I.

LEGAL MEDICINE FINAL EXAMINATION COVERAGE

Sexual Dysfunctions and Sex Crimes
A. Different Kinds of Sexual Dysfunctions
1. Sexual Desire/Appetitive Disorder
These are problems that involve a lack or absence of sexual
drive, also referred to as a low libido. Low levels of the female
hormone estrogen and the male hormone testosterone can lead to a
decrease in sexual desire. Some precipitating factors include
increasing age, pregnancy, depression, anxiety, and the use of
certain
medications
such
as
selective
serotonin
re-uptake
inhibitors.
a. Hypoactive sexual desire disorder - or inhibited sexual desire
(ISD) is characterized as a lack or absence of sexual
fantasies and desire for sexual activity.
b. Sexual Aversion Disorder - is phobic aversion to and avoidance
of sexual contact with a sexual partner, which causes personal
distress. This is the most severe form of sexual desire
disorder. It involves a fear of sexual intercourse and an
intense desire to avoid sexual situations completely.
2. Sexual Arousal Disorder
Previously, terms used to describe a sexual arousal disorder have
included frigidity in the case of women and impotence in the
case of men but these terms are generally not currently used.
Impotence is now described as erectile dysfunction and a number of
terms exist to describe frigidity. These individuals may have an
aversion to or tendency to avoid sexual contact with a partner.
Males may find they can only maintain a partial erection or they may
be unable to obtain one at all. Affected males may also find they
gain no pleasure or excitement from sexual activity. Among affected
females, the vagina may fail to become lubricated.
3. Orgasm Disorders
Individuals affected by an orgasm disorder fail to achieve
climax or find that climax is often delayed. These disorders may be
caused by physical factors, illness or even as a result of using
certain medications. Pain during sexual activity, stress, fatigue,
hormonal changes and reduced libido can all lead to delayed or
absent orgasm.
a. Female orgasmic disorder (inhibited orgasm)
b. Male orgasmic disorder (inhibited orgasm)
c. Premature
ejaculation
is
a
male
sexual
dysfunction
characterized by ejaculation which always or nearly always
occurs prior to or within about one minute of vaginal
penetration; and, inability to delay ejaculation on all or
nearly all vaginal penetrations
4. Sexual Pain Disorder
Sexual pain disorders are mainly confined to women and are caused
by inadequate lubrication of the vagina during sex. This may be
caused by a lack of stimulation or excitement about the sexual
activity or by hormonal changes that occur as a result of pregnancy,
breastfeeding or menopause. Other causes include irritation due to
the use of contraceptive creams and anxiety about engaging in sex.
Sexual pain may also be caused by a condition called vaginismus,
where the muscles of the vaginal wall spasm involuntarily during
intercourse. The cause of these spasms is not clear but previous
sexual trauma such as abuse or assault has been suggested as a
trigger of the condition.
One sexual pain disorder that occurs in males is referred to as
priapism, which is a painful erection that may persist for several
hours, even in the absence of sexual stimulation. This is caused by
blood getting trapped in the penis and failing to drain adequately.
If left untreated, the condition may lead to a permanent loss of
erectile function.

B. Sex Crimes
1. Rape (Art.365 of the RPC)
Committed by having carnal knowledge of a woman under any of the
following circumstances:
1. By using force or intimidation
2. When the woman is deprived of reason or otherwise unconscious.
3. When the woman is under twelve years of age, even though
neither of the circumstances mentioned in the two next
preceding paragraphs shall be present.
2. Qualified Seduction (Art.337 of the RPC)
The seduction of a virgin over twelve years and under eighteen
years of age, committed by any person in public authority, priests,
house-servant, domestic, guardian, teacher, or any person who, in
any capacity, shall be entrusted with the education or custody of
the woman seduced.
3. Incestuous Qualified Seduction
This includes seduction wherein there is blood relationship
between the seducer and the seduced. Father seducing daughter or
other descendants or brother seducing sister. In this type of
seduction, the woman seduced need not be a virgin or may be more
than eighteen years of age.
4. Simple Seduction (Art.338 of the RPC)
The seduction of a woman who is single or a widow of good
reputation, over twelve but under eighteen years of age, committed
by means of deceit.
5. Acts of Lasciviousness
Acts which tend to excite lust, conduct which is wanton, lewd,
voluptuous or lewd emotion. Acts considered lascivious are:
embracing, kissing and holding the womans breast, or placing of the
mans private organ over a girls genital organ.
a. Art.336 of the RPC Acts of lasciviousness
b. Art.339 of the RPC Acts of Lasciviousness with the consent
of the offended party
6. Abduction
Is the carrying away of a woman by an abductor with lewd design.
a. Forcible Abduction (Art.342)
b. Consented Abduction (Art.343)
7. Adultery and Concubinage
a. Adultery (Art.333 of the RPC)
Is committed by any married woman who shall sexual
intercourse with a man not her husband and by the man who has
carnal knowledge of her, knowing her to be married, even if
the marriage be subsequently declared void.
b. Concubinage (Art.334 of the RPC)
Any husband who shall keep a mistress in the conjugal
dwelling, or shall have sexual intercourse, under scandalous
circumstances, with a woman who is not his wife, or shall
cohabit with her in any other place.
8. Prostitution (Art.202, No.5 of the RPC)
A woman who habitually indulges in sexual intercourse or
lascivious acts. When the habitual sexual intercourse or lascivious
act is done for money or profit.
9. Grave Scandal (Art 200 of the RPC)
Any person who shall offend against decency or good customs by
any highly scandalous conduct not expressly falling within any other
article of the code.

