Freeing the San Antonio Four
Published: November 14, 2012
Kellogg testified her examination of the girl showed what she called an "attenuated hymen," or, "[W]hat I saw was very little hymen," which she stated was sign of repeated assault.
Upon reviewing Kellogg's exam notes from the case this month, Martin Finkel, a pediatrician and expert in the field, stated, "Attenuation? I would never say that. I would say that there's a narrow hymen, and I wouldn't say that a narrow hymen on its own is diagnostic."
A widely-circulated guideline published in 1994 in the prominent journal Pediatrics – where Kellogg's own work often appears – lists the condition under "findings that are consistent with, but not diagnostic of sexual assault." Another 1994 study published in the same journal lists a narrow or thin hymen as "suspicious for abuse," having been found in some proportion of abused children, but not "suggestive," or "clear evidence" of assault, the next highest classification categories. Another 2000 study published by the American Journal of Obstetrics and Gynecology comparing hymens in abused and non-abused girls doesn't even list the condition. Researchers in 2002 published a study in the Journal of Pediatrics that tracked non-abused girls' development, finding hymenal tissue may naturally decrease in girls between the ages of 3 and 5.
Finkel told the Current, based on the literature both then and now, he would have never called Kellogg's findings definitive signs of sexual trauma. But Kellogg did. Or to be more precise, the prosecution offered the possibility and Kellogg confirmed it.
At trial, prosecutor Chris DeMartino stated, "And are your findings such that in the area of vaginal penetration such that it's definitive, in your opinion, of that?" Kellogg responded, "In my opinion, that's correct."
The defense called Paul Navar, a Texas pediatrician who regularly evaluated children for child sexual assault for authorities in El Paso County. "It's kind of like fingerprints, or people's noses," Navar testified of hymens. "They're all individual, they look different."
Navar also cited a study published in Pediatrics in 1987 examining three groups of young girls: group one contained cases of confirmed abuse; group two was comprised of girls who had not been abused, but had experienced some sort of genital irritation, like an infection or rash; group three contained girls that had never been abused and had no complications. The study found 20 percent of abused girls had so-called attenuated hymens; 10 percent in the second group had the condition; and 5 percent of non-abused girls had the condition.
Kellogg disregarded that study on the stand, questioning whether the non-abused sample group actually contained abused children. To dispel any doubt over the meaning of her findings, Kellogg even claimed that a thin, or attenuated, hymen had never been confirmed as normal variation in non-abused children.
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