podcast postContent note: this episode addresses sexual violence.

“Not every Ontario hospital has rape evidence kits,” reads a recent Toronto Star headline. “A proposed law would change that.” May is Sexual Assault Prevention Month, and the issue of sexual assault evidence kits not being available to survivors in all hospitals – in Ontario and throughout Canada – is an important one. But sexual assault is one of the most underreported crimes. Survivors may not feel safe enough to report in the first place. Evidence collection is just one piece of a complicated puzzle.

What’s the issue with sexual assault evidence kits in hospitals? And what’s the deeper story about evidence, reporting, supporting survivors, and ultimately, ending sexual violence? Nicole Pietch, Writer and Advocate at the Ontario Coalition of Rape Crisis Centres (OCRCC), joins us to share her insights.

Nicole Pietsch is a past counsellor at the Sexual Assault Centre of Halton and current Writer and Advocate with the Ontario Coalition of Rape Crisis Centres. OCRCC works toward the prevention and eradication of sexual violence. OCRCC’s membership includes community-based sexual violence and rape crisis centres from across Ontario, offering counselling, information and support services to all survivors of recent and historical sexual violence, including sexual harassment and sexual trafficking. Since 1998, Nicole has assisted adults and youth living with violence, including immigrant and refugee women and survivors of sexual violence. Nicole has worked with youth survivors of violence who are incarcerated, those living in an institutional settings, and Deaf youth. Nicole’s written work has appeared in York University’s Journal of the Association for Research on Mothering, and the University of Toronto’s Women’s Health and Urban Life and Canadian Woman Studies/les cahiers de la femme.

If you or someone you know has experienced sexual violence, find support options at OCRCC’s website.


00:00:00 Andrea 

Hi, I’m Andrea at the Canadian Women’s Foundation. 

Hospitals are a place where anyone might go for an array of services and support. If you’ve experienced sexual violence, perhaps you might go there for medical attention. You may ask for counseling or other help. Maybe you would go there and ask about what it would mean to report the assault. Maybe you’d ask about the collection of physical evidence. “Not every Ontario hospital has rape evidence kits” reads a recent Toronto Star headline. A proposed law would change that. 

What is the issue with sexual assault evidence kits in hospitals and what’s the deeper story about evidence collection, reporting, supporting survivors and ultimately ending sexual violence? 

00:00:47 Andrea 

Welcome to Alright, Now What?, a podcast of the Canadian Women’s Foundation.  We put an intersectional feminist lens on stories that make you wonder “Why is this still happening?” We explore systemic roots and strategies for change that will move us closer to the goal of gender justice.           

The work of the Canadian Women’s Foundation and our partners takes place on traditional First Nations, Métis, and Inuit territories. We are grateful for the opportunity to meet and work on this land. However, we recognize that land acknowledgements are not enough. We need to pursue truth, reconciliation, decolonization, and allyship in an ongoing effort to make right with all our relations. 

00:01:31 Andrea 

May is Sexual Assault Prevention Month in Canada. Ending all gender-based violence, including sexual violence is a big part of our work at the Canadian Women’s Foundation. Our grantee partners do anti- violence programming all over the country. They include Prince Edward Island Rape and Sexual Assault CentreMa Mawi Wi Chi Itata Centre in Manitoba, Black Women In Motion in Ontario and Prince George Sexual Assault Centre in British Columbia, to name a few. 

Approximately 4.7 million women, or 30% of all women aged 15 and older, have experienced sexual assault and this is a conservative estimate. The rate of sexual assault against Indigenous women is approximately 3 times higher than among non-Indigenous women. The rate of sexual assault against people with disabilities is about two times higher. Sexual assault is the only violent crime in Canada not on the decline.  

So, this issue of sexual assault evidence kits not being available to survivors in all hospitals, whether in Ontario or other regions of the country, is an important one. But sexual assault is also one of the most underreported crimes. Survivors may not feel safe and supported to report in the first place. Evidence collection is just one piece of the puzzle if our goal is ending sexual violence altogether. 

Nicole Pietsch is writer and advocate at the Ontario Coalition of Rape Crisis Centres also known as OCRCC. She joins us now and starts with what they do. 

00:03:01 Nicole 

We’re a network of over 30 community-based sexual assault centres all across Ontario. And community-based means they’re not associated, let’s say with victim or police services necessarily, and they’re not associated with hospital-based services. And we see survivors who are coming to talk about things that might have happened you know yesterday or a week ago, as well as survivors who experienced sexual violence many years ago and more months ago, and they’re just beginning to talk about it now. 

