After a sexual assault, the journey toward healing is filled with formidable roadblocks of self-blame, depression and crushing anxiety. But painful as this process is, survivors are benefiting more than ever from programs designed to help them navigate the trauma of rape.

In many communities, it’s becoming easier to report a rape to law enforcement. Rape crisis centers in severy state provide 24-hour hotlines, short- and long-term counseling, and advocacy for navigating the system.

This was not always the case. Rape survivors in the past routinely faced more trauma and humiliation as they made their way through a maze of law enforcement, medical and legal proceedings.

“Rape survivors were not taken seriously,” recalls Elsa Granados, executive director of the rape crisis center in Santa Barbara, Calif. “They were dismissed, ridiculed, told to get over it.”

But as the women’s rights movement blossomed in the early 1970s, attitudes started to change and help for survivors of sexual assault became more accessible.

Following an assault, the first step for survivors often is an in-depth medical exam conducted by nurses trained as sexual assault nurse examiners or by other specially trained medical personnel. These practitioners learn to conduct a forensic exam while meeting the physical and psychological needs of survivors.

“One of the most important things we do is listen to [survivors] and believe them,” says Susan Yokoyama, a sexual assault nurse examiner in Bend, Ore. “For the exam, the patient has to relive what has occurred. That’s often hard,” she says.

“The person’s body is the crime scene. We have to ask point-blank questions like, ‘Where did he put his penis?’ We collect DNA swabs wherever [the perpetrator] touched the victim,” Yokoyama says. “We check for trace samples like hair that can be compared to samples where the assault took place. We check for sexually transmitted diseases and HIV exposure, and we make sure the woman has a physician for referral.”

The exam, which can take two hours, can serve as a first step toward healing. “We spend a lot of time with victims,” Yokoyama says. “We see them start to heal a little. Their affect is lighter when we’re done. The role of the nurse is to be supportive, and the idea is to give them back a feeling of control.”

Sharon, a sexual assault survivor in a small town in Idaho, received that kind of support when she went to the emergency room after an attack. “I didn’t have to wait—I went right into the exam room because an advocate had let them know I was coming,” she says. “The nurses and doctors treated with me with such kindness because of what I went through.”

Keeping medical personnel trained and up to date can be difficult, especially in rural communities. Practitioners in sparsely populated areas conduct very few exams a year, “so it’s hard to keep up their skill set,” says Nicole Broder, program coordinator for Oregon’s Sexual Assault Task Force. “It’s also hard to provide enough coverage [geographically].”

Oregon is making a big push to correct that by offering more training in outlying areas. Instructors have trainees conduct mock sexual assault exams to stay in practice. Trainees also learn how to serve as expert witnesses in court cases, Broder says.

Another important step for survivors is reporting their attack to law enforcement officials, something many women are hesitant to do for a variety of reasons, ranging from fear of the perpetrator to fear of not being believed.

“Our society still does a lot of victim blaming,” says Beth Raub, assistant director of the Christopher G. Money Victim Witness Assistance Center, part of the district attorney’s office in San Luis Obispo County, Calif. Some survivors “don’t want to relive the assault,” she says. Others are plagued by shame, self-doubt or the feeling that nothing is going to happen even if they report.

As a result, only 310 out of 1,000 sexual assaults are reported to police, according to the Rape, Abuse & Incest National Network (RAINN).

It took Amy (her name has been changed here to protect her privacy) two years to work up the nerve to report her attack after she was raped in Flagstaff, Ariz., at the age of 20. “It was really hard to talk about it,” she says. “I felt I lost myself, and I felt disgusted.” She finally felt empowered to make the report after undergoing counseling.

Sharon, another survivor, put off calling authorities in her Idaho town because she feared reprisal. At 57 years old, she had endured years of sexual assaults and violence at the hands of a man who threatened to harm her family if she exposed him. She reported her attacker to police only when “I was ready to die because of all the abuse—psychologically and physically.”

It used to be common for survivors to face an indifferent or even hostile reception when they reported a rape. Police in cities such as Philadelphia added insult to injury. According to The Guardian, “for years, (Philadelphia) detectives had got away with filing rape cases under a noncriminal classification code that was the equivalent of sweeping them under the carpet.”

