4 Reasons Why Medical Examinations Can’t Always Prove If Someone Was Raped

(Content Note: sexual violence)

A medical gown laying on top of a medical exam table with clipboard and doctor's notes.

A medical gown laying on top of a medical exam table with clipboard and doctor’s notes.

Some of the most traumatizing moments of my high school career involved sex education.

At my all-girls high school, we were often told a great deal of rape myths. In one particularly notable event, a guest speaker came to our school to discuss his work as a district surgeon. He spoke about a well-known rape case.

“I examined her myself,” he told us. “And there was no evidence of force. There was no way she was raped.”

To this day, the memory of his speech sends shivers up my spine.

I couldn’t put my finger on it at the time, but the reason why his made me uncomfortable is because medical examinations can’t always accurately assess whether someone’s been raped or not.

The process of collecting evidence from the body of a victim or survivor can take up to a few hours. While the process differs from country to country, it often involves checking the genitals for injury, noting any non-genital injury, combing pubic hair, looking for semen samples, looking for samples of skin cells under the fingernails, and more.

The data collected is often referred to as a “rape kit.” The exam could also involve questioning the victim or survivor on the assault and providing follow-up care.

Sometimes, medical evidence can be used to substantiate a victim or survivor’s case in court. Sometimes, it can provide some proof of rape.

But a lack of proof certainly doesn’t mean that the rape never happened.

Unfortunately, this is one of the most widely-believed rape myths – one that’s often even believed by progressive, open-minded people.

This myth results in society letting rapists off the hook. It means that many victims and survivors who can’t medically “prove” their rape are denied the compassion and empathy they deserve. It means that communities fail to protect and support those who experience assault.

Let’s look at why medical examinations are so limited.

1. Rape Doesn’t Always Involve Force

Medical examinations of rape involve looking for genital and non-genital injury. This is the primary means of collecting evidence, amongst other things.

Indeed, rape can often involve the perpetrator causing physical injury to the victim or survivor. But that’s not always the case.

Rape is often legally defined as penetration without consent. Not only do we know that sexual violence encompasses more than that, but physical injury isn’t a criterion for rape. 

It’s often assumed that the perpetrator restrains or physically abuses the victim or survivor into submission in order to assault them. This isn’t necessarily true. Sometimes, a perpetrator can subdue the victim or survivor by making verbal threats, intoxicating them, or waiting until they’re unconscious.

Some victims or survivors freeze up and don’t “fight back,” so their perpetrator might not cause them physical injury. Additionally, they might not scratch their perpetrator, which means there won’t be any skin cells under their fingernails.

The idea that rape always involves causing physical injury is a harmful myth – and one we buy into when we believe that medical evidence can always prove rape.

2. Rape Doesn’t Always Involve Penetration

We often view rape in a very one-dimensional way.

Society often thinks about rape as something that is perpetrated by a cisgender man to a cisgender woman. It’s often assumed that the male perpetrator forcefully penetrates the woman’s vagina with his penis. The medical examination process often works on this assumption.

Of course, this often happens – but rape can be more complicated than that.

Perpetrators and victims or survivors alike can have any gender identity. It might involve vaginal penetration with a penis, but it can also involve other kinds of penetration with other body parts or objects.

Sometimes rape involves the assailant forcing the victim or survivor to penetrate them. While this could result in injury to the patient’s genital area, that’s not always the case.

Often, the medical examination process includes looking for tears and fluid inside the vagina, mouth, or anus. While this process can provide evidence in some cases, it’s not always true if the victim or survivor wasn’t penetrated.

3. There’s Plenty of Room for Error in the Examination Process

It’s important to remember that, even if there was medical evidence of rape, a medical examination can’t always pick it up and carry it through to court.

There are a number of other factors that could interfere with the collection and presentation of medical evidence, such as incompetent medical examiners and untested rape kits. In 2014, it was discovered that the US has a backlog of over 400,000 rape kits.

We also need to remember that many people choose not to undergo any medical examinations after rape, often because the process can retraumatize the patient.

Many others, still, might not get medical examinations because they didn’t report their rape – which is a valid and understandable choice. Others might not know about the option to have medical examinations, or they might have been misled when they reported their rape.

In these cases, they won’t have medical evidence of their sexual assault – but that certainly doesn’t mean it didn’t happen.

Medical evidence or not, these victims and survivors still deserve compassion, love, and understanding.

4. A Medical Kit Can’t Actually Tell You If Someone Consented or Not

A medical kit might be able to tell you whether someone recently came into sexual contact with someone else.

If DNA evidence is available, you might even be able to tell who came into sexual contact with them.

But at the end of the day, it can’t tell you if the contact was consensual.

Let’s use an example. Imagine if two people had sex, and at one point, one of them said he wanted to stop. This means he withdrew his consent. However, his partner continued with sexual activity. This is rape.

Medical evidence will be able to show you that the two people had sexual contact. But is there some kind of medical evidence that will show you whether or not the consent was withdrawn? No.

Because while medicine can tell you a lot about someone, it can’t tell whether they consented.

Ultimately, if we want to eradicate rape myths and challenge rape culture, we need to recognize the importance of consent.

***

When I think back to the times I had been sexually assaulted, I’m almost certain that no medical practitioner would have been able to find a stitch of medical evidence to prove that my rape happened.

But that doesn’t mean it didn’t happen.

If we want to work towards eradicating rape culture and supporting victims, we need to let go of all the rape myths that limit our understanding and empathy.

This includes the myth that a medical examination is an accurate measure of whether or not someone was assaulted.

Sian Ferguson is a full-time freelance writer based in South Africa. Her work has been featured on various sites, including Ravishly, MassRoots, Matador Network and more. She’s particularly interested in writing about queer issues, misogyny, healing after sexual trauma and rape culture. You can follow her on Twitter and Instagram. Read her articles here.