10. Immoral doctrines, obscene publications and exhibitions (Art 201

of the RPC)
When one shall publicly expound or proclaim doctrines openly
contrary to public morals. Authors of obscene literature, published
with their knowledge in any form and the editors publishing such
literature. Those who in theaters, fairs, cinematographs or any other
place open to public view shall exhibit indecent or immoral plays,
scenes, acts or shows. Those who shall sell, give away or exhibit
prints, engravings, sculptures or literature which are offensive to
morals.
C. Medico Legal Ascpect of Sex Crimes
1.Virginity and Defloration
a. Virginity
A condition of a female who has not experienced sexual

intercourse and whose genital organs have not been altered by carnal
connection.

1. Moral Virginity state of not knowing the nature of sexual

life and not having experienced sexual relation. Moral
virginity applies to children below the age of puberty and
whose sex organs and secondary sex characters are not yet
developed.
2. Physical Virginity a condition whereby a woman is conscious
of the nature of sexual life but has not experienced sexual
intercourse. There are no conclusive medical findings to show
that a woman is physically virgin. Reliance is given to the
absence of laceration of the hymen, but a woman might have had
previous sexual intercourse and yet the hymen is unruptured
while others might not have the experienced of sexual
relations but have laceration of the hymen.
If the findings show absence of laceration of the hymen,
distinction should be drawn between true and false physical
virginity.
a. True Physical Virginity condition wherein the hymen is
intact with the edges distinct and regular and the
opening small to barely admit the tip of the smallest
finger of the examiner.
b. False Physical Virginity condition wherein the hymen is
unruptured but the orifice is wide and elastic to admit
two or more fingers of the examiner with a lesser degree
of resistance.
3. Demi-Virginity the term refers to a condition of a woman who
permits any form of sexual liberties as long as they abstain
from rupturing the hymen by sexual act. The woman allows
sexual intercourse but only inter-femora or even interlabia but not to the extent of rupturing the hymen.

4. Virgo Intacta literally the term refers to a truly virgin

woman; that there are no structural changes in her organ to
infer previous sexual intercourse.

2.Parts of the Body To Be Examined to Determine Virginity:

1. Breast The breast, vertically occupies the area from the second to
the 6th rib and horizontally from the side of the sternum to the mid

axillary line. The nipples are conical in shape occupying the 4 th

intercostal space. The nipples are surrounded by a pigmented area
called the Areola which becomes dark during pregnancy.
2. Vaginal Canal Its tightness and degree of resistance on insertion
of a finger or an instrument depends on the integrity of its walls
as lubricating substances.
3. Labia Majora and Labia Minora Entry of the male penis may cause
the labia or lips, to gape due to stretching of the borders.
4. Fourchette As the two labia minora unites posteriorly, it forms a
V-shape appearance. After several distentions, the sharpness of the
acute angle may become rounded with retraction of the edges.
5. Hymen Some hymen may have no opening and is therefore called
imperforate hymen. A septate hymen has two openings which maybe of
equal or different size. A cribriform hymen presents a small
opening.
Defloration This is the laceration or rupture of the hymen, as a
result of sexual intercourse. All other lacerations which are not
due to coitus are not considered deflorations.

Duration of Hymenal Laceration

1.Fresh bleeding laceration the laceration is of recent origin.

2. Fresh Healing with Fibrin formation and edema of the surrounding
tissue usually occurs after 24 hours to four days.
3. Healed laceration with congested edges and with sharp coaptible
borders recently healed laceration and occurs between 4 to 10
days.
4. Healed laceration with sharp coaptible borders without congestion
this occurs between 11 30 days.
5. Healed laceration with rounded non-coaptible
retraction of the edges This occurs after one month.

borders

and

Medico Legal Aspect of Prostitution

1. It promotes the spread of sexually transmitted diseases (STD),

HIV infections and AIDS.
2. Evidences can be obtained to prove sexual or lascivious conduct.