No WAY I'm going to let a cheap shot like that stand. So here goes.
In his book, Det. Thomas states:
"In mid-September, a panel of pediatric experts from around the country reached one of the major conclusions of the investigation - that JonBenet had suffered vaginal trauma prior to the day she was killed. There were no dissenting opinions among them on the issue, and they firmly rejected any possibility that the trauma to the hymen and chronic vaginal inflammation were caused by urination issues or masturbation. We gathered affidavits stating in clear language that there were injuries 'consistent with prior trauma and sexual abuse' ' There was chronic abuse'. . . 'Past violation of the vagina'. . .'Evidence of both acute and injury and chronic sexual abuse.' In other words, the doctors were saying it had happened before."
Thomas does not name these experts. But other sources, including Schiller's book, do name them. Their names read as follows:
- Dr. James Monteleone, Professor of Pediatrics at St. Louis University School of Medicine (and Director of Child Protection Cardinal Glennon Children's Hospital);
- Dr. David Jones, Professor of Preventative Medicine and Biometrics at University of Colorado Health Sciences Center;
- Dr. Ronald Wright, former Medical Examiner, Cook County Illinois;
- Dr. Virginia Rau of Dade County, Florida;
- and Dr. John McCann, Clinical Professor of Medicine, Department. of Pediatrics at University of California at Davis.
McCann was contacted in mid-1997 to give a report for the police department. His findings were written down in the police reports and later transcribed by Bonita Sauer, a Denver legal secretary:
"According to McCann, examination findings that indicate chronic sexual abuse include the thickness of the rim of the hymen, irregularity of the edge of the hymen, the width or narrowness of the wall of the hymen, and exposure of structures of the vagina normally covered by the hymen. His report stated that there was evidence of prior hymeneal trauma as all of these criteria were seen in the post mortem examination of JonBenet.
"There was a three dimensional thickening from inside to outside on the inferior hymeneal rim with a bruise apparent on the external surface of the hymen and a narrowing of the hymeneal rim from the edge of the hymen to where it attaches to the muscular portion of the vaginal openings. At the narrowing area, there appeared to be very little if any hymen present. There was also exposure of the vaginal rugae, a structure of the vagina which is normally covered by an intact hymen. The hymeneal orifice measured one centimeter which is abnormal or unusual for this particular age group and is further evidence of prior sexual abuse with a more recent injury as shown by the bruised area on the inferior hymeneal rim. A generalized increase in redness of the tissues of the vestibule was apparent, and small red flecks of blood were visible around the perineum and the external surface of the genitalia." He also talked about the injury from that night, saying, "the injury appeared to have been caused by a relatively small, very firm object which, due to the area of bruising, had made very forceful contact not only with the hymen, but also with the tissues surrounding the hymen. McCann believed that the object was forcefully jabbed in not just shoved in. Although the bruised area would indicate something about the size of a finger nail, he did not believe it was a finger, because of the well demarcated edges of the bruise indicating an object much firmer than a finger. McCann also noted that in children of this age group the labia, or vaginal lips, remain closed until literally manually separated. In order for there to be an injury to the hymen without injuring the labia, the labia would have to be manually separated before the object was inserted. The examination also indicated that the assault was done while the child was still alive because of the redness in the surrounding tissue and blood in the area. McCann stated that this injury would have been very painful because the area of the injury as indicated by the bruise was at the base of the hymen were most of the nerve endings are located. Such an injury would have caused a six year old child to scream or yell. The doctor also stated that he assumed the object did not have jagged edges because there were no evidence of tears in the bruised area." To qualify his report, Dr. McCann explained "the term 'chronic abuse' meant only that it was 'repeated', but that the number of incidents could not be determined. In the case of JonBenet, the doctor could only say that there was evidence of 'prior abuse'. The examination results were evidence that there was at least one prior penetration of the vagina through the hymeneal membrane. The change in the hymeneal structure is due to healing from a prior penetration. However, it was not possible to determine the number of incidents nor over what period of time. Because the prior injury had healed, any other incidents of abuse probably were more than 10 days prior." He explained that the most common perpetrators of sexual abuse are those with whom the child has close contact with, usually a family member. Increased bedwetting is also a possible sign, he said.
