Understanding the Medical Exam

A medical exam can be conducted any time after an assault. That said, rape kits can only be collected up to 5 days after the assault, and toxicology tests (for drugs) up to 4 days after. Date rape drugs can leave the system between 12-72 hours after consumption. HIV prophylaxis needs to be started within 72 hours.  Emergency contraception can be taken within 5 days, but is more reliable the sooner it is taken.  

At the hospital, you will be asked questions about your general health. You will also be asked specific questions about the assault. It may be difficult to recall some of the details, and it may be emotionally painful to talk about what happened. Medical providers ask specific questions to find out what to look for when they examine you. The information you give helps them conduct a thorough physical evaluation.

Then you can choose to have a general physical exam. The clinician will check for external and internal injuries and test for any sexually transmitted infections. You may be given antibiotics to prevent infection.

Rape Kit

The medical providers will, with your permission, collect physical evidence to be used if you decide to prosecute. Collecting this physical evidence is called a Sexual Assault Evidence Collection Kit, i.e. "rape kit."  Depending on the types of sexual contact that occurred, the search for physical evidence may include taking samples from the vagina, penis, mouth, or rectum to test for sperm cells and semen. Other evidence may be obtained from fingernail scrapings, foreign matter on your body, and the clothes you were wearing at the time of the assault.  The medical provider must ask the survivor if he or she had consensual sex with anyone in the past 5 days who may also have left behind DNA. This step helps determine which DNA was left by a consensual partner and which DNA belongs to the perpetrator.

The kit is a box that contains all the necessary materials to collect evidence. Each kit has a unique number assigned to it. All evidence collected will be placed in envelopes or bags and labeled with this number. You should receive a copy of this number. 

All exam findings are completely confidential and can only be released with your written consent. If you have visible injuries, you may be asked to have photographs taken. Photographing injuries is important because by the time your assailant is prosecuted, the injuries may have healed. 

Going to the hospital does not mean that you have to make a report to the police. That is your choice. The hospital staff will probably ask you to come back for a follow-up checkup. Or, you follow up with a medical provider of your choice. A counselor will be available to talk with you. Additional ongoing counseling will be available to you through the support resources of your choice.

Toxicology Kit

If the survivor or medical provider suspects that a drug was used to facilitate an assault, a blood and/or urine sample may be collected as a part of the rape exam. This is called the "toxicology kit".  The samples in the kit will be tested for the presence of substances, such as drugs and alcohol.  Substances can remain in the blood stream for up to 96 hours after they were ingested.  Many substances leave the body more quickly so a negative result does not mean that a survivor was not drugged. It simply shows that a chemical was not present at the time of the kit collection.  Prescriptions, over the counter medications, alcohol and recreational drugs will be detected with the test.

The toxicology results will generally be available after 12 weeks.  Survivors who reported the assault to police can get the Toxicology results from the Certified Sexual Assault Investigator or the District Attorney handling their case.  Survivors who did not report the assault to the police can access the toxicology results by calling the Statewide Toxicology Results Reporting Line toll-free at 1-866-269-4265.

Male- versus Female-Bodied Survivors

Rape kits are used for both male- and female-bodied survivors.  Female-bodied survivors will be asked about menstrual history and use of contraception and their physical exam will include a pelvic exam and a pregnancy test.  Emergency contraception pills can be requested if they are not offered.  As for female-bodied survivors, the physical exam for male-bodied survivors checks comprehensively for injury and collects any evidence from areas of the body where the assault occurred.  

Adapted from Brown University Health Education and Forensics for Survivors.