Relaxation and Examination for Sexual Abuse

To the Editor.— We were pleased with the article by Herman-Giddens and Frothingham concerning physical findings in sexually abused girls (Pediatrics 1987;80:203-208). Their experiences were similar to ours after evaluation of more than 2,263 cases of alleged sexual abuse since 1980. No mention was made, however, of the effect of the degree of a patient9s relaxation during the examination on the appearance of the vaginal opening. We have seen numerous children in whom the truly enlarged size of an apparently small vaginal opening became obvious when the patient relaxed.