The female journey following sexual assault: Medical care, law enforcement and judicial outcomes

OBJECTIVE: Sexual violence affects 22% of Australian women, posing health and justice challenges. Systemic failures, fragmented data, and low conviction rates hinder effective responses. This study integrates Australian Capital Territory (ACT) medical and policing datasets to examine victim characteristics and case progression from clinical presentation to legal outcomes. METHODS: This retrospective study analyzed 2179 deidentified cases of female sexual assault victims presenting to Forensic and Medical Sexual Assault Care (FAMSAC) between 2004 and 2022. De-identified patient variables and ACT Policing data were integrated and analyzed to examine victim characteristics and case progression from medical consultation to legal outcomes. RESULTS: Of 2179 females presenting for forensic and medical care, 41.8% reported to ACT Policing, 19.2% progressed to court and 10.4% of cases resulted in a conviction. Drug use (14.9%) was negatively associated with case progression, while alcohol use and pre-existing mental health conditions showed no significant effect. No victim, assailant, or medical factors were associated with conviction outcomes. Among cases withdrawn at the policing stage, anal penetration, forensic photography, and presentation outside business hours were associated with continuation to court. Overall, 54.3% of cases that proceeded to court resulted in conviction. CONCLUSION: Through collaborative practices, this study establishes a baseline for continuous system review from forensic medical presentation to court outcome. Legal outcomes were independent of victim characteristics, assault details, and medical findings, with attrition at every stage. Medical documentation alone could not predict conviction, though it may support the finders of fact. Further research is needed to assess whether medical evidence influences police action, court pleas, and convictions.