Violence and Abuse
Rape, also called sexual assault, is any kind of sexual activity committed against someone’s will. Whether the rapist uses force or threats of force is irrelevant. Rape, as a legal term, is defined slightly differently in each state. Most state laws define rape in terms of penetration with the use of force and without the person’s consent. Penetration can be with the penis, fingers, or instruments like bottles or sticks. It can be perpetrated in the vagina, anus, or mouth.
The National Violence Against Women Survey reports that almost 18 percent of women said they have been the victim of a completed or attempted rape at some point in their lifetime, and most women were raped by someone they knew rather than a stranger.8 Rape can happen to us at any age, but girls and young women are at particular risk. In this same survey, which interviewed only women over eighteen, almost 22 percent reported that they were younger than age twelve when they were raped, and over half were under age eighteen.9
When we are raped, survival is our primary instinct, and we protect ourselves as best we can. Some women choose to fight back; others do not. Choosing not to fight back is also a survival strategy.
Although most rapes are perpetrated by men, women can and do rape other women. Women who are raped by women may feel isolated and confused, because we may have thought that only men can commit rape. (For information and resources, see Woman-Woman Rape on the companion website.)
Medical Considerations if You Have Been Raped
If you have been raped, it is critical for your physical and emotional health to receive medical attention as soon as possible, even if you have no obvious injuries. Your first reaction might be to take a shower and try to forget what happened. That is understandable, but you may wash away evidence that could be crucial if you want to prosecute the rapist. Even if you do not think you want to press charges right now, you could change your mind in a few months or years. If you have evidence collected, you can always use it later. Collecting evidence involves going to a hospital and asking to have a rape kit done. A rape kit is designed specifically for collecting evidence of sexual assault, including semen and blood.
If you go to the hospital:
Ideally, when you go to the hospital, an advocate from your local rape crisis center should meet you there. You should also ask to see a trained sexual assault nurse examiner in the emergency room.11 Some hospitals have specialized programs staffed by nurses or doctors who have received extensive training in the medical, legal, and emotional issues associated with sexual assault. The programs are designed to provide sensitive medical exams and the best evidence possible for prosecution.
- Try to have a friend, relative, or rape crisis counselor go with you as an advocate.
- Be aware that most states have passed legislation to assure that rape exams are free of charge.
- Bring a list of medications you are taking; a change of clothing if you are still in the same clothes; or the clothing that you were wearing during the assault, if you have changed your clothes.
Rape can cause physical injuries to any part of the body. Therefore, you should request a thorough examination that includes and/or results in the following:
- A verbal history of the sexual assault and related medical concerns. You will be asked to give a detailed description of the assault, which will be written down. Although it may be difficult to talk about these details, they are important so that the medical provider will know where to check for injuries and what evidence to document, such as bruises, scrapes, or other injuries. Do not answer irrelevant questions about your sexual history or any past therapy, since the perpetrator’s defense might try to gain access to your records later.
- A pelvic exam. In collecting evidence, the practitioner will look for the presence of semen if you were raped by a man. However, semen may not be present after a vaginal or anal rape. The practitioner will also comb your pubic hair for the possible presence of the perpetrator’s pubic hair. This medical evidence will be made available to police or others only with your written permission. You or the person with you at the hospital should check the record for accuracy and objectivity as soon as possible after the exam. Try to do this while the doctor is still present. If you were raped vaginally, see p. 589 for more information about a pelvic exam. You will receive a rectal exam if you were raped anally.
- Examination and treatment of any external injuries. The practitioner will examine you for any external injuries and may photograph bruises or other marks to document the assault. If bruises emerge after the exam, take pictures of them and call the examiner so the information can be added to your record.
- Treatment for prevention of sexually transmitted infections (STIs). The practitioner will recommend giving you two shots of an antibiotic in your buttocks. Some STIs are not detectable until six weeks have passed, so it is a good idea to return for a six-week checkup (see Chapter 15, "Sexually Transmitted Infections").
- Treatment for prevention of pregnancy. If it is possible that you will become pregnant as a result of the rape, the doctor or nurse may offer you emergency contraception (sometimes called "the morning-after pill"). In some states, emergency contraception is available in pharmacies without a prescription (see Chapter 18, "Birth Control"). A pregnancy resulting from rape cannot be detected until several weeks later. If you become pregnant, see Chapters 19, "Unexpected Pregnancy," and 20, "Abortion."
- Information about AIDS/HIV. It is possible to be infected by HIV through a sexual assault. To treat potential HIV infection, you need medication immediately. Although not available everywhere, there are promising new treatments that help prevent HIV infection if taken right away. However, these drugs are controversial and should be taken only after they are fully explained to you. If you are offered testing for HIV, be aware that immediately after the assault is too soon for HIV antibodies to show up. Also, the test results could become part of your medical and legal record. (For more information, see Chapter 16, "HIV and AIDS.")
- A follow-up exam. Although you may feel physically recovered shortly after the rape, a follow-up visit that includes tests and treatment for STIs and a pregnancy test, if indicated, is an important part of taking care of yourself.
Excerpted from the 2005 edition of Our Bodies, Ourselves, © 2005, Boston Women's Health Book Collective.
8. Tjaden and Thoennes, Full Report.
11. Sexual Assault Resources Service and Sexual Assault Nurse Examiners Program.
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