This article contains graphic descriptions of evidence collection in the aftermath of sexual crimes.

It was a hot, dry summer when I took an online biology course in a weak attempt to prepare for an honors class in high school. That July, I swam through my notes on evolution as well as the public pool. While I barely passed the AP Bio exam, one thing I learned stayed with me these last few years: form and function are inseparable. Biological entities develop their structures based on whatever purpose they’re meant to fulfill. Every pore and vein of living things, it’s all there for a reason. Such inherent impetus applies to the tools that humans have crafted over the millennia, from skyscrapers to toothpicks.

This is something I had to remember when learning about rape kits during my Peace Over Violence internship. So many aspects of the practice seemed to me like further humiliation of rape survivors. In her open letter, the Stanford rape victim recounts that during her rape kit, there was “a Nikon pointed right into [her] spread legs”. Why must there be such an extensive examination so soon after a sexual assault? Why can’t the survivor shower without permission? Why can’t people keep their clothes afterwards?

As scary and frustrating as these things sound, the form of this practice does have a function: to help bring justice and peace for the survivor, whether in court or on an individual level. 

Rape kits allow experts to collect forensic evidence like “fibers, hair, or stains” while documenting and caring for injuries. This is why professionals refer to the rape kit as a “medical-legal exam”. Each kit consists of a cardboard box containing utensils to fully gather the different forms of evidence. A comb is used to brush out trace evidence of foreign hairs or fibers, which will then be held in glass slides and envelopes. The survivor’s nails are scraped and clipped to collect any tissue from the perpetrator. Cotton swabs wipe up biological evidence, such as blood, semen, or saliva, from oral, vaginal, or anal cavities. Tubes will hold the survivor’s blood samples to test for sexually-transmitted diseases and pregnancy, if applicable. There may be photographs taken and measured with a ruler and color chart to document the injuries and unique prints, like fingerprints, shoeprints, tire prints, and bite marks. All of this is sealed off in the box, which is then signed and sent away for DNA testing. (That's what's supposed to happen, anyway.)

The exam procedure varies based on the specific experience, but there is a general course of action. The patient should be allowed to pause at any step, and any injuries requiring immediate care must be cared for first. The exam typically lasts around three hours, and begins with the patient signing forms consenting to the kit. All of this, at least, is their choice. They can also choose to inform the police, or else to call an advocate from a local crisis center or a friend for support. 

Then the nurse interviews them to determine what happened during the assault, which will inform the rest of the exam. The patient undresses on a sheet of paper, in case any trace evidence falls from their clothing, which is then placed into another bag of the box. This is followed by a more detailed physical assessment and another round of evidence collection and a focused genital examination. Once the nurse collects as much evidence as possible and documents the findings, they will assess the patient for STDs and potential pregnancy. Before the patient is discharged and allowed to speak to the police (or just go home), the nurse will give them medication, if needed; a list of trauma symptoms to watch for; and a number the patient can call if they have any questions. 

During the exam, they’re not allowed to eat, drink, or smoke anything unless the examiner approves. They can’t shower or even wipe after urinating. All these measures are taken to preserve valuable evidence that could link the survivor’s statement to the assailant and the scene of the assault. The “assault clothes” will probably remain in the kit, so hospitals and crisis centers have a supply of comfortable clothing to change into: sweatpants, a shirt, and flip-flops.

The Violence Against Women Act guarantees that these forensic exams are free of charge, and the patient can apply for financial compensation for any other medical treatment. These exams preserve evidence so that the victim has time to decide if they want to report the assault. Some evidence deteriorates after 3 days, but the kits are still useful to check for injuries and care for the survivor. At every step, the patient is informed of what is happening and what its purpose is in their treatment or possible criminal proceedings. 

This constant exchange is the most important. It doesn’t matter how high-grade the cotton swabs are or how neatly the envelopes are sealed if the rape kit lacks basic human kindness. The Stanford victim thanks an intern who made her oatmeal in the hospital, nurses who calmed her during the exam, a detective who listened to her instead of judging, and the victim advocates who stood unwaveringly beside her. There have been massive leaps in the quality of care that victims receive in just the last few decades, with training and sensitivity programs for physicians and law enforcement officials working to bolster the caring network that every survivor needs and deserves. 

And yet: the US Department of Justice found in an investigation on brutal policing tactics that the Baltimore Police Department would question women in the emergency room and threaten to “hook up women reporting sexual assault to lie detectors”. In cities across America, there are hundreds of thousands of backlogged kits. Some are never even sent from police departments to crime lab facilities, and those that do might not be tested or entered in DNA databases. This can be caused by a lack of funds, a lack effort on the part of the professionals involved, or both. And the consequences can be disastrous: this sort of thing prevents the victim/survivor from getting legal closure and could encourage further crimes in the case of serial rapists.  No matter how many hours are spent in hospital rooms, not a milligram of collected evidence matters if it isn’t appropriately processed. 

It is a thing of comfort to many abuse and assault survivors to know that the cells of our bodies will die and replace themselves. A few weeks from now, we think, I will not have the same skin as I did then. In 10 years, we count, our bone cells will have completely regenerated, bringing us new skeletons that were never bent and twisted and hurt. Never left behind a dumpster, or on a couch at a party, in a car, our own beds.  

The proper processing of rape kits is undeniably important—both to bring immediate peace to the survivor and to prevent future crimes by ensuring that the assailant is punished. Every backlogged forensic kit is another seething cell in the beast of rape culture. So when will the system catch up to the changes that have taken place in our society?

This article was originally published on October 3, 2016. It has since been updated.

Cover Image by Emma Kaufman