00:03:29 Andrea 

So, we see the news every so often talking about sexual assault evidence kits. Give us a background. What are they supposed to do? And what are the access issues that you see in Ontario and other parts of the country that we have to pay attention to? 

00:03:43 Nicole 

So not everyone knows what’s included in a sexual assault evidence kit. These are kits that are conducted at hospitals that are designated centres. They’re usually called a sexual assault and domestic violence forensic centre or sexual assault domestic violence centre that’s connected to a community’s hospital. And they collect the evidence after a recent episode of sexual violence. 

So, for example, if I was sexually assaulted at a party, or, you know by someone I know, I can go to a sexual assault clinic at a hospital and have the evidence kit done. And it includes components like maybe some of the clothing the person might have been wearing, or taking parts of evidence from underneath their fingernails. It also includes more, I would say intimate or more intrusive components, like swabbing some of their private areas where there might be fluid or other bodily evidence of sexual violence. And so some of those things can be used if that person decides to go forward and report to the police and it becomes part of the evidence in the sexual assault case.  

So, it’s important to know that community-based sexual assault centres are different than hospital- based sexual assault centres. It’s the hospital-based ones that actually do this evidence collection and the forensic component, whereas community based sexual assault centres can tell survivors about those process, those processes and accompany them to the hospital or meet them there and be there as like an emotional support and advocate while they go through that process. 

But whether or not they have an advocate with them, to do a sexual assault evidence kit, it’s always the choice of the survivor. So sometimes a survivor, they may choose to do one piece of it or all of the components of it, and some of them may choose not to do it at all. And they can still go to either a hospital or community-based sexual assault centre in order to get support and that other components like let’s say STD testing or prophylactics to reduce the chances of sexually transmitted infection or pregnancy, in the case of their sexual assault. 

00:05:58 Andrea 

That’s really helpful. Now what about the idea that sexual violence is really underreported in Canada and evidence kits then will only do so much for the goal of sexual assault, intervention and prevention.What concerns still loom large for you even though the kits might be available to survivors in every health care site in Canada? Even if that were the case, what would still be a concern for you? 

00:06:23 Nicole 

So, as I’m describing the kit, people might be thinking as they’re listening, you know, that’s just one component of responding to sexual violence or understanding it. 

So for example, while access to an evidence kit is, can be really key for someone who’s choosing to report. There’s lots of folks who they never choose to report for a lot of different reasons. A lot of survivors still they fear being believed. We know that statistically, sexual violence is really challenging in terms of seeing resolution through the criminal justice system, and I’ll share a bit more about that. 

When you think about the sexual assault evidence kit what it does show is that sexual contact occurred. So if I was a survivor and I got the complete kit done yes, we could collect evidence that shows let’s say that I encountered a physical assault. It could also show forensic evidence about who the offender might have been, but at the same time, it doesn’t show whether or not consent occurred. And that’s a huge component of actual sexual assault cases that tend to occur in reality. 

So for example, if I was sexually assaulted by someone I went on a date with or my intimate partner, someone I work with or you know, someone who I invited over to my home just to hang out and spend time with, that would not necessarily show that a sexual assault happened. So in the case when it went to the police or proceeded through the criminal justice system, it still rests on that survivor to be able to convey that they did not consent to that sexual contact, right? So you could have readily available kits, but it may not necessarily increase the chances that we’ll see more convictions. 

Now I will say it’s super important that those kits are readily available. If a survivor was assaulted, you know in the last few days, or week, and they want access to the kit, it might really change their mind if they have to drive, you know, let’s say they live in a rural area, if they have to drive 2 hours to get the hospital that has one. So certainly, I think in particularly in rural remote communities, those access considerations are really key. But I don’t think they’re the magic bullet to addressing or increasing convictions around sexual assault. 

Many survivors got that kit done and still had a really challenging road to go down in terms of being able to convey what happened in the incident of sexual violence and worrying about being believed. That what happened as an act of violence would be kind of constructed as something that was consensual sexual contact. 

00:08:56 Andrea 

Being able to access services is a huge barrier for people. I just am so curious as to what does it mean when you want to have evidence collected? What’s the process like and what does it mean in terms of what are the options for you if you’re not comfortable? 

