Understanding The PERK

written by: Tracy Johnson, F2F intern, summer 2023

content notice: Sexual Violence, Medical Procedures

Our founder, Rosemary Trible, has dedicated her life to supporting sexual assault victims. After witnessing so many people leaving the hospital after a PERK exam looking traumatized and many still even having to wear their hospital gowns out, Rosemary decided to create Fear 2 Freedom in hopes of preserving the dignity of survivors and providing education to communities across the nation. The AfterCare and iCare Kits that we provide to survivors contain basic essentials like clothing and toiletries for after a PERK exam, and also therapy tools for those who undergo this exam or decide to tell their stories later on. To understand the importance of these kits, it is necessary to understand what survivors face when going in to get a PERK exam done. And if you are a survivor who is reading this, contemplating whether or not you’d like to go through with the exam, hopefully this blog answers some of the questions you may be having.

Now some of you may be wondering, what even is a PERK exam. PERK stands for Physical Evidence Recovery Kit, which is a medical examination that collects evidence for a potential criminal investigation and prosecution of sexual assault, domestic violence, and other crimes. This exam is completed at a medical facility by a sexual assault nurse examiner (SANE), who has specialized training for administering these types of exams and providing trauma-informed care to their patients. These exams are thorough and are comprised of many parts, meaning they can take many hours to complete. However, patients are in control of their exam process so they can choose to skip any parts they’re not interested in doing and can stop the process at any point if they feel uncomfortable. Here are some of the common components of a PERK that nurses may go through with patients:

Tending to immediate injuries - The SANE will first tend to any injuries that need medical attention immediately, before the start of the exam. Their main priority is to make sure the survivor is safe and not in any medical danger.

Questions about medical history/general health questions - After attending to immediate health issues, the SANE nurse has to inquire about medical history, just like if someone were to go into the hospital for any type of illness or other injury, to make sure they are taking proper care of the survivor. Information about allergies, previous injuries or surgeries, etc. are important to ensure that the supplies and methods used will not cause further harm to the survivor in any way.

Questions regarding sexual activity and history - The next step is for the SANE nurse to ask some questions about the survivors sexual history. This is the one thing that most people are not prepared for when they go into the exam. The important thing to know about this step is that the SANEs are not asking these questions to judge the survivor or victim blame them in any way, these are just questions that are essential to ask in order to make sure the survivor is given the best care that can be provided. These questions can be very vital in regards to collecting evidence or getting the scope of the crime as a whole. Sometimes, evidence is collected that may not make sense without knowing this background information. Having this history can help answer important questions that SANEs may have when they find certain pieces of evidence that can help make the assessment more accurate for the survivor. This can also be used to make sure that SANEs provide you the best emotional care in not crossing boundaries that become clear with these types of questions.

Questions about the assault that took place - Even if the survivor does not decide to open a police investigation immediately, the nurses will still have to ask relevant questions about the assault that took place. This is meant to guide the nurse in areas they should pay specific attention to when doing the exam to check for injuries and collect as much evidence as possible. For instance, if the assailant kissed a certain part of the survivors body that may not be commonly thought about, such as someone’s forearm or shin rather than their face or neck, then this can cue the SANE nurse that they need to be extra careful when collecting evidence there. These questions are to make sure that the exam is as thorough as possible for the survivor, if they eventually decide to go forth with a formal investigation into the sexual violence that occurred.

Full body examination/testing & evidence gathering - This last step is where the physical examination will take place once all of the background information is gathered. The full body examination that takes place is both internal and external, where the nurses look for any injuries or spots that have evidence to be collected. This can be in the forms of taking samples of blood and urine, body swabs, hair samples, etc. SANEs will also test for pregnancy and STI and offer survivors the proper medication for these things as needed. Once these things are completed, SANE nurses will usually take pictures of the injuries and other evidence, as well as collect whatever clothing may be important for the investigation. Because the nurses will often have to take most of the patient’s clothing, and the fact that this exam can be very physically intrusive, Fear 2 Freedom’s AfterCare kits are very meaningful to help restore some dignity and hope back to the survivor after the exam.

Important General Information:

In Virginia and some other states, the PERK exam and all of the testing along with it is free of charge to survivors to make it more accessible to anyone and everyone. While the survivor is getting this exam done, they have the right to also pull their consent and stop the exam at any point of time. Even if the survivor does not want to completely stop the exam, they are always allowed to ask whatever questions they need to feel more comfortable or if they do not understand what is happening.

To encourage more survivors to come get treated and get the exam done, survivors are not required to report the incident unless the victim is under the age of 18 or a weapon such as a gun or knife was involved. This is called an anonymous PERK, where SANE nurses will complete the exam and then the PERK kit will be stored for a minimum of two years. At the end of these two years, an additional period of 10 years of storage can be requested by the survivor or law enforcement agency with a written objection to the destruction of the anonymous PERK kit.

Frequently Asked Questions:

When should I go to get the exam?

Sooner is always better when it comes to collecting as much accurate information and evidence as possible. It is recommended that survivors get the exam within 120 hours after the assault. However, any time is the right time to go as long as the survivor feels as comfortable. A survivor should not be discouraged to go just because they decided to wait a little bit. Even if there is not much evidence to collect, a survivor could still get tested for pregnancy and STIs, as well as get connected to support resources.

Do I have to go alone?

No. There are places that a survivor can call for support and survivors have a right for a trained advocate to accompany them during the exam. This advocate acts as a confidential support person for the survivors and will be there to provide support, answer questions, advocate for their wellbeing, and connect them with additional resources that they may need. The Center for Sexual Assault Survivors – information listed at the bottom of this blog – is a place local to the Newport News area that provides hospital accompaniments to survivors.

Is it okay to shower/brush my teeth/change my clothes?

In short, yes it is okay. Whatever a survivor needs to do for themselves on their journey is okay. However, if the survivor can hold out on doing any of these things it makes it more probable that accurate evidence that can be used will be found. If the survivor still needs to do any of these things, preserving as much evidence as possible beforehand, like putting their clothing in a paper bag can be helpful.

Will my parents find out?

In Virginia, if a survivor is over the age of 18 they do not have to give their health insurance while they are there, which means that their family will not find out about the assault unless the survivor wants them to. However, if the survivor is under 18 then there is a requirement to report the incident and inform their family.

How long does it take for the results to come back?

According to the Virginia Department of Forensic Science, the longest evidence that usually takes to come back, forensic biology, on average has a turnaround time of 160 days. However, this varies for each piece of evidence and for each case.

Takeaways and Resources:

For survivors, what is important to remember is there is no one correct way that you have to do this. If you do not want to get an exam at all, that’s okay. If you decide you can’t wait and have to shower or brush your teeth beforehand, that’s okay too. It’s all about doing what decision you think is best for you in the moment. The information in this article is here as a resource to help you make decisions, not give you a specific pathway that you absolutely have to follow. Whatever you decide to do, making the decision for yourself is a step in the right direction toward taking control back of your life and getting to a place where you feel free again.

Below our some resources to get more information for either you or a loved one: