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Seven years ago, Marilyn Sommers wondered whether current forensic exams could actually determine whether a woman had consented to sex.

Clinical examinations, the School of Nursing’s now-Associate Director of the Center for Health Disparities Research discovered, were less likely to diagnose sexual injuries in women with darker skin.

In a 120-subject clinical study, volunteers — 50 percent of whom self-identified as white and 50 percent as black — were examined individually after consensual sex with their partners. Consensual subjects were matched with rape victims who volunteered to participate in the study.

After all subjects received clinical examinations, Sommers found that fewer women with dark skin were found to have sexual injuries.

“I thought maybe it was because of skin color, maybe people doing exams couldn’t see the injury,” said Sommers.

At first, Sommers explained, she and her team considered a social explanation for the disparity. However, they soon agreed that the difference probably related to the skin’s biochemical properties — it was unlikely, they thought, that whether or not someone had actually experienced assault was related to skin color.

Today, Sommers is replicating the same study on a larger scale. Along with Nursing researcher Carla Clements and Nursing doctoral student Jeanine Everett, Sommers is examining the relationship between skin color, levels of elasticity and hydration. The team has discovered a possible link between dark skin and increased protection against physical injury.

Everett, who is involved in the laboratory analysis of skin elasticity, said skin is “like a balloon ... one can manipulate it or apply force to it, but it retracts because it’s elastic.”

“If there is more elasticity in darker skin,” she said, the question of why fewer women with darker skin had visible injuries could be answered.

According to Everett, if differences in elasticity are found among people of different skin color, they need to be addressed in evidence-based practices, particularly in assessment of wounds.

“Unfortunately, [most of] the literature has been according to race, rather than skin color,” she said, explaining that social reasons for the disparity in injuries between people of light and dark skin are no longer valid.

She continued, asking, “When we get people into the hospital setting and we know that they’re at risk for say, pressure ulcers, is this person who has very dark skin going to be at increased risk for an ulcer that is harder to see? A light-skinned person might be forming [an injury] in a different way.”

“If you look at the cases that go to court, the more injuries a woman has, the better [she] does in the criminal justice system,” said Sommers. “Many women are brutally raped and don’t have any injuries. If they do have injuries, we know their cases fare better in the court.”

Women who show injuries and women who don’t, possibly because of properties of their skin, “aren’t equal in the justice system. That worries me, too,” Sommers added.

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