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) is 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 exam. 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 exam and evidence collection
Survivors have the option of seeking help at a medical facility that provides specialized sexual assault survivor care. These programs, called Sexual Assault Nurse Examiner (SANE) 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 survivors can have seeking help, and they understand the effects traumatic experiences 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 police unless the patient wants you to call. If they choose for the police to be called, they also do not have to speak with them or give them their name. Medical providers should not call the police before talking with the survivor about the type of report they wish to make.
While most medical facilities can make sure a survivor is okay, not all will have a SANE or FNE program. We strongly encourage you to refer any survivor to a medical facility with one of these specialty programs because they will 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.
Survivors 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 the survivor would like to have evidence collected. The MFE does more than collect potential evidence from the survivor’s body so even if the assault occurred more than seven days ago, it is always a good idea to encourage survivors to seek medical care from a trained practitioner who can support them and help them understand their options.
During the exam, the SANE or FNE will ask a survivor 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 to the survivor. The nurse will explain each step to them before they do it, and a survivor 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 police. Whether the police get a survivor’s contact information is determined by the type of report they choose. It is very important you do not allow a police officer to speak with a survivor of sexual assault until they have been fully informed of their reporting options and made their own choice about next steps. They have a right to report anonymously and if they make contact with a police officer before knowing this, then this right is lost.