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Content warning: sexual assault
Executive Summary: This post outlines the general process of having a rape kit completed, formally known as a Sexual Assault Evidence Kit (SAEK) in Canada. The process may vary slightly from patient to patient, since all sexual assaults are different for each individual. The sexual assault nurse examiner (SANE) will tailor the examination to your individual needs. For example, the examiner may take swabs from areas of your body that are not listed in this post but are areas that may hold DNA evidence from the assault (e.g. breast, neck, etc.). If you find that your experience in having a SAEK done does not follow these general steps, please contact a local sexual assault agency for support and advocacy during this process. Click here for Ending Violence Association of Canada’s comprehensive updated list of all sexual assault agencies in Canada with their agency and crisis line phone numbers.
If you have been sexually assaulted, you do not need to get a SAEK done. As a survivor of sexual assault, the following choices are available to you (7):
You can have a SAEK completed and have the kit submitted to police.
You can have a SAEK completed and choose not to submit the kit to police.***
You do not have a SAEK completed and you move forward with reporting the sexual assault to police.
You do not have a SAEK completed and you do not report the sexual assault to police.
***Note: If you already reported the sexual assault to police and complete a SAEK, it must be submitted to police as evidence. If you do not want to submit the SAEK after reporting the sexual assault to police, you may decide to withdraw your report of sexual assault.
For more information about levels of sexual assault in Canada, please read our FAQ here.
For more information about how to report sexual assault in Canada, please read our FAQ here.
My name is Brittany Pompilii and my pronouns are she/her. I reside on the traditional territory of the Haudenosaunee, Anishinabewaki, Attiwonderonk, Mississauga, and the Mississaugas of the Credit First Nations peoples. This land is currently known as Niagara, Ontario. As the author of this post, I acknowledge that my privilege, and therefore my experiences, inform my perspectives on sexual violence and the healthcare system. I want to acknowledge that my privilege has provided me safety and protection within the healthcare and criminal justice system across my life as a white, able-bodied, heterosexual, cisgender woman. I do not intend to speak on behalf of all women who have experienced sexual assault or have gotten a Sexual Assault Evidence Kit done. Furthermore, I want to acknowledge that my experiences working in the sexual assault and domestic violence field impacts my perspective on sexual assault evidence kits. In addition, some of the information in this post is drawn from my professional knowledge of the process of a SAEK examination.
As a research team member, I am committed to using my research and writing skills to help all women access public health information - a right that all women are entitled to yet do not always receive. I hope that one day, the public health system represents all peoples’ experiences and treats all people equitably. Until that day, I hope to continue advocating for women and their health and safety in any way I can.
Introduction
This post will review everything you need to know about Sexual Assault Evidence Kits (SAEK), also known as rape kits, in Canada. We will answer the following questions:
What is a Sexual Assault Evidence Kit?
A Sexual Assault Evidence Kit (SAEK), or rape kit, is a box of medical examination tools used to collect DNA information from the human body for the purpose of forensic analyses. The content of a SAEK includes (3):
An instruction sheet and checklist for the nurse examiner to follow
Documentation form
Tubes and containers for samples
Paper bags
Swabs
A disposable drop cloth
Comb
Wooden sticks
Labelled envelopes and boxes
Why have a Sexual Assault Evidence Kit completed?
The SAEK’s purpose is to collect forensic evidence to use in police investigations into a sexual assault report. If you report sexual assault to police within 12 days of the assault, the police will most likely suggest having a SAEK completed at a local hospital. Evidence from a SAEK is often one of the only pieces of scientific evidence available that can corroborate a survivor’s report of sexual assault. However, it is not required to complete a SAEK to report sexual assault.
Who administers a Sexual Assault Evidence Kit?
Hospitals across Canada have sexual assault nurse examiners (SANEs) that are specialized in working with survivors of sexual assault, domestic violence, and intimate partner violence. These nurses are specially trained to administer SAEKs in a safe, trauma-informed manner (2, 5). If you decide to have a SAEK completed, you have the option to choose a male-identified or female-identified nurse examiner, however, most SANEs are female-identified (4).
You may also choose to have a friend, family member, or advocate† present during the SAEK examination.
When should I get a Sexual Assault Evidence Kit completed?
While it is recommended SAEKs are done as soon after the sexual assault as possible, that may not be the best option for the survivor. The best chance to collect biological evidence is up to 72 hours (three days) after the sexual assault. However, there may be some evidence available up to 12 days later (7). After 12 days, a SAEK cannot be administered, as the physical evidence on the survivors body is no longer present.
