State v. Thet: Clarifying When Treating Physicians May Testify About a Sexual‑Assault Victim’s “Trauma History” Without Impermissible Credibility Bolstering

I. Introduction

The Supreme Court of New Hampshire’s order in State of New Hampshire v. Aung Thet (No. 2024‑0061, Dec. 23, 2025) addresses an increasingly common evidentiary problem in sexual‑assault prosecutions: how far may a treating physician go in describing a patient’s disclosure of sexual assault and the physician’s responsive care without impermissibly “vouching” for the complainant’s credibility?

The case arises from multiple counts of aggravated felonious sexual assault (AFSA) under RSA 632‑A:2, I(a), (m), where the complainant and the defendant were the only eyewitnesses to the alleged sexual assaults. A key prosecution witness was the victim’s family‑practice physician, Dr. Terra Wilkins, who provided prenatal care and delivered the victim’s baby. The defendant objected when Wilkins testified that:

• the victim’s pregnancy was “high risk” due in part to “mental health concerns and trauma history,” and
• she referred the victim to counseling and community resources because the victim disclosed that her child had been “conceived through rape.”

On appeal, the defendant argued that this testimony was irrelevant, improperly bolstered the victim’s credibility, and, as to the disclosure itself, was not properly admissible as a prior consistent statement. The New Hampshire Supreme Court affirmed the convictions and, in doing so, clarified several important evidentiary principles:

• When testimony about a professional response to a disclosure of abuse crosses the line into impermissible credibility “vouching,”
• When a victim’s disclosure of sexual assault to a treating physician is admissible under the medical treatment/diagnosis hearsay exception (N.H. R. Ev. 803(4)), and
• How relevance (Rule 401), unfair prejudice (Rule 403), and preservation doctrine interact in this context.

II. Summary of the Opinion

After a jury convicted Aung Thet of six counts of AFSA (one count having been dismissed at trial), he appealed, focusing exclusively on the admission of Dr. Wilkins’s testimony. The defense maintained that:

1. Wilkins’s testimony that she referred the victim to services because of her “trauma history” implicitly told the jury that she believed the victim’s allegation of rape; and
2. The victim’s disclosure to Wilkins that the baby was conceived by rape was not admissible as a prior consistent statement and was irrelevant to credibility.

The Supreme Court held:

• The trial court did not commit an “unsustainable exercise of discretion” in overruling the relevance objection to Wilkins’s testimony.
• Wilkins’s description of her referrals did not constitute impermissible opinion testimony on the victim’s credibility and did not “impermissibly bolster” the victim’s testimony.
• The use of the phrase “trauma history” in this context was neutral shorthand for the victim’s own report, not an expert conclusion that abuse occurred, and therefore did not run afoul of the court’s earlier decision in State v. Marden.
• Although the defendant tried to frame the disclosure as an improper prior consistent statement under Rule 801(d)(1)(B), the court exercised its discretion to reach the issue and held that the statement was, in any event, properly admissible under the hearsay exception for statements made for medical diagnosis or treatment (Rule 803(4)).
• The victim’s disclosure to her treating physician was relevant to an issue “of consequence” (credibility) in a case where only the complainant and the defendant witnessed the events, and its probative value was not substantially outweighed by any unfair prejudice (Rule 403).

Accordingly, the convictions were affirmed.

III. Factual and Procedural Background

A. Factual Background

The victim and the defendant, both Burmese immigrants, met through a Burmese‑language Facebook group. The defendant hired the victim to work at a supermarket deli and provided room and board in his shared apartment, also offering to assist with her asylum application.

The jury could have found that, in early 2020, the defendant forcibly engaged in sexual intercourse with the victim on several occasions in the apartment. The victim later discovered she was pregnant, moved out, reported the assaults to the police, and ultimately gave birth in the fall of 2020. A paternity test confirmed the defendant was the father. Post‑birth, the victim learned about the possibility of a U visa for immigrant victims of crime.

