Patients ranged in age from 13 to 55 years. All of the women had some degree of disability; 69 percent were categorized as profoundly retarded. No patient gave a history of sexual abuse at the time of exam. Results indicate that 37 percent of the patients had genital findings that are consistent with prior vaginal penetration. At least one of the patients was vaginally penetrated while institutionalized and became pregnant. It is unknown whether the perpetrator was a staff member, male resident, or other individual with access to the patient. Dilemmas which arose during evaluation included the significance of healed genital lesions in the absence of acute findings, the question of who should evaluate the adult developmentally disabled female for signs of sexual abuse, and the implications of the findings for the residential facility. 24 references (Author abstract modified)