Fear can become a weight on minds and bodies, stalling thinking or action. People don’t have to experience a sexual assault to fear it greatly. In the training manual I was given to study how to be an advocate with Rape Response Services in Bangor, I learned that, according to one study, 82 percent of women report they fear rape and/or death more than anything else. And why not? Sexual assaults can cause physical harm, but they also cause long-lasting psychological and emotional scars. Regaining the lost control and power may not happen as quickly as healing bruises or broken bones.
That’s why, as my class discussed Tuesday, the job of advocates is to help survivors process their feelings by listening, remaining grounded and calm, and validating their experiences. By not providing advice or telling survivors what to do, we return some control to them to make decisions for themselves. One tool, in particular, is used at the hospital to corroborate survivors’ stories and, in that way, return to them some feeling of power. That tool is a forensic medical exam, during which a sexual assault evidence collection kit — often called a “rape kit” — may be used. The kit contains tools that may be used to collect DNA left by a suspect. Of course, if survivors wish, they can receive medical care and not do the full forensic exam.
For many survivors, seeking medical attention is terrifying. Adults may think they will have to report their sexual assault to authorities. (They don’t.) They may be embarrassed at the thought of running into someone they know. (They might, but hospitals generally give sexual assault victims priority, second only to patients with life-threatening injuries, and see them promptly; confidentiality is key.) Or they might think they can’t afford it. (Services for victims are free, thanks largely to the Violence Against Women Act and the Victim Compensation Board.) An advocate will encourage survivors to seek treatment, though it’s a decision over which they must have control. Sometimes survivors may have clear physical injuries, or those injuries may not show up until later. Medical staff can assess survivors and address any potentially received sexually transmitted diseases. If it’s their choice, getting medical care can be a significant step for survivors toward reclaiming control of their bodies.
It’s also their choice whether they want a forensic exam — where a trained sexual assault forensic examiner collects evidence that may be used in an investigation and possible prosecution. Even if survivors agree to the head-to-toe examination, it doesn’t mean they are giving police permission to pursue the case. Advocates, who may accompany survivors through their hospital stay, might explain that doing a forensic exam early will preserve evidence that otherwise can deteriorate quickly and that survivors can always decide later whether to report to police.
In order to preserve possible evidence, it’s also recommended that survivors refrain from things like showering, changing their clothes or brushing their teeth — though, of course, it’s natural to want to do so. If survivors have cleaned themselves, though, it doesn’t necessarily mean no evidence remains or that they shouldn’t have an exam. And if they have changed their clothes, they can always bring the original clothes worn during an assault to the hospital. (Ideally the clothes would be brought in a paper bag, as plastic breaks down evidence and doesn’t allow it to breathe.)
An advocate may be in the room with the survivor as the medical professional swabs a survivor’s mouth, nostrils and genitals and collects fingernail clippings and blood and hair samples. The nurse with special training may take a past medical history, including details of the sexual violence, and do an assessment of physical injuries, such as bites, strangulation marks or bruises. The nurse may use a UV lamp to find dried secretions like saliva, blood or semen. It’s important to understand that just because DNA, such as semen, is found on survivors, doesn’t necessarily mean the offender will be convicted of sexual assault. The exam might show sex happened, but it’s harder to prove it was non-consensual. And even if no semen is found, tearing or other marks on the survivor’s body can corroborate their story.
Validating survivors’ story this way can be healing for them, even if the exam itself is intimidating or embarrassing. Also important is the ability of those who encounter survivors after an assault to return the decision-making process to them, to bolster their strength. In the end, taking back control of their body, at their own pace, is the way toward overcoming the fear and suffering so wrongly thrown into their lives.