Dr. Terra Wilkins, a family‑practice physician, treated the victim during her pregnancy and delivered the baby. She described the pregnancy as “high risk” due to physical health issues and mental‑health concerns, including “trauma history.” She testified that, based on this trauma history, she referred the victim to counseling, community resources, doula services, and care coordination. She also testified that the “trauma experience” the victim disclosed was “that her child had been conceived through rape.”

B. Procedural Posture

• The defendant was indicted on seven counts of AFSA under RSA 632‑A:2, I(a), (m) (2016).
• At trial, after the State presented the victim and other witnesses, it called Dr. Wilkins.
• Defense counsel objected on relevance grounds when Wilkins testified that she referred the victim to services due to “trauma history.”
• The State responded that the referrals were foundational to admissible testimony about the victim’s disclosure of rape to Wilkins, which was relevant because the defendant denied assaulting the victim.
• The State referenced the medical diagnosis/treatment exception (Rule 803(4)); defense counsel clarified that he was not making a hearsay objection, only a relevance objection.
• The trial court overruled the objection, and Wilkins further testified about both the referrals and the content of the disclosure.
• One AFSA count was dismissed; the jury convicted on the remaining six; this appeal followed.

C. Issues on Appeal

On appeal, the defendant argued:

1. The doctor’s testimony about “trauma history” and referrals was irrelevant and unfairly prejudicial because it effectively expressed a professional belief in the victim’s credibility, contrary to the court’s “no vouching” line of cases.
2. The victim’s disclosure to Wilkins was improperly admitted as a prior consistent statement and did not satisfy Rule 801(d)(1)(B) or common‑law limits on such statements.

IV. Precedents and Doctrinal Background

A. Standard of Review and Relevance

The court reiterated the familiar standard:

• Trial courts are given “considerable deference” in evidentiary rulings, reviewed for an “unsustainable exercise of discretion” (State v. Dana, 175 N.H. 27, 32 (2022); State v. VanDerHeyden, 136 N.H. 277, 283 (1992)).
• An “unsustainable exercise of discretion” exists only if the ruling is “clearly untenable or unreasonable to the prejudice of [the defendant’s] case.”

Relevance is governed by N.H. R. Ev. 401:

Evidence is relevant if:
(a) it has any tendency to make a fact more or less probable than it would be without the evidence; and
(b) the fact is of consequence in determining the action.

In sexual‑assault prosecutions with no third‑party eyewitnesses, the court has repeatedly recognized that the victim’s credibility is often “crucial.” (State v. Kornbrekke, 156 N.H. 821, 825–26 (2008)).

B. The “No Vouching / No Credibility Opinion” Cases

The defendant’s main doctrinal foundation was the New Hampshire line of cases forbidding witnesses from commenting on others’ credibility:

• State v. Lopez, 156 N.H. 416 (2007) – Established a “broad prohibition” on questions requiring one witness to comment directly on the credibility of another. Such testimony is not probative and invades the jury’s role as the exclusive judge of credibility.
• State v. Racette, 175 N.H. 132 (2022) – Reaffirmed that lay witnesses may not give opinion testimony about another witness’s credibility. Credibility assessments are “the province and obligation of the jury alone.”
• State v. McDonald, 163 N.H. 115 (2011) – Clarified that the prohibition covers not only explicit statements about credibility but also indirect commentary that effectively tells the jury the witness is truthful or that abuse occurred.
• State v. Marden, 172 N.H. 258 (2019) – Applied these principles to medical testimony in a child sexual‑assault context; held that an expert child‑abuse physician impermissibly bolstered a victim’s credibility by testifying that the victim’s post‑assault symptoms were “symptoms of significance,” effectively inviting the jury to infer an expert conclusion that the child had been sexually abused.

In Marden, the expert status of the physician and the focus on “symptoms” and their meaning were crucial: the court found the only “discernible purpose” of qualifying the doctor as a child‑abuse expert was to encourage the jury to infer that she believed the child’s allegations.

