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Sexual Assault Exam

By

Megan Freedman

What is a sexual assault exam?

A sexual assault exam is a medical procedure conducted after a sexual assault of a woman, a man, or a child. The exam includes diagnosing and treating injuries, infections, and other problems resulting from the assault. A sexual assault exam also involves collecting DNA and other legal evidence of the assault.

A sexual assault exam is a specialized examination of your physical and psychological condition after you have experienced a sexual assault. It can help you recover more quickly from physical and psychological trauma after a sexual assault. It will also preserve the evidence that the court system may need to convict the perpetrator. 

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You may request to have a sexual assault exam, or the police may ask you to have one if you report a sexual assault. However, having a sexual assault exam does not mean that you will have to press charges or testify in a case against the person who assaulted you. 

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Every U.S. state must offer sexual assault exams to people who experience sexual violence, regardless of whether they want to report or prosecute the crime. The primary goal of the exam is to preserve your health and help you recover after an assault.

Why is a sexual assault exam performed? 

Police and healthcare providers recommend a sexual assault exam after a sexual assault. The exam includes diagnosing and treating injuries and other problems resulting from the assault. 

Injuries may include visible injuries such as broken bones and skin tears, as well as less obvious injuries including internal bleeding, damaged internal organs, and concussion. Other problems include psychological trauma and a risk of pregnancy and sexually transmitted diseases.  

Sexual assault exams are also performed to collect evidence of a sexual assault from your body and clothing. The authorities can use this evidence to find or prosecute the perpetrator of the assault.

Who performs a sexual assault exam?

A healthcare provider trained to conduct sexual assault exams performs a sexual assault exam. Your healthcare provider might be a sexual assault forensic examiner (SAFE), a sexual assault nurse examiner (SANE), or one of these types of doctors:

  • Emergency medicine doctors specialize in emergency care of people with serious and life-threatening illnesses and injuries.

  • Primary care providers including internists, family medicine doctors, and pediatricians offer routine and specialized healthcare and treat a wide range of illnesses.

How is a sexual assault exam performed?

You should not shower, change clothes, or eat or drink anything before your sexual assault exam if possible. This helps preserve the evidence of the assault. Evidence can still be collected and you can still be treated if you have done one or more of these activities.

Your sexual assault exam will be performed in a hospital or outpatient setting. The sexual assault exam generally includes these steps:

  1. You may be provided with a support person, such as a specially trained social worker, who will stay with you throughout the process if you choose.

  2. Your provider will talk with you about your health history, your current medication usage, your menstrual cycle (for females), and details about the sexual assault. This includes pain and possible injuries.

  3. Your clothing will be collected as evidence. You will wear a patient gown during the examination and given new clothing to wear home after the exam.

  4. Your provider will carefully examine your entire body to identify and evaluate possible injuries. Your provider may perform imaging tests and other tests as needed to diagnose injuries.

  5. Your provider will treat your injuries.

  6. Your provider will perform a detailed exam of the mouth, anus, and male or female genitalia and reproductive organs. For females, this includes an internal pelvic exam.

  7. Your provider will collect tissue and fluid samples to preserve DNA and other evidence of your assault. Samples are collected from inside your mouth, anus, and vagina or penis. A blood sample and scrapings from underneath your fingernails are collected as well.

  8. Your clothing, photos, fluid and tissue samples, and a record of the exam are sealed in a special sexual assault kit that preserves the chain of evidence for the police. This is important if you chose to prosecute the offender.

  9. Your provider will give you medications to treat pain and prevent pregnancy and sexually transmitted diseases. You will receive phone numbers and other resources for people and organizations who can help you navigate the legal and emotional challenges of a sexual assault.

  10. You may go to the bathroom, take a shower, and get dressed after the exam.

  11. A police officer with training in handling sexual assault cases will take the sexual assault kit and offer to talk with you. You are not required to report the crime or discuss it. You will be given instructions for what to do if you decide to report it later.