00:09:13 Nicole 

For example, I happen to live in Halton region. I think we have four hospitals here and it’s very likely in my community that of those four hospitals, each one probably would take me, you know, maybe once 10 minutes away, but the furthest one is probably more like 40 minutes. And I don’t live in a big region, you know? So for a survivor in my region, there may be only one or two of that total four hospitals that happens to have the sexual assault evidence kit and trained nurses to administer them. That doesn’t mean if you are someone who is closest to one of the hospitals that don’t have it that you can’t get it done. Instead it probably might mean maybe you go to the hospital and you wait for that kit to arrive, delivered by someone from the other hospital. Or it might mean that you’re asked to head to another hospital where they have the kits and the nurses with the training to administer them readily available. 

For people who are encountering any kind of medical issue it’s really tough to be told, you can’t get that service here or there’s going to be an additional wait. Think about it for a survivor or crime that’s just 10 times harder. And there’s a lot of people who’d be really deterred by that and they say, forget it, I’m just going to go home and go to sleep. 

In rural and remote communities, and that includes northern communities, these challenges are just additionally more complex. You may live in a region where, as opposed to your hospital being 10 or 40 minutes away, you may need to drive 40 minutes to get there. In addition to that, rural hospitals may be situated in regions where there’s not as much accessible public transit, so if you didn’t have a drive and you went to one hospital on your own dime and then came to find that place doesn’t have the resources, sort of the kit or the staff trained to administer the kit, it would feel like a real downer and create barriers to someone who might want to actually use it. 

I mean, in an ideal world, a survivor shows up at a hospital and they’re being able to be seen by someone who has the forensic but as well as the trauma-informed training to be able to administer the kit in a short period of time. Waiting can be really arduous and painful for someone who’s been recently victimized. And there may also feel really quite anxious about what’s next in the process. Part about getting the sexual assault evidence kit is understanding what it means. It means understanding what the components are so that that survivor can make decisions about whether or not they feel OK to go through that physical process. Another part is understanding what will happen if I choose to move forward and report to the police. 

Some survivors have the evidence kit and they choose not to report and then down the road they can report at a later time. That evidence stays in a freezer, it’s ready to go when they’re ready. And then there’s some people who may choose never to do a sexual assault evidence kit. That doesn’t mean that you can’t proceed and report what happened to the police, it just means you are not going to have the physical evidence for it. 

And as I said before, because consent is something that isn’t necessarily proven through physical evidence, it’s not necessarily going to make or break all of the cases, but we know sexual assault cases going through the criminal justice system, there’s lots of inherent challenges to it. One of the largest ones being that that evidence your body as the victim of the crime is a large part of it. There’s barriers and emotional challenges for survivors to play that role, to be that victim witness. And at the same time, the piece of the evidence kit also, it just doesn’t have the ability to capture all the pieces. For example, whether or not you said yes or no to sexual contact, that’s just not clear when we look at physical evidence. 

00:12:54 Andrea 

And I wonder about the social location as a barrier. 

00:12:58 Nicole 

When you are doing a sexual assault evidence kit it’s different than, let’s say accessing support from someone you know, someone who’s a person or a leader in your own community. It’s different from somewhere where you have to make a case for what happened. 

Disclosure is really a key part about working through an experience of sexual violence. 

We know that for some racialized people, they have a relationship with some supportive people in their community, or they may have had negative experiences with systems and systems includes you know formal reporting processes like going to the police or dealing with like a human rights tribunal. And so some people, they’ve had negative experiences with systems like that, and so they may not want to go down that formal road. At the same time, there’s some good resources at hospitals but hospitals are also a system. 

In recent years, we’ve seen some really good reporting in the media about the experiences of Indigenous and Black people and their experiences in receiving healthcare. Even just going through this pandemic, we’ve really seen how racialized or communities who are who have limited, let’s say financial resources are facing way more barriers to things, just accessing supports or being able to have a rapport or relationship with community-based and system-based services. And that’s the same as in situations of sexual violence. 

So for example, there might be some survivors of violence who they have family members or friends who are from the same racial or faith background as themselves that may have felt that they had an interaction with health services where they weren’t understood or treated respectfully. And it makes a big difference in how people choose who they’re going to go to for support in the future. 

From a way of addressing barriers, we always say there should be more options than less. 

