Human Sexuality 5-7

Question 1

Define rape under sexual offences law

Answer 1

Rape is committed if:
- A man has unlawful sexual intercourse with a woman who does not give consent during the intercourse

• The man knows she does not give consent but is reckless anyways
• Any penetration of male penis into female vagina * (ejaculation is not required)

Question 2

Age of consent in HK

Consequence of underage sex

Answer 2

16

Sexual intercourse with a girl under 16 is a criminal offense regardless of her consent

Question 3

Laws on protection of children against sexual offenses?

Answer 3

1) Any intercourse with a girl under 14 is rape
2) Any exposure of sexually explicit material to a child is a crime
3) Any photo or video of naked children showing private parts or children in sexual act is an international crime

Question 4

Define indecent assault under HK law

Answer 4

Indecent acts or touching or penetration of bodily orifices by objects other than a male genitalia

e.g. forced oral sex

Question 5

Highest age group in rape victims

Answer 5

15-19

Question 6

Offender-victim relationship in rape incidences?

Answer 6

Majority = Friends
2nd and 3rd = Stranger and Intimate Partners
4th and 5th = Work colleagues and Family members

Question 7

Main places of sexual assault?

Answer 7

Majority = Residential 
2nd = Hotel/ Hostel/ Villa
3rd = Outdoor

Question 8

Main mode of intoxication during sexual assault?

Answer 8

Alcohol

Question 9

6 main procedures to perform when assessing a rape victim

Answer 9

1) Collect evidence of sexual assault
2) Assist in criminal prosecution
3) Documentation of injury and treatment
4) Screen for STD
5) Prophylaxis for STD
6) Pregnancy test

Question 10

4 types of control evidence for rape conviction

Answer 10

Hair
Blood
Saliva
Blood or fluids of spouse and sexual partner

Question 11

How to collect contact evidence from the victim?

Should the victim clean?

Answer 11

Do not change or wash clothes
Do not shower or clean after an attack

Victim stands on clean sheet of paper and undress, clothing collected and packed individually

Question 12

How to document injuries on rape victim?

Answer 12

Record type, location, size and shape of injury

Interpret age of injury, probable cause of injury

Drawing, photo, video evidence with specific consent

Question 13

List physical evidences that are collected for rape victims

Answer 13

• Fingernails: for blood, skin or fibers trapped under
• Swabs for dried saliva, semen, blood…
• Genital swabs
• Speculum exam
• Photographic documentation of wounds, hymen

Question 14

Incidence of physical trauma in rape cases?

Answer 14

Injuries are only found in minority of rape victims

But absence of injuries does not exclude rape

Question 15

Difference in services provided to rape victims who report vs not report rape

Answer 15

Report:

• Forensic medical exam and evidence collection
• Prophylaxis from A&E doctors

Do not report:
- Prophylaxis from A&E doctors

Question 16

4 reasons for delayed/ poor reporting of substance-assisted rape

Answer 16

• Retrograde amnesia
• Loss of consciousness
• Disinhibitions
• Relationship between victim and offender

Question 17

Causes of gender dysphoria (5)

Answer 17

• Severe genital abnormalities
• Androgen exposure
• Specific mutations: RYR3, CYP17 …etc
• Twins (especially male)
• Neuroanatomy changes

Question 18

Scope of Treatment for gender dysphoria

Answer 18

• Hormone therapy
• Surgery
• Psychotherapy
• Voice and communication therapy
• Social support

Question 19

Patient management before starting treatment for gender dysphoria

Answer 19

Treat psychiatric comorbidities

Live in identity congruent gender role for 12 months before operative

Question 20

Physical changes in Transman after hormone therapy

Answer 20

Increase muscle mass and strength 
Deepen voice 
Fat redistribution 
Body and facial hair growth 
Clitoral enlargement and vaginal atrophy

Question 21

Physical changes in Transwomen after hormone therapy

Answer 21

Softening skin 
Decrease muscle mass and strength 
Breast growth 
Fat redistribution 
Decreased hair growth
Decrease erection and sperm production

Question 22

Options for fertility preservation for transgenders

Answer 22

Transwomen: Frozen sperm
Transman: Gamete preservation

Question 23

Surgery options for transgenders

Answer 23

Male to Female:

• Vaginoplasty
• Breast augmentation
• Vocal cord surgery
• Orchiectomy
• Vaginoplasty
• Facial feminization surgery

Female to Male:

• Phalloplasty
• Subcutaneous Mastectomy
• Vaginoplasty
• Hysterectomy

Question 24

Paraphilia

• Criteria
• Examples of types

Answer 24

DSM:

• Recurrent intense sexually arousing fantasies/ urges/ behavior involving non-human objects, children, non-consenting person, or humiliation of self or partner
• 6 months +

Fetishism
Pedophilia
Sexual sadism
Voyeurism

Question 25

Paraphilic disorder

- Criteria

Answer 25

DSM:

• Personal distress about interest
• Sexual behavior that involves another person’s psychological distress, injury, or death
• Desire for sexual behavior involving unwilling persons or persons unable to give consent

Question 26

4 examples of sex chromosome disorders

Answer 26

Klinefelter syndrome - XXY

Turner syndrome - X only

Triple-X syndrome- XXX

Mixed gonadal dysgenesis - X only or XY

Question 27

Victim- Offender relationship in rape and indecent assault cases?

Answer 27

Rape: 98% acquaintances

Indecent assault: 38% acquaintances, 62% strangers

Question 28

Most common type of sexual offense?

Answer 28

Voyeuristic disorder

Paraphilic disorder - derive pleasure from looking at naked bodies ad genital organs, or observing sexual act of others

Question 29

Voyeuristic disorder

- Criteria

Answer 29

In at least 6 months:

• Recurrent and intense sexual arousal from observing an unsuspecting person who is naked, disrobing or engaged in sexual activity
• Acted on sexual urges with non-consenting person, or urges causing clinically significant distress and daily functional impairment
• Individual with arousal or urges is at least 18

Question 30

2 types of incest

Answer 30

Incest - sexual activity between family members

Covert/ Emotional incest - Parent or caregiver relies on child for support that a romantic partner would give

Question 31

Pharmacological treatment for Voyeuristic disorder

Answer 31

Reduce impulse and urges:

Antiandrogens
Antigonadotropics
SSRI