior relationship with assailant) rather than internal psychological barriers (shame, anxiety, fear).