Lux Alptraum is a journalist and author in Brooklyn, New York, who volunteers as an advocate for sexual assault and domestic violence survivors who arrive at her local emergency department. For Sexual Assault Awareness Month we asked her to educate us about what a victim advocate does, and what she’s learned from her experience that all survivors and those who love them, should know.
How did you become a volunteer advocate?
It started because an artist friend of mine named Aliza Shvarts was working on an installation on rape kits. It looks at what rape kits mean for survivors and how we talk and think about sexual assault. People think of a rape kit as being something that proves rape, but the thing that defines rape is the presence or absence of consent which can’t be proven by a rape kit. This got me thinking about how rape kits come from a 1970s assumption that rape is committed by a stranger, and that you need DNA to determine who the rapist is. But when the assailant is known, which is statistically more likely, or when the encounter begins as consensual but becomes non-consensual, a rape kit doesn’t do much for that
So I wrote an article called The Problem with Rape Kits, and spoke with a volunteer advocate as part of that and became interested in volunteering as one myself. Rape victim advocates are called to the hospital to provide support for a sexual assault victim, with the goal of making it healing rather than traumatizing. I applied, interviewed, completed training and began volunteering in late 2018.
What does a session look like?
When a sexual assault victim is assessed at the hospital, the hospital calls the nonprofit where I volunteer and they call me and I go to the hospital immediately. Now that I have been volunteering for over a year I can always say ‘no’ if it’s not a good time, and they’ll call another advocate.
When I show up I introduce myself to the victim and say “I’m a volunteer advocate and my job is to make things as easy as possible for you right now.” Making things easier for a victim can look like a lot of different things — from giving advice about their rights to going to get them a snack from the cafeteria, or if they’ve been waiting for a long time I can go and ask how long things will be. Or the survivor can ignore me, it’s their choice.
What medical things happen in the hospital after a sexual assault?
Typically, they’ll give you the first pill of the HIV prevention medication PEP and write you a prescription for the rest of the pills, a shot for syphilis, antibiotics prophylactically for other STIs, and emergency contraception if needed. Sometimes people only want to get that treatment and aren’t interested in any sort of exam or collecting evidence.
Do you help survivors make the decision about whether to do a rape kit exam?
Informing the patient about the exam and the rape kit, if they choose to complete one, is one of the most important roles of a rape victim advocate. When it’s not done well, or when a victim doesn’t feel in control of the process, getting a rape kit done can be very traumatic for survivors, and can be physically painful. In the best case scenario the rape kit is collected by a trained sex assault nurse examiner, also called a SANE. They are trained to do this and be very sensitive to the needs of survivors. But in many cases, the patient is seen by whatever resident or attending physician is available and that person might not know anything about these exams. Some older kits say to pull pubic hair from the victim, which is totally unnecessary and obviously painful. As an advocate I can tell the physician that that’s not necessary.
Even in that best-case scenario of a SANE doing the exam, it’s still very important to have an advocate present because I can have conversations that the examiner can’t have. As a patient, especially in a vulnerable situation, if a doctor tells you you can do something you might feel like you have to comply. I was once with a survivor who started to do the kit but when she saw all the envelopes she kind of panicked. I was able to say, “Listen you need to know you don’t have to do this kit if you don’t want to. If you never want to go to the police there’s no need to do this.”
This is the thing, there can be this idea that if you didn’t get a rape kit done you weren’t really raped. People have no idea how stressful and time consuming and difficult it can be to get a rape kit done, and for others you might need to drive several hours. But if you feel hurt or traumatized that’s a valid injury, that’s a valid experience. If you feel violated you were violated and everything else is window dressing.
How is it different when the survivor is a victim of intimate partner violence?
For domestic violence a lot of it is providing support in whatever way they need. If they’re ready to leave we can help them plan around that, if not we do safety planning — make a plan for how they’re going to stay safe. They’re experts on their own safety and often they need to talk through the process and understand resources that are available.
Often just listening and letting them unload is really, really valuable — just having somebody say “I believe you and it’s not your fault.”
What advice do you give to a friend or family member of a survivor?
If the survivor brings a friend or a family member to the hospital, then that person is considered a co-survivor and I’ll provide support to co-survivors, too, either by giving advice or just listening to their feelings.
If a loved one has been sexually assaulted, first and foremost believe them and validate them and let them know that you will do what they want to do. People think, “I should protect them and rush out and get revenge against the person who did this to them,” but what you want to do might not be the thing that is helpful to them. It’s really important to say, “What can I do? How can I be helpful to you?” You can offer your help but remind them and you that it’s up to them, not to you.
Offer options, not suggestions. Resist the urge to say “You really should do a rape kit” or “You have to go to the police.”
What would you say is the very most important thing an advocate provides?
Of all the things, I think the most fundamental is letting the survivor know that everything that happens to them will be something they want to happen, telling them that they don’t have to do the rape kit, they don’t have to get the police involved, they don’t have to leave their abuser if they’re not ready. I let them know they have choices and nothing is mandatory.
That helps them restore a feeling of autonomy. When we talk about both sexual assault and domestic violence, yes there is physical violence but if you strip away all of that, they are crimes of being robbed of your bodily autonomy and your ability to say no and be in control of your body. An advocate helps restore that sense of autonomy by saying “You are in control here, and what you want matters.”
It’s also important to make sure they know there are no wrong decisions. One thing that can escalate trauma is people feel ashamed and stupid already, and feeling like they aren’t in control of their decisions after the assault can make that worse. The role of the advocate is to say, “All your choices are the right choices because they’re yours.”
Do all or most hospitals provide access to advocates?
Not necessarily, it varies a lot by location and hospital, and there’s no consistent national protocol. It’s heartbreaking that some survivors don’t have advocates present, because it can be transformative.
What should somebody do if they’re interested in volunteering this way?
Look for your local program and see what their needs are and what kind of volunteers they’ll accept. Some programs just want social workers, but in general they are looking for people who care and who have the character to do this work. For some people this work can be too traumatic, but for me there is nothing more rewarding than showing up for a survivor who needs support and making their life a little easier.
Lux Alptraum is a Peabody-nominated writer whose work has appeared in numerous outlets, including The New York Times, Cosmopolitan, and Hustl
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.