Physical signs of child sexual abuse 2015 (Purple Book) – about

This guidance includes good practice in relation to the paediatric forensic examination where there are concerns about child sexual abuse. It also provides an evidenced-based review of the interpretation of physical signs.

Coming soon: 2023 version

A fully updated version of the ‘Purple Book’ will soon be available on this website to RCPCH members (most membership types) and other health and legal professionals on subscription. Users will be able to download chapters as PDFs, and there will be two versions – text only and full (with images) – depending on your role and subscription.

Get updated when we publish the 2023 version

About the 2015 version

In 2015 the RCPCH, in collaboration with the American Academy of Pediatrics (AAP), the Royal College of Physicians of London (RCP) and The Faculty of Forensic and Legal Medicine (FFLM), updated the 2008 RCPCH publication entitled ‘The Physical Signs of Child Sexual Abuse’ based on the best available evidence.

The publication updated previous evidence and included new reviews such as:

  • anogenital signs of accidental injuries in girls and boys
  • genital bleeding in prepubertal girls
  • healing in anogenital injuries.

This publication is to be used by clinicians with specialist child protection skills with specific training and competences in the forensic assessment of children and young people where there are concerns about child physical abuse.

The review is provided free of charge if you are:

  • an RCPCH member and
  • a named or designated doctor for safeguarding children and
  • involved in the forensic medical examination of children for suspected CSA.

Others may purchase a copy through our stockists, Lavenham Press:

  • If you are a member of the RCPCH, Faculty of Foresnic & Legal Medicine (FFLM), Royal College of Physicians (RCP), British Association of Paediatric Surgeons (BAPS), or American Academy of Pediatrics the cost is £35 plus delivery – please contact to request your coupon code which you can use when placing your order
  • For all non-members the cost is £49 plus delivery

You can also pay by cheque; contact / 01787 249 290. You’ll need to make the cheque payable to ‘Lavenham Press Ltd’ and post to Lavenham Press Ltd, Arbons House, 47 Water Street, Lavenham, Suffolk CO10 9RN.

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