Sexual Assault & Hospital Advocacy

Healing is not linear—but it is possible.

Every survivor’s journey is unique, and there is no single path to healing. Recovery often happens in stages, which may overlap or repeat. The following is a general guide to what many survivors may experience:

Stage 1: Immediate Aftermath (First Few Days to One Week)

In the early days following an assault, it’s common to feel overwhelmed, numb, or in shock. Physical symptoms such as headaches, nausea, fatigue, or nightmares may occur. Emotionally, survivors may feel fearful, confused, or disconnected. These are natural trauma responses—your body and mind are reacting to protect you.

Focus on: Safety, medical attention, rest, and being surrounded by supportive people.

Stage 2: Adjustment and Emotional Reactions (First Few Weeks)

As the initial shock fades, deeper emotional responses may begin to emerge. Mood swings, anger, guilt, or difficulty trusting others are common. Survivors may feel conflicted about their emotions or blame themselves. You may also notice a desire to withdraw or give others control as you try to cope.

Focus on: Reclaiming small pieces of control, staying connected to trusted support systems, and remembering that all feelings are valid.

Stage 3: Reorganization and Long-Term Healing (Weeks to Months Later)

This stage often brings a return to routine, where survivors may appear “fine” on the outside. But deeper emotional processing continues below the surface. Later, more intense feelings may resurface—such as anxiety, anger, or sadness. This is not a setback—it’s a sign of readiness to process trauma more deeply. Some survivors begin to make lifestyle changes or take steps to feel safer and more in control.

Focus on: Long-term support, regaining a sense of self, and making empowering decisions that support your well-being.

Recovery is possible. You may carry parts of this experience with you, but it does not define you. With time, support, and self-compassion, healing is within reach.

If you need help or someone to talk to, call our 24/7 crisis line at 910-347-4000. We are here for you.

Survivors of sexual assault may experience a wide range of emotional, psychological, physical, and behavioral responses. These effects can surface immediately or develop over time. Healing is possible, and support is available every step of the way.

Emotional and Psychological Effects

Anxiety

Survivors may experience generalized anxiety, panic attacks, irrational fears, or phobias related to people, places, or situations.

Attachment Issues

Following trauma, survivors may have difficulty forming or maintaining trusting relationships and may struggle with intimacy or emotional closeness.

Body Memories

Unprocessed trauma can surface as unexplained physical sensations or pain, often in areas associated with the assault.

Depression

A common response to trauma, survivors may feel sadness, hopelessness, emotional numbness, or a lack of interest in daily life.

Dissociative Identity Disorder (DID)

In rare cases, extreme trauma can lead to DID, where two or more distinct identities emerge as a coping mechanism.

Eating Disorders

Survivors may attempt to control food intake or body image as a way to reclaim control after experiencing violation.

Post-Traumatic Stress Disorder (PTSD)

PTSD includes symptoms such as flashbacks, emotional numbness, hypervigilance, and avoidance of reminders of the trauma.

Self-Harm / Self-Injury

Some survivors may intentionally hurt themselves to cope with overwhelming emotions, numbness, or internalized blame.

Sleep Disorders

Nightmares, insomnia, or disrupted sleep are common among survivors and can stem from anxiety or hypervigilance.

Suicidal Thoughts

Survivors may experience thoughts of suicide. These feelings are serious and deserve immediate attention and care.

Coping Mechanisms and Trauma Responses

Stockholm Syndrome

Some survivors subconsciously develop emotional bonds with their abuser as a survival response. This can cause confusion, guilt, or conflicting emotions.

Substance Use

Survivors may turn to alcohol or drugs as a way to numb emotional pain or escape distressing thoughts, though this can worsen mental health over time.

Physical Health Effects

Sexually Transmitted Infections (STIs)

Sexual assault can lead to exposure to infections such as HIV/AIDS, Hepatitis B and C, Gonorrhea, Chlamydia, HPV, Genital Warts, Herpes, and Pubic Lice. Medical evaluation is essential for care and peace of mind.

