Who should I contact if I have been sexually assaulted?
In Japan, there are one or more One-stop support centers for victims of sexual crimes and sexual violence in each prefecture.
They provide advice on how to respond, in collaboration with doctors, mental health counsellors, and legal experts.
If you are unable to contact a One-Stop Support Center in your prefecture or you live in a prefecture where the center is not open 24 hours a day, please visit an emergency hospital or obstetrics and gynecology hospital that is open when you need.
Before going to the hospital, it is important to preserve evidence.
To do so, please be aware of the following:
1. Do not take a shower or bath
2. Keep the clothes you were wearing without washing them
I don’t think it’s a situation where you can think about everything, but it’s important to keep evidence for future reference.
If anything happens, don’t suffer alone, contact a hospital or a One-stop center first.
What would be done in the hospital?
At the hospital, a medical interview will first be conducted to ask about the situation and medical history.
And a physical examination will be conducted to check for any injuries or damage.
Explaining the circumstances of the sexual assault can be very difficult for a victim.
For this reason, medical staff need to be considerate and create an atmosphere where the victim can feel safe and calm to talk.
The same goes for physical examinations; as many parts of the body are examined which are hidden by clothing, the examiner explains to the victim which areas will be examined each time and obtains their consent.
After that, collecting evidence is done, and several tests including infectious diseases and pregnancy are carried out.
The main tests performed in Japan are shown in the table below.
| Infectious diseases | ||
| Blood test | Syphilis, HIV, Hepatitis B, Hepatitis C, Chlamydia, etc. | |
| Vaginal secretions and urine (and other samples taken from the mouth and rectum if necessary) tests | Gonorrhea, chlamydia, trichomoniasis, general bacteria, etc. | |
| Drugs | ||
| Urine and blood tests | Drug screening | |
| Pregnancy | ||
| Urine test | Testing done within hours of a sexual assault can determine if the victim was pregnant before the assault or not. |
One of the reasons why it is important to go to the hospital after a sexual assault is because there are preventive measures.
The main preventive measures are as below.
| Prevention of pregnancy | ||
| Emergency contraceptive pill | Take the medicine as soon as possible to get the best effect. If possible, take it within 72 hours. It can be taken within 120 hours (5 days), but the effect will decrease with each passing day. | |
| Intrauterine contraceptive devices | It is a form of emergency contraception if done within five days of an assault. | |
| Prevention of infectious diseases | ||
| HIV Post-Exposure Prophylaxis (PEP) | Medication must be started within 72 hours of the assault. Taking medication lasts for 28 days. | |
| Hepatitis B vaccine | This is for people who have never received the Hepatitis B vaccine before or have not completed the three doses. | |
| Antibiotics | Taking antibiotics that are effective against gonorrhoea and chlamydia infections, etc. |
There are many things you can do to prevent, so be sure to consult a doctor as soon as possible.
I’m worried about the cost of visiting a hospital. Is financial support available?
If you visit a hospital after a sexual assault, some medical expenses may be covered by public funds.
The main items covered by public funds are as follows:
- Initial consultation fee
- Costs for infectious disease tests
- Emergency contraception
- Medical certificate fee
- Costs for induced abortion
The conditions for eligibility for public funding depend on each prefecture.
For example, in Tokyo, medical expenses are subsidized if a support officer from the Tokyo One-Stop Support Center for Victims of Sexual Crime and Sexual Violence accompanies you.
For psychological counselling, the eligibility and amount of public funding also vary by prefecture.
Please ask a One-stop center for more detailed information.
References
– Cabinet Office Gender Equality Bureau. One-stop support center for victims of sexual crimes and sexual violence. https://www.gender.go.jp/policy/no_violence/seibouryoku/consult.html
– Thyme. Information platform for supporting victims of sexual violence https://thyme.buzz/sexual_violence_4/
– Japan PCIT Training Center. World Health Organization (WHO) guideline Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines, 2013 Japanese Edition https://pcittc-japan.com/healthcare-handbook/
– Japan Association of Obstetrics and Gynecology. Manual for obstetricians and gynecologists to respond to victims of sexual assault. June 2008. https://www.jaog.or.jp/wp/wp-content/uploads/2017/01/manual_2008.pdf
– Japan Society of Obstetrics and Gynecology. Revised version of the Checklist for Medical Treatment of Victims of Sexual Crime and Sexual Violence. June 2020. https://www.jaog.or.jp/wp/wp-content/uploads/2011/12/3767d5e2e4f58857306d39fc2f243404.pdf
– MSD Manual. Medical examination of the rape victim. https://www.msdmanuals.com/ja-jp/professional/18-%E5%A9%A6%E4%BA%BA%E7%A7%91%E3%81%8A%E3%82%88%E3%81%B3%E7%94%A3%E7%A7%91/%E3%83%89%E3%83%A1%E3%82%B9%E3%83%86%E3%82%A3%E3%83%83%E3%82%AF%E3%83%90%E3%82%A4%E3%82%AA%E3%83%AC%E3%83%B3%E3%82%B9%E3%81%8A%E3%82%88%E3%81%B3%E6%80%A7%E7%9A%84%E6%9A%B4%E8%A1%8C/%E3%83%AC%E3%82%A4%E3%83%97%E8%A2%AB%E5%AE%B3%E8%80%85%E3%81%AE%E5%8C%BB%E5%AD%A6%E7%9A%84%E8%A8%BA%E5%AF%9F
– National Center for Global Health and Medicine. AIDSClinical Center https://www.acc.ncgm.go.jp/general/pep_jpn.html
– National Police Agency. Measures for crime victims. Public expenditure system. https://www.npa.go.jp/hanzaihigai/keisatsu/kouhi.html
– Mental health information page for crime victims. Further improvement of the public funding system for counseling fees. http://victims-mental.umin.jp/topics/01.html
– Tokyo Metropolitan Government, Bureau of General Affairs. One-Stop Support Program for Victims of Sexual Crimes and Sexual Violence https://www.soumu.metro.tokyo.lg.jp/10jinken/hanzai/onestop