For an ‘ideal’ SAEK examination and ultimately, the most accurate results, it is recommended a survivor does not shower, urinate, defecate, or use a douching product after the assault (5, 7). This is to preserve as much of the perpetrator’s DNA evidence until it is collected during the examination. However, please do what feels right for your body and your physical and emotional needs. Evidence may still be collected even if you do shower, urinate, defecate, or use a douching product after the assault (7).
How long does a Sexual Assault Evidence Kit take to complete?
It can take between one to eight hours for a SAEK to be administered (1*). The length of time depends on the survivor’s sexual assault experience, presence of injuries, if the survivor would like to take breaks during the process, and how much of the kit is administered. Survivors may choose to have certain parts of the kit done, and not others (7). For example, a survivor may consent to have an oral swab done, but not a vaginal/penile swab. If the full SAEK is not administered, it will take less time to complete. The SAEK may take longer to complete if the examiner asks to take swabs of additional areas of the body. Depending on the details of the sexual assault, additional swabs may be taken (5). For example, if the perpetrator touched the survivor’s shoulder, the SANE would ask to take a skin swab of that specific area.
Where do I get a Sexual Assault Evidence Kit completed?
You can have a SAEK completed at your local emergency hospital (6). You may show up by yourself, with a friend or family member(s), an advocate, or a police officer. Depending on your location, the hospital may have a Sexual Assault/Domestic Violence Care Centre (SA/DVCC) where the SAEK can be completed. For a list of SA/DVCCs in Ontario, click here. If you reside outside of Ontario, please call your local hospital to inquire about SA/DVCC locations near you. In addition to administering SAEKs, these centres provide emergency services, follow-up supports, referrals to sexual assault centres, and counselling for survivors of sexual assault, domestic violence, or intimate partner violence (2).
Step-by-Step Process of a Sexual Assault Evidence Kit Examination
Step 1 - Arrive at Hospital: Once you arrive at the hospital, you will be guided to a private waiting room or exam room right away. This is to protect your privacy, foster safety, and build rapport with the examiner, the SANE.
Step 2 - Description of the Sexual Assault: Before the SAEK is administered, the SANE will ask for you to provide details of the sexual assault. The purpose of providing an account of the assault is to help the examiner tailor the SAEK to your individual experience. Since the SAEK is used as forensic evidence in police investigations, the examiner will want to make sure they are collecting the perpetrator’s DNA evidence from your body (5). It also helps the examiner determine which parts of the SAEK are most important to do first, which can be helpful if the patient does not want to stay long.
Step 3 - Providing Consent: The SANE will ask for your consent to administer the SAEK. There are multiple components to the SAEK, and the examiner will ask for your consent before administering each component (5). The consent process during a SAEK examination is ongoing and your consent can be withdrawn at any point. You may stop or take a break anytime during the examination, and the SANE will continuously remind you of that to ensure you are comfortable.
Step 4 - Undressing: After consenting to the SAEK, you will be asked to undress on a disposable drop cloth (5). The drop cloth is meant to collect hair or other physical evidence from one’s clothing or body. The examiner will give you a hospital gown to wear for the duration of the examination.
4A - Collecting Clothing: The examiner may ask to collect your clothing, including underwear, to use for evidence. This is only the case if the clothing was worn during, or immediately after, the sexual assault. If you consent to giving your clothing as evidence, the examiner will put each piece of clothing into a separate paper bag. It will be labelled as evidence and given to the police with the SAEK, if you have decided to submit the SAEK to police. If you did not bring a second set of clothes to wear home, you will be provided with additional apparel at the end of your appointment (3, 5, 7).
Step 5 - Physical Assessment for Injuries: Once you have changed into the gown, you will be asked to sit on the exam bed as the examiner assesses your body for injuries or soreness. Injuries (e.g. scratches, tearing, bruising, etc.) may be photographed as evidence with your consent. Any injuries or soreness will be noted on a documentation form included in the SAEK. During this assessment, the examiner may ask to take samples from your body, such as (5, 7):
Fingernail scrapings (using the wooden sticks)
Urine
Blood (if alcohol/drugs were involved)
Head hair
Additional swabs
Taking these samples will depend on the description of the sexual assault that you provide to the SANE before the examination, as the examiner will collect samples from your body according to what you have shared.
Step 6 - Swabbing: After the physical assessment, the examiner will ask to take oral and cheek swabs. The oral swabs are used to identify the perpetrator’s body fluids that may still be in the mouth (5). The cheek swabs are meant to collect your DNA to allow forensics to differentiate between your DNA and the perpetrator’s DNA.