After prodding from women’s advocates and an investigation by the FBI, Philadelphia police did an about-face. With regard to treatment of rape survivors, they now have one of the country’s most progressive departments.In 2013, Human Rights Watch issued a report about how police in four cities—Philadelphia, Grand Rapids, Mich., Kansas City, Mo., and Austin, Texas—have created a compassionate, nonjudgmental environment for survivors to tell their stories.

But progress in this area varies from community to community. In many cities, law enforcement officials still view rape survivors with suspicion rather than offering support. Consider Amy’s treatment when she reported to the Flagstaff police that she’d been raped in the past. “They were not supportive,” she says. “They asked, ‘How do we know you’re not lying?’ “

About the time of her assault in 2011, an innovative program called Callisto was developed to allow college students to report rapes without approaching law enforcement personnel. (Amy didn’t use Callisto to report her assault, but she has since recommended that the school she now attends work with that organization.)

When a survivor uses Callisto, she has three ways to proceed. She can go online to record time-stamped details of her assault in a confidential file; she can electronically report the assault to her school; and/or she can opt into a matching system, which means the information she enters will only be released to school authorities if another user identifies the same perpetrator. (The third option is the only one that requires the identity of the assailant.)

Callisto offers two pluses for survivors: It gives them control over how their story is shared, and it helps identify serial rapists who may have attacked other women.

According to the Callisto website, “less than 10% of college assault survivors report to administrators, local police, campus security, or other authorities. … When survivors do report, the most common motivation is to protect their community. Most survivors would report if they knew their assailant was a repeat perpetrator.”

Callisto partners with seven U.S. college campuses, and students and parents are encouraged to recommend other schools for the program.

Regardless of her reporting method, if a survivor chooses to press charges, she can expect a lengthy legal journey. “It can be an arduous process,” says Raub of San Luis Obispo County.

Her office provides trained advocates to help survivors navigate the system. “The advocates explain the arraignment, the preliminary hearing, the mechanical process of the criminal justice system. If the district attorney needs to meet with a survivor, the advocate can be in room. If a survivor has to testify, the advocate can sit on the stand with her. Advocates also keep survivors updated on their rights and on what’s happening in the case.”

When it comes to prosecution and conviction of perpetrators, statistics are grim. Of the 310 out of 1,000 rapes that are reported, only 11 wind up being referred to prosecutors, according to RAINN, the national anti-sexual violence network. Of those, a mere seven cases result in felony convictions, and only six lead to incarceration of the perpetrator.

This is because prosecutors must prove an attack beyond a reasonable doubt. “There has to be enough evidence,” Raub says. “It can be a big problem coming up with that proof. If a person was drugged or drunk [at the time of the assault], that person may not be able to provide enough evidence to meet the burden of proof.”

Amy, who was sexually assaulted in Flagstaff, says she is proud she had the strength to report the attack, but she wasn’t satisfied with the results.

Initially, the parents of her attacker offered her money to drop the proceedings. “They wanted to pay me off, wanted me to shut up. It was white privilege at its finest,” says Amy, who is Laotian-American.

The amount she was offered would have been enough to pay off her hefty student loans, but “I wasn’t doing it to make money,” she says.

In court, the perpetrator denied the attack, but witness testimony made Amy’s case. “He was suspended from Northern Arizona University indefinitely, but he just got probation,” she says. “I’m not happy with the verdict.”

Sharon, the Idaho survivor of multiple sexual assaults by the same man, did see her abuser go to jail. “He’s still in prison,” she says. “He got a 24-year fixed sentence and another six years on top of that.”

Helping get the perpetrator off the streets—something she may not have been able to do had she not received the kind of support she did—gave Sharon her life back. “I knew he’d be locked up and couldn’t get to me, nor my kids nor any of my family,” she says. “That was one of the main ways he controlled me.”

Barbara Dunlap is an award-winning journalist with years of writing and editing experience at publications such as the San Francisco Chronicle. She also served on the board of Winning Over Anger & Violence, a nonprofit working to end the cycle of violence in central Oregon.

Part 2 of this report will examine rape crisis centers and the services they provide survivors, including confidential hotlines, counseling and advocacy.


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