That doesn't appear to be the case in his actual findings on the subject of child sexual abuse. Part of the article I reproduce here:
"Recent research by John McCann on the ano/genital anatomy in nonabused children has established that findings often attributed to sexual abuse are found in many normal children. McCann's findings were applied to 158 children who had been medically examined in cases of alleged sexual abuse. Nearly all the findings attributed to sexual abuse were present in McCann's sample of nonabused children. " snip
"An early but influential article was that of Woodling and Kossoris (1981). A collaboration of a family practitioner and a district attorney, this article listed findings which the authors claimed were indicative of abuse. These included a number of findings which are either extremely nonspecific or open to subjective interpretation by the examining physician, such as perihymenal erythema (redness), tightness (too much or too little) of pubic or anal muscles, anal fissures, and hymenal irregularities interpreted as either "transections" or evidence of scarring.
In support of these alleged indicators of prior sexual contact, Woodling offered only his "experience," which he wrote "suggests that only forced penile penetration causes actual transection of the hymen or perihymenal injuries. Chronic molestation or repeated coitus will result in multiple hymenal transections which eventually heal and leave multiple rounded remnants present between 3 and 9 o'clock ..."
When a growing number of physicians and nurses began to take a special interest in forensic ano/genital examinations of suspected child sexual abuse victims, these new specialists eagerly absorbed such ideas, despite the lack of any research corroboration. Take, for example, Woodling's Training Syllabus: Medical Examination of the Sexually Abused Child (1985). To the above list of supposed indicators of molest he added "rounded scars called synechiae," which "when magnified may show neovascularization." Another unsupported claim: "the rectal sphincter may manifest laxity or may reflexively relax when stimulated by direct contact with an examining finger, perianal stroking with a cotton bud (perianal wink reflex) or by lateral traction of the buttocks." snip
"Pediatricians and other qualified physicians refused to do such examinations, deferring to those few who claimed to be "specialists." Law enforcement and child protection workers quickly learned which examiners were likely to make findings supportive of an allegation of molest. Most often these examiners were attached to a "sex abuse team."
I have had the opportunity to read the reports and testimony of these examiners in cases involving 158 children suspected to have been molested. The confidence expressed, to the effect that findings like those mentioned above are reliable indicators of molest, is usually very high. Rounded hymenal edges and anal relaxation, to mention just two examples, are seen as signs of molest, and only molest.
Behind the scenes, however, doubts were being expressed. Perhaps far fewer doubts than scientific caution dictated, but nonetheless more doubts than law enforcement officials, judges, or juries were hearing. Take, for example, a meeting in April, 1985, during which physicians and nurses came to learn how to examine children who might have been molested.
Dr. Woodling acknowledged that "there is a significant variation in hymenal types ... we need to realize that hymens are like people's faces, there are lots of variations ... there are often times cuts or transections but they're not traumatic, they're just clefts that the child was born with ... and can in fact appear to the untrained eye as an old transection .. " (Woodling & Heger, 1985).
I have seen countless cases in which exactly these findings were said to be unequivocal evidence of molest. Likewise, to take another example, vaginal size may be cited as evidence of molest. A paper by Cantwell (1983) is still cited as support for the proposition that a vaginal opening size above four millimeters is supportive of molest. Woodling nonetheless acknowledged that this had "not held true in our experience" (Woodling & Heger, 1985)." snip
"What emerges from these meetings is the fact that these "specialists" have seen a lot of children, and opined on which ones were molest victims, but they have no way of checking the accuracy of their conclusions. Even if they agree on how to interpret a particular finding, this doesn't mean they are correct. Only controlled research will allow them to decide whether a particular finding is indicative of molest.
Dr. Robert ten Bensel, a physician long involved in the effort to increase awareness of child abuse, has commented on the difference between consensus and true scientific evidence. In response to a 1985 Los Angeles conference at which there was an attempt to reach consensus of positive findings among doctors doing these examinations, ten Bensel wrote, "I am not comfortable with the reported 'consensus of positive findings.' This is not the procedure of science; rather, it is simply an agreement among a select group of physicians invited ..." (1985).