Every survivor’s experience is unique. If you or someone you know is struggling with any of these effects, support is available. You are not alone. For 24/7 confidential assistance, call 910-347-4000.

When someone you care about discloses that they’ve been sexually assaulted, your response can have a powerful impact. The most important thing you can do is to listen, believe them, and support their choices—without judgment or pressure. Here are meaningful ways to offer support:

Empower Their Decisions

Let them know you trust their ability to make decisions about their own healing process. Support them in taking steps at their own pace, and avoid telling them what they should do.

Believe and Validate

Believe their story. Acknowledge that their experience is real and valid. Assure them that it’s okay to talk to someone—whether it’s family, friends, or a sexual assault advocate at Onslow Victims Center.

Practice Nonjudgmental Listening

Be present. Listen without interrupting or trying to fix things. Respect their thoughts and beliefs, even if they differ from your own. Your role is to support—not to control or direct.

Reinforce That It Was Not Their Fault

Gently remind them: the victim is never to blame. It does not matter what they were wearing, where they were, how late it was, or if alcohol, drugs, or prior consensual activity were involved. Rape is never justified. The responsibility lies solely with the perpetrator.

Encourage Medical Care

Encourage the survivor to visit a doctor or hospital to check for internal injuries, STIs, or pregnancy—even if they do not want a forensic exam. If they’re open to it, explain the option of completing a Rape Kit and offer to accompany them for support.

Offer Legal Resources

If the survivor expresses interest in legal action, suggest contacting the police or the District Attorney’s office. Let them lead the way, and support them in whatever choice they make.

Offer Comfort—If Invited

Physical comfort, such as a hug or hand-holding, can be meaningful—but only if the survivor initiates or clearly expresses comfort with it. Always respect their boundaries.

Most Importantly: Be There

Ongoing, consistent support means more than saying the "right thing." Let them know you are here, and that you’ll continue to support them—no matter what they choose or how long their healing takes.

A sexual assault forensic exam, often referred to as a rape kit or Sexual Assault Evidence Kit (SAEK), is a medical procedure designed to collect physical evidence after a sexual assault. The exam is conducted by a specially trained medical professional and is available at no cost to the survivor.

What’s in a Rape Kit?

The contents may vary by state and jurisdiction, but commonly include:

• Swabs for DNA collection

• Materials for blood and urine samples

• Paper bags for clothing and personal items

• Documentation forms and consent paperwork

• Combs for hair evidence

• Instructions and checklists for medical personnel

Preparing for the Exam

If possible, try to avoid doing the following before the exam, as these actions may affect evidence collection:

• Bathing or showering

• Using the restroom

• Changing clothes

• Combing your hair

• Cleaning the scene of the assault

Note: Even if you’ve already done any of these things, you can still receive an exam. Bring a change of clothes if you can, and place any items worn during the assault in a paper bag to preserve evidence.

What to Expect During the Exam

The process may take a few hours. You can pause, skip, or stop at any time—you are always in control.

1. Immediate Care

Any urgent medical needs will be treated first.

2. Medical History & Assault Details

You’ll be asked questions about your health, recent consensual activity, and what happened during the assault. This helps guide evidence collection.

3. Head-to-Toe Exam

This may include:

• Full body and internal exams (mouth, vagina, and/or anus)

• Collection of swabs, blood, urine, and hair samples

• Photographs (with consent) to document injuries

• Collection of clothing and other physical evidence

4. Mandatory Reporting

If you are a minor, the medical provider may be required to report the assault to law enforcement.

5. Follow-Up Care

You may be offered STI prevention, emergency contraception, and information for ongoing medical or emotional support. The facility may help schedule follow-up appointments or connect you to local resources.

Who Performs the Exam?