Next, the examiner will ask you to lie down on the exam table and put your feet in stirrups for the next swabbing component of the SAEK, if you consent. The purpose of swabbing is to collect the perpetrator’s body fluids (e.g. semen, sweat, blood, etc.) that may be left on the survivor’s body. The examiner will swab the following, if applicable (5, 6):
External genitalia
Vaginal and cervical area
Penis and scrotum area
Rectal area (Note: rectal swabs will only be taken if rectal sexual assault is reported. They will not be collected for survivors under 18 years old.)
At each step of the process, the examiner will ask for your consent and will detail each move to ensure your comfortability and emotional wellbeing.
Step 7 - Pubic Combing: The examiner will ask if they can comb your pubic hair to collect the perpetrator’s hair or DNA. The examiner will carefully brush through your pubic hair and put the collected hair in an envelope (5). The examiner will gently cut pieces of your own pubic hair to use as a DNA standard; this allows forensic analysts to determine what hair belongs to you, and what hair belongs to the perpetrator. If you do not have pubic hair, a swab may be taken from your pubic area (5).
Step 8 - End of Examination: After the examination is complete, the examiner will ask you to redress. All biological evidence collected during the exam will be put in the SAEK box and labelled with your name.
Step 9 - Debrief: The examiner will sit with you (along with anyone who has been present throughout the examination, such as a friend, advocate, family member, etc.) to discuss next steps. The examiner may suggest taking antibiotics to prevent sexually transmitted infections (STIs) and/or offer emergency contraceptives to prevent pregnancy. It is your choice to accept or refuse this medication (1*, 7).
If an advocate† is present, they will provide resources that you can access as a survivor of sexual assault. These resources include counselling, emotional support, and healthcare options (1*). If no advocate is present, the examiner will go over these options with you.
What happens to the Sexual Assault Evidence Kit after it is completed?
It is your choice whether or not the SAEK is submitted to police, however, if you have already reported the sexual assault to police it must be provided as evidence. Not releasing the SAEK to police after making a sexual assault report is considered withholding evidence in an investigation. You can decide not to proceed with the case after making the report, and at this point you do not have to submit the SAEK to police. If you do not proceed with the case or the case is unsolved, the kit will be kept by the hospital indefinitely (7).
If you report sexual assault to police after having the SAEK done, it will be submitted to police as evidence; you will be notified when this occurs.
If you have not reported the sexual assault to police, then it is not required to submit the SAEK to police. If you choose not to submit the SAEK to police after completing the SAEK, the kit may be kept at the hospital for up to six months. After this period, the SAEK is destroyed by the hospital (7).
The SAEK will not be accessed or tested without your consent, even when it is submitted to the police (7).
*These sources do not specify the gender identity of the women included. Historical representation leads us to believe that only cisgender women were included.
† An advocate refers to a professional working at a local sexual assault agency. An advocate is specially trained to provide emotional support for survivors during a SAEK examination.
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References
Doe J. Who benefits from a Sexual Assault Evidence Kit? In: Sexual Assault in Canada: Law, legal practice and women’s activism. Ottawa: Presses de l’Université d’Ottawa (CAN); 2021. Available from: https://books.openedition.org/uop/577?lang=en.
Du Mont J & Parnis D. Forensic Nursing in the Context of Sexual Assault: Comparing the Opinions and Practices of Nurse Examiners and Nurses. Applied Nursing Research; 2003, 16(3), 173-183. Available from https://10.1016/S0897-1897(03)00044-2.
End the Backlog. What is a Rape Kit and Rape Kit Exam? New York: Joyful Heart Foundation (US). Available from: http://www.endthebacklog.org/information-survivors-dna-and-rape-kit-evidence/what-rape-kit-and-rape-kit-exam.
Maier SL. The emotional challenges faced by Sexual Assault Nurse Examiners: “ER nursing is stressful on a good day without rape victims”. Journal of Forensic Nursing; 2011, 7, 161-172. Available from: https://doi.org/10.1111/j.1939-3938.2011.01118.x.
Ontario Hospital Association. Hospital Guidelines for the Treatment of Persons Who Have Been Sexually Assaulted. Toronto: Ontario Hospital Association (CAN); 2019.
Royal Canadian Mounted Police. Information for sexual assault survivors. Canada: Government of Canada; 2019. Available from: https://www.rcmp-grc.gc.ca/en/relationship-violence/information-sexual-assault-survivors.
Toronto Police Services. What is a sexual assault evidence kit? Toronto: Government of Ontario (CAN). Available from: https://yourchoice.to/evidence-kit.php.