Forensic sciences

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:18] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode one of our 2022 Sexual Assault Awareness Month mini season, Just Science sat down with Mary Weston, the Assistant Prosecuting Attorney, Supervisor of the Cold Case Unit, and Project Manager of the Sexual Assault Kit Task Force at Cuyahoga County Prosecutor's Office to discuss sexual assault response with vulnerable populations. Different challenges may arise when prosecuting sexual assault cases involving vulnerable populations, including cases with male victims. Listen along as Mary Weston discusses strategies for effective prosecution of cases with male victims, provides rationales for why members of vulnerable populations may be targeted for sexual assault, and presents considerations for the safety, healing, and well-being of survivors. This episode is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:23] Hello and welcome to Just Science. I'm your host Tyler Raible with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. April is Sexual Assault Awareness Month, and in honor of the month, we're sitting down with various subject matter experts to discuss emerging topics in the field of sexual assault response reform. To help guide us in our conversation today, I'm joined by our guest, Mary Weston, Assistant Prosecuting Attorney, Supervisor of the Cold Case Unit at the Cuyahoga County Prosecutor's Office, and Project Manager of the Cuyahoga County Sexual Assault Kit Task Force. Mary, it's great to see you again. Welcome back to the show.

Mary Weston [00:01:53] Thank you so much for having me.

Tyler Raible [00:01:54] So, Mary, you've been on here before and you've spoken to us about topics like crossover offending, prosecution, and the state of the sexual assault kit backlog in Cuyahoga County. So Mary, you're a prosecutor and someone who's actively addressing, and frankly, improving the response to sexual assault in your community. Can you tell us a little bit about yourself and what a typical day might look like for you?

Mary Weston [00:02:16] Tyler, I am first and foremost a prosecutor. I've been a prosecutor since 2006, and since 2013 I have focused on prosecuting sex offenses. Our county was one of many counties across the nation that discovered untested sexual assault kits, primarily in the city of Cleveland. So starting in 2013, our office made a concerted effort to make resources available to test those kits, investigate those kits, and prosecute the leads that came from those investigations. So I was one of the very first prosecutors assigned to the task force in 2013. There were three of us at the time. As the years went on, I was prosecuting those cases in court, and we've gotten to a point in our county where we've tested all of our untested kits, and we're just dealing with the prosecutions at this point of that initial project. And at this point, I am now the supervisor of the task force, so I'm now more overseeing the prosecutions and the investigations - it's more management.

Tyler Raible [00:03:21] Mary, that's incredible. And the work that you all are doing is just fascinating and there's so much impact behind it. Can you tell us a little bit about what sexual assault response reform looks like in Cuyahoga County? Are there any achievements that you'd like to highlight or let our audience know about?

Mary Weston [00:03:35] Absolutely. It all started when there was a serial murderer actually who was identified here in Cleveland - number of bodies were found in his yard, Anthony Sowell was his name - and in the wake of that discovery, there were women that came forward and said that he had attacked them and that they had done what we expect women to do in that situation. They had reported it, and they complained that nothing had happened in their cases. They hadn't resulted in him being prosecuted. And you can imagine there was some outrage because families lost their loved ones who were murdered by this man because he was still out there on the streets. And so in the wake of that sort of outcry, like what happened with these women's cases, thousands of rape kits were discovered that had never even been submitted to the lab. It turns out we are not the only jurisdiction with this problem. It was nice to meet folks from other cities who also were lucky enough to benefit from DOJ SAKI funding later on - you know, originally, even prior to us receiving the SAKI funding, we realized we had an issue on our hands here in Cuyahoga County, and we put together a task force to combat it. Then we were lucky enough to get SAKI funding to add investigators, to add victim advocates, to make a whole team approach to looking at these cases, following up on all the DNA leads. I mean, when you test thousands of kits, you start getting leads like crazy in terms of CODIS hits and CODIS matches - you got to follow up on those. So all those kits from the original project have been tested. It resulted in over eight hundred new indictments because in Ohio, when we started in about 2012, 2013, we were only able to go back 20 years based on Ohio's statute of limitations for rape at the time. So we went back to 1993 - over eight hundred indictments to date. Prosecutions are still ongoing. But in terms of sexual assault reform, a lot of things changed in that time frame. We changed our statute of limitations for rape - now 25 years, it was 20 at the time. You know, do I wish there was no statute of limitations? Yes, but we were able to get an additional five years. And we were able to get a provision that says, even if you're beyond that 25 years, if you get a DNA lead, you get five years. So even if it's been 26 years, you still get five years to investigate that DNA lead. And that is huge. There were cases where we weren't able to follow up on leads because we were beyond the statute of limitations. But that won't be a problem anymore if you got a DNA hit like a CODIS hit. And I would say the other big reform was in Ohio was it's now law to test all kits and that's huge - testing every single kit, even if the perpetrator is known. It was a learning curve for me and a lot of people. You know, why- why would I test a kit where there's no question who the perpetrator is? And to learn because that DNA to a known individual may hit to another kit that was a stranger and solve stranger cases - that took some time to understand and get people on board with and Ohio passed that law. So we have done some good things here in Ohio.

Tyler Raible [00:06:33] You're doing some incredible things. It's obviously a huge effort, but it's an effort worth doing and it's really highlighting some palpable results. So Mary, I really want to dive in today because I want to make sure that we capitalize on our time together. You know, when we're discussing a topic like sexual assault, we often hear this term vulnerable populations kind of tossed around willy-nilly. I was hoping we could first kind of tie that down. What does the term vulnerable populations mean? And then why is it relevant to sexual assault cases?

Mary Weston [00:06:59] Vulnerable populations, to me, mean victims of sexual assault who are more likely to be targeted or victims of sexual assault crimes that are less likely to be prioritized in terms of investigations or prosecutions. And it's important and relevant to sexual assault response because sexual predators are targeting these individuals, and they're targeting these individuals because they feel that they are more likely to get away with the sexual assault of certain populations. And it's also important as a prosecutor and an investigator to know who the vulnerable populations are because those are probably most of your sexual assaults. That's probably where most of them are. You know, most of your sexual assaults are not the sexual assault of the people in the highest status in your jurisdiction. Predators are not selecting individuals that are going to be believed and are going to be prioritized. They are selecting individuals that will hopefully never even report the crime, or if they do report the crime may not be believed or won't be prioritized as a victim. So as a prosecutor and as investigators, you need to identify those vulnerable populations in your jurisdictions, know that that's where most of the rapes are happening, and that if you want to hold offenders accountable, that's where they're most likely going to be perpetrating.

Tyler Raible [00:08:23] So if it's not the people that are kind of a higher status, what are some of examples of vulnerable populations? What makes these groups vulnerable?

Mary Weston [00:08:30] Predators select people that are vulnerable because they want to get away with their crimes number one, right? So predators are not out there committing their crimes in front of a baseball stadium or in front of an audience. They certainly want to get away with it like all criminals do. So they are going to select people who number one maybe won't report the crime at all because it's just too embarrassing. Or maybe they don't even know what happened. Or maybe they realize it's too embarrassing to report. Or maybe they- the victim feels like they won't be believed. Maybe the victim doesn't even understand what happened to them. That could be- that's a vulnerability. So examples of these kinds of populations are sex workers. Right. So sex workers historically have not been believed when they report that they have been raped. There's a common rape myth that they're asking for it because they are operating this line of work. Historically, they have not been believed and they are targeted by sex predators. Another population is drug users, the mentally ill, our LGBTQ+ communities. So these are populations that may not be believed because of rape myths, may not be taken seriously, may not be prioritized, in terms of being mentally ill or on drugs may not even really understand what happened to them. May not know it's a crime. May not know it's wrong, so therefore may not report it or truly understand the gravity of what has happened to them.

Tyler Raible [00:09:55] I'm sure there are probably scores of other vulnerable populations as well, like elderly communities would fall into this category, too, right?

Mary Weston [00:10:02] Absolutely, Tyler.