C. Prior Decisions on Professional Actions vs. Vouching

The State, and ultimately the court, relied on another, less restrictive strand of precedents, holding that testimony about professional actions taken in response to a complaint does not itself amount to vouching:

• State v. Kulas, 145 N.H. 246 (2000) – A victim’s attorney testified she contacted police to investigate a “possible rape” after hearing the client’s account. The court held this did not express an opinion on credibility: at most, the jury could infer that if the facts were as reported, there were grounds to report a possible crime.
• State v. Fleetwood, 149 N.H. 396 (2003) – A medical examiner testified that the defendant’s confession was the “most compelling factor” supporting his conclusion that a baby had been smothered. The court held this was permissible: medical examiners may rely on case histories, and noting that reliance does not become a credibility opinion.
• State v. Morrill, 151 N.H. 331 (2004) – A DCYF caseworker testified that the agency closed its investigation after the child recanted. The court found that a rational juror would not construe that testimony as reflecting the caseworker’s personal belief in the truth or falsity of the original allegations.

These cases collectively stand for the proposition that:

• Professionals may describe the steps they took in response to a report or statement (e.g., contacting police, closing a file, referring a patient to services), and
• The mere fact that a professional acted on a statement does not automatically convey a personal endorsement of its truth or an expert conclusion about credibility.

D. Hearsay Framework: Prior Consistent Statements vs. Medical‑Treatment Exception

Two hearsay doctrines are important here:

1. Prior Consistent Statements – Rule 801(d)(1)(B) & Common Law
   Under N.H. R. Ev. 801(d)(1)(B) and cases like State v. McSheehan, 137 N.H. 180 (1993), and State v. White, 159 N.H. 76 (2009), a prior consistent statement:
   • Is not hearsay and may be used substantively when offered to rebut a charge of recent fabrication or improper motive, and
   • May be used, in limited circumstances, at common law to rehabilitate a witness after impeachment.
   These doctrines are relatively narrow and keyed to the manner and timing of impeachment.
2. Statements for Medical Diagnosis or Treatment – Rule 803(4)
   N.H. R. Ev. 803(4) allows admission of statements:
   • Made for—and reasonably pertinent to—medical diagnosis or treatment, and
   • Describing medical history, symptoms, pain, or the cause or source of those conditions.
   The leading case State v. Roberts, 136 N.H. 731 (1993), frames a three‑part inquiry:
   1. The declarant must have intended the statement to obtain medical diagnosis or treatment.
   2. The statement must be reasonably pertinent to diagnosis or treatment (including mental‑health and emotional conditions).
   3. Circumstances must indicate that the statement is trustworthy.
   The court has repeatedly applied this exception to sexual‑assault disclosures to medical providers, including in State v. Munroe, 161 N.H. 618 (2011); State v. Letendre, 161 N.H. 370 (2011); and State v. Bader, 148 N.H. 265 (2002).

E. Preservation Doctrine

New Hampshire’s preservation rules require a timely, specific objection at trial:

• State v. Plantamuro, 171 N.H. 253 (2018) – Issues not raised at trial are generally not considered on appeal.
• State v. Leroux, 175 N.H. 204 (2022) – The appellant bears the burden of proving preservation; a “specific and contemporaneous” objection is required.
• State v. Batista‑Salva, 171 N.H. 818 (2019) – Preservation is a limit on the parties, not the court; the Supreme Court may, in its discretion, waive its preservation requirement, especially when no further factual development is needed.
• Petition of Retired Keene School Teachers, 177 N.H. 29 (2024) – The court may decide an unpreserved legal issue when the existing record is sufficient.

In Thet, this doctrine is important because the defense at trial explicitly disclaimed a hearsay objection and argued only relevance. On appeal, however, the defendant framed the issue partly in terms of prior consistent statements under Rule 801(d)(1)(B) and common law.

