By Jori Hamilton

According to current research, every 1.5 minutes an American is sexually assaulted. Native American girls and women and LGBTQ folks are the highest at risk next to heterosexual females. It should be no surprise that 78% of sexual assaults are perpetrated by men. Yet, these assaults are not the only harm perpetrated on victims.

There is a drastic shortage of qualified nurses trained to deal specifically with sexual assault in the U.S. Of the 6,210 hospitals in the country, less than half are staffed with registered sexual assault nurse examiners. 

Those who have gone through traumatic experiences of sexual violence are often confronted with this terrible situation. They often head to the closest hospital expecting to find help. Instead, they are made to literally wait in line. As the minutes and hours tick by, so does their chance at having justice served. 

Unfortunately, the world at large doesn’t seem to recognize just how widespread, retraumatizing, and unjust the shortage of these trained nurses is.

The Shortage Is Massive

Of the more than 4 million registered nurses in the United States, about 2,600 of these nurses are sexual assault nurse examiners registered with the International Association of Forensic Nurses. That’s less than 7 out of 10,000 of the nurses who have received the much needed training and experience to provide comprehensive medical care for victims of sexual assault. It goes without saying that the rate of burnout among these nurses, who regularly have to testify in court and repeatedly review the graphic material related to cases, is very high.

For nurses who want to become sexual assault examiners, obtaining the certification is daunting. Forty hours of training costs $650 for non-members. Nurses often must use their vacation hours or time off without pay to complete the training—usually at a cost they have to pay themselves. This puts the onus of sexual assault care preparedness directly onto the shoulders of individual nurses—instead of the government or the hospitals themselves.

The shortage of qualified nurses directly translates into hundreds of thousands of untested rape kits across the country. In Detroit alone, the local prosecutor’s office found 11,304 untested rape kits inside a police storage facility in 2008. While those kits sit untested, individuals who could easily be identified remain in the community to commit even more sex crimes.

Good for the Criminal, Bad for the Victim

While the shortage of forensic nurses leads to an enormous backlog of untested rape kits across the country, it also means that victims of sexual assault may never receive a rape kit in the first place. Victims often wait up to 12 hours in the ER before a medical professional can even see them and administer a rape kit. Consequently, many leave before they can be seen.

Additionally, it is critical for the victim at this stage to give testimony that can later be used as evidence in court. Without testimony or a rape kit, many perpetrators of sexual assault walk away without consequence. 

When victims don’t receive a rape kit in time, doctors can’t recommend options for potential sexually transmitted infections (STIs) or pregnancy that might occur as a result of the assault. Doctors also can’t provide emergency contraceptives such as Plan B or prescribe antivirals like Truvada to reduce the risk of contracting STIs like HIV. Ultimately, it comes down to the fact that everyone deserves respectful and appropriate healthcare, no matter their gender, economic situation, creed, or race. 

This sends the message that our (rape) culture does not take sexual assault seriously—that the burden rests on the potential victim to protect themselves from perpetrators and the long-term effects of sexual assault.

Sexual Assault Has Lasting Impacts

Without access to appropriate care after an assault, a victim is more prone to emotional and mental suffering. Symptoms of post-traumatic stress disorder—including guilt, shame, self-blame, vulnerability, depression, nightmares, flashbacks, changes in eating or sleeping patterns, and an increased startle response—are all common reactions that can last years after a sexual assault. 

Sexual violence isn’t something that happens within a vacuum; it’s an event that reverberates throughout one’s entire life.

The lasting physical effects of sexual assault include an increased risk of high blood pressure, high triglycerides, and a lower quality of sleep. Chronic anxiety and other mental health conditions stemming from this trauma can become a lifelong struggle. Even the most seemingly innocuous situations can trigger intrusive memories that force someone to relive their traumatic experience. 

Additionally, sexual assault can fundamentally change how someone engages in sexual relationships for the rest of their lives, adding a deep and complex layer of emotional, physical, and mental stress to any sexual act. Consent is, of course, already a prerequisite for any sexual activity, but for those that have experienced sexual assault, the idea of consent takes on new gravitas. It can take years and years for the wounds of sexual assault to heal, and the severe lack of qualified healthcare professionals can compound the negative aspects of an already terrible situation.

Ending Rape Culture

Thankfully, there are actions being taken to curb the prevalence of sexual assault and the need for sexual assault nurse examiners in the first place. Organizations like RAINN are working to educate the public on how to prevent and stop sexual violence, and even the CDC’s STOP SV prevention strategy is working towards creating a safer, healthier environment for future generations. 

Also, there have been efforts to shed light on the need to educate young men specifically about consent. A wide variety of men’s anti-violence organizations are collaborating to put a stop to the toxic elements of our society that perpetuate rape culture and sexual violence. Even companies have begun to bring this topic into mainstream discussion, with brands like Gillette and AXE creating advertisements to question elements of toxic masculinity. We shouldn’t merely expect those at risk to protect themselves from assault. We must teach men and boys how to respect and appreciate others and not objectify them.

The systemic problems related to sexual assault extend beyond healthcare shortages. But a start would be to implement policies that remove the barriers that prevent further training for nurses in becoming sexual assault nurse examiners. Stymying rape culture not only requires improved education and  increased awareness of the issue, but also changes in policy to prioritize the prevention of sexual assault and protect survivors in the first place. As the conversation surrounding sexual assault continues to shift the blame toward those truly responsible and the system that supports them, we may begin to see real results.