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Sexual Abuse or Assault (Rape)
Sexual abuse or assault (rape) can happen to anyone. If it has happened to you, you aren't to blame. Sexual abuse is any type of sexual activity that is done against your will. It can be nonviolent sexual abuse. Examples include nontouching sexual exposure (like being forced to look at sexual pictures) and unwanted or forced sexual touching. Or it can mean a violent sexual assault, such as rape or attempted rape. The attacker may be a stranger or someone you don't know well. Or it may be a close friend or a family member (incest). Many victims of abuse or assault know their attacker.
Teens and young adults may be at risk for becoming victims of sexual assault or violent behavior in situations where certain date rape drugs are used.
It's often hard for people to talk about sexual abuse or assault. The person who was abused often feels shame or guilt and may be too afraid of the abuser to say anything. But it's important to seek help and then keep getting help for as long as you need it. Talk to the police or to a health professional, such as a doctor, nurse, or counselor. Or call a local rape crisis center. Any of these people can help you get medical treatment, deal with your feelings, and take steps to stop the abuser or rapist.
Nonviolent sexual abuse
Sexual abuse can be something spoken or seen. Or it can be anything that forces a person to join in unwanted sexual contact. This type of abuse may occur over and over. Examples of nonviolent sexual abuse include forcing a person to:
- Look at a naked body or naked genital area.
- Watch, look at, or be a part of sexual pictures.
- Watch a sexual act, such as masturbation.
- Be touched (fondled).
Violent sexual assault
Violent sexual assault is any forced sexual contact where something is put into (penetrates) the vagina, anus, or mouth. Violence or fear is used to force the person to have sex. Examples include:
- An object placed into the vagina or anus.
- Forced oral sex.
- Forced sexual intercourse (rape).
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Sexual abuse is any type of sexual activity that is done against your will. It can be:
- Nonviolent sexual abuse, such as unwanted touching or being forced to watch or look at sexual pictures.
- Violent sexual assault, such as rape or forced oral sex.
Neglect is a form of abuse. It happens when caregivers do not protect the health and well-being of the person they are supposed to take care of.
Two common types of neglect are:
- Child neglect. This happens when parents (or other caregivers) fail to provide a child with the food, shelter, schooling, clothing, medical care, or protection the child needs.
- Elder neglect. This includes failing to provide an older person with food, clothing, shelter, medical care, and other basics. Neglect can include failing to pay nursing home or medical costs for the person if you have a legal responsibility to do so.
If you have just been sexually abused or assaulted, try to preserve any evidence of the attack.
- Do not change your clothes.
- Do not bathe, shower, brush your teeth, or clean up in any way.
- Do not eat or drink anything.
- Do not smoke.
- Write down everything you can remember about the assault and about the person who assaulted you.
Physical abuse may include:
- Acts of physical violence, like hitting, pushing, shaking, slapping, kicking, pinching, choking, strangling, and burning.
- Threats of physical violence against you, your family, or your pets.
Seek Care Today
Based on your answers, you may need help soon.
Call your local YMCA, YWCA, hospital, clinic, or police department, or call an abuse hotline.
You may also call 911.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Seek Care Now
Based on your answers, you may need help right away.
Call your local hospital, clinic, or police department, or call an abuse hotline.
You may also call 911.
If you feel threatened or need help right away:
- Call 911.
- If you've been assaulted:
- Call the police now, or call a health professional such as a doctor, nurse, or counselor.
- Remember that the assault (rape) wasn't your fault.
- Find a safe environment—anywhere away from the attacker.
- Preserve evidence of the attack. Don't change your clothes, eat, drink, smoke, bathe, brush your teeth, or clean up in any way. Write down all the details about the attack and the attacker.
- Get medical attention. Even if you have no physical injuries, it's important to find out if you are pregnant or have sexually transmitted infections (STIs), such as chlamydia, gonorrhea, hepatitis B, or HIV. To preserve evidence, ask the hospital to do a special exam (called a forensic medical exam). If you think you may have been drugged, ask that a urine sample be taken.
- Call the National Sexual Assault Hotline toll-free (1-800-656-HOPE or 1-800-656-4673) for free, confidential counseling.
- Call the National Teen Dating Abuse Hotline toll-free (1-866-331-9474) or (1-866-331-8453 TTY).
- Find local resources that can help in a crisis. Your local rape crisis center or hotline, police department, mental health clinic, or hospital can help you.
- Be alert to warning signs, such as threats or drunkenness, so that you can avoid a dangerous situation.
- If a child tells you that they have been sexually abused or assaulted, stay calm. Tell the child that you believe them and that you will do your best to keep them safe. Report the abuse or assault to the local police or a child protective services agency.
If you have been a victim of abuse and keep having problems related to the abuse, you may have post-traumatic stress disorder (PTSD).
Signs of sexual abuse
Signs of sexual abuse may not be apparent without an examination of the genital area. These signs include:
- Bruises, scars, chafing, or bite marks in the genital area.
- Discharge or bleeding from the vagina.
- Rectal or genital bleeding.
- Anal tears or dilation.
- Symptoms of a sexually transmitted infection (STI), such as gonorrhea, chlamydia, syphilis, or HIV.
Vaginal bleeding in a child before the beginning of menstruation is abnormal, as are other vaginal or genital symptoms such as sores, warts, pain, or unusual discharge. Abnormal vaginal bleeding may be caused by physical or sexual abuse that injures the abdominal or vaginal area. Vaginal bleeding that is caused by abuse often is the result of minor physical injuries that will get better on their own or with home treatment.
You may feel uneasy if your child's doctor brings up the issue of abuse. But doctors have a professional duty and legal obligation to evaluate the possibility of abuse. It is important to consider this, especially if there were no witnesses to the injury that caused the child's vaginal bleeding.
If you think your child has been sexually abused, call your child's doctor or contact the National Child Abuse Hotline and Referral Service at 1-800-422-4453.
When to call for help during self-care
Call a doctor if problems from violence or abuse occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: November 22, 2021
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & H. Michael O'Connor MD - Emergency Medicine & Martin J. Gabica MD - Family Medicine