V. The Court’s Legal Reasoning

A. Professional Referrals and “Trauma History” as Non‑Vouching Testimony

1. Referrals do not implicitly endorse credibility

The defendant argued that Wilkins’s testimony—explaining that she referred the victim to counseling and other resources after the victim’s disclosure—effectively communicated that she believed the victim’s report of rape. The Supreme Court rejected this characterization and aligned Wilkins’s testimony with Kulas, Fleetwood, and Morrill:

• Wilkins testified that after the victim “shared her trauma experience,” she referred her to community resources, counseling, doula services, and care coordination.
• The court concluded that a rational juror would understand this as a doctor fulfilling her professional obligations—operating on a general assumption of patient candor—not as a personal certification that the allegation was true.
• As in Kulas, where an attorney’s request for a police investigation of a “possible rape” did not equate to vouching, Wilkins’s referrals did not “imbue her testimony with an aura of importance, or any sense of enhanced believability.”
• As in Morrill, where closing a DCYF investigation after recantation did not reveal the caseworker’s personal belief, Wilkins’s referral decisions likewise did not communicate her own credibility determination.

The court also cited the Connecticut Supreme Court’s decision in State v. Long, 975 A.2d 660 (Conn. 2009), approving the view that a doctor’s decision to examine a patient who reports sexual assault is not contingent on a prior credibility determination.

2. “Trauma history” as neutral shorthand, not expert credibility assessment

The defendant further contended that Wilkins’s reference to the victim’s “trauma history” was tantamount to an expert conclusion that the victim had indeed experienced trauma from rape, akin to the impermissible expert testimony in Marden. The court distinguished Marden on two critical grounds:

1. Wilkins was not testifying as an expert on abuse.
   In Marden, the doctor was explicitly qualified as an expert in child‑abuse pediatrics, and the court found that the only plausible purpose of that expert qualification was to invite the jury to infer an expert opinion that the child had been abused. Here, Wilkins was not qualified as an expert in sexual‑abuse behavior or trauma; she testified solely as a treating physician with percipient knowledge of her own care.
2. The term “trauma history” described the patient’s report, not observed symptoms.
   In Marden, the doctor identified particular symptoms (low appetite, poor concentration, etc.) as “symptoms of significance,” a phrase that implied professional evaluation that those symptoms were medically meaningful and, by context, indicative of sexual abuse. By contrast:
   • Wilkins used “trauma history” only as shorthand for the victim’s self‑reported experience: that the child was conceived through rape.
   • She did not describe any constellation of behaviors or symptoms that she had evaluated as consistent (or inconsistent) with sexual abuse.
   • She did not testify that the victim’s behavior was “consistent with” a sexual‑assault victim or otherwise offer a “profile” opinion.

Thus, Wilkins’s testimony fell well within the permissible zone of describing what the patient said and what the doctor did in response, and well outside the prohibited zone of expert‑style credibility bolstering condemned in Marden. The court expressly concluded that she did not “impermissibly attest to the truth of the victim’s disclosure.”

B. Admissibility of the Disclosure Under the Medical‑Treatment Hearsay Exception (Rule 803(4))

1. Preservation and the court’s discretionary review

The State argued that the defense’s “prior consistent statement” arguments were unpreserved because the only trial objection was relevance, coupled with an express disavowal of hearsay objection. The court agreed that the specific 801(d)(1)(B)/common‑law theory was not raised below but chose to exercise its discretion to waive preservation, because:

• The record was “sufficiently developed” to resolve the purely legal issue.
• No additional factual development was needed, bringing the case within the rationale of Batista‑Salva and Petition of Retired Keene School Teachers.

Having done so, the court reasoned that, regardless of 801(d)(1)(B), the trial court could have properly admitted the disclosure under Rule 803(4). In effect, this applies a “right result, different reason” principle to uphold the evidentiary ruling.

