Deborah White

Client satisfaction with nursing-led sexual assault and domestic violence services in Ontario.

Introduction: There is still little known about survivors’ experiences of and satisfaction with comprehensive nursing-led hospital-based sexual assault and domestic violence treatment programs. Method: To address this gap, we surveyed and collected information from clients/guardians presenting to 30 of 35 of Ontario’s Sexual Assault/Domestic Violence Treatment Centres across seven domains: presentation characteristics, client characteristics, assailant characteristics, assault characteristics, health consequences, service use, and satisfaction with services. Results: One thousand four hundred eighty-four clients participated in the study, 96% of whom were women/girls. Most were White (75.3%), 12–44 years old (87.8%), and living with family (69.6%); 97.9% of clients used at least one service. The most commonly used service was assessment and/or documentation of injury (84.8%), followed by on-site follow-up care (73.6%). Almost all clients/guardians reported that they received the care needed (98.6%), rated the overall care as excellent or good (98.8%), and stated that the care had been provided in a sensitive manner (95.4%). Concerns and recommendations to improve care expressed by a small proportion of clients/guardians focused on long wait times, negative emergency department staff attitudes, issues of privacy and confidentiality, and difficulty with accessing services. Discussion: The high uptake and positive evaluation of services provided by Ontario’s Sexual Assault/Domestic Violence Treatment Centre programs confirms the value of nursing-led, hospital-based care in the aftermath of sexual assault and domestic violence. Ongoing evaluation of such services will ensure the best care possible for this patient population.

Barriers to the Effective Use of Medico-Legal Findings in Sexual Assault Cases Worldwide

Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and “grey” literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.

Seeking a better world for women and girls

A moral and political movement is needed to end gendered oppression

Examination for Sexual Assault: Evaluating the Literature for Indicators of Women-Centered Care

This study aimed to assess the extent to which recent peer-reviewed published literature on the acute management of sexual assault was women–centered. We developed indicators and a framework that operationalized women-centered care provision in the context of sexual assault. We then reviewed and evaluated the literature in relation to these indicators. A systematic search identified a total of 20 relevant articles for inclusion in the analysis. These were published in medical journals (65%, 13/20), nursing journals (20%, 4/20), and journals targeted toward other health care practitioners (15%, 3/20), and originated from the United States (65%, 13/20), the United Kingdom (15%, 3/20), Australia (10%, 2/20), Spain (5%, 1/20), and Canada (5%, 1/20) between January 2000 and August 2005. We found little acknowledgment of the inherent tensions faced by sexual assault examiners in providing women-centered care. Moreover, absent from most articles were discussions of the complexities of consent in sexual assault examinations, social justice issues, the need for gender-sensitive training for health care providers, and a critical appraisal of colposcopic and DNA technologies. Indicators of respect, safety and restoring control, and connections to community were present in the majority of articles.

Silly girls and "nice young lads" vilification and vindication in the perceptions of medico-legal practitioners in rape cases

In this article, we explore perceptions and presumptions in relation to rape, raped women, and rapists, among medico-legal professionals who perform forensic medical examinations in rape cases. We draw upon data from in-depth interviews conducted with forensic medical examiners and forensic nurse practitioners in one area of England. Findings reveal that many of these personnel hold particular views centered broadly on the vilification of victims and the vindication of perpetrators. We conclude that these perceptions and presumptions may hold concerning implications for both victim experiences and evidentiary and judicial outcomes.

“To This Day She Continues to Struggle with the Terror Imposed upon Her”: Rape Narratives in Victim Impact Statements

This study locates the victim impact statements of raped women in the sociolegal context of significant sentencing law reforms introduced in Canada to address an ascendant victim’s rights movement. We examine 38 reported sentencing decisions in sexual assault cases in Ontario, Canada (1999–2010). Our objectives are to discern (a) whether the archetype of the ideal victim continues to influence juridical discourse after conviction and (b) what narratives of harm intersect with sentencing objectives and aggravating factors. Our findings suggest women express profound fear of re-victimization and traumatic effects of sexual violence regardless of the relational context of their rape experience. Most surprisingly, our data show sentencing judges view the sexual assault of an intoxicated rape victim as an aggravating factor. Future consideration for victim impact statements in sexual assault cases is discussed.

Self-Defense or Undermining the Self? Exploring the Possibilities and Limitations of a Novel Anti-Rape Technology

Despite decades of feminist-inspired law reforms, rape remains highly prevalent. While many continue to fight for broad cultural and institutional changes, some argue that more immediate interventions are required. Self-defense techniques represent a key strategy of resistance to rape, and empirical evidence suggests that women’s active resistance may hold a number of positive benefits. In this essay, we compare the aims and objectives of a novel anti-rape technology, known as the Rape-aXe, with traditional self-defense techniques, focusing upon the potential for both to resist individual acts of sexual aggression and, more broadly, end gendered sexual violence.