<p>This narrative review synthesizes existing literature on psychological distress in children undergoing forensic medical examinations (FMEs), with a particular focus on implications for Puerto Rican youth. Although FMEs are medically essential, they often elicit significant anxiety shaped by developmental, trauma-related, procedural, caregiver, and contextual factors. In Puerto Rico, broader structural and sociocultural conditions—including exposure to community violence, natural disasters, socioeconomic adversity, and culturally patterned expressions of distress—may influence how children experience forensic care. Despite the recognized importance of trauma-informed care (TIC) in mitigating distress, empirical research on its implementation in pediatric forensic settings, particularly among Hispanic and Puerto Rican populations, remains limited. Educational preparation appears to be a promising strategy for reducing anticipatory anxiety by enhancing predictability, control, and caregiver involvement, although supporting evidence is largely drawn from broader pediatric procedural literature. The review identifies critical gaps in culturally responsive and intervention-focused research, underscoring the need for contextually grounded trauma-informed strategies to support Puerto Rican youth undergoing FMEs.</p>