From Silence to Systems Change: What Sexual Assault Awareness Month Should Actually Demand

April is Sexual Assault Awareness Month, but awareness alone is not enough. 

At the SHE+ Foundation, we believe this month must move beyond recognition into accountability, healthcare access, and systems change. Because sexual violence is not just a social issue - it is a public health crisis.

The Reality: Sexual Violence is a Public Health Issue 

Sexual violence is not rare. Sexual violence affects millions of people in the United States and has lasting impacts on physical, mental, and reproductive health.

• Approximately 1 in 5 women in the U.S. experience sexual assault in their lifetime (Centers for Disease Control and Prevention [CDC], 2022)

• Most survivors know their perpetrator (Rape, Abuse & Incest National Network [RAINN], 2023)

• The majority of assaults go unreported (RAINN, 2023)

This is not just about prevalence, it is about impact. Sexual violence is associated with: 

• Chronic pain conditions

• Gastrointestinal disorders

• Increased risk of depression, PTSD, and suicidality

• Reproductive health complications

(CDC, 2022; World Health Organization [WHO], 2021)

The Healthcare Gap: Where Survivors are Failed 

For many survivors, the healthcare system is the first point of contact - and too often, it is where harm is compounded. 

Survivors frequently encounter: 

• Providers without trauma-informed training 

• Dismissive or stigmatizing responses 

• Limited access to specialized forensic care 

• High out-of-pocket costs for follow-up treatment

Even in emergency settings, access to Sexual Assault Nurse Examiners (SANEs), registered nurses specifically trained to provide trauma-informed forensic exams - is inconsistent across to U.S. (U.S. Department of Justice Office on Violence Against Women (OVW, 2020). 

What SANE Nurses Do - and Why They Matter 

SANE nurses are a critical bridge between healthcare and justice. They provide: 

• Comprehensive forensic exams (often called “rape kits”)

• Trauma-informed, patient-centered care. 

• Documentation that can support legal cases 

• Emotional stabilization and resource connection 

Research shows that SANE programs: 

• Improve evidence collection

• Increase prosecution rates 

• Reduce retraumatization during exams

(OVW, 2020; Campbell et al., 2021)

And yet, many hospitals, especially in rural and underfunded areas, do not have SANE coverage 24/7, leaving survivors without appropriate care in the moments that matter most. 

Silence is Often a Healthcare Outcome

We often frame silence as a personal choice, but in reality, silence is frequently the result of systemic failure.

Survivors ask themselves:  

• Will I be believed? 

• Will I be blamed? 

• Will seeking care retraumatize me? 

When healthcare systems are inaccessible, inconsistent, or harmful, survivors are less likely to: 

• Seek medical care 

• Report assault 

• Access mental health support

Sexual Health and Sexual Violence are Inseparable 

At SHE+, we are clear: you cannot address sexual health without addressing sexual violence. 

Sexual assault directly impacts: 

• Gynecological and reproductive health 

• STI risk and prevention access

• Chronic pelvic pain and sexual dysfunction 

• Long-term mental health outcomes 

(WHO, 2021) 

Yet care is often fragmented, forcing survivors to navigate: emergency care, primary care, mental health services, legal systems, with coordination, continuity, or support.  

What Survivors Actually Need

If Sexual Assault Awareness Month is to mean anything, it must demand systems that are built for survivors. Survivors deserve universal access to SANE-trained providers, trauma-informed care across all healthcare settings, and affordable, ongoing medical and mental health support. Survivors deserve integrated care models that reduce fragmentation, and education rooted in consent, autonomy, and bodily literacy. 

What We’re Doing at SHE+ 

At the SHE+ Foundation, we are working to close the gaps where survivors are often left unsupported. 

Through our programs, grant funding, and the SHE+ Resource Hub, we: 

• Expand access to sexual and reproductive health information 

• Support survivor-centered providers and organizations

• Elevate conversations that have been historically silenced through our She’s Not Dramatic campaign

• Advocate for policy changes in women’s health. 

Moving beyond awareness means Sexual Assault Awareness Month should not end with a hashtag.

You can:

• Support organizations expanding survivor-centered healthcare

• Advocate for SANE funding in your state

• Learn how trauma impacts the body and care-seeking behavior

• Challenge stigma in conversations and communities

Awareness without action maintains the status quo.

This month, and every month, we must ask: What does it take to build systems that actually support survivors?

References (APA Style)

Campbell, R., et al. (2021). The effectiveness of Sexual Assault Nurse Examiner (SANE) programs: A review of psychological, medical, legal, and community outcomes. Trauma, Violence, & Abuse, 22(2), 245–259.

Centers for Disease Control and Prevention. (2022). Preventing sexual violence. https://www.cdc.gov/violenceprevention

Rape, Abuse & Incest National Network. (2023). Victims of sexual violence: Statistics. https://www.rainn.org

U.S. Department of Justice, Office on Violence Against Women. (2020). Sexual Assault Nurse Examiner (SANE) programs. https://www.justice.gov/ovw

World Health Organization. (2021). Violence against women prevalence estimates. https://www.who.int