Tyler Raible [00:10:04] Okay, so Mary, do you have any cases that involved a victim from a vulnerable population that you'd like to share?

Mary Weston [00:10:09] I can think of a few that really stand out to me. There was a defendant in our community named Stacey Belle. He was not known at the time, but we got some CODIS matches, meaning same male DNA in multiple sexual assault kits. As the task force investigated those cases, it was a similar M.O. in each of those cases. It was- it was always a female victim, and it was a victim who was looking to trade sex for drugs on the street and willing to do that with a stranger, right. So in each of these cases, the

woman was looking for crack cocaine. In each case, she was approached by a short black male with a bald head who offered to take her to a place where he knew he could get crack cocaine for them and that they would, you know, have sex in exchange for him obtaining the crack for them. When the victim agreed, he would take her to another location, which was usually an abandoned building - in one case, it was the basement of an abandoned building - and there was no crack to be had - at least he wasn't going to give our victim any - and then a forcible rape ensued. So all three of those cases were very, very similar, and they all came back to this guy, Stacey Belle. So he wanted a trial. I think he banked on the fact that these victims would not be believed. One of our victims was so unable to cope with what had happened to her, and because she was addicted to crack cocaine, after the rape and before going to the hospital, she had traded sex for drugs with another individual that did not assault her but that used a condom. So we were able to prevail at trial by trying all the cases together to show, really, this was Stacey Belle's M.O., right? This is what he does. His DNA was on all the cases, and that- since the DNA was so important, to show that it was his DNA and not, for instance, the male that one of our victims had been with sexually after the rape. And we were also, I think, able to prevail in that case because we had a narcotics detective that testified in that case to talk about his experience working closely with sex workers and drug addicts on the street. So he testified that in his experience, for instance, prostitutes or drug addicts are not interested in taking a couple of hours off the street to go to the hospital to submit to a sexual assault kit examination. They are, in his experience, they're even more behind than ever. They now just wasted an hour with somebody who they thought was going to get them drugs. Their top priority is to go get those drugs that they were originally looking for, or to make up the money that they thought they were going to get paid and didn't get paid. So that was important testimony to our trier of fact in that case, I believe, and it was also important that that narcotics detective was able to dispel myths about how drug users are able to perceive the world. So, for instance, there was some defense arguments or suggestion that hey, if these women are on crack cocaine, how can we believe anything they say, you know, they probably don't even know what's going on right in front of them. And this narcotics detective was able to testify to how savvy and street-smart drug addicts are, particularly crack addicts. So they're out there making their way through life and making it in the world, and they are perfectly able to tell him what's going on right in front of their very eyes. So that was important testimony, too. And that's just- that's just one case I can highlight that was very powerful, really, and as a prosecutor, I was proud to put that case on to say we are standing up for these kinds of victims. This guy totally thought he was going to get away with this. He thought those girls would never be believed. And instead, he's doing a life sentence now because he was found guilty of those crimes. The trier of fact was able to see what was going on, that this was his pattern. The focus was on him, whereas I believe, you know, he probably would have preferred the focus to be on the victims and their vulnerabilities, as we're saying, and their lifestyles.

Tyler Raible [00:13:55] It's great that you're able to put him away, but this sounds like it's a, I mean it's a really specific M.O. Part of the prosecution's job then, was kind of twofold, right? So it's- it's uncovering a pattern, and then also trying to overcome some of these maybe internal biases towards these vulnerable populations - is that fair to say or am I misreading that?

Mary Weston [00:14:15] No, I think that's absolutely fair to say - to educate your trier of fact, usually your juries, right - unless it's a judge deciding the case - but educating your trier of fact about these kinds of populations, the fact that they're being targeted and dispelling rape myths or just- or myths in general, like I just said the myth that drug users don't know what's going on in front of their faces. Well, that's a myth, right? So it's

something that most people don't know. Your jury may not understand that. So it's important to get somebody on the stand who does see that day to day, who's out there on the street talking to drug users, you know, arresting them, using them as informants. Cops are using drug users as informants because they can be trusted to obtain important information for them. So these kinds of people are important for gathering information and in assisting investigations, but they can also be victims of these crimes. In fact, they're more likely to be victims of these crimes for that very reason because they are out there on the street and accessible - I guess that's the best word - they are accessible to predators.

Tyler Raible [00:15:16] Yeah, I think accessibility is probably the driving factor there, huh?

Mary Weston [00:15:20] Absolutely.

Tyler Raible [00:15:21] Mary, you kind of hinted at this. Can you tell me a little bit about the role of educating in this capacity? Because it seems like that is a huge part of it, and you've kind of mentioned a couple of times, you know, with the value of having the narcotics officer come in and give a description and then trying to kind of dismantle these myths. So how does educating your audience really play into this?

Mary Weston [00:15:40] As a prosecutor, it starts with your jury selection. So as a prosecutor, you get a chance to usually talk to your jury during jury selection. You can ask them what they think are the typical sexual assault myths, you know, and juries know that someone will raise their hand and say, "Oh, if she was wearing a short skirt, she was asking for it." So this is a really old school myth, but that's what you're going to get with your juries. But you can turn that into a conversation about other kinds of myths, and you could have a conversation with your jury about the fact that predators want to get away with their crimes. So I usually will start by asking "Can we all agree that, you know, sexual predators or criminals are not likely to commit their crimes in front of an audience," and they'll all agree. But then you get into a conversation about why that is, you know, why are they not targeting, you know, the cream of the crop in terms of our populations? Why is that, and juries just sit- sitting there and talking about it will understand this all really comes down to predators wanting to get away with it. So who are they going to select? Who's the most accessible to them? Who's the most vulnerable? Who's the least likely to be believed? By the end of this kind of discussion, your jury is not expecting, you know, Mother Teresa to be up on the stand testifying that she was sexually assaulted. They understand that you probably don't have that kind of victim in this case, and that that's not likely anyway, right? That those aren't the kind of people that are really being targeted by predators. So your education with your fact finder starts at the beginning, but it doesn't end there. With the example I used earlier where I had that narcotics detective testify, it's a corroborating witness, so I knew in that case my vulnerability was the drug use of my victims. And why would they want to make it up? What do they get out of going to the hospital and getting a sexual assault kit if they weren't raped when they're trying to make money? Another way that you can educate the jury is by pulling in more information about your defendant. So one thing I like to do, especially with vulnerable populations like we're talking about, is to move the focus from the victim to the defendant. So like in the case of Stacey Belle, focus on who he selects, what's he doing out there? What are his behaviors? What's he looking for? What's he doing day to day? Pulling in other crimes or of your defendant showing his behavior, showing none of this would have happened without the defendant - the defendant's actions brings your audience, which is your jury, around to saying, "Oh yeah, we're here because he did something wrong, not because the victim did something wrong," you know, not because we're going to sit here and blame the victim for being out too late or, you know, walking alone down the street or all these things we think

victims shouldn't be doing. It doesn't matter that they were doing those things. It's the actions of the defendant that brings us here to the courtroom today.

Tyler Raible [00:18:14] That makes perfect sense. This is a little bit of a shift here, but I've been reading some research that indicates that male and transgender individuals are disproportionately likely to be assaulted.

Mary Weston [00:18:25] I am not surprised by that. I have read similar research that males and transgender victims are less likely to get sexual assault kits when they are assaulted. That research, I do believe it makes sense to me in terms of just like any vulnerable population, a population that is less likely to report the rape and less likely to be believed if they do report the rape. That makes sense to me, that tracks.

Tyler Raible [00:18:49] So why do you think that male and transgender victims are less likely to report?