2. Application of the three‑part Roberts test

Under State v. Roberts, 136 N.H. 731 (1993), three factors must be satisfied for Rule 803(4):

1. Intent to obtain medical diagnosis or treatment.
   The victim disclosed that the baby was conceived by rape during a routine obstetric appointment, “freely and at her own timing,” not in response to a particular question. The court reasoned that one can infer that a person who voluntarily visits a doctor does so to obtain medical care, and the disclosure, made in that context, was directed toward her physician as part of ongoing prenatal care.
2. Relevance to diagnosis or treatment.
   The disclosure concerned the cause of her pregnancy—rape by the defendant. This was medically pertinent because:
   • Her pregnancy was “high risk” not only due to physical conditions but also “mental health concerns and trauma history.”
   • Knowledge that the pregnancy resulted from sexual violence informs the physician’s assessment of the patient’s psychological state and risk factors and guides appropriate referrals (e.g., counseling, support services).
   • Courts recognize that statements about sexual abuse may be “medically necessary for treatment or diagnosis of sexual abuse and other psychiatric or emotional disorders” (Roberts at 741–42).
3. Trustworthiness of the statement.
   The court noted several trustworthiness indicators:
   • The disclosure was made in the setting of an established treatment relationship with the patient’s prenatal provider.
   • The victim’s relationship with Wilkins was analogous to the “open and honest, professional relationship” in Roberts, and similar to the trusting relationship with a long‑time family physician in Bader.
   • The disclosure aligned with Wilkins’s broader assessment of high‑risk pregnancy due to mental‑health factors, reinforcing its clinical significance.

On this basis, the court held that Rule 803(4) provided a proper foundation for admitting the victim’s disclosure to Wilkins that her baby was conceived through rape. This made it unnecessary to decide whether the statement was also independently admissible as a prior consistent statement.

C. Relevance, Credibility, and Rule 403 Balancing

The defendant’s alternative relevance argument, stripped of hearsay framing, was that the victim’s disclosure to Wilkins should have been deemed irrelevant—or at least minimally probative—unless and until the defense launched a significant assault on credibility.

The court responded by returning to two core points:

1. Credibility was plainly “of consequence.”
   In a case where the defendant denied any sexual assault and no third-party eyewitnesses existed, the victim’s credibility was itself a central factual issue. Citing Kornbrekke, the court underscored that credibility evidence in such cases is “crucial.”
2. The disclosure had probative value that was not substantially outweighed by unfair prejudice (Rule 403).
   The court briefly but clearly concluded that:
   • The victim’s consistent disclosure to her doctor that the pregnancy resulted from rape had a tendency to make a consequential fact—whether she was sexually assaulted by the defendant—more probable.
   • There was no basis to find that this probative value was “substantially outweighed” by dangers such as unfair prejudice, confusion, or misleading the jury.
   • Any prejudice to the defendant was of the ordinary sort that accompanies relevant inculpatory evidence, not the kind of unfair prejudice Rule 403 is designed to guard against.

Thus, the trial court’s admission of Wilkins’s testimony did not constitute an unsustainable exercise of discretion under the deferential standard of review.

VI. Impact and Future Implications

A. Clarifying the Boundary Between Professional Action and Credibility Vouching

State v. Thet refines New Hampshire’s vouching doctrine in a way highly relevant to sexual‑assault prosecutions:

• It confirms that professionals may explain what they did in response to a complainant’s report (e.g., referrals, examinations, reporting), without that testimony being treated as an implied endorsement of the complainant’s credibility.
• It distinguishes between:
  • Neutral descriptions of a complaint and a resulting course of treatment, and
  • Expert testimony that a complainant’s behavior/symptoms are “consistent with” abuse or are “of significance” in a way that implies a specialized credibility judgment.
• It provides prosecutors and trial courts with clearer guidance on how far a treating physician may go without crossing into the prohibited territory marked out in cases like Marden and McDonald.

In practice, this means:

• Prosecutors can more confidently elicit testimony from treating physicians about:
  • The fact and general content of the patient’s disclosure of rape, and
  • The physician’s clinical response (diagnosis, “high‑risk” assessment, referrals, counseling recommendations),
  provided they avoid framing the physician as an expert on abuse behavior and avoid questions calling for “consistency with” abuse or profile‑type opinions.
• Defense counsel should focus objections not simply on the existence of referrals or the use of generic terms like “trauma history,” but on:
  • Any shift toward opinion testimony suggesting that the physician believes the abuse occurred or that the complainant’s behavior is “consistent” with an abuse profile, and
  • Any effort to qualify the physician as a specialized abuse expert where the practical effect would be to invite credibility inferences.

