INTRODUCTION
Sexual violence is a public health issue. But when survivors of sexual violence seek health care in the immediate aftermath of a sexual assault, the health care provided is typically focused on evidence collection—a legal response rather than a health care response. Even when attention is paid to the immediate medical needs of survivors, the health care setting typically fails to attend to their long-term mental, physical, and emotional health. Moreover, for many survivors, the care they need is priced beyond their reach. Attacks on access to health care coverage and to comprehensive reproductive health care—including abortion and barriers to LGBTQIA-affirming care— also harm survivors of sexual violence, and disproportionately harm survivors of color. Further, the health care system can itself be a site of sexual harassment, including sexual violence.
No matter their sex, race, class, caste, sexual orientation, gender identity, immigration status, or whether they have a disability, all survivors of sexual violence should receive trauma-informed, culturally competent, linguistically appropriate, identity-affirming health care that addresses both their immediate trauma and the long-term physical and mental impacts of sexual violence. Financial insecurity should not be a barrier to receiving that care. This care must prioritize survivors’ needs and be responsive to their own objectives, rather than automatically prioritizing the needs of the criminal legal system. For survivors who can become pregnant, this includes ensuring emergency contraception and abortion are available, affordable, and provided without stigma.
WE ARE CALLING FOR
- Universal, quality health insurance that ensures comprehensive coverage is available for short- and long-term health consequences of sexual violence, including reproductive health care (including contraception and abortion) and mental health care, at no cost.
- All health insurance policies to fully cover mental health services without co-pay, including a range of trauma-informed therapies, community healing services, substance abuse treatment, and harm reduction services, culturally-competent and identity-affirming services and healers.
- Ensuring health care providers are trained in trauma-informed care, that they routinely screen for sexual violence, that medical schools and national associations provide specialized training in health care that meets the needs of survivors of sexual assault, (including the needs of survivors of color, immigrant survivors, survivors whose preferred language is not English, and LGBTQIA+ survivors) and that those providers receiving training represent a diverse array of communities.
- Increased availability of health care for survivors, including through federal investments in growing the number of specialized providers (including sexual assault nurse examiners) in underserved areas, increased funding for community health care centers to expand survivor-centered, trauma-informed services, and expanded mobile health care.
- Robust enforcement of protections against sexual violence and other forms of sexual harassment by health care providers, including public education about these protections.
POLICIES THAT MOVE US FORWARD
- Expansion of health coverage, including Medicaid and Medicare coverage, and exploration of a publicly-funded, national health insurance program that covers everyone, including full coverage of the services that survivors need to thrive.
- Expand access to abortion care through the EACH Woman Act, which would abolish the Hyde Amendment and ensure abortion coverage in Medicaid and other federal health insurance programs. Eliminate state restrictions to abortion care by passing the Women’s Health Protection Act.
- Pass the Access to Birth Control Act to protect and access to contraception at pharmacies.
- Offer and make available a free of charge full course of HIV Post-Exposure Prophylaxis medication to all survivors including young people (without the need of a consent from a parent or a guardian) and follow-up care.
- Pass the Dignity for Incarcerated Women Act to protect and restore the dignity of survivors in federal, state and local correctional facilities.