Mary Weston [00:18:54] Well, in terms of males in particular, I guess I can say what I have learned through prosecuting these kinds of cases or investigating these kinds of cases with male victims, I notice a lot of self-doubt and a lot of self-blame based on gender stereotypes. Men believe that they should have been able to get out of the situation. They should have been able to fight their way out, that men don't submit. They're less likely to be comforted by someone telling them, "Well, of course you submitted because you could have been killed." They're less likely to - I mean, nobody likes the role of victim, but my impression in my experience is that men, more than anybody, don't want to be called a victim, right? So they worry that they also won't be taken seriously for those very same things. Right. They worry that juries are not going to think that they couldn't fight an attacker off. I think that causes men to not even want to report that to begin with and it would be the same reasons for a transgender victim as well, concerned that they won't be believed. A concern that they won't be taken seriously and maybe won't be prioritized, maybe would be made fun of - all of these I believe contribute to not reporting or underreporting and not getting the sexual assault kits.

Tyler Raible [00:20:04] And I'm sure that there's some myths associated with like the- the anatomical response, right? Isn't there an argument to be made that, well, if you weren't interested, you couldn't have gotten an erection - like that kind of conversation, right?

Mary Weston [00:20:16] Yes, I have seen that in cases where a man could be a victim of a sexual assault, and I've had defense attorneys say to me, "if he didn't want to do it, how could he have had an erection? How could he have ejaculated?" And you talked to medical personnel, and medical personnel will tell you that biologically, just because the victim, you know, had an erection or even ejaculated, it's a biological response - that does not mean this person enjoyed what was happening. Sometimes the body, it fails you, and it does things that don't make sense. And you can imagine the shame or confusion a man would feel if he is submitting to nonconsensual sex acts and his body is reacting in a certain way that the world believes signifies pleasure. And it causes even more embarrassment, confusion, and these kinds of cases are not prosecuted regularly. They still aren't - the culture around sexual assault, it's drastically better than it used to be. There's still room for improvement.

Tyler Raible [00:21:16] If you're in the situation where you- where you have to prosecute a case with a male or trans victim - how would you approach that?

Mary Weston [00:21:23] My focus would be on making a safe space for your victim. And that means a lot, though, it means making sure that your case is solid so that your victim will be part of it. So what I would do is corroborate everything I could with that case. I would find disclosure witnesses. I would find any other kind of witnesses that would corroborate all the little things that add up in a case. So recently, I had a case where a victim was robbed and raped. One of the things the robbers stole was the person's driver's license. So I went and got the DMV records showing the person got a new driver's license the following week. You know what I mean? It's just like the little things show to the jury like if the person made it up, where's the driver's license? It obviously is gone because they had to get a new one. These might be tiny things, but they corroborate things because you don't want your victim to have to come into- these are- they're already in a vulnerable position, right? They're already worried they're not going to believed, they're already worried that it's going to be hell to testify and be subjected to cross-examination. So corroborate every little thing you can with other witnesses and other evidence. I would also prepare that victim really well for trial and meet several times and prior to any sort of testimony, ask them questions like how they felt about reporting the crime, how they felt about going to the hospital, who in that process made them feel safe, who made them not feel safe? And I will bring that out in testimony. I think juries are not going to understand this unless it's told to them how these kinds of victims are treated from the get-go in a case like this. Who treated them well, who didn't treat them well? All the obstacles this victim had to overcome just to get where we are in front of a jury. What you're not saying is why would they do that if they were just making it up? You know what I mean? Like, this is quite a journey. They've had to tell how many different people about what happened to them. The police officer, the hospital personnel, maybe the EMS driver, maybe the sex crimes detective, maybe somebody from the Rape Crisis Center, maybe the prosecutor. By the time they're in front of the jury, I mean, how many other times have they had to say what happened to them, I would really kind of highlight that. I would also take testimony from people that are sympathetic to your victim. Friends and family members are good people to testify about how a crime affected a victim, what kind of changes they saw in the victim? You know, they've known your victim for 20 years, let's say, and they've never noticed the kinds of behaviors they started noticing after the assault. That was not the sister or brother that they know. Again, if somebody is making something up, they don't generally stop going outside at night after an assault or stop dating after an assault or quit their job because that's where the assault happened. And juries are more likely to believe victims that other people believe, too. When the victim's loved ones believe them, the people that know them the best, I think that that's good testimony to get in front of a jury and have them be able to assess and consider.

Tyler Raible [00:24:16] From what you described, especially the survivor's journey dealing with all these different people, having to retell their story, how do you think that this affects their, their willingness to stay engaged through the whole process?

Mary Weston [00:24:27] At least for my experience, you have people that are like this close - and I'm holding up my finger and my thumb - this close to falling off all the time. By the time we get a case as prosecutors, they've already had to tell so many people what happened to them. Right when the rape happens, that victim is hearing from a lot of people, and they're getting sometimes some support at that time. You know, they're getting the police officers following up with them. They're getting the hospital who's collecting evidence from them and treating them and maybe giving them some medication - like all that kind of stuff happens right at the beginning, and then sometimes victims don't hear anything for a while. You know, maybe the detective will follow up and say, I'm forwarding the case to the prosecutor, and then maybe they don't hear anything for a

while. By the time I get a case as a prosecutor, sometimes you're- you're fighting to get a victim reengaged, really. So we try as prosecutors and most prosecutors do this, try to get victims invested. I like to get them in, meet with them, and even just to get to know them maybe for the first meeting or two. It's really kind of the comfort level of the victim. I want them to trust me and to know that I'm fighting hard on their case, that I believe them, that I know these things happen. And you know, my job is to hold the people that did- do these things accountable. It can be really hard. And in fact, one thing that you'll see as prosecutors and victim advocates, investigators is the closer you get to trial, victims may fall off because it is becoming real for them that soon there may be a need to testify. So one of the things that was a learning curve for me is that that is trauma. So I would think, "Oh, you know, these victims are not answering my phone calls. All of a sudden she's just falling off. She must not care anymore." Well, it's not because the victim doesn't care anymore. It's trauma. Trauma is rearing its ugly head and causing victims to have difficulty coping with what's going on. Right. Trial is coming up, that means testimony. That means telling people what happened to them, and the fear of the verdict, right? The fear of the verdict being maybe they won't believe me. Maybe this will all come to nothing. And the defendant's going to be in court. You know, the defendant has a right to confront witnesses. He has a right to be in the courtroom. You know, that could be extremely hard for a victim. So it's hard. But all prosecutors can do is try to make their victims know and understand that the prosecutor is working every day on their case. I think it's important to keep victims involved in scheduling and keeping them updated, and that has been particularly hard with COVID. For instance, we had to kind of change tactics, and I started having the prosecutors here update victims about every single delay that the court put into place - if they were delaying jury trials, call your victims. Let them know we understand it's completely frustrating. You know, we brought this up after so many years, and now we're making them wait again, and try to find out what resources might help them with this further delay. What can we do? That has been hard. But it is- it is a challenge keeping victims engaged, Tyler. It is a challenge.

Tyler Raible [00:27:23] I can only imagine. I mean, you have people put in this horrific situation, and it's exacerbated by all of these other external factors. So Mary, is there anything coming up you're excited about? What's next for you?

Mary Weston [00:27:34] Well, we are doing some genealogy on some of our cases now. So like I said, we had over 800 indictments, but almost 200 of those were indictments where we knew the DNA profile on the evidence was the perpetrator's DNA, but we didn't have a hit to anybody, so we didn't have a known offender. So we indicted those as John Doe's to stop the statute of limitations because as I said earlier, we had a 20-year statute of limitations at the time and there- at that time, there was no extension of that statute of limitations with a DNA hit. So we were indicting John Doe indictments, and to be honest, we still do sometimes if we don't want something to fall off the radar, even though we now have that five-year extra period of time to investigate John Doe's if we get a hit, even if it's beyond the 25 years. So of those 180 now John Doe's, you have to imagine if we haven't gotten a hit, we're probably never going to get a hit. You know, it's probably somebody who's not going to, you know, they're hiding in plain sight. They're not going to be arrested. They're not going to have their DNA put into the database. Or, you know, maybe they're dead, frankly. So we were lucky enough to get some BJA SAKI funding starting in 2019 that we started using those funds to do genealogy research on those DNA profiles. And so we had sent 20 sexual assault cases to a genealogist, and we've solved five of them so far. But actually, it solved more than - I'm going to do the math now - it solves more than five sexual assaults because like one of them solved three - it was one DNA profile. He was linked to three crimes. Unfortunately, he was dead, but we were able to tell the victims

of the crimes, we know who did this to you. He's not out there on the street anymore. You're never going to see this guy again. So that was gratifying and valuable. Another guy was linked to two separate stranger rapes. He's in pretrial right now. Another guy was linked to one, another guy was linked to one. Another guy was linked to one. So it's five DNA profiles. But it solved eight cases so far, and we just sent nine more cases to our genealogy vendor. So we're hopeful to get some more solves. And by the way, we're also going to use some of this funding to do the same thing with homicide cases. We're looking through our homicide cases right now just to try to identify some where genealogy might be able to provide some leads. That's really exciting. It's something new, something our county has never done before, you know, use genealogy to try to solve crimes. We've used familial DNA in a few cases. This is our first time doing straight up genealogy, and it's very exciting.