B. Reinforcing the Use of Rule 803(4) for Sexual‑Assault Disclosures

The decision reinforces and marginally expands an already strong line of New Hampshire authority admitting sexual‑assault disclosures to medical professionals under Rule 803(4):

• It extends this reasoning into the prenatal/obstetric context, recognizing that whether a pregnancy was conceived through rape can be medically pertinent to both mental‑health and obstetric management.
• It emphasizes that mental‑health and trauma‑related aspects of care are squarely within the ambit of Rule 803(4), consistent with Roberts and later cases.
• It confirms that such statements may be admitted as substantive evidence of what happened—not merely as background—when the three‑part trustworthiness test is satisfied.

For future cases, especially those involving immigrants or delayed disclosures, Thet will likely be cited to:

• Support admission of victim statements to obstetricians, family‑practice providers, and other non‑specialist physicians about past sexual assaults that bear on current treatment.
• Underscore the importance of the doctor–patient relationship and treatment context in establishing trustworthiness.

C. Strategic Lessons on Preservation and Framing of Objections

The case also has practical implications for appellate and trial practice:

• Defense counsel’s explicit disavowal of a hearsay objection constrained the appellate posture but did not completely foreclose review because the Supreme Court exercised its discretionary power to address the unpreserved legal theory.
• That said, Thet illustrates the risk of limiting objections to “relevance” when a statement also raises hearsay issues and potential vouching concerns:
  • Had defense counsel objected under Rules 801(d)(1)(B), 803(4), and 403, the trial court might have had to articulate its reasoning more precisely, and the appellate court might have engaged more deeply with the prior‑consistent‑statement framework.
  • Future defense counsel are likely to raise multi‑ground objections (relevance, hearsay, 403, vouching) to preserve all lines of attack.
• The decision signals that the Supreme Court is willing, in appropriate cases, to uphold evidentiary rulings on alternative grounds not expressly invoked below, so long as the record is adequate.

D. Continued Emphasis on Credibility in “He‑Said/She‑Said” Sexual‑Assault Cases

Finally, Thet reinforces the court’s recognition that in sexual‑assault cases without eyewitnesses beyond the complainant and defendant:

• Evidence that bears on the complainant’s credibility—such as consistent disclosures to treating physicians—will usually satisfy Rule 401’s low threshold of relevance.
• Rule 403 balancing will generally favor admission unless the evidence introduces some distinct risk of confusion, undue delay, or misleading emphasis beyond its probative value.

This approach tends to support the admission of corroborating disclosures made in medical and therapeutic contexts, provided vouching constraints and hearsay rules are observed.

VII. Complex Concepts Simplified

A. “Unsustainable Exercise of Discretion”

When the Supreme Court reviews evidentiary rulings, it does not ask whether it would have ruled differently. Instead, it asks whether the trial court’s ruling was:

• Clearly unreasonable or untenable in light of the record, and
• Prejudicial to the complaining party.

If reasonable judges could differ about the proper ruling, and the ruling falls within a range of reasonable choices, it is not an “unsustainable exercise of discretion,” even if another judge might have excluded the evidence.

B. Hearsay and the Medical‑Treatment Exception (Rule 803(4))

“Hearsay” is an out‑of‑court statement offered to prove the truth of what it asserts. Ordinarily, hearsay is inadmissible unless an exception applies. Rule 803(4) creates one such exception for statements made for medical diagnosis or treatment, on the theory that:

• Patients have a strong incentive to tell the truth to their medical providers to receive appropriate care, and
• Doctors rely on patients’ descriptions of what happened (such as how an injury occurred or whether sex was consensual) to diagnose and treat both physical and psychological conditions.

