Rape
Alternative names:
sex and rape
Information:
DEFINITION
Sexual intercourse forced on a nonconsenting person.
BACKGROUND INFORMATION
The potential causes of rape are varied and controversial. Among factors that contribute to rape are: decreased status (or perceived power) of women within a society; pervasive media exposure of sex; availability of pornographic materials, especially those involving acts of violence; inadequate information or misconceptions regarding sexual behaviors; and the prevalence of child sexual abuse. It is important to realize that the victim is not the cause. Less than 4% of all rapes are classified as "victim provoked."
Rape is usually a violent act by a male upon a female; however, numerous cases of rape have been reported where the woman is the rapist and the man is the victim. Rape may occur between members of the same sex. This is more prevalent in institutions where access to the opposite sex is restricted (such as prisons, military settings, and noncoed schools).
About 45% of rapists are 15 to 25 years old. They frequently harbor feelings of violence or hatred towards women and often feel insecure or inadequate and may have experienced problems with sexual performance (such as impotence or premature ejaculation). Nearly half of the time the rapist is known to the victim, at least casually, or works or lives near the victim.
A rape is reported every 6 to 7 minutes in the United States, and it is estimated that 80 to 90% of rapes are not reported. Current trends project that 1 in 3 American women will be sexually assaulted at some point during life. Children are frequently the victims of rape. The highest incidence is among females 10 to 19 years of age. However, rape of elderly or disabled women is increasing rapidly. The incidence of rape, with victims over 65 years, has risen 800% over the past 15 years. Over 50% of rapes occur in the victim's home with the rapist either breaking into the home or gaining access under false pretenses (such as asking to use the phone, posing as a repairman or salesman).
People who are targeted for some form of discrimination (including racial discrimination) are believed to be at higher risk for sexual assault. This may be attributed to increased vulnerability because of decreased ability to call for help (for example, those with limited language skills or disabilities), decreased "perceived" credibility (prostitutes or convicted prisoners), and any women whose "male protectors" are either nonexistent, less socially powerful, or not readily visible.
PREVENTION
Much of the information regarding the prevention of rape is aimed at victim behavior. This approach tends to blame the victim as the cause ("if she had not been alone at night," "if she did not dress that way," "if she had not accepted a ride home from the party, office or school with him"). True prevention involves permeating society with the message that individuals must stop being blind to violent acts, stop each other from committing such acts, stop condoning such violent behaviors in others, and stop blaming victims.
Until such concepts are the norm throughout our culture, safety tips which may prove helpful include:- Keep doors/ windows secured with locks.
- If walking or jogging, stay out of secluded or isolated areas and arrange to do activity with at least one other friend rather than alone. It is best to engage in activities during daylight hours.
- Try to appear strong, confident, and secure with surroundings.
- Keep car doors locked while driving, check back of car for intruders prior to getting in, and park in open, well-lighted areas.
- On public transportation, sit near the driver or up front if possible; avoid sitting near groups of young men obviously associated with one another.
- Learn the basics of self-defense. Self-defense may include a variety of activities that promote self-confidence, self-reliance, and self-knowledge (such as assertiveness training, sports conditioning and participation, and martial arts).
- Carry items that could potentially be used as weapons (for example, a roll of coins, an umbrella or a cane, a spray bottle filled with ammonia, or a cigarette lighter).
- If an assault attempt is initiated, scream loudly and/or blow a whistle.
- Do not hitchhike. If your vehicle breaks down and someone offers to give you a ride, ask the person to call for help while you stay locked in your vehicle.
Numerous studies have shown that people (especially women) who respond to the situation quickly and actively resist the attacker are more likely to avoid being raped than those who exhibit either passive behavior or no resistance.
SYMPTOMS
The victim may or may not be able to verbalize that she was actually raped or may present a different complaint. Emotional reactions differ greatly and may include: confusion, withdrawal, crying, nervous (or seemingly inappropriate) laughter, calm, directive, hostile, and scared. The victim may have a variety of other physical concerns needing to be addressed. (Physical abuse other than the rape frequently occurs.)
SIGNS AND TESTS
A history should be obtained including the date and time of the rape attack, setting where it occurred, details of the attack, and what the victim has done since the attack occurred (for example, showered and changed clothes as opposed to coming directly to the hospital). If possible, this should be done with both medical and investigating police present, to eliminate the need to have the victim repeatedly recall the incident.
Additional medical history information that should be obtained includes: any possibility of pregnancy prior to the attack; the date of the last menstrual period; any drug allergies; a pertinent gynecological history, including any prior sexual abuse or assault; and the presence of chronic illness or recent illness or injury, as well as current medications.
A complete physical examination should be done to document any objective signs of trauma. Pictures may be taken to note bruises, scrapes, or cuts. X-rays will be taken if fractures are suspected.
Numerous samples and specimens may be collected for evidence including clothing, pubic hair samples (particularly if foreign materials are noted within it), fingernail scrapings, and vaginal (and mouth or anal, if indicated) samples to examine for evidence of sperm and test for sexually transmitted diseases.
TREATMENT
In many cities, rape cases are referred to specific emergency rooms. This has allowed those sites to provide more specialized care for the unique needs of the rape victim and assure proper procedures are followed to maintain the "chain of evidence" necessary for a case that may go to trial. Such sexual assault treatment centers may also employ, or have available on-call, a team specialized in assessing and dealing with the psychosocial, physical, and legal issues a rape victim faces. Most state laws require that the victim be evaluated in the emergency room prior to the rape being officially reported. It is recommended that a rape victim go to the hospital immediately after the rape incident occurs, without changing clothes, showering douching, urinating since such activities may alter or destroy evidence helpful in identifying and prosecuting the rapist.
Treatment focuses upon providing sufficient emotional support while attempting to collect adequate objective evidence to verify the victim's complaint of rape. If the victim has a support person she wants present, efforts should be made to make that possible; otherwise someone (such as the nurse) should be "assigned" to stay with the victim throughout the interviews and examination. The victim should not be left alone unless that desire is expressed. The choice, to be initially interviewed in street clothes rather than immediately being directed to disrobe and put on a patient gown, should be offered. The examination and collection of specimens should be fully explained beforehand to the victim, and whenever possible, the victim should be given choices in an attempt to regain a sense of control. Maintaining a supportive environment, free from any judgmental statements, may encourage the victim to express whatever feelings arise.
Treatment includes addressing any potential for pregnancy or sexually transmitted diseases, offering information pertinent to those possibilities, and providing care for the immediate physical and emotional trauma incurred, as well as planning follow-up care. Referral to a local rape crisis center may be helpful for the victim to receive peer support and advice necessary for adequate healing from the trauma.
PROGNOSIS AND OUTCOME
Recovery from a rape typically includes the acute phase (immediate period of physical pain and wound healing, emotional reactions and coping mechanisms put into action) and the reorganization phase (occurring about one week after the rape and lasting months to years, as the victim attempts to restructure and "get on with life").
COMPLICATIONS
Many women are never fully able to emotionally recover from a rape incident. Phobias may develop related to specific general circumstances of the assault. More than 50% of rape victims have difficulty in re-establishing relationships with spouses or partners or, if unattached, re-entering the "dating scene." Any pre-existing psychiatric disorders may be exacerbated. Suicidal behaviors, substance abuse and neurotic behaviors may develop or become more prominent.
CALL YOUR HEALTH CARE PROVIDER IF- you have recently experienced a rape
- you are the victim of past sexual assault but never sought or received adequate care
- you have been raped (recently or in the past) and are experiencing personal or relationship problems.
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The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2000 adam.com, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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