- The risk of pregnancy following a sexual assault is dependent upon the nature of the assault, time of the assault in relation to the menstrual cycle, current use of contraception, and individual factors relative to fertility and the assailant.
- Choosing any post-assault forensic examination and/or treatment is a very personal matter, and as a health issue, should be seriously considered. Victims of sexual assault can receive information, counseling, and/or referral with regard to all options.
- Emergency contraception (EC) prevents an egg from being fertilized and/or implantation. EC will not affect a pre-existing pregnancy. It is equivalent to a large dose of birth control pills. Ideally, it should be taken within 72 hours of the sexual assault, and in some cases can be taken up to five days (120 hours) following an assault.
- Emergency contraception, most commonly know as "Plan B", should be available as part of the forensic exam, and is a covered expense of the exam. Hospitals are required by law (RCW 70.41.350 &WAC 246-320-370) to provide EC to victims of sexual assault.
- EC is also legally available without a prescription ("over-the-counter") from a pharmacist. For victims who choose not to have a forensic exam or seek other medical treatment, this is an option. Victims under the age of 18 will need a prescription.
- Though emergency contraception (EC) is not abortion, some medical facilities and some pharmacists have attempted to refuse to provide certain treatment and/or medications citing moral objections.
There are many common reactions to sexual violence. Not all survivors of sexual violence are the same, nor will any act of sexual violence affect two people in the same way. There is no wrong or right way to feel or react. As the body and mind process the devastation of sexual violence, many different emotions, behaviors, and physical responses appear and disappear and may reappear. This is simply an introduction to help better understand what a survivor may be experiencing. As an advocate, support person, or someone working with a survivor of sexual assault, helping to identify and normalize these reactions can be important.
While each survivor is unique in their experience, many survivors are impacted in the following ways:
Survivors thinking they are bad, wrong, dirty, or permanently flawed.
Survivors feeling that the abuse was their fault. It is very difficult for survivors to place the blame on the person who assaulted them. Often the offender was a person close to them that they want to protect. Conversely, it may be that by placing the blame on the offender they then feel helplessness.
Survivors saying, "It wasn't that bad." "It only happened once." "I am fine, I don't need anything."
Minimizing the assault can be a coping strategy. It might include survivors thinking that their abuse was not as bad as someone else's. Those supporting a survivor should validate the impact of the abuse and that it is appropriate that the survivor is upset, traumatized, or hurting from it.
Because sexual violence is such a boundary violation, it impacts the survivor's perception of when or how to set boundaries. Survivors may be unfamiliar with boundaries in general; they may not know that they have a right to create and reinforce them. Many survivors need support developing and practicing boundaries.
Sexual assault is a betrayal of trust. Most survivors find it difficult to trust other people as well as themselves and their own perceptions. On the other hand, they may place an inappropriate level of trust in everyone.
Survivors' sense of safety has been altered; they may assess unsafe situations as safe and perceive safe situations as dangerous. It is important to explore with a survivor what feels safe by asking specific questions about safety.
This is a big issue for adult survivors. Many feel that they do not deserve support, that they are tainted, and that others will not want to be their friends or lovers. A survivor's culture and (lack of) community connections can, at times, compound feelings of isolation. Survivors may have been shunned or avoided by their families and/or communities because of their disclosure.
A survivor may not remember what happened. In the long-term, if the sexual assault happened before the development of language, the survivor may not have memory that can be verbalized.
A survivor may have dissociated during the sexual assault incident(s). They may describe "floating up out of their body" or "looking over their own shoulder" during the abuse. Dissociation can happen even when the survivor is not being assaulted/abused; an event or memory can bring up emotions which trigger dissociation.
The body is where the sexual abuse took place and many survivors feel betrayed by their bodies in various ways. They may have tried to numb/dissociate from their bodies in order not to experience the feelings brought on by the abuse. Sometimes in connection with the experience of numbness, survivors may seek out experiences that provide more intense physical sensations like self-injury.
Survivors may have somatic (body) complaints, eating disturbances, anxiety, difficulty concentrating, and physical symptoms related to areas on their body affected by assault.
Survivors may be very expressive (anger, sadness), disoriented (disbelief, denial), or controlled (distant, calm).
Survivors may be unable to block out thoughts of the assault, or alternately, forget entire parts of it. They may constantly think about things they should have done differently. Nightmares are common. Survivors may also have thoughts or fantasies of being in a similar situation and "mastering" the traumatic event.
Other related issues that may emerge are eating disorders, physical changes, changes in sexuality, substance abuse, self-harm, thoughts of suicide, anger, and mood disorders such as depression and post-traumatic stress.
Long term reactions include coping mechanisms which may be beneficial and adaptive (social support), or counterproductive and maladaptive (self-harm, substance abuse, eating disorders).
- continuing anxiety
- poor health
- sense of helplessness
- persistent fear
- mood swings
- sleep disturbances
- panic attacks
- relationship difficulties
- localized pain