MEDICO-LEGAL ANALYSIS OF SODOMY CASES REFERRED TO THE BAGHDAD MEDICO-LEGAL DIRECTORATE OVER A TWO-YEAR PERIOD (2023–2024): A RETROSPECTIVE DESCRIPTIVE STUDY

Abstract

Background: Allegations of sodomy present distinctive challenges in forensic practice, requiring a balance between clinical objectivity and legal responsibility. Reliable local data on the magnitude and pattern of medico-legally confirmed cases are scarce in Iraq. Objectives: To describe the frequency, demographic distribution, and documented physical findings of medico-legally confirmed sodomy cases referred to the Baghdad Medico-Legal Directorate during 2023–2024, and to examine their association with sex, age, type of finding, and month of presentation. Methods: A retrospective, single-centre, records-based descriptive study was conducted in the Department of Forensic Living Examination and the Clinical Management of Rape Unit of the Baghdad Medico-Legal Directorate. All 381 examinations performed for an isolated request of sodomy examination between 1 January 2023 and 31 December 2024 were reviewed; record retrieval and data analysis were carried out between January and June 2025. A case was classified as confirmed when one or more pre-defined acute or habitual anal findings were documented by a certified examiner. Data were summarised using frequencies and percentages; the chi-square and Fisher exact tests were used to assess associations, with a two-sided p<0.05 considered statistically significant. The study was reported in accordance with the STROBE guideline for observational studies. Results: Of 381 examinations performed for an isolated sodomy request, 37 (9.7%) met the pre-defined criteria for a confirmed finding. Confirmed cases were more frequent in males (34/37, 91.9%) than females (3/37, 8.1%). Acute findings were documented in 27 cases (73.0%) and habitual findings in 10 cases (27.0%); all acute findings occurred in males. The most affected age group was 11–15 years (16/37, 43.2%). The difference in confirmed cases between males and females did not reach statistical significance (p=0.057). The most common acute finding was an anal/perianal wound, and the most common habitual finding was a sexually transmitted infection (anogenital warts). Conclusion: Within this referred sample, medico-legally confirmed sodomy accounted for a small proportion of examinations and was concentrated among male children aged 11–15 years. Because only cases referred to the Directorate were included, these figures describe the referred population and should not be interpreted as community prevalence. Findings are descriptive and associative; no causal inference is made.