Reflex anal dilatation
Reflex anal dilatation refers to the theory that in child victims of anal rape, the anus will reflexively open on stimulation to a diameter larger than 2 cm. Some clinicians such as Marietta Higgs and her followers have gained clearance to probe the anuses of suspected child victims, going on to claim that resulting dilation is proof of sodomy. Anal dilation has been observed in children with suspected chronic anal rape and children with chronic constipation, as well as in normal children. In one study, 49% of nonabused children displayed reflex anal dilation.
Day of Reckoning
- "In 1986, toddler Lyndsey Wise scratched her arms while picking bilberries. At Middlesbrough General Hospital, she and her sister were examined by Dr. Marietta Higgs. Not only were their parents accused of sexually abusing their daughters, the foster parents with whom the girls were placed and who intended to adopt them were also accused, the foster father arrested for buggery on Higgs’ further testimony. By 1987 the activities of Higgs had filled the wards of Middlesbrough General Hospital with children taken from their parents after alleged sexual abuse, all of whom had undergone similar ordeals to that of the Wise sisters. The affair became the notorious Cleveland Child Abuse Controversy, but despite public outrage and all the parents being cleared, Marietta Higgs never conceded that she was wrong and continued to work as a paediatrician.
- A general view was that the only abuse the children had suffered was from the probing fingers of Higgs and her abuse hunting team."
Comparison with anal wink
Reflex anal dilatation as a theory, appears to conflict with that of anal wink, an American theory in which the opposite reaction is deemed to be evidence of abuse in legal cases.
- NW Read, WM Sun, Reflex anal dilatation: effect of parting the buttocks on anal function in normal subjects and patients with anorectal and spinal disease, Gut (Jun, 1991)
- C. Hobbs and J. Wynne, Buggery in childhood – a common syndrome of child abuse, Lancet 2 (1986), pp. 792–796
- J. Adams, K. Harper and S. Knudson et al., Examination findings in legally confirmed cases of child sexual abuse: it's normal to be normal, Pediatrics 94 (1994), pp. 310–317
- G. Clayden, Reflex anal dilatation associated with severe chronic constipation in children, Arch Dis Child 63 (1988), pp. 832–836
- Goodyear-Smith, Felicity (1994). "Medical Considerations in the Diagnosis of Child Sexual Abuse," Issues In Child Abuse Accusations, 6.
- McCann, J., Voris J., Simon, M., & Wells, R. (1989). "Perianal findings in prepubertal children selected for nonabuse: A descriptive study," Child Abuse & Neglect, 13, 179-193.
- David Bernard, Melissa Peters, Kathi Makoroff, "The Evaluation of Suspected Pediatric Sexual Abuse", Clinical Pediatric Emergency Medicine, Volume 7, Issue 3, September 2006, Pages 161-169
- Joyce A. Adamns, "Medical Evaluation of Suspected Child Sexual Abuse", The Journal of Pediatric and Adolescent Gynecology, Vol 17, 2005, pp 191–197J
- Marilyn Strachan Peterson, Michael Durfee, Kevin Coulter, Child abuse and neglect: Guidelines for Identification, Assessment, and Case Management, Volcano Press, 2003, ISBN: 1884244211
- Joyce A. Adams, Rich A. Kaplan, Suzanne P. Starling, Neha H. Mehta, Martin A. Finkel, Ann S. Botash, Nancy D. Kellogg and Robert A. Shapiro, Guidelines for Medical Care of Children Who May Have Been Sexually Abused, Journal of Pediatric and Adolescent Gynecology, Volume 20, Issue 3, June 2007, Pages 163-172
- Day of Reckoning