Tyler Raible [00:29:57] It's incredibly exciting. So- and many of the guests that we've had on the show talk about how we're all collectively trying to do better, right - the situation was dire. It's always improving. Do you have any thoughts as to what could be done to encourage people to report to get the medical help they need, or maybe even engage with the criminal justice system?

Mary Weston [00:30:16] I mean, my message to individuals who have been sexually assaulted is to definitely report your crime and definitely go to the hospital. You know, people are more and more in a position to investigate these cases and take them seriously and do the kind of work that is needed for these kinds of cases. There has been such, such a swing in terms of our culture and how we interact and believe rape victims. We know more than ever how prevalent it is. We didn't- in ways that we never really knew or understood or believed or wanted to think about before. So my message to victims is, you know, we believe you. Prosecutors know this is happening. We believe it's happening to you and we want to hold offenders accountable. So no matter what happened to you, no matter what kind of act occurred or what kind of circumstances the sexual assault happened in, prosecutors and investigators are more trained than ever before to respond to these kinds of acts, to investigate them really well, and to prosecute to the fullest.

Tyler Raible [00:31:19] That's a great way to wrap up today. So I want to thank you, Mary, for sitting down with Just Science to discuss vulnerable populations and just, just for being here and the work that you do. So thank you so much for taking the time out of your day to sit down and talk to me.

Mary Weston [00:31:33] Tyler, it is always a pleasure. Thank you.

Tyler Raible [00:31:35] And for those of you listening at home, in the car, wherever you enjoy your podcasts, be sure to like and follow Just Science on your platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:31:54] Next week, Just Science sits down with Dr. Julie Valentine to discuss her recent research on sexual assault cases associated with dating apps and the prevalence of strangulation in sexual assault cases. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:19] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In the final episode of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Natasha Alexenko, Lieutenant Jordan Satinsky, and Marya Simmons to discuss at-home sexual assault kits through a victim-centered lens. Throughout this season, Just Science has spoken with various subject matter experts to discuss several perspectives posed by the use of at-home sexual assault evidence collection kits. As criminal justice practitioners and advocates, Natasha, Jordan, and Marya have prioritized focusing on trauma-informed, victim-centered approaches to support survivors of sexual violence. Listen along as our guests discuss their work in sexual assault response, the complexities of evidence collection, and their thoughts on at-home sexual assault kits in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:27] Hello and welcome to Just Science. I'm your host, Tyler Raible, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. This season, we've been talking about at-home sexual assault evidence collection kits. We've been referring to them as at-home kits. And today we're going to take more of a holistic approach to the conversation. So I'm joined by three different subject matter expert in varying fields, but I'm joined by Natasha Alexenko, Jordan Satinsky, and Marya Simmons. Natasha, Jordan, Marya, it's so great to see you again. It's always awesome to have you guys on the show.

Natasha Alexenko [00:01:55] It is always great to be here.

Marya Simmons [00:01:58] Absolutely. Thank you for having us back again.

Jordan Satinsky [00:02:00] Yes, thank you very much.

Tyler Raible [00:02:01] I'm thrilled to have everybody here, and as our audience may or may not know, you- you've been guests on the show before. But for anybody who isn't necessarily familiar, let's- let's take a second to talk a little bit about what each of you do. Jordan, do you want to go first?

Jordan Satinsky [00:02:13] My name is Jordan Satinsky. I'm a Lieutenant with Montgomery County Police Department in Maryland. Currently, I'm the executive officer to one of the existing chiefs. But prior to that, I spent about 15 or so years in the sexual assault world as either a child sexual assault, physical assault investigator or an adult sex crimes investigator. And then I went back and started up our adult sex crimes unit. I worked active and acute cases, and I've been working with this program and some others for many years talking all about and educating folks all about sexual assault investigations.

Tyler Raible [00:02:44] Natasha, how about you?

Natasha Alexenko [00:02:45] Hi, Tyler. My name is Natasha Alexenko. I am a survivor of sexual assault. I was raped and robbed at gunpoint in the 90s. My kit remained untested for nearly a decade. Thankfully, the man that raped and robbed me was found in CODIS through DNA many years later. But really, my gratitude and the people I met along the journey, my journey for justice really inspired me to utilize my story as a springboard to help others and perhaps formulate something that works across the board - ways in which we can take our system and improve upon it. And just utilizing this amazing idea of teamwork, coming together as a multi-disciplinary team. I think it's just brilliant to include survivors in this dialogue. We have a unique expertise and a unique voice to include in this story.

Tyler Raible [00:03:40] And Marya, can you introduce yourself?

Marya Simmons [00:03:42] Absolutely. My name is Marya Simmons. My background is in victim advocacy in the criminal justice field. I have worked in the capacity of being a victim advocate for over 12, 13 years now and where I really supported victims of sexual assault, human trafficking, domestic violence, and families of homicide victims inside and outside of the judicial system process. And prior to being a victim advocate, I worked as a chemical dependency counselor. I also worked in my county prosecutor's office as a victim witness supervisor as well as my local rape crisis center where I supported victims of sexual assault and trauma from children all the way to the elderly population. My passion for victim advocacy and strengthening multidisciplinary teams really stems from my dedication to supporting and empowering victims and contributing to systemic changes to elevate their voices.

Tyler Raible [00:04:33] I love that, that all of you brought up the- this concept of the multidisciplinary team, and I know that the three of you have conducted trainings together as part of this multidisciplinary approach on topics like trauma-informed practices and recommendations for supporting survivors. So could you all tell us a little bit about these trainings and these trauma-informed practices?

Jordan Satinsky [00:04:52] You know, this is such a unique group, and I really appreciate working with Natasha and Marya. Having an officer, a victim advocate, and a survivor all together to talk about the approach to these types of investigations is unique. It doesn't happen. I give Natasha so much credit for coming forward and doing what she's doing and helping us educate the world on and those of my yoke on how to conduct these investigations. And Marya brings this other side of it from victim advocacy, which is so important - that is really starting to become into the fold of law enforcement. But wasn't, I mean, the victim advocacy role over the last 10 years has wildly changed within law enforcement. When I was a young detective, victim advocates stood outside the room. Now, we work together. It's a very, very different model. And the trainings that we go and we do on a state and national level all encompass this multidisciplinary approach, working together, and I think the biggest thing, and I'll let the other two speak to it as well, is really just checking your ego at the door and just working these cases in a very victim-centered, trauma-informed manner and really working for your victim, whether there's an arrest or not. It's entirely up to the survivor what happens and, you know, you work the cases the best you can.

Natasha Alexenko [00:06:02] Now, very, very well put, Jordan, and Marya and Jordan, you know, working with the two of you has just been one of the greatest experiences I've ever had and really hearing from you both the evolution, how essential having an advocate is in the room in order to conduct victim-centered, trauma-informed interview practices.

And I think that we're learning a lot and growing and- and that's something I think I've taken out of this is just how positive it can be when you bring a group of dynamic people together who have like a history and understand where we're coming from and really a great vision for the future. I think that positivity brings, brings just so much to the table that you can't possibly articulate into words.

