adjacent vulval and vaginal mucosa” and “old deflowering and signs of genital trauma caused more than eight days previously.” Other injuries included multiple facial, thoracic, abdominal, and cranioencephalic trauma, as well as bite marks on her breasts and burns. The severity of the injuries was also evident in wounds such as the torn inner labia, the “cauliflower ears” resulting from severe beatings over a long period of time, and the damage to her vision. Her medical history also indicates she was given nutritional treatment after being rescued because she was suffering from “severe anemia.” The number of times Linda Loaiza López had to have surgery and reconstructive surgery also reflect per se the existence of the injuries she described and the brutality with which they were inflicted. 195. Additionally, the reports on Linda Loaiza López’s mental health indicate conditions consistent with the violence she describes. The IACHR therefore finds that it is establish fact that Linda Loaiza López has suffered serious impacts on her mental health and was diagnosed with posttraumatic stress syndrome, depression, and “being a victim of rape or terrorism,” among other things. The degree to which the mental health reports on a victim and the victim’s testimony coincide has been considered relevant in other cases as an additional piece of evidence on what happened, especially with regard to sexual issues.272 196. Third, in addition to Linda Loaiza López’s testimony and the medical and psychological evidence, the Commission has testimony from officials who participated in her rescue and specialists who gave her medical attention. As indicated in the proven facts, both the officials and the medical personnel agreed on the gravity and severity of the injuries they could see, even stating that if she remained there one more day she probably would have died. It was also stated that the injuries were caused with “extreme brutality and cruelty” and that they looked as if they had been caused by firearms. 197. Fourth, the Commission takes into consideration the State’s response at both in her rescue and medical examination and in the investigations carried out domestically. In this regard, the Commission highlights that signs of many of the acts of sexual violence described by Linda Loaiza López could have been immediately documented if comprehensive examinations have been carried out in keeping with international standards on cases of reports of sexual violence. Yet despite awareness of the descriptions of acts of sexual violence and rape provided by Linda Loaiza López immediately upon being rescued, no immediate or adequate investigative steps were taken to collect the corresponding evidence. 198. The Commission thus notes that the State did not respond immediately with an investigation employing comprehensive medical examinations appropriate to the sexual violence described by Linda Loaiza López. Likewise, throughout the investigation, essential steps for collecting evidence on the sexual violence described and who committed it were omitted. Thus for example, the semen found in the place of rescue was not tested in any way to see if it matched the individual identified by Linda Loaiza López as her attacker. These omissions will be analyzed in more detail in the section on judicial guarantees and judicial protection. What is relevant for this point is that regarding the acts of sexual violence and rape described that could have left some physical evidence as to their occurrence or perpetrator, it was the State’s omission that prevented collecting that evidence in a timely manner. This circumstance provides evidentiary weight to the elements described in the previous paragraphs. As the Court has indicated on a number of occasions, “reaching another conclusion, would mean allowing the State to shield itself behind the negligence and ineffectiveness of the investigation.” 199. In consideration of these elements taken together, the IACHR has reached the conclusion that Linda Loaiza López was held in a situation of deprivation of liberty against her will and that during that time she was subjected to severe and extreme acts of physical, sexual, and psychological violence, which were committed with special cruelty by her womanhood. This includes the conclusion that Linda Loaiza López was raped repeatedly and in different ways while she was being held. These facts constituted grave violations of her rights to personal integrity, private life, autonomy and dignity, personal liberty, to equality and nondiscrimination and to live a life free of violence. The Commission also concludes that these facts constituted a 272 Inter-American Court, Case of Rosendo Cantú et al. v. Mexico. Preliminary Objections, Merits, Reparations and Costs. Judgment of August 31, 2010. Series C No. 216, para. 99.