Hospital/ER

Why You May Need to Go to the Hospital

Rape and other forms of sexual assault are, by definition, violent crimes, and victims of these acts are survivors of violence. There is no such thing as non-violent rape. Some sexual assaults also include other forms of physical violence. Just as any violent crime victim might, you may go to the hospital for a few different reasons.

  • To be examined and receive emergency medical care for physical injuries sustained during a crime
  • To have physical evidence collected for a police report or criminal prosecution
  • To be examined for injuries and receive medical care if you are unconscious or drugged and can not make the decision yourself to seek medical care. In rare cases, victims may be transported to ERs by EMTs or police.

Choosing to go to the hospital after a rape or assault is entirely up to you. Going to the hospital can allow you to get proper medical care and/or complete a sexual assault forensic evidence kit, which can be used if you choose to report the assault. Evidence collection does not mean that you have to report to the police, but it allows you to do so in the future. You may refuse any exam or treatment offered and you can stop receiving either at any time. Going to the hospital, receiving medical care, and possibly doing a sexual assault forensic evidence kit can take up to a few hours. 

Click here to learn more about going to the police.

Feeling Safe About Going to the Hospital

Going to the hospital may feel scary. ERs can be large and busy, especially in cities, and you may feel overwhelmed when entering them. As a victim of a sexual crime, you may feel unsafe entering into a hospital, or feel an additional loss of control over your body. Here are some things, though, that may reassure you and help give you the courage to seek out necessary medical care.

  • ERs are places with well trained staff who are equipped to treat your injuries and provide you with medical care.
  • In both the United States and Canada, ERs must treat anybody who comes seeking treatment. It is especially important to note that you can visit an ER in the United States and receive emergency care even if you do not have health insurance. 
  • Hospitals are not interested in your immigration status. You should not be asked about it, and should not be afraid to access care even if you are undocumented.
  • ER staff generally have access to translation services in whatever language you speak. You will be able to communicate with your doctor. 
  • You may ask for female medical staff to treat you. This is a common request, and the hospital will do their best to accommodate it. 
  • ERs have dedicated social workers who will be able to help you access other types of services like victim support and counseling. They will offer support for domestic and intimate partner abuse.
  • You will be able to have a loved one remain with you, but will also be able to be seen alone without anybody else present.
  • If you are a minor, you will be able to speak with ER staff without having your parents present, so that you may give any information to them that you want them to have.
  • In both the United States and Canada, all medical personnel are mandated reporters and will report any cases of suspected child abuse or crimes against minors. 

What to Expect at the Hospital

Although the healthcare systems differ between the United States and Canada, the processes that survivors will go through if they go to the hospital tend to be very similar. 

Treating Your Injuries

  • When you first arrive at the ER, you will be asked why you are visiting the hospital. You are then likely to meet with a doctor, nurse, sexual assault nurse examiner (SANE), or a member of a sexual assault response team (SART). 
  • Your medical injuries and physical condition will first be addressed, treating any urgent medical needs first. 
  • You will likely be asked about your medical history, current medications, and pre-existing conditions. If possible, you may want to take a photo of any medication you are using, so that you will be able to remember what the names and doses are. Remember that you are the expert on your own body and health and have the right to tell the medical staff anything important that they need to know.
  • You may receive antibiotics in case the perpetrator had any sexually transmitted infections. 
  • You may also take a pregnancy test. 
  • Sometimes, survivors are brought to the ER when they are unconscious. In that case, you will be brought through a specific Trauma Bay process that will include a complete physical examination that is designed to find any life threatening injuries. You may wake up and find that you have been changed into a hospital gown. Please know that the staff has done everything possible to respect your privacy and to treat you professionally and with respect. 

Evidence Collection

  • You will be told about the process of evidence collection, and given the option to have it performed. If you choose to proceed, you have the right to request that an advocate from your local rape crisis center or other organization be there to support you. Evidence collection is completed using a sexual assault evidence kit, which consists of bottles, containers, a comb, bags for collection, documentation forms, blood sample materials, and swabs.
  • They may ask you for an account of what occurred so they know where to collect DNA evidence. They will then examine you from head-to-toe, which will allow them to collect evidence and document everything. Evidence collection can consist of swabs of skin, genital region, and inside of the mouth, fingernail scrapings, and any other biological material. Additionally, blood and urine samples may be taken in the case you were drugged or poisoned. Sometimes hair samples are also taken. At any point during the forensic exam, you can refuse any part of it that you do not feel comfortable with. 
  • If you choose not to report, evidence collection kits will be stored. The amount of time that kits are kept varies by state. Each state has different rules for disposing of them.

Some Notes on Cost and Health Insurance Coverage That You May Find Helpful

United States

  • The Violence Against Women Act of 1994 ensures that most states in the United States will provide sexual assault forensic exams for free. Additionally, there are non-profits across the U.S. that will help cover the costs of these exams. Some of these non-profits can be found on our resource page.
  • Other medical care, drugs, and follow-up appointments will most likely not be free, requiring survivors to pay out of pocket or with insurance. 

Canada

  • In Canada, all essential medical care tends to be covered. For example, there are certain areas of healthcare that provinces guarantee to their citizens, such as emergency rooms or family doctor visits. In the situation that you choose to go to a hospital’s emergency room following sexual violence, you will be covered. 
    • Additionally, things such as follow-up care and referrals to specialists may be covered too. 
      • Certain things that are NOT covered under Canadian health insurance including some therapy such as psychology.
      • Check your provincial health insurance and provincial government website to see what is covered. For example, some prescriptions are covered for those under 25 years of age in Ontario.
    • However, each province does have its own health care insurance plan so plans may vary in what they cover. The provincial government healthcare websites will have all the information needed regarding healthcare services and coverage.
      • Specific rules apply for out-of-province care, for example if you attend college or university in another province. Much of your healthcare is still covered, but will need to be paid out-of-pocket to later be reimbursed by your provincial healthcare plan. In some instances and clinics, with proof of provincial health insurance, they will bill directly back to your home province if you are finding health services out-of-province. Additionally, there are certain services (such as prescriptions) that are covered in-province that will NOT be covered if you are out-of-province.
      • Abortion is covered out-of-province, and will either be billed directly back to your home province or will be reimbursed by your home province at the rate it costs back home. Check the provincial websites and phone provincial telephone numbers to confirm this as insurance may vary between provinces (this information is based on Ontario health coverage).
      • If you attend college or university out-of-province, your school’s medical clinic will have much of the information you need on healthcare coverage, and will always be able to provide you the help you need.
  • Sexual violence forensic exams and evidence collection kits tend to be free in Canada, but seem not to be widely available.