Marya Simmons [00:06:51] Thank you, Jordan and Natasha. I also kind of just cosign what they both said, is that the work that we've done together has been very impactful. Hearing from the different angles and expertise that we all can contribute to these conversations, really to educate and spread awareness about the importance of working as a multidisciplinary team. And as Jordan had said, ten years ago, this process looked a lot different. Ten years ago, I really had to work hard to establish myself as a victim advocate to be in the rooms with victims and working with law enforcement and prosecutors, and that building rapport and trust with law enforcement and prosecutors for us to be at the table and have a voice for victims is so important. The focus of our conversations is facilitated through our personal experiences and expertise on best practice approaches and being trauma-informed, understanding what the impact of trauma looks like.

Tyler Raible [00:07:44] We've spent a lot of time talking about what we've been referring to as an at-home sexual assault kit. I was hoping before we really dive in, I could- I could gather your initial thoughts and maybe if you have any considerations or concerns about a person attempting to collect evidence with one of these kits?

Marya Simmons [00:08:00] Absolutely, Tyler. I have several concerns with the at-home rape kits. Although, this consideration may sound appealing in mitigating the challenges with the pandemic and trying to make this process more convenient, there are so many other aspects to consider. With that being said, my knowledge about the process and ethics in supporting victims, my initial thoughts are what about the victim's psychological safety, their level of trauma, the lack of necessary support during and after this process? How will victims be impacted if there are extensive injuries, and how will that affect them during the examination? Are victims being charged to pay for the kit when sexual assault examinations are free, and how this process will affect evidence collection and the investigative and prosecutorial process as well? Another one is what if there are language barriers? Is there access to translators and interpreters through the entire process? But there's also a lack of safety precautions in place. How do we know who's receiving these kits when they arrive? Is the perpetrator in the home? And what happens to the kits if it gets into the wrong hands, does that put the victim more in danger? So there are a lot of different things that concern me with this process, which I'm sure that we'll be able to kind of dive into a little bit further.

Tyler Raible [00:09:17] Absolutely. I'm looking forward to it. Natasha, what about you - what are your thoughts?

Natasha Alexenko [00:09:20] As a survivor and speaking to others who are just kind of share the same concerns as me, the issue is I think that so many of us are laymen before we kind of enter this world, and oftentimes fortunately so, and we really don't understand a lot of the process. How does a rape kit work? Where does it go, et cetera? And I think that a lot of us were confused initially on what these kits did. And if I'm being frank, I'm still a little confused. You know, now that I've been working in this field for a while, I understand CODIS. I understand how profiles are uploaded into the system. And I think that an individual who may not be aware of the process may instantly think that this kit has the

ability to find a perpetrator or enter a, you know, federal database. And my fear is that lack of information that comes along with it. I mean, we're so used to living in 2022 through a pandemic, these type of tests having instant results like doing a COVID test at home and in 15 minutes or less, you find out whether or not you have COVID and similar tests of that nature. So I'm concerned that there will be a misunderstanding of how these kits work and whether or not they are eligible to kind of enter the system and be part of the justice system. And I think there's just not enough information - that concerns me. So if someone is assaulted and they assume that this kit is sanctioned by law enforcement, sanctioned federally, they may not be aware of that case. And I, I think oftentimes, and I'm guilty of this as well, we kind of run under the assumption that everyone kind of knows how this process works, when that's not the case, and when the only other measurement you have is something that has instantaneous results, you don't necessarily have enough information to make an informed decision. And that is my concern, and that's a concern I'm hearing from other survivors. What does this kit do? I certainly echo 100 percent of everything being said in terms of, you know, a survivor may not have access to advocacy. There may be injuries that, due to shock, they're not aware of. So if you eliminate someone with medical expertise, someone with psychological expertise, that leaves you in a new vulnerable space because you're just kind of left alone without the amazing tools we have in place to support what your needs may be.

Jordan Satinsky [00:12:00] Natasha and Marya, I echo everything you both just said about how these at-home kits come into play and how they work with our system, our criminal justice system. And I think the biggest part of this from the law enforcement angle is these at-home kits provide victims with a false sense of security in a certain aspect. They're not evidentiary value. We can't put them into CODIS. I can't use them to help us further to find a suspect. And it basically closes off a door as far as the- that part of the investigation is concerned. If it was in a certain timeframe, maybe we could do it again. But it just really depends on if the victim wants to do that and if it's a reasonable option based on the totality of the circumstances, and what was contained in the kit. What they did, did they follow all the steps? Did they do everything? The other part, they're missing out on Marya, they're missing out on victim advocacy, they're missing out on that holistic approach to this. Cops aren't therapists. They're not advocates in that aspect. As much as they sometimes want to help, they just can't. They need that other arm. And then there's the forensic medical approach. All of that, you have somebody looking over you from not only a evidentiary collection standpoint, which is important for the police investigation, but also what about anything else that may have happened? Were there injuries, were there things that need to be checked on? We're missing out on those. We could end up with people taking an at-home kit having undiagnosed injuries and then being further injured or even dying because they weren't treated. Those are things that are sometimes caught at- during a medical clearance or even during a forensic medical evaluation. I just think these at-home kits, especially, and I believe Natasha said it earlier, the post-pandemic, you know, everything's at home, you know, it's easy. You know, we recreated how we work our lives. These at-home kits, they just create a false sense of security, and I feel like it's going to end up hurting more than it does helping.

Tyler Raible [00:13:39] Jordan, that's actually an excellent segue because I do want to really unpack a lot of, a lot of that was said here because we are working with multiple perspectives. And Natasha, so you mentioned this, this kind of, I don't want to say level of ignorance, but maybe this confusion that might be surrounding how these work - do you have any ideas or recommendations on, you know, how do we get the information to the people who need it?

Natasha Alexenko [00:14:00] Right, that's certainly always been a concern. You know, I hope no one ever needs to know this information. I hope that people go through their lives without having to understand this process at all. But I think it's an important one for a survivor to recognize. One, a rape kit, obviously, is collecting evidence. But there's other issues as well. There's antivirals to take into consideration - that can be done in the hospital. And you know, I understand that some survivors may not wish to go forward with a case for a variety of reasons. So perhaps there's a fear in place of, well, I don't necessarily want to get a rape kit done because perhaps I don't want to move forward with a case, whether it's for fear of retaliation from the perpetrator or whatever the case may be. I want more survivors to be aware of the fact that they don't have to move forward with a case if they get- have a rape kit done in a hospital setting. You know, that's a part of why a rape kit, why that evidence is collected, but it is not the only reason. It's to be connected with advocacy, to receive medical treatment, and perhaps to put things in stasis until a time where the survivor is ready to move forward. And communicating that is essential when we talk about advocacy. When we talk about support mechanisms for survivors, I think a large portion that is missing from what we kind of move forward with is the education piece. It's educating people on how to approach sexual assault and what to do if someone's sexually assaulted. And the other reason, besides educating the public, besides making everyone aware so they can make informed decisions as they move forward - we know that sexual assault is so underreported, and I feel if we empower people with this knowledge, the reporting rate will grow because individuals will be more confident in the process, will be more confident in the system and understand and have that perspective, and communicating that should be a part of what we do when we go out and we do sexual assault reform is, is education.

Tyler Raible [00:16:14] Yeah, I think the education piece is important and, you know, a lack of education kind of creates a barrier. And Marya, you'd mentioned a few barriers, including the well-being of the survivor. What else do we need to consider?