In Thet, the victim’s statement that her pregnancy was the result of rape was admitted under this exception because:

• It was made in the course of obtaining prenatal care,
• It was relevant to managing her “high‑risk” pregnancy, especially her mental health and trauma, and
• The established doctor–patient relationship made the statement trustworthy.

C. Prior Consistent Statements (Rule 801(d)(1)(B) and Common Law)

A “prior consistent statement” is simply an earlier statement by a witness that is consistent with their testimony at trial. Such statements are generally hearsay. However, they may be used:

• Substantively (as evidence of the truth of what was said) when offered to rebut a specific charge of recent fabrication or improper motive (Rule 801(d)(1)(B)), and
• For rehabilitation only, under limited common‑law circumstances, after a witness’s credibility has been attacked.

The defendant tried to argue that the victim’s disclosure to Wilkins could not qualify under these doctrines. The court sidestepped a definitive ruling on that point because it found a separate, more straightforward basis for admissibility under Rule 803(4).

D. “Vouching” and “Impermissible Bolstering”

“Vouching” means a witness, directly or indirectly, telling the jury:

• “I believe this other witness is telling the truth,” or
• “Based on my expertise, this person’s behavior is consistent with a truthful victim.”

New Hampshire bars both:

• Direct opinions on another witness’s credibility (Lopez, Racette), and
• Indirect opinions that effectively amount to the same thing (McDonald, Marden).

Thet clarifies that:

• A doctor’s testimony that “the patient told me X, and as a result I did Y” is ordinarily not vouching.
• The line is crossed when the doctor, especially if presented as an abuse expert, testifies that specific behaviors or symptoms are “of significance” or “consistent with” sexual abuse, thereby implying an expert credibility judgment.

E. Rule 401 Relevance and Rule 403 Unfair Prejudice

Under Rule 401:

• Evidence is relevant if it even slightly helps or harms the likelihood of a fact that matters to the case.

Under Rule 403:

• Even relevant evidence may be excluded if its probative value is substantially outweighed by the risk of:
  • Unfair prejudice,
  • Confusion of the issues,
  • Misleading the jury, or
  • Undue delay or needless cumulative evidence.

In sexual‑assault cases where credibility is central, consistent disclosures to medical professionals typically have clear probative value. Thet confirms that such evidence will rarely be excluded under Rule 403 unless it carries some unusual risk beyond its inherent tendency to incriminate.

VIII. Conclusion

State v. Thet is a significant clarification, rather than a sharp doctrinal shift, in New Hampshire evidence law. It harmonizes the State’s strong prohibition on credibility vouching with the practical realities of medical treatment and the centrality of medical testimony in sexual‑assault prosecutions.

The decision establishes and reinforces several key points:

• A treating physician may testify that a complainant disclosed rape and that the physician responded with referrals or specialized care, without thereby “vouching” for the complainant’s credibility.
• Use of neutral terms such as “trauma history” is not, standing alone, an expert conclusion that abuse occurred—particularly where the doctor is not presented as an abuse expert and is merely describing the patient’s report.
• Victims’ disclosures of sexual assault to medical providers—including in obstetric contexts—are often admissible under Rule 803(4), provided they are pertinent to diagnosis or treatment and sufficiently trustworthy.
• In “he‑said/she‑said” sexual‑assault cases, a victim’s credibility is a fact “of consequence,” and consistent disclosures to a treating physician are generally relevant and not unduly prejudicial under Rules 401 and 403.
• While preservation requirements remain important, the Supreme Court retains discretion to consider unpreserved arguments in appropriate cases and to affirm evidentiary rulings on any valid legal ground supported by the record.

In the broader legal landscape, Thet provides useful guidance for trial courts, prosecutors, and defense attorneys navigating the delicate interface between medical testimony and credibility assessments. It allows juries to hear how and when sexual‑assault victims disclose their experiences to medical professionals and how that shapes their care, while preserving the jury’s exclusive role as arbiter of credibility and safeguarding against disguised expert endorsements of a complainant’s truthfulness.