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. It is important to understand that because of the stigma and shame survivors may be feeling, as a supporter to the survivor they will need time to process their experiences and may not feel 100% comfortable opening up about everything that happened. Therefore, the best option would be to encourage them to seek support and assistance from resources specializing in sexual assault trauma.
“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.
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.
There are specialized programs in the State of Colorado called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nurse Examiner (FNE) programs.
These programs employ forensic nurses who receive specialized, extensive training in trauma, working with patients who have experienced sexual assault, the requirements of evidence collection, and how to provide expert testimony. We strongly encourage you to refer your clients to a SANE or FNE program if they would like to seek medical care.
Why is it important to encourage survivors to seek medical care at one of the SANE or FNE programs in the state?
Nurses in these programs are trained to understand the difficulty survivors can have seeking help, they understand the effects such a traumatic experience can have on them, and their reporting options.
They can speak with survivors confidentially about what happened and talk with them about their options and how they can help.
Speaking with a medical provider should not trigger a call to law enforcement (if the survivor is between ages 18-69) unless they want the medical provider to call. If a survivor chooses for law enforcement to be called, the survivor does not have to speak with or even give law enforcement their name.
Who authorizes a medical forensic exam and when can they be performed?
Medical Forensic Exams (MFEs) are optional. If the survivor wants one, the nurse must provide one. In general, MFEs are best performed within seven days of the assault. 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.
What happens during the medical forensic exam?
During the MFE, a nurse will ask about what happened, collect potential evidence from the body, and recommend any additional treatment. After the exam, the MFE is sent to a crime lab. The MFE can take anywhere from around 2-8 hours and it moves at a pace that is comfortable for the survivor. The nurse will explain each step before they do it. Survivors can 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”). It is optional to add the survivor’s name to the evidence so if the survivor is concerned about their confidentiality you can let them know that it is not required. Afterwards, the evidence is sent to the police who will either store it or deliver it to a lab to get tested depending on the survivor’s reporting choice.
Part of your role as an advocate, medical provider, or mental health professional can be to ensure a law enforcement officer does not try to speak with a survivor of sexual assault until the survivor has been fully informed of their reporting options and made their own choice about next steps. Survivors have a right to report anonymously. Also keep in mind that survivors may not be able to communicate in English and it is important to be culturally sensitive. If they make contact with a law enforcement officer, then their right to remain anonymous is lost. Some law enforcement may not know laws related to sexual assault if they don’t work sex assault cases often. It is important for professionals working with survivors to become familiar with Colorado laws surrounding sexual assault so you can inform survivors accurately.