Marya Simmons [00:16:27] Yes, I think it's first important for the victim's psychological safety. The level of trauma and how their emotions and mental state will be impacted by performing such an invasive examination on their own is a huge concern for me. I've been in the hospital rooms with victims prior to, during, and after a forensic examination. Those raw emotions, trauma responses, the fear that victims experience is, is very overwhelming. Getting past the tears is one of the first hurdles, but the most impactful piece of it is having someone there by their side who is trauma-informed and who will be there for the long haul. And that is the most vital piece in getting over to the next hurdles that they will face going forward. SANE nurses, as Natasha had just talked about, who specialize in forensic collection for rape kits also play a vital role in this process. They have hours of training that strengthens their expertise in the nuances of effectively supporting victims of sexual assault, using trauma-informed practices, and they know what to look for and how to properly collect the evidence that is needed, and they know how to explain the process to victims to minimize retraumatization and anxiety. The lack of necessary support, again, during and after the examination for victims, I have worked with victims of sexual assault who have required immediate attention and access to resources to address their trauma and mental health concerns after their assault. I have had to contact mobile crisis for victims who have presented suicidal thoughts or had plans, and I've also worked with victims who are sober and had the potential of relapsing, which is extremely likely, and/or were concerns that they would further harm themselves because they were fearful, they may have blamed themselves, or were alone, and no one was there to support them, or they didn't know that there were supportive resources that would be there to help them. So as a victim advocate, I understand the importance of me being there as an advocate

following up with them after the examination. As Natasha just talked about, giving them information so they can make informed decisions and explaining things in a way for them to understand every step of the way. Without having that knowledge, victims are forced to process and deal with unanswered questions and concerns in real time, and the DIY rape kits cannot be a numbers process. Victims of sexual assault require a significantly higher level of support than a patient who may just be seeking telehealth services for a sick visit. Therapist and mental health professionals who provide telehealth services can appreciate the necessity of patience in the process to get victims to really begin to talk about what happened to them, let alone performing an examination that can take hours for a victim to do themselves. Another concern of mine is how will victims be impacted if there are extensive injuries? As Natasha's talked about, a SANE nurse's main priority is to make sure that they are treating their patient. If there are extensive or other injuries that may not have been noticed before, this victim is then going to be exposed to having to find out that they have injuries and how are they able to cope with that on their own? Scratches, bruises, tears or even cuts, they may need additional lab work done, X-rays, antibiotics, things of that nature and being able to explain what that looks like to a victim from a trained professional is very important. And so, according to the International Association for Forensic Nurses, they state that some patients experience strangulation during their assault, which can inflict hidden internal injuries that can have long causing medical and health consequences or even death, as Jordan had just talked about. So it's really important for us to consider all of these different nuances that can be existing for victims of sexual assault as they are going through this process, again, on their own.

Tyler Raible [00:20:21] Thank you, Marya, and I think that really highlights the value of having the SANE in the room. And I think that it also really underscores the value of their training expertise, and Jordan, you kind of mentioned this, too, that having the SANE there was important. And you mentioned, Jordan, that this at-home kit is likely not of evidentiary value. Can you tell us a little bit more about that?

Jordan Satinsky [00:20:40] Part of the issue with the DIY kit, as Marya was calling it, there's no training involved in that. You read a piece of paper. You take your samples. You put it back in a box. A SANE nurse goes through very specific training to not only work with their victim, get them the right services, make sure that, you know, they're physically OK and get them the services for mental, but also how to pull evidence from the victim in order to provide to law enforcement so we can utilize that under appropriate practices and chain of custody so we can input that into our local, state, and national databases for DNA. We have to be able to verify who took it, where it came from, who took it, that person was trained, and it meets all these requirements in order for us to put it into these databases. These at-home kits, they could have anything in there - standards that aren't well-produced, information that's not well-produced, and plus, who's taking the actual sample - the victim or a friend or someone they know, which is even worse, like having the victim do their own kit in-and-of themselves, I can't even imagine the mental load that puts on them. And then to invite a friend to help out, potentially, another person that you're now bringing into this. These folks are trained on how to do this. From the baseline law enforcement aspect, absolutely it's a chain of custody and enter into evidence systems issue, as well as documenting other injuries as there most likely are other injuries whether they're strangulation, scratches, cuts, other wounds where you could get potentially other DNA evidence, touch DNA, things along those lines that we would lose. Plus, you have to consider the clothing. There are certain ways that forensic nurse and/or the detective would take this clothing and package it, which these DIY kits don't provide for in some cases. So DIY kits present a, what I like to call, the instant gratification. Yes, I have this. I can do this. I don't have to include anyone else. But the problem when they show up at the

police station with the kit, first thing the detective is going to say once they figure out what's going on as they do become more prevalent, he or she is going to say, "What is this? I can't use this," and that's going to send a victim down a road. I mean, our criminal justice system is not set up particularly to embrace our victim. Our state is our victim. The victim - Natasha, sorry, you were a witness to the state, you know, and it's how to set that up in your mind correctly, where you are now a witness not a victim. Even though as police and victim advocates, we strive, and even prosecutors, to really push that victim narrative - on paper, when you read it and when you get those documents, it doesn't say that, and by bringing in these kits, you know, companies want to make money. And when they push these kits to victims, they see what appears to be the best process, and it's not. You know, one of the things in law enforcement - we're guilty of it as well as anyone else - there's not like there's an educational system for our victims out there. You know, we do have Sexual Assault Awareness Month, all that, I'm not saying about that, but we don't publicize, well, if this happens, these are the steps that are most likely going to happen. This is what we're going to end up doing. We're asking you to participate and potentially if you want. We do a lot of work amongst our own world - prior to me becoming a law enforcement officer, I couldn't tell you how any of this worked, and I'm sorry Natasha knows anything about it. You know, 90 percent of me is like that, the other 10 percent, I'm glad she's here as an advocate so other folks get it.

Tyler Raible [00:23:39] Yeah, that makes perfect sense, Jordan. And I think that maybe from a- from a survivor perspective and from a victim perspective, there might be some, some appeal to these at-home kits. Marya, is this at-home kit giving control back to the survivor or is it kind of like a false empowerment?

Marya Simmons [00:23:56] I think it could be false empowerment or potentially a delusional way of seeking justice for victims if they're not given the proper tools, resources, and information on what this process really looks like, as Jordan just talked about. We as professionals know how this process looks, and we're able to explain it no matter what professional that the victim engages with, whether it starts at the hospital or if it's law enforcement and/or if it's through counseling and therapy. All of us are trained for trauma-informed practices and what it looks like for victims to go through this process, and we can explain it step by step by step and/or linking them to other professionals who can support them through the process. So I think that the selling point that can be done in the privacy of their own homes, and that they do not have to go to a hospital or emergency room for the examination, that it could reduce anxiety or fear or being seen or judged by others. And/or they may think that because the kits are being done at their home, that the process will be less traumatizing. And again, because they may not have the information on what this process really looks like or should look like, then they may not make those informed decisions on their own.

Tyler Raible [00:25:08] From that kind of same vein, Natasha, then, is this a viable option for a survivor?

Natasha Alexenko [00:25:14] Well, you know, from- from my perspective, and being completely frank, you know, after I was assaulted, the first thing I wanted to do was take a shower. I certainly didn't want to go to the hospital for a rape kit. I didn't want to relive the trauma. If this at-home kit was available to me, with the limited amount of information I had at that time, I would have utilized it as an option. There is a stigma around sexual assault - eliminating that by not having to share, by not seeing someone face-to-face is easy. And I know, in my case in particular, when I went for my sexual assault evidence kit collection, there were things I was unaware of. I was unaware that antivirals were available to me,

and that was something I was fortunately given at that time. Trauma - I had no idea what trauma was. What did that mean? What did that look like for me? But somebody who met with me in the hospital, they were very aware of what that was, and they were really looking for signs of that. And, you know, I think that's what some of the danger is. The thing I regret the least about the process of my case is getting that rape kit done. Getting that rape kit done changed my life. I was the complaining witness in the case. The most important thing to me, even at that time, was to ensure that no one else was hurt, that it stopped with me, that I was the last person harmed in this process. So that's why it was important to me to enter my story in the system. Now I recognize that I'm coming from my own perspective, and there are men and women out there who have a completely different perspective, and mine is unique to me, and I understand that. But from where I'm sitting, that's how I felt in the process. And I think the system, as Jordan said, is not perfect. But when we put in another variable like this, which obviously there is a need for - it was created because there's a stigma around sexual assault - this gives the power back to the survivor or whatever the rationale is. But I think what we lose in this process is the fact that we've all been fighting so hard to reform, to make things better, and they have been getting better. I've seen it happen. And if we are not kind of focusing on continuing to make the process better, easier, and more comfortable for survivors, then we're not doing our job. If we're kind of distracted by these sorts of things, we're not putting the effort where it should be - in what we have and strengthening it, ensuring that it continues to evolve, it continues to meet the needs of survivors.

