Navigating post-assault medical care: A comprehensive guide for survivors of sexual assault

If you’ve experienced sexual assault, know that you’re far from alone: More than half of people with vaginas will experience sexual assault in their lifetimes. No matter what happened, none of this is your fault.

Surviving sexual violence can impact people in ways that are both visible and invisible, in the short term and the long term, and can have far-reaching effects on physical and mental health. For these reasons, understanding when and how to get medical care is important—whether or not you choose to report the assault to police.

What you’re going through is incredibly challenging, and we’re so sorry you’re here. But remember that you’re never alone. There are many professional and community resources in your corner. To help you through this experience, we’ve created a comprehensive guide on medical care and other forms of support after sexual assault. You don’t have to go through this on your own.

What to do after a sexual assault

You deserve all the time you need to process what you’ve been through. However, it’s important to know that seeking out medical care as soon as possible (but within five days, if you’re an adult) is recommended if you’re considering reporting your assault.

Ensure your immediate safety

After experiencing an assault, the effects of trauma can, understandably, make it really hard to think clearly. As soon as you’re able to, make sure you’re physically safe. Do you need to leave a location or share it with someone you trust? Can you get back home safely on your own or would you like someone to come pick you up? 

Consider what will feel the most supportive for you in that moment and take steps to do that. If you’re in immediate danger, call 911.

Preserve evidence if you plan to report the assault

Your only responsibility after experiencing an assault is to take care of yourself. If part of that process involves reporting the assault to law enforcement, there are some recommended ways to preserve physical evidence.

The Rape, Abuse & Incest National Network (RAINN) suggests, when possible, avoiding the following activities:

• Bathing or showering
• Using the bathroom
• Changing your clothes
• Combing your hair
• Cleaning up the area

Wanting to wash off the physical signs of a recent assault makes a lot of sense. If you want to report the assault, however, preserving evidence can be very helpful. Even if you’re unable to avoid the above activities, you can still get a sexual assault forensic exam (SAFE).

Seek out support

You deserve whatever support you need following assault. Trusted friends and family members can be a great help for processing events. Therapists and support groups can give you the benefit of connecting with compassionate individuals who have distance from your daily life. In some cases, it may feel safer talking to people who aren’t close to you. What feels the most supportive is different for everyone.

If you’re considering pressing charges, go to a sexual assault service provide within 72 hours of the assault. This way, it’ll be easier to collect physical evidence.Evidence can be collected up to 5 days after an assault- but the earlier the better. Regardless of your decision on whether to press charges, it’s important to seek out medical care.

Understand the importance of medical care following a sexual assault

After a sexual assault, there can be short-term and long-term effects that may or may not be visible to the eye. Seeking out a compassionate, trauma-informed healthcare provider can help you manage all of it.

Physical injuries may include:

• Scratches
• Bruises
• Welts
• Fractures
• Head and facial trauma
• Lacerations

Sexual violence of any kind can also contribute to mental health conditions. These may include:

• Depression
• Post-traumatic stress disorder (PTSD)
• Panic attacks
• Flashbacks
• Disassociation
• Eating disorders
• Sleep disorders
• Substance use disorders

Once you’re physically safe from further harm, the National Sexual Assault Hotline can connect you with local sexual assault service providers—or you can search their database. If you plan to report the assault, sexual assault service providers can help you collect evidence.

For trauma-informed mental health professionals, you can explore platforms like Psychology Today, Inclusive Therapists, and Open Path. Your health care provider can also refer you to someone.

Good health care providers should be focused on your care and safety—rather than whether or not you’ll press charges. You deserve to feel safe. You also deserve to feel agency over your care, especially after an experience that was outside of your control. You can always ask to work with another provider or seek out other providers if you don’t feel supported.

Know about the risk of sexually transmitted infections (STIs) following a sexual assault

If your assault included vaginal, oral or anal penetration without a barrier method (e.g., condom), there is a risk of sexually transmitted infections (STIs). Because of this, experts recommend getting tested and proactively treated for certain infections. We’ll get into the specifics later in this article.

Know about the possibility of pregnancy following a sexual assault

If your assault included vaginal penetration and ejaculation inside of your vagina and you’re not on any form of birth control, there is a possibility of pregnancy. Navigating this reality on top of the experience of assault can be overwhelming. But there are ways to decrease the chances of getting pregnant and end a pregnancy if one begins, which we’ll cover in a later section.

Medical care and examinations following a sexual assault: what to expect

Here’s an overview of the exams and testing you can expect after sexual assault.

Sexual assault forensic exam (SAFE)

The sexual assault forensic exam (SAFE), or “rape kit,” is an exam where a trained professional collects evidence to identify and charge the person who did the assault. These professionals can be Sexual Assault Nurse Examiners (SANE), Sexual Assault Forensic Examiners (SAFEs), or Sexual Assault Examiners (SAEs). 

