What to Expect if You’re Considering a Sexual Assault Forensic Exam

Many people only know what happens in hospital rooms after a sexual assault from watching movies. Very few people know what a sexual assault forensic exam actually entails or where it fits into our justice system and the healing of survivors. This article aims to outline the most important aspects of getting an exam done, for the benefit of all survivors and allies, and also provides information on how to become further involved in sexual assault advocacy.

What is a “rape kit”?

• The term “rape kit” is often used to refer to the sexual assault forensic exam that victims can opt into after rape or assault to collect DNA evidence from their body, clothing, and belongings.  They can also be called a Sexual Assault Evidence Kit (SAEK) and will be referred to as such for the rest of the article.

• SAEKs are completely free to have done under the Violence Against Women Act which means that not only is insurance not needed, but parents/guardians won’t be notified unless there is a hospital policy regarding sharing the incident with a minor’s guardian.

• Contents vary by state, but a SAEK generally includes a comb, swabs, blood sampling tools, and evidence collection bags.

• The exam and collection process can take 4-6 hours depending on where you are. It can also be very uncomfortable and traumatic to have someone poking around intimate places after such a traumatic experience - some facilities allow support persons to accompany you, but be aware they may then be called as a witness if you decide to report the crime.

How to prepare:

• If you are opting to have a SAEK done to collect evidence, it is important to avoid “tampering” with evidence. Avoid eating, drinking, using the restroom, showering, changing clothes, or brushing your hair. 

• Although it’s natural to want to go through these motions after a traumatic experience. If you have done any of these activities, you can still have an exam performed. You may want to bring a spare change of clothes with you to the hospital or health facility where you’re going to have the exam as they do not typically provide clothing for survivors to change into (which is what spurred Cor-a’s creation!).

• Kits typically must be done within 72 hours of the incident in order to get reliable evidence.

• You may want to consider having someone else drive you to and from the hospital. While you may not be ready to tell someone what happened or are worried what they will think, it may be worth reaching out to a friend or family member to avoid driving during a traumatic and uncertain time.

Who can perform these exams?

• While any doctor or nurse can perform the examination by following the instructions provided in the kit, some hospitals, like Mount Nittany at Penn State, have specially trained personnel on staff called Sexual Assault Forensic Examiners (SAFEs) or Sexual Assault Nurse Examiners (SANEs) to perform the forensic medical examination. SAFEs and SANEs have completed additional education and training requirements in order to provide the most comprehensive care to sexual assault survivors. Research shows that programs with trained examiners significantly increase evidence collection and investigation in sexual assault cases, which results in significantly higher prosecution rates. Further, SANEs and SAFEs are trained to conduct exams that are sensitive, dignified, and reduce further trauma. 

• To find a location near you that performs sexual assault forensic exams, call the National Sexual Assault Hotline at 800.656.HOPE (4673) or talk to your local sexual assault service provider, which you can find through this RAINN resource.

What happens during the exam?

• IMPORTANT NOTE: YOU HAVE THE RIGHT TO REFUSE ANY PART OF THE EXAM AT ANY TIME.

• Any immediate injuries that need tended to will be taken care of first.

• The nurse will ask about your medical history, as well as your sexual history in order to provide the best care to you.

• The nurse will ask you about the event so they can determine where evidence may be located on your body.

• The survivor stands on a large sheet of paper while undressing in order to catch any hair or fiber evidence that may fall from their body.

• The nurse will then perform a head-to-toe examination. This part of the exam may be based on your specific experience, which is why it is important to give an accurate history. It may include a full body examination, including internal examinations of the mouth, vagina, and/or anus. It may also include taking samples of blood, urine, swabs of body surface areas, and sometimes hair samples. The trained professional performing the exam may take pictures of your body to document injuries and the examination. With your permission, they may also collect items of clothing, including undergarments. Any other forms of physical evidence that are identified during the examination may be collected and packaged for analysis, such as a torn piece of the perpetrator’s clothing, a stray hair, or debris.

• Laws regarding mandatory reporting vary state by state and sometimes facility to facility. You can check the laws in your state here.

• Followup care may include preemptive STI treatment or scheduling medical appointments for other injuries.

What’s the benefit of having a SAKE completed?

• Increases likelihood of identifying the perpetrator. Analyzing DNA samples allows forensic scientists to compare the profile of the perpetrator against a large database with thousands of profiles run by the FBI called CODIS, the Combined DNA Index System.

• Increases likelihood of holding perpetrators accountable. If the state presses charges against a perpetrator, DNA evidence will likely carry weight in court. Many cases of sexual violence rely on first hand accounts and other evidence that leaves room for interpretation. DNA evidence helps build a stronger case against the perpetrator.

• Prevents future sexual assaults from occurring. Perpetrators of violence tend to be serial criminals, and sexual violence tends to be a serial crime. When you agree to a sexual assault forensic exam and DNA testing, you increase the chances of taking the perpetrator off the streets and preventing any future instances of sexual violence. Even if the perpetrator is not prosecuted, their DNA will be added to the database, making it easier to connect the perpetrator to a crime in the future.

• DNA evidence is tantamount in identifying, prosecuting, and convicting perpetrators, but you do not HAVE TO have an exam done or DNA evidence to pursue the case. It can strengthen a case to have the exam done and to have a DNA profile on the perpetrator. While the decision to have a rape kit done is a very personal and traumatic one, please be aware that with the current state of society, the decision to not get a kit done or not having DNA evidence collected may influence your case negatively.

• “You know, it's possible to have a rape where no DNA is left. For example, if the suspect wears a condom, if the suspect uses an instrument. If it just happens that the DNA is not deposited there, could not be tested, or is contaminated, there are lots of explanations. On the other hand, don't forget the defense only has to raise a reasonable doubt, and in this era, where people and the jurors expect DNA, it's easier to do if the prosecutors don't have the DNA. …frankly, even though we think that we've advanced to a time of equality, you know, jurors are still very suspicious of the victim. …It's hard to give her the credibility she needs for the prosecution to win the case.”  - Laurie Levenson, a former federal prosecutor. She now teaches at Loyola Law School in Los Angeles.

• Despite DNA evidence being so important, there is a backlog of SAEKs in the US, leading to over 50 million untested kits sitting in storage rooms, keeping cases from being pursued and criminals being put behind bars. States like Pennsylvania have been working hard to end the backlog, thanks in no small part to community organizers and individuals contacting their representatives. Pennsylvania has gone from nearly 3500 kits being untested to less than 200 – an incredible amount of progress, but there are still victims waiting on these tests to pursue justice.

• How can you help with the backlog?

• You can write and call your representatives, urging them to tackle the local backlog.

• Join local efforts like the Rape Kit Action Project.

• Donate to organizations like RAINN and SAKI

• Explore organizations like End the Backlog.

When it comes to the decision whether or not to have a SAEK done, it is entirely up to the victim, but we hope that by knowing what to expect and knowing how to advocate for others helps survivors make an informed and empowered decision in the moments they need it most.