Tyler Raible [00:27:45] And Natasha, you'd mentioned earlier about this kind of common misconception that if you get the kit done at a hospital, then you automatically have to engage with law enforcement, and that's not the case. So Jordan, from- from your perspective, if someone goes into this thinking, I don't want to engage with law enforcement now, but they're looking at it as an option to engage with law enforcement later after using this kit, is that an option?

Jordan Satinsky [00:28:10] Realistically, as far as if somebody wanted to wait and use one of these kits, could we use them in the future? That- we can't put them into CODIS, I can't take anything from it that would help us get to the right person. I've been mulling over this for a long time trying to figure out how do you help it along to see if you can use this information to create your case and move it forward. But every time I keep coming up to this block where it would end up getting crushed in court under some sort of a fruits of a poisonous tree doctrine, when meaning that the evidence was obtained inappropriately, or if I have the evidence that the victim or survivor produced and it wasn't taken correctly, I can't put it into CODIS. I can't match it to anyone. It's unfortunate and it's going to end up, much like Marya and Natasha both said earlier, I'm going to end up retraumatizing my victim by even attempting to do this because I'm giving them that false hope that I can. And I understand the mentality behind it. I have- I'm not a survivor. I'm not begrudging anyone - if they ever did it or do it, that is a choice and I understand. So there's really not much we could use from the kit. If they kept their clothes, potentially we could use something. But again, there would be a lot of questions about that, about where it was stored, how it came from, length of time, things along those lines.

Tyler Raible [00:29:21] Absolutely. And I was kind of thinking, as you're explaining, you know, in terms of supporting survivors, how do you have a trauma-informed conversation with a survivor who has undergone an at-home kit?

Jordan Satinsky [00:29:33] So that's a great question, Tyler. And I think the- the best way to do it, you know, being sensitive to the topic, obviously, but also to be upfront about it,

not trying to make it confusing, not trying to make it colorful. Just be direct and explain that the criminal, this is how this works within the criminal justice system, and it's not something that anyone in law enforcement can control. These are the rules that were set up. There are, like you said, other avenues. Are there digital outside of this kit? Are there digital aspects we can look at as far as social media, cellular phones, emails, things along those lines, other witness interviews, text messages, things that we may be able to utilize to make this case? Potentially. But unfortunately, the items that are in the kit aren't going to be viable option. And outside of the criminal investigation, and hopefully I would have my victim advocate with me while having this discussion because I can't even imagine having to be the recipient of that news, is making sure that they get the assistance they need mentally first. My criminal investigation could wait. This needs to happen first. I've just told you, you thought in your head, this horrible thing happened, you thought you did the best thing that you could with what you had at the time. And now, I've just basically told you I can't use it. This is where Marya comes in. Hey, let's get this victim, this survivor to the right folks. Let's get them the right help. And if they're ready to go then and there, remember what I said earlier, victim-centered, trauma-informed. We'll go. But if they're not, I'm OK stepping back.

Tyler Raible [00:30:48] Yeah, that's perfect. So then, Marya, how do you support a survivor when it's possible the investigation might not go forward because of one of these at-home kits?

Marya Simmons [00:30:56] Giving them real-time information and support, being transparent about the details of the case. I think that there is nothing like being kept in the dark or having someone sugarcoat difficult conversations, as Jordan just talked about - that will damage trust and rapport with and further engagement with the victim. Having uncomfortable conversations are temporary, but the exasperated trauma that will boil over for victims of being left in the dark with thoughts of uncertainty, doubt, fear, self-blame, and isolation - commonly, victims may not tell anyone about their assault, as Natasha had discussed earlier. That can be debilitating. And so supporting victims of sexual assault as a victim advocate encourage me to fight with them through a system who often finds it easy to resolve sexual assault cases without a victim's input sometimes, and then dealing with the challenges of genuinely advocating for the rights and justice of victims and requiring that they deserve that empathy, the patience, and the fierce dedication to hold offenders accountable at the highest penalties. And being a voice for victims even when they don't have a voice for themselves through the process. So with that being said, that my famous motto is justice looks different for everyone. Some victims may not want their case to go to trial because they may not want to have to testify on the most intimate details of their lives. And that's OK. But being able to allow them that information to make those decisions for themselves on how they see their justice for themselves, whether that's going forward with the case or not going forward with the case, but having the professionals support them either way, that is very critical in supporting victims whether their case goes forward or not. When cases face challenges, and they're not going forward with the case, I made it my priority as a victim advocate to make sure that I contacted the assigned prosecutor and our law enforcement so that we could both communicate the news with that victim. Therefore, I was there to support that victim, and the prosecutor, and our investigator was there to answer any questions legally that I may not have been able to answer, but we were both there to support that survivor through that conversation, as difficult as it may have been. It's also about follow-up, meeting victims where they are and addressing those immediate concerns. It's about being authentic and genuine in every interaction that we have, no matter where we start. So it's, again, about communication in

real time and being able for those victims to see that there's a team behind them to support them.

Tyler Raible [00:33:29] So Natasha, how does a survivor reconcile this news? You know, how do they move forward towards their own justice in this capacity?

Natasha Alexenko [00:33:37] Well, I think it's really important to say that survivors who have done this at home, there's zero blame. I'm at least coming from a point of complete understanding. This is not something, you know, you didn't make a mistake. It's OK. I think that's an important point to make, and I don't think that anyone had like anything nefarious, whether creating these kits or whether taking them, I think everybody at the end of the day has, you know, the best interests of survivors in mind. And I recognize that that's where it's coming from. I also know not everyone has the luxury of having, you know, like I do at my access, and I have to say the individuals I'm- I'm fortunate enough to share this podcast with, they have a truth behind them. They don't have an agenda. You know, their agenda, they're mission-oriented toward survivors. And that's really true, and I wouldn't be here if that were not the case. Another excellent point that was brought up is just the follow up, and I was really fortunate to have that moving forward. You know, other survivors I've spoken to who's case- who decided to not even move forward with the case, they still had that follow up. They still had advocates calling them, contacting them, making sure they were OK, seeing what their needs were, even like financially. Those things are in place for a reason. Again, you know, I know I'm sitting in a luxurious position of having access to these experts who understand, and I know that if I didn't have this luxury, I, you know, I can definitely see why I, without the knowledge I have now, would take this route of doing something at home without knowing what is missing in the process, not just from a criminal justice perspective, which is important to me personally, but from all the other resources that won't be available to me anymore. And they're important to me, and I think they're important in the healing process, which to the survivor, outside of being a complaining witness, is the most important component is the healing, is the recovery process, and you'll be kind of left in the dark without those things. Not everyone is aware of what resources are available, though sometimes it's really beneficial to have what resources there are out there pointed out to you. You may not be aware. I was unaware of, for example, victim compensation - never even knew there was such a thing. There's one thing when you're kind of in the midst of trauma, of being given all this literature to kind of have to read through, but it's quite different when you have someone trauma-informed, looking you in the eye and saying this is what is available to you. And that kind of back and forth of someone seeing if you recognize what's out there and perhaps you're not ready to receive that information. But, you know, moving forward and again, the follow up saying, OK, perhaps you're ready for this now, this is what's available to you. But you know, the layman doesn't know what that is. I certainly don't know. And reading a piece of paper when you're in the middle of trauma, not being able to kind of absorb some of those details, I think is a detriment. And those resources are important and they're important sometimes very, very quickly, especially, you know, DNA evidence. Jordan mentioned clothing and that sort of thing, but, you know, anti-virals - that's necessary immediately, traumatic injuries you may not be aware of because you're in the midst of- of just feeling like in a state of shock, that's an immediate thing. There are things that these kind of at-home kits may not supply that are immediate, crucial needs.

