Wilbur Gаbe appeals his conviction for three sexual offenses committed against his adopted daughter in Indian country: one count of abusive sexual contact with a child under the age of twelve, and two counts of aggravated sexual abuse. See 18 U.S.C. §§ 1153, 2241(a)(1) and (c), 2244(a)(1), and 2246(2). On appeal, Gabe challenges the admission of the victim’s statement tо an examining physician identifying Gabe as her abuser, the admission of testimony describing two prior sexual offenses, the sufficiency of the evidence as to each count of conviction, and the district court’s 1 denial of his motion for a new trial. We affirm.
I. Background.
We will refer to the minor victim as V.G. In May 1998, V.G.’s aunt removed V.G. from Gabe’s home, suspecting the fifteen- *957 year-old girl was being abused. Shortly thereafter, V.G. told F.B.I. agent Joseph Weir that Gabe had been sexually abusing her since 1988 or 1989, when she was in the first grade. After further investigation, Gabe was charged with nine counts of sexual abuse against four different victims:
Count I — abusive sexual contact with V.G. in 1988 or 1989.
Counts II-VI — five instances of aggravated sexual abuse of V.G. between August 1996 and May 1998.
Count VII — aggravated sexual abuse of Kathleen Tiger in May 1998.
Count VIII — abusive sexual contact with Nell Miner in December 1995.
Count IX — aggravated sexual abuse of Shannon Cloud in 1991.
Count IX was dismissed before trial as time-barred. At trial, V.G. testified that the abuse began when she was six years old and occurred frequently because her mother left the house twice each week to play bingo. The abuse began with vaginal touching and digital penetration of her vagina and progressed to vaginal and anal intercourse when she was thirteen years old. V.G. described in detail the three incidents underlying Counts I, II, and V, for which Gabe was ultimately convicted. In addition, Kathleen Tiger testified that Gabe raped her the night V.G. was removed from the Gabe home, and Nell Miner testified that Gabe touched her sexually when she visited the Gabe home as a teenager.
The district court acquitted Gabe on Counts III, IV, and VI because the government failed to prove he used force to cause V.G. to engage in the alleged offenses. See 18 U.S.C. § 2241(a)(1). The jury acquitted Gabe on Counts VII and VIII, the alleged offenses against Kathleen Tiger and Nell Miner. The jury convicted him of the offenses аgainst V.G. charged in Counts I, II, and V. The court denied Gabe’s motions for judgment of acquittal and a new trial and sentenced him to 236 months in prison. ’
II. The Victim Hearsay Issue.
After V.G. told agent Weir about Gabe’s alleged sexual abuse, the F.B.I. and the tribal Department of Social Services referred her to Dr. John B. Jones for a medical examination. Dr. Jones is a board-certified family prаctitioner to whom authorities in central South Dakota frequently refer suspected sexual abuse victims for medical examinations. At trial, Dr. Jones testified that he discovered substantial physical evidence of sexual abuse over a long period of time, beginning at an early age, and that V.G. told him she had been sexually abused. Gabe did not objеct to this testimony. However, Gabe did object to Dr. Jones’s testimony that V.G. told him Gabe had sexually abused her “from the age of the first grade on to now.” The district court admitted this testimony under the medical-treatment hearsay exception, codified in Rule 803(4) of the Federal Rules of Evidence. Gabe challenges this ruling on appeal. We conclude it was error to admit V.G.’s identity statement to Dr. Jones under Rule 803(4), but the error was harmless. 2
Statements made by a patient for purposes of medical diagnosis or treatment are an established exception to the hearsay rule because “a statement made in the course of procuring medical services, where the declarant knоws that a false statement may cause misdiagnosis or mistreatment, carries special guarantees of credibility.”
White v. Illinois,
In cases of sex abuse, however, the identity of the abuser may be relevant to treating the victim’s emotional and psychological injuries. For this reason, we have upheld the admission of hearsay statements identifying the abuser tо a physician “where the physician makes clear to the victim that the inquiry into the identity of the abuser is important to diagnosis and treatment, and the victim manifests such an understanding.”
United States v. Renville,
The government argues that V.G.’s statement to Dr. Jones falls within the medical-treatment hearsay exception because “she was clearly of an age where she understood the physician’s role in order to trigger the motivation to provide truthful infоrmation.” We agree that most adults and older children generally understand a physician’s role in providing diagnosis and treatment. But not even an adult necessarily understands the connection between a sex abuser’s identity and her medical treatment. Rule 803(4) is premised on the patient’s selfish motive in receiving proper medical treatment; therefore, the proponent must establish that the declarant’s frapie of mind when making the hearsay declaration “was that of a patient seeking medical treatment.”
Olesen v. Class,
Error in admitting a sex abuse victim’s out-of-court declarations is subject to harmless error analysis.
Balfany,
Q And you heard her testimony in court again ... you heard the testimony of [V.G.]?
A I did.
Q And was it consistent with the things that she told you?
A Yes, it was.
And on cross examination:
Q Did [V.G.] tell you that FBI Agent Joe Weir was the first person she ever told about this stuff?
A Yes, she did.
Thus, the jury knew that V.G.’s trial testimony identifying Gabe as her abuser was consistent with what she previously told agent Weir and counselor Pier. In these circumstances, the admission of Dr. Jones’s hearsay testimony was harmless error.
III. Prior Bad Act Evidence Issues.
Evidence of prior bad acts is generally not admissible to prove a defendant’s character or propensity to commit crime. FED. R. EVID. 404(b). However, Congress altered this rule in sex offense cases when it adopted Rules 413 and 414 of the Federal Rules of Evidence. Now, in sexual assault and child molestation cases, evidence that the defendant committed a pri- or similar offense “mаy be considered for its bearing on any matter to which it is relevant,” including the defendant’s propensity to commit such offenses. FED. R. EVID. 413(a), 414(a). If relevant, such evidence is admissible unless its probative value is “substantially outweighed” by one or more of the factors enumerated in Rule 403, including “the danger of unfair prejudice.”
