After a Sexual Assault, Where Can You Get a Medical and Forensic Exam?

There is a national shortage of nurses and doctors trained to conduct sexual assault forensic exams. NBC News mapped where they're available in each state

She went to the ER for a rape exam. Her nurse didn't know how to do one.
Kristan Lieb/Chicago Tribune/Tribune News Service via Getty Images

If you or someone you know is experiencing sexual violence, contact the National Sexual Assault Hotline by calling 1-800-656-HOPE (4673), visit the lifeline crisis chat at, or find your local rape crisis center at

After a rape, the first step toward a conviction — before evidence testing, charges and a trial — is a sexual assault forensic exam. Commonly known as a rape kit, the forensic exam can take anywhere from two to six hours. It addresses victims’ health needs, gives them the opportunity to have evidence collected and connects them to advocates — who often accompany them during exams — and police if they choose. A small fraction of reported rapes make it to trial, and a key piece of determining if a case moves forward is if the victim received a thorough exam shortly after the assault. But in many parts of the United States, as Griffin found out, getting that exam from a specially trained provider is not as simple as walking into the nearest ER.

Nationwide, there is a shortage of medical providers trained to conduct exams — mostly nurses called Sexual Assault Nurse Examiners (SANEs), experts say. Few hospitals have robust forensic exam programs and nurses are often on call 24 hours a day to do exams, on top of their other full-time responsibilities. Burnout is high and examiner retention is a consistent problem around the country. Nonprofit programs often struggle with funding, sometimes closing suddenly, while hospitals have little incentive to invest in programs because they do not generate profits.

“This practice loses the hospital money. It sounds cold and calculated, but it’s a very real consideration,” said Nicole Broder, the SANE coordinator for the Oregon Sexual Assault Task Force. Oregon has a statewide program with more than 40 hospitals with SANE programs, but at least 10 of those have limited funding and employ only one or two SANEs, Broder said.

An NBC News analysis of all 50 states and Washington, D.C., found varying standards, patchwork regulations and a lack of funding and support for sexual assault forensic examiners. Examiners are less likely to be available in rural areas, but even in many urban regions, staffing shortages make it difficult for hospitals to have an examiner on call 24/7. New York state has sexual assault exam programs at hospitals in 22 of its 62 counties. Michigan has them in 31 of 83 counties. Indiana has programs in 38 of its 92 counties. Around the country, some facilities may only have one nurse with training on staff, and it can be up to chance if they are available when a sexual assault patient arrives at the ER.

To understand the availability of sexual assault forensic exams nationwide, NBC News spoke to the statewide coalition against sexual assault or equivalent group in every state, government agencies, attorney general offices, university training programs and dozens of program coordinators and individual examiners. Then, using the best available data for each state, reporters built a national map of the findings — the first of its kind — showing where and how those exams are provided.

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