teencut-150x150Sexual assault is a subject that can be uncomfortable to talk about for many reasons: there is stigma and blame for victims, no parent wants to think it could happen to their child, and no parent wants to think their child could be a perpetrator. Recent media events have outlined allegations that Bill Cosby drugged an assaulted numerous women. We’re not here to give opinions about his innocence or guilt, but this is an opportunity to talk about this problem. Dr. Anne-Marie Amies Oelschlager, Pediatric and Adolescent Gynecologist, is our guest blogger. She gives her perspective on sexual assault and offers sound advice for anyone who has been a victim.

I laughed for about ten minutes straight during the Golden Globes at Tina Fey’s and Amy Poehler’s jokes about Bill Cosby’s rape allegations. The jokes were perfectly inappropriate and could have only been launched so effectively at this moment in history without Hollywood heads rolling. Some of you may have felt that they crossed a line and that this was unnecessarily humiliating for Cosby. Let’s be clear that these were jokes. Fey and Poehler did not drug and rape Bill Cosby. 

I am so tired of rape. Every clinic I hear a story of molestation/rape from a young teen. It is almost always by someone with power over her: an uncle, a boyfriend with more money, some random guy who slipped a drug into her drink, her mom’s boyfriend, a physically stronger stranger, a coach, etc. The victim stays quiet out of fear, blames herself, or speaks up and isn’t believed. The rapists all take advantage of the fact that they are rarely prosecuted, let alone convicted. Once convicted, the sex offender registry is one strategy of public humiliation, but if every perpetrator knew that he would be the butt of a joke on national television, we actually might start to see a decline in the incidence of rape. So I laughed, not only because the joke was hilarious and well executed amidst the grimacing audience, but because Fey and Poehler are two women with power who are insisting that this injustice is heard. I am not a comedian, but I do have a voice and so do you. We need to speak more about rape.

As a gynecologist, I am writing this to young women, but guys are raped too, so feel free to change the pronouns. The majority of rapes which occur are perpetrated by a male on a female, but same sex violence is also common, so pretty much, this advice pertains to everyone. Here is my advice to you, my young patients, who are figuring out who you are while you are heading out into the world of independent living, college campuses, parties and relationships. I hope that you will never experience sexual violence.

Here is my advice in case you find yourself in scary situation:

If you are in a scary situation, try to escape. Make a scene! If you are about to be raped, scream, hit, bite, yell “rape” as loud as you can over and over.  Struggle. Statistics suggest the more you fight, the less likely it will continue. While you are struggling, dig your fingernails in to the rapist’s skin and get as much DNA under your fingernails as you can. Do not wash your hands until the DNA has been collected.

Go to the closest emergency room (ER) that is specialized in care of rape victims. This is probably not your campus health center. My patients have shared with me that their rape accounts have been swept under the rug by their campus health centers and counselors. If up to one in five women report being raped in college, how can some colleges boast 0%? This is not plausible and smells of an administration trying to make their campus appear safe.

Go to the ER right away if possible and take a friend to go with you for support. If you don’t have a friend to go with you, go alone. Go! Do not bathe, do not shower, do not douche (you shouldn’t be doing douching anyway). Do not change your clothes. Even if you have already bathed or changed your clothes, take the clothes you were wearing when you were raped. The faster you go, the more likely there will be DNA evidence and the earlier you can get treatment to prevent pregnancy and sexually transmitted infections. Go!

When you get to the ER, tell them everything you remember. Speak with the doctors and nurses. Speak with the police. Speak with the social worker. You may feel numb, afraid, angry, confused, sad, or whatever. They are all normal emotions. There is no “right” emotion for a rape victim. You will probably feel like someone has violated you and a loss of sense of control. You have control over what happens from here. They will ask for your consent to do an exam. Even if you were drugged and you can’t remember much, tell them everything you can remember and let them collect the DNA. A good ER will have the ability to collect DNA evidence and may be able to take pictures if you consent. If they don’t have the DNA collection kit, ask them where the nearest ER is with that capability. Go there to have the exam.

Ask for a drug test to check for Rohypnol. If they find other drugs in your system, that is ok. Just because you drank, smoked pot, or took something else, you still should not have been raped. If the perpetrator drugged you, he intended to rape you. He is a rapist and will likely do it again. They may not catch him for a while, but if you give them DNA, it is much more likely that he will be punished for the crime and that he can be prevented from raping others.

Take everything preventive that they have to offer. The ER should offer you emergency contraception and treatment for gonorrhea, chlamydia, and trichomonas. They may offer you the hepatitis B vaccine, or HIV prophylaxis. Get retested for everything in a few months. Be proactive.

Blame the rapist, not yourself.  You may have worn very small amounts of clothing, you may have had some consensual intimacy, you may have an Instagram photo in a bikini, etc. None of these mean that you “deserved” to be raped. Don’t blame yourself.

If you have been raped, you may have very complicated feelings about future intimacy because of what happened. It will take time and usually counseling before you may be in a healthy place for emotional and physical intimacy. Go slowly and be kind to yourself. Remember that most people are not rapists. Remember that sex is a wonderful gift that you give from yourself. It can be one of the most amazing parts of human existence. Given the power of sex, treat it with respect and only seek intimacy with a partner who you love and who truly loves and cares about you. This is the safest and most pleasurable situation for sex, so don’t set your standards low.

Now here is my advice about prevention.

I want to help shepherd women into adulthood safely with as few of really regrettable experiences as possible. Please be clear, I am not giving fodder to blame the victim if you do or don’t do these things and rape happens.  Regardless of whether you are walking alone at night or posting half naked pictures of yourself online, no one should feel that they have the right to touch you without your consent.

