What is a Medical Forensic Exam?
Moving Away From “Rape Kits”
While “rape kit” is often heard in the media and on television crime shows, this term is not trauma-informed or supportive to an individual in crisis. It also does not fully encompass the spectrum of care given in a medical forensic exam and may discourage individuals who do not identify with the term “rape” from seeking medical care.
“Medical forensic exam” is a broad term used for specialized medical care following a disclosure or suspicion of sexual assault. There are many aspects of care that may or may not be included in the exam. Care (or medical actions) are determined by the patient’s history, choices, and risks versus the benefits from a medical standpoint.
“Evidence collection” is one action that may or may not be appropriate within a medical forensic exam. If it is appropriate, and the patient consents, a sexual assault evidence collection kit may be used to collect evidence. If a sexual assault evidence collection kit is utilized, it is given to law enforcement for storage and/or testing.
These terms more accurately encompass the spectrum of sexual violence, as well as the comprehensive care received during a medical forensic examination. However, it is not uncommon for survivors to use the term, “rape kit,” and it is important that professionals are able to provide accurate education about the medical forensic examination and evidence collection.
Your friend, family member and/or loved one has the option of seeking help at a medical facility that provides specialized sexual assault survivor care. These programs, called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nurse Examiner (FNE) programs, employ specially trained nurses who can work with survivors to document the assault and make sure they are okay. They can also work with survivors to collect evidence, if they would like.
Nurses in these programs are trained to understand the difficulty your friend, family member, and/or loved one might be having seeking help, and they understand the effects such a traumatic experience can have on them. They can speak with them confidentially about what happened and talk with them about their options and how they can help. Speaking with one of these nurses (or any medical provider) should not trigger a call to the law enforcement unless they want the medical provider to call. If your friend, family member, and/or loved one choose for law enforcement to be called, they also don’t have to speak with them or give them their name.
While most medical facilities can make your friend, family member, and/or loved one is okay, not all will have SANE or FNE programs. We strongly encourage you to suggest your friend, family member, and/or loved one to visit a medical facility with one of these specialty programs to receive expert care and advice tailored to their specific concerns and circumstances. These specialty programs also understand the laws designed to assist survivors and cover their medical fees if they do not wish to use, or do not have, health insurance.
The exam is called a medical forensic exam (MFE), but you may know it as a rape kit. Your friend, family member, and/or loved one cannot be refused an MFE if they want one and law enforcement does not authorize its use. However, most MFEs are best performed within seven days of the assault if a survivor would like to have evidence collected. The MFE does more than collect potential evidence from your friend, family member, and/or loved one’s body. Even if the assault occurred more than seven days ago, it is always a good idea to encourage them to seek medical care from a trained practitioner who can support them and help them understand their options.
During the exam, the nurse will ask your friend, family member, and/or loved one about what happened and collect any potential evidence from their body. This process can take a few hours and it moves at a pace comfortable for your friend, family member, and/or loved one. The nurse will explain each step before they do it, and your friend, family member, and/or loved one can agree to or decline any part of the exam they don’t like.
The evidence collected is stored in an envelope (a “kit” or “sexual assault evidence collection kit”) and given to the law enforcement. Whether law enforcement is given your friend, family member, and/or loved one’s contact information is determined by the type of report they choose. If you are at the hospital with your friend, family member, and/or loved one, you can provide support in ensuring their wishes are respected by law enforcement. Because survivors in Colorado have the right to report anonymously, if they make contact with a law enforcement officer before knowing this, then this right is lost.
A note on mandatory reporting for medical providers:
Under Colorado law (C.R.S. §12-36-135 (1)), any injury occurring due to a suspected criminal act must be reported to the law enforcement agency in the treating facility’s jurisdiction. However, with sexual assault, medical providers should make a report based on the survivor’s choice (law enforcement report, medical report, or anonymous report detailed below). Colorado law (C.R.S. §18-3-407.5) allows for the survivor to have evidence collected at no cost without reporting to law enforcement. If the survivor does not have evidence is collected, then sexual assault is not a mandatory report unless the medical licensee believes there is serious bodily injury (like strangulation or a gun-shot wound).
Under Colorado law (C.R.S. §18-6.5-108), medical providers (and other specified professionals) are required by law to report physical abuse, sexual abuse, caretaker neglect, and exploitation of at-risk elders and at-risk adults with intellectual and developmental disabilities (IDD). An at-risk adult with IDD is a person who is eighteen years of age or older who has an onset of an intellectual and developmental disability before the person is 22 years old. An adult with IDD has an I.Q. of 70 or below and/or has significant limitations in the ability to socialize, provide self-care, or communicate. IDD includes autism spectrum disorders, epilepsy, cerebral palsy, developmental delays, Down Syndrome, fetal alcohol syndrome, and other disorders.