Doing a SAFE is 100% your decision. You can still receive treatment for physical injuries even if you don’t feel comfortable doing a SAFE. You can also choose to do a SAFE just in case you want to report the assault in the future.

The exam can take a few hours, but the entire process may be longer than that. How long the evidence is stored for depends on where you receive the exam. This timeline may or may not align with the statute of limitation (how long you have to report the assault).

The “rape kit” used to conduct the SAFE varies by location, but it may include:

• Bags and paper sheets
• Comb
• Forms
• Envelopes
• Instructions
• Blood sample materials
• Swabs

Here’s what you can expect from a SAFE if you choose to do one:

1. Receive immediate medical care for any injuries.
2. Conduct a health history.
3. Discuss the specifics of the assault.
4. Be examined from head to toe and pass over any relevant personal items.
5. Navigate mandatory reporting of the assault if you’re a minor. (Learn about the laws in your state.)
6. Receive preventive treatment for STIs, emergency contraception, and other care that might need follow-up. You may schedule another appointment at the same clinic or go to one of your community’s resources for sexual assault.
7. Learn about your options for reporting the assault.

You can stop your exam at any time or skip any of the steps. Listen to your body, and remember that you get to decide what you’re comfortable with.

STI testing and prevention

According to the Centers for Disease Control and Prevention, initial STI testing after a sexual assault may include:

• Testing for chlamydia
• Testing for gonorrhea
• Testing for syphilis 
• Testing for trichomoniasis (“trich”)
• Testing for bacterial vaginosis
• Testing for yeast infection
• Testing for HIV
• Testing for hepatitis B

STI prevention steps may include:

• Hepatitis B and human papillomavirus (HPV) vaccinations
• Post-exposure prophylaxis (PEP) to prevent HIV transmission within 72 hours if medically indicated
• Counseling for pre-exposure prophylaxis (PrEP) to prevent HIV transmission
• Preventive or Prophylactic treatment for bacterial infections like chlamydia and gonorrhea.

Follow-up STI care may include:

• Physical exams
• Discussion of test results and repeat testing
• Counseling and treatment for contracted STIs

Pregnancy testing and options counseling

You can use emergency contraception within 3-5 days of the assault to decrease the chances of pregnancy. However, most forms (aside from the intrauterine device) only work if they’re used before ovulation.

There is no right or wrong way to respond to a pregnancy after sexual assault. Some people may end their pregnancies, while others want to continue them. You can seek out compassionate, nonjudgmental pregnancy options counseling through your healthcare provider or the All-Options Talkline. For those who would prefer speaking with a spiritual counselor, Faith Aloud offers a nondenominational and supportive clergy line.

If you do end up getting pregnant and want to terminate the pregnancy, it’s important to know that medication abortion may not be the right path forward for everyone. If you want to press charges and want the abortion to be included in the charges, the products of conception may need to be part of the evidence. In those instances, it may be easier to isolate and preserve those products with an in-clinic procedure. Find the most accessible clinics for abortion procedures on I Need an A.

If you are not pressing charges and want to terminate the pregnancy, a virtual provider like Hey Jane will allow you to quickly access treatment from anywhere that feels safe and comfortable to you (no need to wait for an appointment or travel to an in-person clinic) with our team trained in trauma-informed care. 

Treatment for physical injuries

In addition to SAFEs, medical care after a sexual assault may include treatment for visible and internal injuries or trauma. Many survivors of sexual assault, however, do not have physical injuries from their assault. 

For some survivors, interactions with health care providers can be very difficult. Finding providers who approach care through a trauma-informed lens may help.

While all providers should be trained in trauma-informed care, you may feel more or less supported by different providers. If at any point you don’t feel safe or heard, you have the right to stop care and seek out another provider. You deserve to be treated with compassion and respect.

Mental health support and recovery following a sexual assault

Your mental health matters—just as much as your physical health. Here’s how to get the support you need.

Immediate emotional support and crisis intervention

The National Sexual Assault Hotline is available 24 hours a day, 365 days a year to support sexual assault survivors. For those who’ve also experienced intimate partner violence, the National Domestic Violence Hotline is also available 24/7.

If you’re ever in a crisis situation, reaching out to 911 or 988 can help you get the immediate support you need.

Finding the right therapist or support group

The right therapist or support group for managing the mental health effects of assault is different for everyone. You don’t have to stick with the first person or group you meet with. 

Above all else, it’s important to make sure your therapist or group is compassionate, knowledgeable about trauma, and trained in trauma-informed care. 

Keep searching until you find the right therapist or group for you. Psychology Today, Inclusive Therapists, Open Path, and the National Alliance on Mental Illness (NAMI) are great places to start.

