Skip to main content

How Sexual Assault Victims' Advocates Are Training Doctors to Provide Better Care

Josie Torielli, who works for the NYC Alliance Against Sexual Assault, spoke to Pacific Standard about the impact of the #MeToo movement, the importance of SAFETI, and the myth of false reporting.
A woman speaks with her doctor on November 27th, 2002, in Newark, New Jersey.

Last month, Secretary of Education Betsy DeVos unveiled a proposal to change the legal requirements for colleges' handling of sexual misconduct, namely by strengthening due process and narrowly defining sex-based harassment. If implemented, the change would effectively strengthen protections for accused sexual assaulters, and would represent a significant blow against Title IX protections. The proposal is currently in a 60-day period of public comment.

Over the past year, DeVos has alluded that false accusations against men are rampant, even though research suggests otherwise.

Josie Torielli, who directs the Training Institute and Direct Service programs at the NYC Alliance Against Sexual Assault, says that if Title IX regulations are changed, students will be deterred from reporting and seeking help and resources after an assault. That would make it even more important that health-care professionals receive guidance in caring for assault survivors; if students are deterred from reporting incidents, it's even more important that nurses and doctors know which questions to ask in the first place.

Torielli trains licensed doctors, registered nurses, and physician assistants to ensure that sexual violence survivors receive expert, compassionate, and trauma-informed care. The alliance's signature training program, the Sexual Assault Forensic Examiner Training Institute, is the largest state Department of Health-certified training program for licensed emergency department and medical professionals in New York.

For more insights on the importance of proper training for Sexual Assault Forensic Examiners (SAFEs), Pacific Standard spoke to Torielli about the impact of the #MeToo movement, the importance of SAFETI, and the myth of false reporting.


In your experience, how uncommon is false reporting?

Statistically, sexual assault has no higher of a rate of false reporting than other crimes. Numerous studies have indicated that false reporting is very low for sexual assault, on a national level. Also, these studies don't indicate people who might recant based upon pressure from the perpetrator, or recant due to difficulty of the process of reporting and investigation.

What can medical professionals expect from SAFETI training?

SAFETI offers several different courses. The beginning course is called "Assessment and Evaluation of Survivors of Sexual Assault and Intimate Partner Violence." This course entails a total of 40 hours of instruction, both in person and online. Classroom portions of the training include: instruction on completing a forensic rape exam; community members offering expertise on working with differing populations of patients; dynamics of sexual violence and trauma-informed response; and information on the criminal legal process in New York.

The basic course includes a clinical day, which contains a simulated patient interaction that aims to teach ideal communication skills, and a unit on performing trauma-informed pelvic exams, utilizing gynecological teaching associates as instructors. SAFETI also offers a basic skills course and continuing education courses that seek to instruct SAFEs and provide them with tools to keep their skills current.

Do any other states offer anything similar to SAFETI?

The International Association of Forensic Nurses offers an online SAFE course. States vary widely in their approaches to treatment of patients reporting sexual assault in an emergency department, so training approaches vary widely.

Is the training mandated or optional for medical professionals?

The training is optional. Most providers take the course because of a long-standing interest in forensic science. Many know someone who has experienced sexual assault and want to be able to provide expert and compassionate care to patients reporting sexual violence.

The alliance strongly believes that every medical provider should know at least the basics of providing trauma informed care to a patient reporting sexual violence. We know that patients who receive care from a trained SAFE experience better physical and emotional health outcomes, along with improved criminal legal outcomes.

Why is SAFETI vital to sexual assault/violence response?

A SAFETI trained provider is better able to provide patient-centered, trauma-informed response to a patient reporting sexual violence. Working with a trained provider is essential for patients to begin healing right from their first interaction with the medical system. SAFETI trainees are provided information not only in working individually with patients but also for becoming 'ambassadors' for respectful and informed care. SAFETI trained SAFEs work within systems to advise and educate their colleagues and co-workers. They are advocates for a higher standard of care in working with sexual violence and trauma.

How long did it take for the courses to fill prior to #MeToo?

Prior to the activation of the #MeToo movement, courses might fill in two to three months or might have open spots. #MeToo has been important in raising awareness and understanding of sexual violence. Along with awareness and increased discourse, there has been an increase in utilization of services like counseling, advocacy, and medical support. It is heartening to see that medical providers want to train to be in the role of SAFE to offer essential support services to survivors.

How does the #MeToo movement relate to the work you do with SAFETI?

We include information about sexual violence dynamics and impacts within SAFETI training. We aim to create awareness of not only the medical and forensic portions of performing an exam, but knowledge of: trauma response; trauma symptoms; working with self-blame; information about rape culture; information about victim blaming; and sexual violence statistics.

This interview has been edited for length and clarity.