For different survivors, they’re facing different barriers, and they’re also facing different myths that can get in the way of whether or not it feels safe to disclose. 

So for example, if I was someone who used mobility device to get around, I might think twice about whether or not I want to go to a hospital setting that I’m not too familiar with. So if that evidence kit wasn’t the one near it wasn’t in the hospital nearby, it was somewhere I’ve never been, I might think, oh man, do I really want to go there? I don’t know what to expect. And I would say the same for people with let’s say communication differences. So if you’re someone who communicates with ASL, accessing some of these system-based supports, there’s an additional layer of access barriers. Or someone who speaks a language other than English and they’d prefer to community based, to go to a community-based setting where they can speak to someone in their own first language, and that’s how they wish to share that first time disclosure of sexual violence. 

So these are all the, I would say, the big picture things, quite a number of different things that can get in the way for someone who’s been sexually assaulted. 

00:16:26 Andrea 

What do you think needs to happen now to end sexual violence and best support all survivors from that intersectional lens that you’re talking about? 

00:16:33 Nicole 

I think a lot of people think there’s not much that they can do, but there are. Some of those things are things that we do every day. 

It might be if you are someone from a particular community you have connections to young people. Maybe that means talking to them about what their sexual rights are, letting them know what healthy relationships look like, being open to them when they talk about things like, let’s say what sexual harassment looks to them at work, looks to them to be able to provide that lens of what their rights are. 

 I think also too part of trying to end sexual violence also means being aware of a lot of the cultural things in the world we live in, not only that foster victim blame but also pieces that don’t hold sexual violence offenders accountable. 

One of the greatest ones that we often think about in communities is sexual assault myths. 

There’s a lot of sexual assault myths that unfortunately they still remain that survivors lie about what happened in order to get revenge or to be perhaps they feel bad about having consensual sex, and so they make up an allegation. We know that that is one of the biggest myths out there, and it still continues to keep survivors from speaking out.  

There’s a long history to colonial violence that is sexualized, so for women identified folks who are racialized, so let’s say Indigenous women, Black women and other women of color. A lot of colonial myths suggested that women in these racialized communities were sexually available, or were the property of people with white skin privilege. For survivors of colour who go through the system they will often face these myths in themselves, right? So they they worry about them themselves, and they may also face them when they are beginning to share their story about sexual violence. 

So these are some of the systemic pieces that I think it’s really important to be aware of and to not be nervous about having conversations about. So when we hear those myths or racialized or gendered stereotypes, think about how they connect with sexual violence and may seem to make it more permissible. 

But we all have a role to play in speaking out against that. And I’ve said already before more options is better than less. To have, you know, options that are hospital-based clinical as well as police-based options such as reporting. They’re also important to have community-based options. In community based sexual assault centres, we often hear from survivors who might have lived with that story of what happened to them for many months or weeks or years. And they’re just speaking out about it now. That means it’s really important for survivors to know their options. When we checked in with survivors in rural communities in a needs assessment a few years ago, and we learned that many of them had believed if they didn’t report, they didn’t have any support options. And that’s not true. 

Some survivors choose to report to the criminal justice system what happened. Some go to hospitals for medical treatment in some of the processes we’ve talked about here, and some just choose to speak to a counselor in a confidential space in a community-based setting. 

When we talk about people from different backgrounds, they might feel safer and more supportive talking with someone who is a known leader and not necessarily associated with, let’s say, a formal social service agency. 

And if you’re a person in leadership like government or funder, think about what that looks like. 

We know the prevalence of sexual violence, is it still remains high. More people are speaking out than ever before. And yet community-based services that support survivors of sexual violence, they have waiting lists and their crisis line calls are increasing more than they were even three or four years ago. 

What we found in our member agencies when we polled them recently about their pandemic experiences, I think it was something like over 70% had seen an increase in demand for counseling services for sexual assault survivors.  And over 80% of our member centres said they had seen an increase since the pandemic started in their crisis line calls. 

00:20:45 Andrea 

Alright, now what?  

Nicole gave us some great directions on how we can challenge sexual violence. If you want to learn more about how you can offer judgment-free support to those dealing with abuse in your life, go to signalresponder.ca. It builds on the well-recognized Signal for Help we launched in the pandemic and it offers tools and training to people like me and you who want to learn how to transform stigma and silence about abuse into effective action and support. Sign up for the learning journey today at signalresponder.ca. 

00:21:18 Andrea 

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