Trigger warning: This content uses language that may trigger sexual assault survivors.

Sexual assault is a complex and horrible issue. It is personal, it is heartbreaking and it is different in every case. But if we ever want to put an end to sexual assault, we have to stop letting its complexity get in our way.

This is the eighth story in a semester-long series where the Daily will publish a multitude of stories related to sexual assault, including discussions about various resources survivors can obtain if they are comfortable doing so. 

— Emily Barske, editor in chief 

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Reporting a sexual assault is not meant to be a difficult process, and Story County SART is trying to make it easier for survivors.

For survivors of sexual assault, it may be hard to tell close friends or relatives about their assault and even more difficult to tell a complete stranger.

The Sexual Assault Response Team (SART) implements techniques to make the reporting process easier to keep it victim-centered and in its control. 

Both the Ames and ISU Police departments are part of SART, which has a mission to “serve sexual assault victims by coordinating an immediate, high-quality, multi-disciplinary, victim-centered response …” This response will typically provide three groups of professionals: medical, law enforcement and advocacy.

In Ames, the SART agencies include: ISU Police, Ames Police, Mary Greeley Medical Center, ACCESS (Assault Care Center Extending Shelter and Support) office and Thielen Student Health Center.

Anthony Greiter, ISU police officer, is trained in how to interact with survivors of sexual assault during the reporting process. 

“We’re not here to judge them,” Greiter said. “We may ask difficult questions, but we’re here to help.”

The first thing a SART professional does is offer resources to the survivor and lets them choose how to proceed. If the survivor chooses to proceed, they decide how the process will unfold. Not all cases are the same because it all depends on the victim.

The victim does not have to tell all of their story. They have the option of completing a sexual assault medical forensic exam and they can begin the steps to file charges. If they do choose to tell their story and names are mentioned, the police may automatically have to report the assault.

“If they give me names and they are affiliated with the university, either suspect or victim, I have to report that to the university,” Greiter said.

Iowa State University is required by federal guidelines to begin an investigation headed by the Office of Equal Opportunity and Title IX, which handles cases of dating violence, domestic abuse, sexual assault, stalking and more. 

If a student is suspected and found guilty, they will have violated the student code of conduct and will be expelled.

If the survivor reports to an Ames police officer, the department is not required to report to the university.

The medical side of SART is the SANE, or sexual assault nurse examiner, who meets with patients who decide to go forward with the sexual assault medical forensic exam. The first order of business is always informing the patient about options.

If they proceed, the discussion turns to what processes will take place, the medications that are offered and what they will treat.

The kit includes envelopes, cotton swabs and papers that the SANE will fill out. The nurse will first administer prophylactic drugs, but the patient is not forced to take them. This is a preventive measure to ensure the patient does not contract a sexually transmitted disease.

“We get ahead of that so [the victims] don’t have to be diagnosed with a transmitted sexual infection,” Shannon Knudsen, sexual assault exam coordinator, said. 

More evidence that is needed, such as clothes, can be collected in paper bags. The paper bag allows the DNA to “breathe,” whereas a plastic bag will make the evidence decompose.

Another tool that is not included in the kit is the speculum, which is inserted into the vagina to analyze for injuries.

After receiving consent, the first exam by the nurse examiner is a full-body visual exam that looks for injuries such as scratch marks, bruising and anything that may contain the perpetrator’s DNA. The nurse will use a certain flashlight that illuminates body fluid of any kind to collect for evidence.

“We do that exam for injuries, and then as I’m doing that exam I’m going through the kits as well and collecting those pieces of evidence,” Knudsen said.

The first swab administered is the buccal swab, which lets the lab know which DNA is the patient’s and which is the perpetrator’s. The buccal swab is taken from the mouth, but if there is an oral assault, an oral swab will be used and blood will be taken instead. 

With the patient’s consent, medical practitioners will take swabs of the body parts the perpetrator touched. If the patient wishes, only certain parts of the kit can be carried out. The whole kit is not necessary, and the processes are defined by the decisions of the patient.

“I am mandated by [the Health Insurance Portability and Accountability Act], so what they tell me I can’t share with anybody else,” Knudsen said. “If they want to pursue an investigation, then I have to have permission to talk to law enforcement.”

This does not include if the victim is a child or dependent adult, or if human trafficking is suspected. In those cases, mandatory reports are issued.

If the patient feels uncomfortable, the kit can stop. According to SART, whatever the survivor is most comfortable with is priority. If the kit has been completed but the patient is not sure what steps to take next, the statutes of limitations are 10 years in Iowa. The survivor has that amount of time to come to a decision of what they want.

Sexual assault medical forensic exams are not needed in some cases. Greiter said some sexual assault cases in Story County have been won without DNA evidence of the attacker. The sexual assault medical forensic exam is always just an option, and most aspects of reporting are within the control of the survivor.

In Iowa, there are more than 4,200 untested sexual assault medical forensic exams. Officials hope to soon push for all of them to be tested in order to identify the perpetrator and ultimately charge them. Some of these tests date to the 1990s.

The effort, which is part of a nationwide initiative, is being funded by a $3 million grant from the U.S. Department of Justice. The initiative will also work to establish a statewide sexual assault medical forensic exam tracking system.