Supporting Survivors
Content warning: sexual assault, sexual violence
Following Sexual Assault Awareness Month in the United States in April, and with Sexual Assault Prevention Month underway across Canada, we affirm our support for survivors, and acknowledge the ongoing challenges for folks who may be seeking care and/or justice related to their experiences. It can be discouraging to consider the pressure that severe abortion restrictions are placing on survivors in the United States, at times creating demands that individuals provide evidence of their experiences of sexual violence as a precondition to accessing time-sensitive healthcare. At Choice in Health, we advocate for a trauma and violence-informed care (TVIC) approach, which takes into account the lived realities of survivors and ensures the provision of sensitive, timely, and safe health care.
Requiring survivors to recall their experiences of sexual violence in order to access abortion care contradicts the key tenets of trauma and violence-informed care. This demand infringes on individuals’ bodily autonomy and their sense of personal agency over their health care decisions. It assumes that survivors have processed their experiences and identified them as sexual violence; however, as evidence and countless lived experiences show, such a process may take years. The emotions surrounding a sexual assault could further compound existing complex feelings about pregnancy and abortion; and victim-blaming and misogyny within our wider social context can contribute to an environment of under-reporting and a reticence to seek medical care. It is deeply harmful to determine eligibility for abortion care based on whether a survivor can provide an account of their experience of sexual assault, and it is wrong to think that this approach will not affect timely access to care.
Here at CIHC, we strongly advocate for and provide trauma-informed abortion care to all clients, regardless of disclosed trauma history, including of sexual assault and violence. Our team has worked hard to develop a forensic evidence collection policy for pregnancy tissue to support survivors who may wish to report their assault to police. In addition, we have strong community connections with sexual assault and domestic violence care centres in the city, with our closest location being Sexual Assault/Domestic Violence Care Centre at Women’s College Hospital.
If you are a survivor hoping to seek abortion care and you do not wish to collect forensic evidence of pregnancy tissue, that is entirely okay. We support everyone and their choices. We do not require folks to disclose a sexual assault history to access an abortion. You are the expert of your body and what you need, and we will do our best to support you.
We wish to further acknowledge how access to healthcare can be difficult, and survivors will often lack physical evidence to support their account of sexual assault. A medical forensic exam exam can allow for steps like the treatment of any injuries that may need immediate attention, as well as collecting and storing specimens that could potentially be linked to a perpetrator, but with no requirement for the individual to report to police. Health policy research hub KFF describes how, “despite the intention of the [Violence Against Women Act in the US] to provide no-cost rape kits to all survivors of sexual violence, some survivors still face out-of-pocket charges for minimum standard rape kit services as well as other medical care that takes place following a sexual assault.” There can also be challenges accessing a trained provider, such as a Sexual Assault Nurse Examiner (SANE) to complete a medical Forensic Exam; however, we have reached out to International Association of Forensic Nurses (IAFN) and aim to share an up-to-date link here to their listing of SANE programs in hospitals.
If you wish to learn more about sexual violence support services, which may also offer forensic evidence and medical support, please visit: Ontario Network of Sexual Assault/Domestic Violence Treatment Centres (sadvtreatmentcentres.ca). The comprehensive care package by Sexual Assault/Domestic Violence Care Centre at Women’s College Hospital offers strategies and resources including medical, legal and social supports to help survivors feel less alone. Our team is committed to ongoing learning to improve the care and resources that we provide to survivors. We encourage you to check in with us about anything you may need during your time here at CIHC, and beyond your appointment.