United States v. LeCompte,
1. The district court admitted under Rule 414 testimony by Holly Thompson that Gabe had sexually abused her some twenty years earlier, when Thomрson was seven years old. This incident is similar to Count I, the alleged abusive sexual contact with V.G. when she was in the first grade. V.G. testified that, on that occasion, Gabe was sitting in a rocking chair in their living room, she was laying below him, and he touched her vagina with his finger, first over, then under, her clothes. V.G. cried, but Gabe told her to “shut up” because she would get used to it. Holly Thomрson testified that, when she was seven years old, Gabe was visiting her family, and she awakened from a nap when Gabe inserted his finger into her vagina. Gabe told her to be quiet and continued touching her until they “heard footsteps coming down our hallway and then he removed his finger, or his hand. And he got up and then he walked out of the bedroom like nothing happеned.”
A court considering the admissibility of Rule 414 evidence must first determine whether the evidence has probative value, recognizing “the strong legislative judgment that evidence of prior sexual offenses should ordinarily be admissible.”
LeCompte,
Gabe argues that Holly Thompson’s testimony was unfairly prejudicial because the twenty-year lapse of time both diluted its probative value and prevented Gabe from effectively defending against her accusation. When Rule 414 was enacted, Congress expressly rejected imposing any time limit on prior sex offense evidence. 4 The passage of time certainly raises reliability issues. One is whether the accuser’s memory has faded. But it is reasonable to assume that a victim of child abuse is not likely to forget such a traumatic event. And here, Holly Thompson testified in detail about the incident and was vigorously cross examined on the reliability of her memory. For example, Thompson testified that she was wearing “yellow stretch pants with a white shirt with flowers or something around the sleeves.” On cross exam, defense counsel asked:
Q: Okay. Twenty years ago you can remember that you had yellow stretch pants and a white shirt?
A: Yes, I can.
Q: Can you remember what you were wearing three weeks ago on this date?
* * * * * *
A: I had black web pants with a Mic- ■ key Mouse shirt with my white tennis shoes.
The passage of time can also make it difficult to find third party witnesses and extrinsic evidence to counter the alleged pri- or sexual offense. But here, Thompson, like V.G., accused Gabe of furtive abuse carefully committed outside the presence of others. Extrinsic evidence was unlikely to be persuasive, and Gabe was free to take the stand to refute both accusers. That he elected not to testify is not unfair prejudicе.
For all of these reasons, we find the district court did not abuse its discretion in admitting Holly Thompson’s testimony under Rule 414.
See United States v. Meacham,
2. The district court admitted under Rule 413 testimony by Shannon Cloud, an adult, that Gabe attempted to rape her in 1991. Cloud’s testimony was admitted because the underlying circumstances were similar to Count VII, Gabe’s alleged aggravated sexual abuse of Kathleen Tiger in May 1998. Gabe was acquitted of that charge, so obviously the jury was not unfairly prejudiced in considering the one count to which Cloud’s testimony was relevant. That testimony could not have unfairly prejudiced Gabe’s defense of the totally unrelated charge that he sexually abused V.G. as a child.
IV. Sufficiency and New Trial Issues.
Gabe argues the district court erred in denying his motion for judgment of acquittal because the evidence is insufficient to convict on all three counts. “The verdict
*961
must be upheld if there is an interpretation of the evidence that would allow a reasonable jury to conclude guilt beyond a reasonable doubt. Decisions regarding credibility of witnesses are to be resolved in favor of the jury’s verdict.”
United States v. Eagle,
Gabe first argues the evidence is insufficient to convict him of Count I, abusive sexual contact of V.G. when she was in the first grade, because there is no evidence corroborating V.G.’s testimony that Gabe abusеd her. However, a victim’s testimony alone is sufficient to persuade a reasonable jury of the defendant’s guilt beyond a reasonable doubt.
United States v. Wright,
Gabe next argues the evidence is insufficient to convict him of the aggravated sexual abuse alleged in Counts II and V because there is no evidence he used force to cause V.G. to engage in these sexual acts. Force is an element of the offense of aggravated sexual abuse. 18 U.S.C. § 2241(a)(1). The rеquisite force is established “if the defendant overcomes, restrains, or injures the victim or if the defendant uses a threat of harm sufficient to coerce or compel submission.”
Eagle,
Finally, Gabe argues the district court erred in denying his motion for a new trial.
See
Fed. R. CRiM. P. 33. The district court “should grant a new trial only if the evidence weighs heavily enough against the verdict that a miscarriage of justice may have occurred.”
United States v. Brown,
The judgment of the district court is affirmed.
Notes
. The HONORABLE CHARLES B. KORN-MANN, United States District Judge for the District of South Dakota.
. The district court also admitted this testimony under the residual hearsay exception found in Rule 807. The government does not defend this ruling on appeal, and wisely so. V.G.'s cumulative hearsay statement to Dr. Jones does not satisfy Rule 807's requirement that “(B) the [hearsay] is more probative on the point for which it is offered than any other evidence which the proponent can procure through reasonable efforts.”
See United States v. Balfany,
. Dr. Jones knew V.G. wаs already receiving psychological counseling. Thus, he did not ask V.G. to identify her abuser for the purpose of advising whether she needed psychological counseling, as the testifying physicians did in
Renville,
. See 140 Cong. Rec. H8,992 (daily ed. Aug. 21, 1994) (statement of Rep. Molinari) ("evidence of other sex offenses by the defendant is often probative and admitted, notwithstanding very substantial lapses of time in relation to the charged offense or offenses”).