SEXUAL ASSAULT OVERVIEW
Last excerpt from Modern Birth Control Booklet. Reference information included.
Sexual Assault includes forced or coerced sexual behavior or contact that happens without consent. Child molestation, incest (sexual assault by a family member), fondling and unwanted touching through clothing or beneath clothing, rape, attempted rape, sexual harassment or threats, are all included. Additional illegal acts: voyeurism (peeping, watching private sexual acts without consent), exhibitionism (self-exposure in public by either men or women), forcing someone to pose for sexual photos. Half of all women have experienced some type of sexual assault.
Rape is common and often not reported. Approximately 23 million women in the U.S. have been raped: 1 in 6, half of them under the age of 18. Male rape is less common, but reported by about 2 million men, about 1 in 33.
Sexual assaults are most often committed by someone the victim knows: friends, acquaintances, relatives, dates or a partner. Stranger rapes are less common. Many cases of sexual abuse of children go unreported. When this occurs, the child is abandoned to the pedophile without hope of escape. Reporting to law enforcement and child protective services is a legal requirement and may save a life.
The U.S. Department of Justice announced a revision of the Uniform Crime Report’s (UCR) definition of rape in 2012. Without a comprehensive definition, reporting is variable and inaccurate. In the UCR, the definition rape is: The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.
The revised definition includes situations when the victim is not capable of giving consent due to temporary or permanent mental or physical disability. State statutes still determine the ability of a victim to give consent with specific details related to age, age differences between the victim and perpetrator and if drugs were used to incapacitate the victim.
* Be of age to consent (16 – 18 years old depending on state laws).
* Not be impaired mentally or physically (due to drugs, alcohol, illness or disability).
* Not be threatened (re: job, physical harm, rumors), forced, coerced or manipulated into agreement.
What to Do if Assaulted:
* Find a safe place as fast as you can. If you remain in danger, call 9-1-1.
* Do not wash, shower or change clothes.
* Do not change anything at the scene of the attack.
* Bring a change of clothing with you if possible and go to the nearest hospital ER immediately for an exam and evidence collection. (NOTE: Most physicians do not have rape kits and are not prepared to do forensic valuations. ERs are required to do the exam or refer you to a facility prepared to do so.)
* A doctor will perform an exam and document a medical report.
* Either the doctor or a sexual assault forensic examiner (SAFE – often a nurse) will use a rape kit to collect evidence including: swabs of semen, skin swabs, hair samples, saliva and fibers. Your clothing will be collected as evidence and bagged.
* If you believe you were drugged, tell the ER staff so proper testing will be performed. Drugs include: Rohypnol, gamma hydroxybutyrate (GHB), alcohol and other sedatives.
Pelvic cultures are done to document STDs. Blood test baselines record status related to existing disease such as HIV, syphilis, hepatitis and other health issues.
It is customary to treat sexual assault victims with preventive antibiotics that cover most STDs, and to provide Emergency Contraception for women of childbearing age.
Appointment for proper follow-up must be arranged to determine need for further testing, treatment or counseling.
Each case is different. Treatment depends on injuries, psychological state, safety after exam, and personal or family support. Some victims require hospitalization and sedation. Rape injuries can require surgical repair. Safe-house placement may be necessary, or discharge to protective family and friends.
Police reports are essential to prosecute the perpetrator. Officers will come to the ER to obtain a report. Some victims are afraid to report a rapist. The decision to “press charges” is up to the state. Prosecutors may move forward even when the victim does not want to be involved in prosecuting.
For additional legal information see the website for Rape Abuse and Incest National Network (RAINN): https://rainn.org
Local police departments often provide referrals to victims of violence. Safe houses are sometimes available for victims who remain at risk from the perpetrator.
Following a sexual assault most people are left feeling vulnerable, frightened and anxious. Many symptoms are reported. Sometimes issues persist for months or longer. Symptoms of Post-Traumatic Stress Disorder may occur: high anxiety, fear, hypervigilence, poor sleep and depression. Later, abuse of drugs and alcohol may occur along with erratic behavior.
Counseling is very important and should be obtained immediately to begin healing after the traumatic event.
General information: www.womenshealth.gov
National Sexual Violence Resource Center http://www.nsvrc.org 1-800-656-HOPE
Sexual Assault Online Hotline https://ohl.rainn.org/online/1-800-799-HOPE
The Gift of Fear – Survival Signals that Protect Us from Violence Author: Gavin De Becker
Preventing assault may not be possible, but there are steps that could reduce your risk.
* Do not walk alone or walk along talking on your phone or listening to music.
* Be aware of your surroundings and stay in brightly illuminated areas.
* Carry a small canister of pepper spray, readily accessible. (Check local laws.)
* Walk to your car rapidly, get in and lock the doors.
* If you are attending a party, go with at least one friend and stay together. Look out for each other. If people are drinking and you begin to feel unsafe, leave.
* Don’t drink from a punch bowl. Watch your drink at all times to avoid being drugged.
* Make a phone call for help.
* Trust your instincts.
The most effective contraception is abstinence. For most adult men and women that is not an option. For young people who have not yet reached maturity, it is best to abstain from sexual contact until you are sure and fully understand reproduction and contraception.
Unplanned pregnancies in teens are often related to situations where drugs and alcohol were involved and decisions unsound. In drug environments, promiscuity and inappropriate sexual interactions occur more often. This increases risk for sexual assaults and so-called date rapes.
Finding you are pregnant, unmarried and unable to support yourself, places you in an untenable situation. Your future has changed. If you plan ahead, are educated, and understand your actions have consequences, you are ready to make life decisions. That is true for any age.
Because of the high risk of venereal disease with unprotected sex, one action may not just change your future plans, you may find yourself with an incurable disease. Acting responsibly and always using a condom along with an additional contraceptive of choice, you are taking responsibility for your actions.
A woman should be in control of her body and with the information in this pamphlet, I hope both men and women are better prepared to make decisions in their best interest.
Men need to realize “no” means no. Any under-age, drug or alcohol impaired female is not legally capable of giving consent. Intercourse without consent is rape. Rape conviction can carry a long prison term and you will be required to register as a sex offender.
Some contraceptive options are too costly for many people to consider unless they are partially covered by insurance. Some of the more expensive choices are the most convenient, but there are many inexpensive effective choices. Condoms, both male and female, used with spermicide are inexpensive, readily available and when used appropriately are effective contraceptives and reduce STD exposure. The contraceptive sponge is also inexpensive and when used with a condom, effective.
Insurances often cover birth control evaluations and contraceptives. If you compare prices, you will find the cost of birth control pills and contraceptive options vary depending on the source. Large national pharmacies tend to have lower prices. The prices listed in the pamphlet are estimates based on many sources.
Money, convenience, comfort, safety, and long term health are all important factors in contraceptive decisions. Hormonal products are effective and safe for most women but carry some health risks that need to be considered and discussed with your health practitioner.
If you have difficulty seeing a physician, consider choosing a nurse practitioner as your primary care provider.
Publications by Betty Kuffel, MD
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