Do not hang out with rapists. What? The trouble with this advice is that rapists usually don’t have a big R on their forehead or have a whistle to announce that they are about to rape you. The truth is that most people are raped by someone they know. If you are dating someone, don’t go to their apartment, to their dorm room, or in their car alone until you are ready. If you feel uneasy, trust that vibe. Date on neutral ground until you are ready and feel a sense of mutual trust and respect. You can take a quiz to assess if your relationship is healthy at http://www.loveisrespect.org/. Critically evaluate your relationships and do not tolerate abusive partners. You deserve respect; don’t let anyone tell you otherwise.

If you are getting weird vibes from anyone: a family member, teacher, coach, TELL A TRUSTED ADULT. Sometimes heartbreakingly, parents don’t believe their children. You can always tell a teacher, a doctor, or social worker. We have to report it to make sure that you are safe. You deserve to be safe. The real advice is that if you are not getting a healthy, respectful vibe from someone, trust that vibe and speak up. If you are in a scary situation, get away. You have my permission to lie to the creepy person if it helps you to escape.

 Don’t be a rapist.  Before you are intimate with someone, check in and ask for permission. “Is this ok with you?” “Do you want to have sex?” Ask! If the answer is not a very clear “yes,” do not go further! Wait. Life is long. Be patient and let your relationship mature. You deserve respect and so does your partner. Guys also feel ambivalent about sex, so don’t assume that all guys want it all the time with any gal. This is a myth. Most guys also want loving, intimate relationships. Don’t be fooled by the myths.

Don’t walk in sketchy places alone. This is standard: call the campus security officers to walk you home at night and park in a well-lit place near the entrance of wherever you are. When I was taking call at the Harborview Emergency Room, before the new parking lot was built, I would park in a dark corner street lot in downtown Seattle. I would hear my patient’s horrible rape story, care for her, and then try to dart to my car at 3 am. This was too much adrenaline for me, so I would ask one of the ER security guards to watch me run to my car or walk with me. You don’t need to have scary walks home or to your car, so ask for someone safe to walk with you or watch you get to your car.

Have a herd mentality. Don’t go into someone’s fraternity room alone without other friends. Not only are those rooms completely nasty (seriously: where has that sofa/mattress been?!?), you don’t want to be away from your herd. If you have watched any shows about big cats killing gazelles, it is the one that gets pulled away from the herd that the herd cannot protect. Stick with the herd. Have a herd plan with your friends. Look out for each other and speak up if you see something that you know is not right.

State/yell what you are thinking. Think out loud! If he is about to rape you, say “you are raping me!!!” So that there is no uncertainty about what is happening. He may have interpreted your dress, your dance techniques, your sexts, or your Shapchat photos as evidence that you are “easy,” but your words can counteract this.  Use them. Your actions speak, but so do your words. You may make him realize that what he wants to do is completely wrong.

Don’t drink too much. Ok, here is the part where some people say that I am blaming the victim. This is not the case, as whether you are drunk or sober, you do not deserve to be raped. However, excessive drinking is really bad for your health, so as a doctor, I am telling you that excessive drinking is something you should avoid. Binge drinking is a problem for adolescents and young adults and is rampant on college campuses. If you are going to drink, you need to learn how to drink safely and not be poisoned. Rapists seek out the intoxicated because they are less likely to remember what happened and have less strength to struggle. Drink less than those around you and never drink enough to pass out.

This advice is also more of a brain power issue. Bingeing on alcohol damages your brain. We as a society need all of your brain power. We need your generation’s brain power to make sure that legislation is passed where wealthy, powerful, and white rapists are just as likely to go to jail as rapists of other colors and from disadvantaged backgrounds. We need legislation to test all the DNA that has been and will be collected. We need more funding for discussion about consent and what makes a good and bad relationship. We need to make sure that victims can access care more easily and be listened to. We need more funding for counseling for rape victims. We need strategies to fix the blame-the-victim mentality so that victims will feel safer telling their stories. We need to prosecute venues where rapes occur (fraternities, etc.). We need to call attention to sexual violence in the media. We need a less patriarchal society. We need your brain power.

If you are going to drink, don’t accept a drink from someone else. Go to the source and get your drink yourself. A laced cocktail is concerning; it looks like a normal drink but it is laced. Rohypnol is being used.  Just a few days ago, several University of Washington students realized that they had been given laced drinks at a fraternity party. Get the drink straight from the bartender, keg, or bring your own bottle of alcohol. If you feel woozy, tell your friends immediately so that they can care for you. Chivalry is dead when it comes to rape.  A rapist who brings you a laced drink is never chivalrous.

Have a plan with your friends in advance. Talk about this with your dorm mates. Talk about it with your roommates. Have a code text message that can convey if you need help. Know which ER to go in advance. If you are raped, you will feel overwhelmed. If you know in advance what you should do, you are more likely to do it.

I am so encouraged by all the local and national conversations about rape. There is more to be done. Be an activist! March in your local SlutWalk. Work with your campus to increase awareness. Think about what the future can hold, not only in our country, but internationally in countries where women may have fewer legal rights. All humans deserve to choose loving, consensual, safe, intimate relationships and to live without fear of violence. We all need to work toward this goal.

If you would like to read more, check out these resources:

www.futureswithoutviolence.org

Rape, Incest, and Abuse National Network (RAINN) https://www.rainn.org/get-information/sexual-assault-prevention

The University of Washington Center for Sexual Assault and Traumatic Stress: http://depts.washington.edu/hcsats/

http://www.loveisrespect.org/