Sexual Assault

Sexual assault occurs when a perpetrator intentionally touches another in a sexual manner without consent. In other words, sexual assault (SA) occurs when an individual chooses to take advantage of their power (physical, social, emotional) to coerce or force a sex act. Sexual assault is the act of the attacker, not the victim.

People who are particularly at risk for sexual violence are those who are physically or socially vulnerable already. Women, children, elderly, and LGBTQ+ individuals are at greatest risk of becoming victims. While we may rightfully consider SA to occur when a man forces sexual acts on a woman, it can originate from any gender and victimize any age. Most cases of sexual assault are perpetrated by someone known to the victim.

The nature of sexual assault and mental trauma may result in a delayed call for help. Often there are few if any immediate life threats. Slow down your assessment and treatments and take every opportunity to give the SA victim back their agency to direct treatments. Be an advocate for them. Do not pressure them into assessments, treatments, or decisions that they are not comfortable with.

Some tips for caring for a victim of sexual assault:

• Be an active listener. Let them have the last word. If they raise their voice, lower yours.
• Let them express their emotions. You may see emotions ranging anywhere from anger to laughing and anything in between. The emotions may not be what you would expect, but this is not your place to judge or second guess what has happened. Simply provide the space for them to express whatever it is they feel.
• If they choose not to cooperate – that’s okay. Set boundaries only as necessary, such as if they become a physical harm or threat to themselves and others.
• When treating injuries, allow them to participate in their own care and provide them with supplies such as gauze or band aid as needed. When there are no life threats, let them lead the treatment.
• Tell them everything you are doing before you do it and ask for their permission or if they have any questions prior to beginning.
• If they want to change clothes, let them, this grants them back their autonomy. Remember, they are patients first and evidence second. Evidence on clothing whether it’s on the body or off the body is still evidence, nonetheless. However, first look for evidence of clothes being worn inside out or backwards and notate those findings, because that is evidence too.
• Save all clothing and transport them to the hospital.
  • Place items in a paper bag if available – long term storage of biologic material in plastic bags promotes growth of mold which can degrade evidence.
• There is no rush for the victim to report the assault. DNA evidence can be collected days later. There is time to decide.
  • Vaginal swabs should be collected within 5 days of the assault.
  • Oral or anal swabs should be collected within 24 hours of the assault.
• A sexual assault examination does not equate to reporting. Reporting is solely up to the adult victim of competent decision-making skills. The examination at very least can find, prevent, and treat STIs.
• Sexual assault of a child or minor comes with a few differences in protocol such as the following:
  • There must be mandatory reporting to police and child protective services.

Use the following statements as a guide for communication:

“None of what happened to you is okay. I’m here to help. You are in control now. You get to decide what care you want. You get to say “no” to anything that makes you uncomfortable. There are people with specialized training in this that are highly sensitive to your needs and will help you in every way possible. Right now, I am here to help you, and I hear you and see you. I care about your safety and well-being.”