Coping strategies and self-care tips

Clinical psychologist and sexual violence support expert Elizabeth L. Jeglic PhD shared coping strategies and self-care tips after an assault in an article published on Psychology Today:

• Seek out mental health support: Dr. Jeglic specifically recommends cognitive behavioral therapy (CBT) or trauma-focused CBT for young people and CBT or eye movement desensitization and reprocessing (EMDR) therapy for adults.
• Practice mindfulness: Breathing exercises and mindful meditation can help with mental health symptoms.
• Seek out social support: Dr. Jeglic cites research demonstrating that having a social support system (family, friends, and community) can help protect people against the possibility of negative outcomes after sexual assault.
• Incorporate self-care: Quality sleep, balanced eating, and regular exercise (including mindful walks in nature) can help with managing difficult symptoms.
• Ground yourself: It’s common after an assault to feel disconnected from your body. Grounding strategies like the “5 senses technique” can help. 

Navigating the health care system

Here’s what you need to know about navigating the health care system as a sexual assault survivor.

Understanding your rights as a survivor

Most importantly, know that you have the right to respond to your assault however you want to. You’re not required to report the assault or press charges. However, if you’re a minor and disclose the assault to a mandated reporter, they will be required to notify authorities.

Law-based rights for survivors vary by state and situation:

• All states have victims’ rights laws that require you to be treated with fairness, dignity, and respect.
• In many states and Washington, DC, survivors have the right to know where their physical evidence is being stored and where it is in the process.
• If your assault happened on federal property (e.g., in a federal building or on federal park land), 2016 federal law gives you the right to have your SAFE results preserved through the statute of limitations, know your forensic results, and know when your evidence may be destroyed.

Resources for covering the cost of medical care

No survivor of sexual assault should have to pay for medical care. Unfortunately, that’s not always the case. However, the Violence Against Women Act (VAWA), which was reauthorized in 2022, provides funding to prevent this from happening.

If you receive care through one of the sexual assault services providers listed by RAINN, that should limit out-of-pocket costs. Coverage of care beyond evidence collection varies by state and insurance status. Your state’s Crime Victims Compensation Board may be able to help.

How advocacy services can help

Survivor advocates aren’t mandated reporters. Their one-and-only job is to support you through whatever you need. This may include going with you to appointments, helping you find safe housing, and providing you with compassionate emotional support.

If you don’t have someone in your life who you feel comfortable accompanying you to get medical care, or you think you might otherwise benefit from advocacy services, the National Sexual Assault Hotline can refer you to an advocate.

Long-term health considerations following a sexual assault

Here’s some of what you can expect in the weeks, months, and years after your assault.

Ongoing care for physical injuries

Sometimes physical or mental health effects may show up weeks or months after an assault. Later possible effects can include chronic pelvic pain, painful periods, or issues with sex. If any of these come up, or you have any concerns related to your reproductive or sexual health, know that your health care provider is always there to support you.

Continued STI testing and monitoring

When it makes sense based on your health history, the circumstances surrounding the assault, and symptoms, you may continue being tested and monitored for STIs.

Recognizing signs of PTSD and seeking help

After an assault, feeling stress, anxiety, or other uncomfortable emotions is common. When symptoms become more severe or disruptive, they could be signs of PTSD. PTSD can be caused by any kind of trauma, including sexual assault.

Possible signs of PTSD include:

• Flashbacks
• Dreams of the assault
• Intrusive thoughts
• Avoidance of situations that are linked to the assault
• Losing interest in activities
• Feeling on edge
• Difficulty sleeping
• Startling easily
• Sudden outbursts

Working with a mental health professional who specializes in trauma can help you better manage these symptoms.

The importance of regular check-ups and self-care

Recovery and healing are ongoing processes without specific timelines. Seek out support when you need it—and remember to incorporate as much self-care as possible into your daily routine.

The most timely consideration after sexual assault is collecting evidence within 72 hours- but it is possible to collect up to 5 days. Once you’re in a physically safe space and ready for support, you can reach out to the National Sexual Assault Hotline for help finding a sexual assault service provider near you. Medical care and mental health support are important regardless of whether or not you choose to press charges.

Although none of this is your fault, this may be an incredibly challenging time for you. Know that there are many professional and community resources in your corner.

All of us are more resilient than we may realize. If you need someone to listen, offer support, and hold your hand through this experience, know that Hey Jane’s team of providers is always here for you. You will get through this.

Resources for care following a sexual assault

• All-Options
• Faith Aloud
• Inclusive Therapists
• NAMI Connection
• National Association of Crime Victim Compensation Boards
• National Domestic Violence Hotline
• National Sexual Violence Resource Center
• Open Path
• Psychology Today
• RAINN/National Sexual Assault Hotline
• RAINN tool for finding sexual assault service providers near you
• Safe Horizon
• State resources