Consensus, in other words, is no substitute for research. " snip
"Emans, Woods, Flagg, and Freeman (1987) attempted to compare three groups of girls; abused (group 1), normal girls with no genital complaints (group 2), and girls with other genital complaints (group 3). The study has serious flaws. The examiners were not blind to which category each girl belonged; no information is given on how certain it was that alleged molest victims were true victims; and examiners were not randomly assigned. Instead the lead author was the exclusive examiner of girls assumed to be molested.
Nonetheless, the authors deserve credit for addressing what has been ignored by so many others. They concluded from their literature search, just as I have from my own, that "no previous study has reported the incidence of various genital findings in girls ..."
Presence or absence of twenty genital findings were recorded on each child. These included hymenal clefts, hymenal bumps, synechiae (tissue bands), labial adhesions, increased vascularity and erythema (redness), scarring, friability (easy bleeding), rounding of hymenal border, abrasions, anal tags, anal fissures, and condyloma accuminata (venereal warts). These are the kinds of findings which are being attributed to sexual abuse in courts across the land, despite there having been "no previous study ..."
Their findings: "The genital findings in groups 1 and 3 were remarkably similar ... There was no difference between groups 1 and 3 in the occurrence of friability, scars, attenuation of the hymen, rounding of the hymen, bumps, clefts, or synechiae to the vagina." These findings, in other words, are not specific to molest." snip
"At a meeting in San Diego in January, 1988, sponsored by the Center for Child Protection of the San Diego Children's Hospital, McCann reported on this research. Three hundred prepubertal children, carefully screened to rule out prior molest, were examined, and it was found that many of the things currently being attributed to molest are present in normal children.
Here are some conclusions:
Vaginal opening size varies widely in the same child, depending on how much traction is applied and the position of the child while being examined. Knee-chest position (Emans, 1980) leads to different results from frog position.
Fifty percent of the girls had what McCann calls bands around the urethra. He has heard these described as scars indicative of molest.
Fifty percent of the girls had small (less than 2 mm) labial adhesions when examined with magnification (colposcope). Twenty-five percent had larger adhesions visible with the naked eye.
Only 25 percent of hymens are smooth in contour. Half are redundant, and a high percentage are irregular.
What are often called clefts in the hymen, and attributed to molest, were present in 50 percent of the girls. Commenting on his team's mistaken assumptions at the outset of their study, McCann said, "We were struck with the fact that we couldn't find a normal (hymen). It took us three years before we found a normal of what we had in our minds as a preconceived normal ... you see a lot of variation in this area just like any other part of the body ... We need a lot more information about kids ... we found a wide variety ... " (my emphasis).
"... in the literature, they talk about ... intravaginal synechiae and it turns out that ... we saw them everywhere ... We couldn't find one that we couldn't find those ridges."
"When does normal (hymenal) asymmetry become a cleft? I don't know."
McCann's anal examination were equally revealing of a good deal more variation among normal children than the "experts" have so far been recognizing:
Thirty-five percent of children had perianal pigmentation.
Forty percent had perianal redness. The younger the age group, the more likely this finding.
One third of the children showed anal dilation less than 30 seconds after being positioned for the examination.
Intermittent dilation, said by Hobbs and Wynne (1986) to be clear evidence of molest, was found in two thirds of the children.
Recall that Emans found that while abused (by "history" at least) girls were remarkably similar to nonabused but symptomatic girls (infections, rashes, etc.), hymenal tears and intravaginal synechiae were said to be found only in the abused group. We now see that McCann's findings contradict both these alleged differences between molested and nonmolested children. McCann saw no way to distinguish between a healed hymenal tear and "normal asymmetry." He also routinely saw "intravaginal synechiae" in his population of normal girls.
What little research exists, then, shows that a small group of self-appointed "experts" has been given undeserved credibility by an all-too-eager law enforcement and child protection bureaucracy. This has misled the courts, falsely diagnosed sexual abuse, and damaged the lives of countless nonabused children and falsely accused adults. "
