I’m a Medical Forensic Examiner: What to Expect from a Health Response After a Sexual Assault

A Medical Forensic Examination after a Sexual Assault: What to Expect

An estimated one in five women and one in 16 men in Australia have experienced sexual violence. After such a traumatic experience, it’s understandable that many are unsure if they want to report it to the police. In fact, less than 10% of Australian women who experience sexual assault ever make a police report.

In Australia, there is no time limit on reporting sexual assault to police. However, there are tight time frames for collecting forensic evidence, which can sometimes be an important part of the police investigation, whether it’s commenced at the time or later.

A Team of Specialists

There are about 100 sexual assault services throughout Australia providing 24-hour care. As with other areas of healthcare, there are extra challenges in regional and rural areas where there are often further distances to travel and staff shortages. Sexual assault services in Australia are free, regardless of Medicare status. To find your nearest service, you can call 1800 RESPECT (1800 737 732) or Full Stop Australia (1800 385 578), who can also provide immediate telephone counselling support.

It’s important to call the local sexual assault service before turning up. They can provide the victim-survivor with information and advice to prevent delays and make the process as helpful as possible.

Collecting Forensic Samples

Samples collected during a medical forensic examination can sometimes identify the perpetrator’s DNA or intoxicating substances (alcohol or drugs that might be relevant to the investigation). The window of opportunity to collect these samples can be as short as 12 hours, or up to 5–7 days, depending on the nature of the sexual assault.

In most of Australia, an adult who has experienced a recent sexual assault can be offered a medical forensic examination without making a report to police.

How about STIs and Pregnancy?

During the consultation, the doctor or nurse will address any concerns about sexually transmitted infections (STIs) and pregnancy, if applicable. In most cases, the risk of STIs is small. But follow-up testing at 1–2 weeks for infections such as chlamydia and gonorrhoea, and at 6–12 weeks for infections such as syphilis and HIV, is usually recommended.

Things Have Improved Over Time

When I was a junior doctor in the late 90s, taking forensic swabs was usually the responsibility of the busy obstetrics and gynaecology trainee in the emergency department, who was often managing multiple patients and had little training in forensics. There was also usually no supportive counsellor. Anecdotally, both the doctor and the patient were traumatised by this experience. Research shows that when specialised, integrated services are not provided, victim-survivors’ feelings of powerlessness are magnified.

But the way we carry out medical forensic examinations after sexual assault in Australia has improved over the years. With patient-centred practices, and designated forensic and counselling staff, the experience for the patient is thought to be empowering rather than re-traumatising.

Our Research

In new research published in the Australian Journal of General Practice, my colleagues and I explored the experience of the medical forensic examination from the victim-survivor’s perspective. We surveyed 291 patients presenting to a sexual assault service in New South Wales over four years.

Some 75% of patients reported the examination was reassuring and another 20% reported it was OK. Only 2% reported that it was traumatising. The majority (98%) said they would recommend a friend present to a sexual assault service if they were in a similar situation.

While patients spoke positively about the care they received, many commented that the sexual assault service was not visible enough. They didn’t know how to find it or even that it existed.

Conclusion

Many victim-survivors don’t present to a sexual assault service or undergo a medical forensic examination after a sexual assault. So we need to do more to increase the visibility of these services.

The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.

FAQs

* Is there a time limit for reporting sexual assault to police?
+ No, there is no time limit in Australia.
* Can I have a medical forensic examination if I don’t make a police report?
+ Yes, in most cases, you can have a medical forensic examination without making a police report.
* What happens during a medical forensic examination?
+ A doctor or nurse will take a history of the assault, collect forensic samples, and provide medical care and counseling.
* How can I get help after a sexual assault?
+ You can call 1800 RESPECT (1800 737 732) or Full Stop Australia (1800 385 578) for immediate telephone counselling support.