Content warning: the following article discusses sexual assault.
In November of 2018, Stanford University and President Marc Tessier-Lavigne agreed in writing to provide a space at Stanford Hospital and Clinics (SHC) for Sexual Assault Forensic Exams (SAFE) for victims of sexual assualt, a service previously only offered for the county at Santa Clara Valley Medical Center (SCVMC). Three years later, a dedicated space for sexual assault exams at Stanford still does not exist.
SAFE exams, also referred to as “rape kits,” are critical to survivors of sexual assault who choose to preserve DNA evidence and receive medical assistance. The exams can be incredibly traumatic and consist of four hours of touching and prodding every intimate part of the body you can think of. Adding to the stress, the exams ideally should take place within 72 hours of the assault for evidence purposes (though with new technology, survivors are now urged to get the exams even as long as two weeks later). Immediately after an assault, survivors are advised to not shower, change clothes, use the bathroom or undergo any other basic hygiene tasks until after their exam, in order to preserve evidence.
After experiencing the unimaginable physical violation of assault, survivors are immediately subject to the difficult process of SAFE exams. Out of 1,000 sexual assaults, only 25 perpetrators will spend even one day in jail. The odds of convicting a rapist in this country are unbelievably low, but without a completed SAFE exam, it might as well be impossible. Stanford’s current policies are making the trauma of SAFE exams even more unbearable, meaning fewer survivors will be examined, and their rapists are unlikely to be held accountable.
That’s why it is especially concerning that a student-run investigation in May found that Stanford has failed to keep its commitment to provide a space for SAFE exams.
Initially, it seemed like a relief in 2018 when President Tessier-Lavigne and the University committed to providing space for SAFE exams; previously, Stanford students and others in northern Santa Clara County would have to drive 30 minutes to Valley Medical Center in San Jose to receive SAFE exams, drawing out and complicating an already grueling experience for survivors. By offering equivalent care at Stanford, President Tessier-Lavigne seemed to be taking steps benefiting survivors. It turns out, however, that the care is not at all equivalent.
At Valley Medical Center, SAFE exams are conducted in a private dedicated suite that includes a sterilized and prepared exam room, private waiting room where the survivor can meet with a confidential advocate, bathroom and shower. Survivors are triaged by the SAFE exam nurse so that they do not need to tell their story to multiple providers.
Stanford provides none of these things. Despite President Tessier-Lavigne’s 2018 commitment that space would be provided, there is no dedicated site for SAFE exams at Stanford. At Stanford, unlike Valley Medical Center, survivors do not have access to a dedicated private bathroom, shower or waiting room. Rather than being triaged in a private space by a trained forensic nurse, at Stanford survivors are triaged by staff in the Emergency Department, forcing survivors to share their trauma multiple times in a stressful environment. As other emergency room patients come and go, survivors are currently facing extended wait times since there is no designated room for their exams. Instead, they must wait for a gynecological exam room to become available and then be properly re-sterilized for a forensic examination.
One student has already suffered from these conditions. An anonymous survivor in early June reported leaving Stanford Hospital without an exam after three hours of being triaged by multiple people in the general emergency room, waiting, crying and vomiting. As a consequence of Stanford’s lack of a dedicated site, the survivor did not receive their SAFE exam, a crucial medical assistance and DNA evidence tool. This means they were not thoroughly tested and treated for the possible health impacts of the assault within the optimal 72-hour window, limiting their options for making a complaint against their assailant. This means that that survivor will forever know that institutions that were supposed to protect them, a hospital and a university, betrayed them.
In addition to concerns about the quality of care, Stanford’s failure to provide a dedicated space like that at Valley Medical Center raises significant potential privacy and safety concerns. For example, a student recently reported that a survivor was identified by a fellow student in the Stanford Emergency Room when the survivor was overheard speaking with healthcare personnel. It would not be difficult for a perpetrator to locate a survivor in the Stanford Emergency Room waiting room in an effort to dissuade the survivor from having the exam or reporting to the University or police.
Under a 2020 contract with Santa Clara County, Stanford agreed to provide both an exam room and a private waiting room that would be available 24/7. However, it has instead created a toxic impersonation of a true SAFE location, hurting survivors and their mental health.
Stanford must take swift action to improve the patient experience for SAFE exams by:
- Providing a dedicated private waiting room;
- Designating a dedicated SAFE exam room;
- Creating a dedicated private restroom and shower for survivors;
- Allowing trained SAFE examination nurses to handle survivor triage in the dedicated private exam room, just as they do at Valley Medical Center.
We are eager to work with Stanford to remedy these issues as quickly as possible. But if Stanford is not willing to provide adequate SAFE services by making the necessary changes, then Santa Clara County must suspend Stanford’s program immediately until Stanford makes the necessary improvements to patient care.
Stanford University officials were first contacted by student advocates about the patient experience deficiencies for SAFE exams more than a month ago. Even intermediary steps, like simply providing a dedicated private waiting room, have yet to be taken. Soon Stanford will be approaching a particularly dangerous “red zone,” with two new classes of freshmen coming to campus for the first time with no knowledge of the environment, people and power dynamics, as well as safety measures and resources available to them. The first quarter on campus in freshmen year is when students are most vulnerable to sexual violence. Three thousand students are about to move onto the campus of a university that is currently not properly equipped to educate them, protect them and advocate for them.
Stanford should have already taken steps to remedy the outlined SAFE exam concerns, but it would be particularly irresponsible for no action on this issue to be taken when students will soon repopulate the area and require these services. We urge concerned community members to contact relevant University officials to call for the SAFE exam situation to be remedied, including President Marc Tessier-Lavigne, Emergency Medicine Department chair Andra L. Blomkalns, vice provost for institutional equity, access and community Patrick Dunkley and Title IX coordinator and SHARE director Stephen Chen. This form email can be used for these communications.
Not only has Stanford reneged on its multiple written commitments to provide adequate SAFE exam services, it has fallen through on its ethical commitments to its students, affiliates and the greater Santa Clara County community. Actions must be taken immediately to stop more preventable trauma and harm. No more survivors should be left without completed rape kits and without options.
Kirsten Mettler ’23, ASSU Co-Director of Sexual Violence Prevention
Ari Gabriel ’23, ASSU Co-Director of Sexual Violence Prevention
Sofia Scarlat ’24, ASSU Co-Director of Sexual Violence Prevention
If you are seeking information or support, YWCA @ Stanford provides free and confidential advocacy and healing services to all survivors in the Stanford community. For a county-wide YWCA 24/7 hotline, please call 800-572-2782. To contact YWCA @ Stanford, refer to their website: https://yourywca.stanford.edu/