  12. You can go home right after the exam if you do not have serious injuries. A hospital stay may be needed to treat serious injuries.

Will I feel pain?

Your physical and emotional comfort is important to your care team. It can be difficult to have a sexual assault exam after sexual assault. Remember that a sexual assault exam is not meant to cause you further pain or psychological trauma. The goal is to help you recover as fast as possible and prevent further problems, such as sexually transmitted diseases. 

You may have some discomfort caused by mild pressure from the examiner’s hands, or the devices, such as a speculum used to widen the opening to your vagina. Take a few long, deep breaths to help yourself relax. Tell your care team if you are in pain or if any discomfort does not pass quickly.

What are the risks and potential complications of a sexual assault exam?  

There are no known risks associated with sexual assault exams. It may be emotionally painful or embarrassing to talk about a sexual assault and to be examined and photographed. 

There are many organizations and resources available to help your physical and emotional recovery.  Your healthcare providers will provide these resources for you before you go home. Remember that your healthcare team and sexual assault resources are available to help and comfort you. 

What should I ask my healthcare provider during or after a sexual assault exam?

Having a medical procedure can be stressful, but it may be especially distressing to have a sexual assault exam and to talk about the assault. You might have questions and concerns about the exam and what happens afterwards. It is important to contact your doctor with questions and concerns before your exam and between follow-up appointments.

Here is a list of questions that might help you. It is also a good idea to bring your list of questions to the exam if possible. Questions may include:

  • Why do I need a sexual assault exam?

  • Is the healthcare provider performing my sexual assault exam a certified sexual assault forensic examiner (SAFE) or a sexual assault nurse examiner (SANE)?

  • How long will the procedure take? When can I go home?

  • Who will pay for this exam?

  • Where will the evidence in the sexual assault kit be taken? What will be done with it?

  • When and how will I receive the results of the samples taken from my body and clothing?

  • What tests or treatments might I need now and later? How will you treat my pain?

  • How can I prevent sexual transmitted diseases and pregnancy? When and how will I know that the prevention measures worked?

  • When and where will I talk to the police? Do I have to talk to the police?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my sexual assault exam?

Knowing what to expect after a sexual assault exam can help you get back to your everyday life as soon as possible.

How will I feel after the sexual assault exam?

A person who has been sexually assaulted may be afraid to go home or to be alone. Your healthcare team and sexual assault recovery team members are available to help and comfort you. Tell your healthcare provider if you do not have a safe place to stay or if you do not have trusted family or friends to stay with you. Your healthcare provider can contact organizations and resources to help you.

A sexual assault exam is a thorough internal and external examination of your body, but you should not feel physically worse after the exam. Tell your care team if you have physical pain or discomfort after the exam. 

When can I go home?

You will probably go home immediately after the exam. You may need to stay in the hospital if you have serious injuries.

When should I call my doctor?

You should keep your follow-up appointments after a sexual assault exam. This is important to prevent sexually transmitted diseases, which may require further testing and treatments. Call your doctor if you have any concerns or questions between appointments.

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 2, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. A National Protocol for Sexual Assault Medical Forensic Examinations. U.S. Department of Justice. https://www.ncjrs.gov/pdffiles1/ovw/241903.pdf.
  2. Preserving and Collecting Forensic Evidence. Rape, Abuse & Incest National Network. http://www.rainn.org/get-information/aftermath-of-sexual-assault/preserving-and-collecting-forensic-....
  3. Receiving Medical Attention. Rape, Abuse & Incest National Network. http://www.rainn.org/get-information/aftermath-of-sexual-assault/receiving-medical-attention.
  4. Sexual Assault Nurse Examiner (SANE) Program: Frequently Asked Questions. Attorney General of Texas. https://www.oag.state.tx.us/victims/sane.shtml#3.
  5. What is a Rape Kit? Rape, Abuse & Incest National Network. http://www.rainn.org/get-information/sexual-assault-recovery/rape-kit.

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