During the Jan. 28 episode of The Bachelor, 23-year-old contestant Caelynn Miller-Keyes opened up about her experience as a survivor of sexual assault. Miller-Keyes, a Miss USA runner-up who has used her platform to advocate for sexual assault survivors in the past, disclosed that she was drugged and raped during her sophomore year in college, and described how she was initially turned away from receiving a rape kit, a forensic exam that gathers and preserves any possible physical and DNA evidence of sexual assault, at a hospital.
“They told me they wouldn’t do a rape kit unless I filed a police report,” Miller-Keyes told People. “At that point, these were friends of mine and I wasn’t entirely sure what had happened, so I wasn’t positive I wanted to file a police report. But later that night, I did, once I figured out what had really happened.”
She added how difficult the reporting process was, and how she wasn’t aware it was possible to be turned away from a hospital in the first place. Upon visiting a second hospital, she said she was “able to get a rape kit and speak to authorities and go through that process.” Unfortunately, after she’d reached the second hospital, enough time had passed that the kit results proved inconclusive. She said only one of the men involved in the situation ending up being expelled from school, while others weren’t punished.
Hospitals being ill-equipped to handle medical attention for sexual assault survivors have long been a topic of national discussion. But Miller-Keyes’ story highlights an aspect of sexual assault that is less discussed: what should a victim of sexual assault do if they're denied a rape kit?
“If someone believes they have been sexually assaulted, even when they cannot recall all of the details like in a drug-facilitated assault, they should seek care in a hospital emergency room as soon as possible,” Jennifer Pierce-Weeks, RN, SANE-A, SANE-P, and C.E.O. of the International Association of Forensic Nurses, tells Bustle. “They do not need to know whether or not they wish to report the crime.”
Brittni Kellom, founder and executive director of Just Speak, an organization that advocates for survivors of childhood trauma, tells Bustle that survivors can call the Rape, Abuse & Incest National Network (RAINN) for detailed information by zip code of where they can go to have an examination done. Dr. Adeeti Gupta, an ob-gyn and founder of Walk In GYN Care, tells Bustle that victims should go to a safe place with family or friends first to find someone to accompany them to the E.R. She adds that the victim should not shower, douche, or change their clothes and underwear prior to the hospital visit.
The national protocol for sexual assault medical forensic examinations, which was developed by the U.S. Department of Justice Office on Violence Against Women, states: “Except in situations covered by mandatory reporting laws, patients, not health care workers, make the decision to report a sexual assault to law enforcement.” The document notes that in some jurisdictions, health care workers are legally required to report “some or all forms of sexual assault, regardless of patients’ wishes. In the remaining jurisdictions, no report should be made without the consent of patients…In jurisdictions in which mandatory reporting by health care personnel is required, patients should be informed of the legal obligations of health care personnel, what triggers a mandatory report, that a report is being made, and the contents of the report.”
"It's very important for victims and survivors to have that control at that moment."
Regardless of jurisdiction, the recommended protocol for a survivor of sexual assault is the same. Adult survivors are meant to be offered evidence collection if they are within the window for evidence whether or not they intend to file a police report, Pierce-Weeks says. “The majority of states do not require mandatory reporting to law enforcement of sexual assault in adult cases. The evidence can be ‘known’ — as in the patient is reporting the crime to law enforcement; or ‘anonymous’ — the patient is uncertain about whether or not they want to report the crime.”
In anonymous cases, evidence is still collected and preserved for the possibility of future reporting by the survivor. Along with gathering evidence, Pierce-Weeks says that timely hospital visits are necessary for the effectiveness of other possible treatments like emergency contraception or HIV prevention medication, which need to be administered within a specific window of time following the assault.
The only potential scenario where a sexual assault victim might not be offered evidence collection, according to Dr. Gupta and Pierce-Weeks, is if the patient arrived at a hospital outside the evidence window. “The standard window for evidence collection in adult cases is 120 hours/5 days,” Pierce-Weeks says. “That said, there are cases where the clinician may opt to collect regardless.”
In a situation where a person is denied a rape kit, they should head to another hospital that offers medical forensic exams. The Rape, Abuse, and Incest National Network (RAINN) offers a useful online resource to find help nearby. “It can be helpful if the victim calls the sexual assault hotline and talks to a community-based advocate because they may be able to direct the victim to a hospital capable of providing the appropriate services,” Pierce-Weeks says.
"The problematic thing," Kellom says, is when the survivor may not be able to advocate for themselves, especially in the immediate aftermath of a trauma. "It's very important for victims and survivors to have that control at that moment," she says. "It's better to tell that person to take the time that they need for themselves and still give them all the information" they may need to later report the assault. "It's about the survivor taking care of themselves."
If you or someone you know has been sexually assaulted, call the National Sexual Assault Telephone Hotline at 800-656-HOPE (4673) or visit online.rainn.org.