What to expect from the Sexual Assault Forensic Medical Exam?
TALKING ABOUT THE ASSAULT
Before the forensic examiner begins the exam, you will be asked to give detailed information about the sexual assault. This can be difficult, so take your time and request what you need from the rape crisis counselor advocate or the forensic examiner in order to feel more comfortable.
The police officer and forensic examiner will want to know exactly what kind of sexual acts were performed and how many times so that they know how best to collect evidence. You have the option of using pictures to help tell what happened rather than describing the sexual acts in detail. You are not expected to know all of the medical terms, so do not be afraid to ask for explanations. Remember to let the rape crisis counselor advocate, forensic examiner, or police officer know if you feel uncomfortable and need to take a break. At any time, you maintain the right to stop the questioning or examination.
Your rape crisis counselor advocate is there to support your decisions, make sure your rights are being respected, and answer any questions that you may have.
TALKING ABOUT YOUR HEALTH HISTORY
The forensic examiner will then ask you general questions about your overall health, including your menstrual history, usual method of contraception, and the last time you had consensual sex. This information is useful for the examiner to know how best to examine you and provide appropriate medical care.
THE PHYSICAL EXAMINATION AND EVIDENCE COLLECTION
You will then be taken to a private examination room and given a robe to wear for the exam. If you are wearing the clothes you wore at the time of the assault, there is a good chance the forensic examiner will take them to give to the police in a sealed bag for evidence. Clothing worn at the time of an assault often provides excellent biological evidence, such as hair, fibers, or blood, which can be analyzed using DNA technology. If you didn’t bring a change of clothes with you, the rape crisis counselor advocate can provide you with clothes to wear upon leaving the hospital.
Next, the forensic examiner will take your blood pressure, pulse, and temperature. They will thoroughly examine your body for physical injuries, so be sure to say if you are experiencing any soreness, pain or discomfort. Any visible injuries that you have will be photographed with your permission. Keep in mind that sometimes it can take 6-21 days after the injury for bruises to appear on your body. If this happens, call the detective handling your case to request that additional photographs be taken.
Following the general examination, the forensic examiner will perform a pelvic exam almost identical to what you might have received from your own doctor during a gynecological exam. If you have never had a pelvic exam, be sure to tell the examiner so that they can help you feel more comfortable. You will be asked to lie flat on the examining table, place your legs in footrests with your knees apart, and slide your body to the edge of the examining table. To make the exam more comfortable, try to relax your stomach and back muscles, close your eyes, and breathe deeply. Ask your rape crisis counselor advocate for whatever support you need— they are there to hold your hand if you want, answer any questions you may have, and communicate your needs to the examiner as you would like.
The pelvic exam will include taking swabs of the fluids in your vagina. A swab of your rectum might be taken, depending on the type of assault. A special microscope with a camera attached to it, called a colposcope, may be used to take pictures of any external and internal injuries, bruises or microscopic tears in your vagina. The examiner may also take fingernail scrapings and samples of hairs from your head and pubic area. A special UV lamp may be used to detect semen or saliva on your body that can be sampled for evidence. The exam may also include taking blood and urine samples and mouth swabs for forensic testing purposes. The forensic examiner will do a pregnancy test for all female survivors.
The sexual assault evidentiary exam does not include a pap smear or actual testing for sexually transmitted infections (STIs). You will need to seek follow-up medical care at a doctor’s office or clinic for these purposes. Please see the section called “Who can help me?” for listings of free clinics and hospitals.
AFTER THE EXAMINATION
After the exam, the forensic examiner will offer you medication to treat you for certain sexually transmitted infections (STIs) that you might have been exposed to during the assault. You will also have the option of taking emergency contraception, sometimes called “the morning after pill,” which can significantly reduce the risk of pregnancy.
After the exam and interview are finished, the rape crisis counselor advocate will ask if they can follow up with you in a couple of days to see how you are doing and offer to connect you with additional services, such as counseling. If a friend or relative took you to the hospital, you may now go home with her/him. If no one accompanied you to the hospital, the police officer will take you back home or to a safe location.
FOLLOW UP
You should plan to schedule follow-up appointments with your regular doctor, a health clinic or the hospital.
Your first follow-up appointment should be made two weeks after your evidentiary exam. This appointment is necessary for taking follow-up tests for gonorrhea, chlamydia, pregnancy, and HIV/AIDS. This is also your opportunity to receive any additional medical care you need, like a pap smear, full gynecological exam, and vaccinations.
Your second follow-up appointment should be made six weeks after your emergency room examination. At this appointment, you should test for syphilis, HIV/AIDS, and take a final pregnancy test.