Not every facility has trained personnel on-site. Exams are typically conducted by:

• Sexual Assault Nurse Examiners (SANEs) – Registered nurses with specialized training

• Sexual Assault Forensic Examiners (SAFEs) or Sexual Assault Examiners (SAEs) – Other qualified healthcare professionals

If you're unsure where to go, contact Onslow Victims Center at 910-347-4000 to speak with an advocate. We can help direct you to a trained provider and may be able to accompany you during the exam.

Why Consider a Sexual Assault Forensic Exam?

• It’s free. You will not be charged for the exam.

• You don’t have to report right away. Evidence is preserved in case you decide to report later.

• It supports accountability. DNA evidence may help identify or prosecute a perpetrator and may help prevent future assaults.

• Your health matters. The exam can detect internal injuries, STIs, and provide access to emergency contraception.

Support is available. If you’re considering a forensic exam or have questions about the process, please call our 24/7 crisis line at 910-347-4000. You don’t have to go through this alone.

Understanding Your Options and Rights

Choosing whether to report a sexual assault or press charges is a deeply personal decision. There is no right or wrong choice—only what feels best for you. The legal process can be overwhelming, but support is available every step of the way.

Considering Legal Action

If you are thinking about pursuing criminal charges, it’s recommended that you visit a hospital or medical facility as soon as possible for a sexual assault forensic exam (rape kit). This helps preserve evidence that may be critical in a legal case.

After receiving medical care, you can file a report with your local police department. If you’re unsure about pressing charges, some states allow you to submit a blind report—an anonymous report that documents your experience without triggering a formal investigation. If you change your mind later, you can convert a blind report into a formal one.

What Does It Mean to Press Charges?

After an initial report is made to law enforcement, investigators gather evidence and determine whether there is enough to move forward. If the case progresses, the prosecutor—representing the state—ultimately decides whether to formally file charges. In rare cases, the prosecutor may choose to press charges even if the survivor does not want to participate in the process.

Why Charges May Not Be Filed

A case may not move forward for several reasons:

• Lack of sufficient evidence

• Inability to identify the perpetrator

• Challenges proving the case in court

This outcome can be difficult, but it does not diminish your experience. Statistically, out of every 1,000 sexual assaults, only 13 result in prosecution, and about 7 lead to felony convictions. Even so, reporting may help prevent future assaults and connect the perpetrator to other cases.

Other Avenues for Justice

If the criminal process does not move forward—or if you choose not to pursue it—you may have the option to file a civil suit, which seeks financial compensation rather than criminal penalties. Civil suits are handled separately and can offer another form of legal acknowledgment.

If Charges Are Filed: What Happens Next?

Most sexual assault cases are resolved through a plea bargain, where the perpetrator pleads guilty in exchange for a reduced sentence. In many cases, this process does not require survivor testimony.

If the case goes to trial, it will be heard in criminal court, and you may be asked to testify. Many states have legal protections in place to support survivors during this process, such as rape shield laws that limit questions about your sexual history.

You have the right to have a victim advocate or support person with you. Onslow Victims Center can help connect you with resources and guidance throughout the trial process.

Preparing to Testify: Tips for the Courtroom

Testifying in court can feel intimidating. Here are a few tips to help you prepare:

• Take pauses if you feel overwhelmed—ask for a short break if needed

• Bring water and stay hydrated

• Focus on the attorney questioning you—not the defendant or others in the room

• Tell the truth, even if you don’t remember everything perfectly

• Only answer what is asked—don’t offer extra information

• If you don’t understand a question, ask for it to be repeated or rephrased

• Clarify your statements if something came out wrong or was misunderstood

You're Not Alone

Legal professionals, prosecutors, and advocates are there to support you. If you have questions about reporting, testifying, or your rights, contact Onslow Victims Center at 910-347-4000 to speak with a trained advocate.

Whatever path you choose—whether reporting, waiting, or not pursuing legal action—your choice is valid, and your story matters.