Tyler Raible [00:37:01] So as we're- as we're kind of wrapping up today's episode, what's the one thing that you want everybody to know, at least from your individual perspectives? So Marya, could we start with you if that's OK?

Marya Simmons [00:37:12] What I would want the community to know is that these kits are not sick visit appointments, right? They are invasive examinations that require victims to collect evidence on every aspect of their bodies that remember was just violated and injured. Their power, their dignity, their control was stripped from them, and the ability to make a rational, informed decision may be distorted. Every victim has a choice and a right to make a decision that's best for them. And we, as professionals, can have our own opinions and beliefs on this topic, but it's important to weigh all aspects from a victim's perspective, a professional's perspective, and a justice perspective. And so consider these questions - how many offenders will return to communities to revictimize due to the criminal justice system not being able to pursue criminal cases because their cases were unintentionally compromised during evidence collection? How many victims will obtain the healing and resiliency, as Natasha has talked about, if we do not have those essential support systems in place - access and resources necessary before, during, and after their rape kit has been collected? How do we determine and evaluate if this is a trauma-informed process? What research and evaluation is being done to conduct or measure these results from a victim's perspective? There's nothing more valuable, right, than hearing from a victim's perspective. And as we know, going through and participating and watching the evolution of this rape kit initiative across the nation, what it has brought is the survivor's perspective, and it is so important for us to be able to incorporate and implement and allow victims to have their voices heard throughout this process, but also consider what policies are in place, and does this really go state-by-state or is this- there is an overarching goal and mission to be able to make sure that these victims are supported through this process outside of the accessibility and the convenience of these rape kits. There's just so many different perspectives that we need to consider and not just looking at it from one focus and one lens.

Jordan Satinsky [00:39:17] I want to start with, I echo everything Marya just said. I mean, that's all very, very excellent points, and I agree. From the survivor, I can only imagine, you know, here is something, much like Natasha said earlier, I could do in the privacy of my own home, by myself, and I don't have to involve all of us, all these strangers you don't know who are going to be peppering you with questions - hopefully not, but that's the vision. And this is going to sound strange, I want people to trust the system. I want people to trust the fact that we're trying to do the right thing. We're going to try to do everything we can to make it the best possible experience for the worst possible experience of their life, if that makes sense, and do what they want us to do. Unfortunately, those kits, if I could do anything with them, I would say I wish they would stop selling them just for the simple fact that it creates this secondary level of trauma. They miss out on so much. They've had this horrible thing happen. They miss out on so much of all the assistance they can get from the folks, from the victim advocacy group, from law enforcement, from the forensic medical team. These things are just lost when this happens, and then when they bring these at-home kits in with this hope in their head that, oh, now I can go find out who did this to me - especially if it's a stranger case, God forbid - now I can find out who did this to me, and the first thing they hear is, uh, there's nothing I can do, or I have very limited options. From my perspective from my silo in the world in this area, that causes issues for them where we're now giving this secondary trauma to them. And I would hope that there would be people out there in a narrative that would provide them a backdrop to say, "Hey, don't use these kits. Go find someone. Go to victim advocacy. Go to a forensic medical." You don't have to come engage law enforcement, that's fine. You can get an anonymous kit. Not a problem. And much like Natasha said earlier, it's in stasis in that aspect. If you want to call us later, call us. That's fine. Where I work in Maryland, I happen to have the luxury of not having a statute of limitations on these types of crimes. I know some states do. I don't. We are

seeing a national push to have that kind of change to either 20, 30 years or, much like Maryland, no limitation. So I'll wait. When you're ready, come see me.

Tyler Raible [00:41:14] Excellent. Thank you, Jordan. And Natasha, what about you?

Natasha Alexenko [00:41:18] Well, first of all, I appreciate innovation, especially when it comes to sexual assault. I think that's something that we absolutely need to focus on innovation. And you know, I- I think that these kits should really serve as a catalyst for how we kind of look at things - how do we integrate innovation into sexual assault? How do we educate the general public into the process? This should really start a conversation and a dialogue. This isn't something- a door that's being shut. This is a door that's being opened so we can have a conversation about this. How do we learn from this? What is the need? What is this resource trying to fill? How do we close the gap? And so I really hope that we continue to utilize this subject as a way to continue evolving and to elicit continued conversations. And I think that's with anything along the lines that comes into our sphere, a new thing. The only way we can kind of grow and change, and we must, is by taking these issues head on, having an honest and frank discussion that is putting survivors first, but also recognizing some of the hurdles. And then there's the necessity of the justice system and that it looks different for everyone. And again, it's really important to recognize, I don't think this comes from a nefarious place at all. I think that everyone is really looking out for the best interests. But we really need to recognize that we're a community here, and it's important for us to continue to have these discussions, to not eliminate a group from those discussions because as you can just hear here from the three of us speaking, we all have a really unique voice to add to this conversation.

Tyler Raible [00:43:01] Thank you, Natasha. And I think that's an excellent way to wrap up today's episode. So as we're closing out, first, I want to- I want to thank Natasha, Marya, Jordan, all of you for sitting down with Just Science to share your perspectives and to discuss these at-home kits, so thank you all so much for being here and taking the time out of your day to sit down and chat with me.

Marya Simmons [00:43:21] Always great to be here, Tyler. Thank you.

Jordan Satinsky [00:43:23] Thank you so much.

Natasha Alexenko [00:43:24] Looking forward to more conversations like this soon.

Jordan Satinsky [00:43:27] Me too. For those of you listening at home, on your car ride, or wherever you enjoy podcasts, if you enjoyed today's conversation, be sure to like and follow Just Science on your podcast platform of choice. For more information on today's topic and resources in the forensic field, go ahead and visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:43:50] This episode will conclude our Perspectives on At-Home Sexual Assault Kits season. Tune into the next season of Just Science on community relations. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

ntroduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:19] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research and actionable strategies to improve the criminal justice system. In episode seven of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Patti Powers, an attorney advisor at Equitas and a former senior deputy prosecuting attorney in Washington State, to discuss at-home sexual assault kits from a prosecutorial point of view. For many survivors of sexual violence, engaging in prosecution can be an important step in their healing process. As a former prosecutor and nationally recognized leader addressing sexual assault cases, Paddy Powers has addressed sexual violence both in and out of the courtroom for more than 30 years. Listen along as she discusses the process of prosecuting sexual assault cases and the impact of at-home sexual assault kits on case resolutions in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:26] Hello and welcome to Just Science. I'm your host Tyler Raible with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today, we'll be discussing at-home sexual assault kits from a legal perspective with our guest Patti Powers, an attorney advisor with Equitas. Patti, welcome. It's great to see you.

Pattie Powers [00:01:41] Thank you so much, Tyler. I really look forward to this conversation.
Tyler Raible [00:01:45] Me too. So, Patti, you're a nationally known prosecutor, trainer and expert in addressing sexual assault cases, both cold cases and current cases. Can you tell us a little bit about your career, and you know how you got here?

Pattie Powers [00:01:58] Well, first of all, I was a senior deputy prosecuting attorney in Washington State for 27 years where I had the privilege of supervising our sexual assault and domestic violence unit three different times. I also tried a high volume of cases, specifically sexual assault, domestic violence, child abuse and related homicides. I developed an expertize in both current and cold cases. Two of the cold case homicides that I tried were featured on the Paula Zahn case show, and I mention that because it really was an opportunity to show how important multidisciplinary relationships are to advancing justice in both cold and current cases. I also had the opportunity of serving as a subject matter expert, a highly qualified expert, for the United States Army for five years on an intermittent basis and was able to provide not only training but also consult on sexual assault and domestic violence cases. From those 27 years, when I was also presenting nationally, I think that began in 1998, it was a logical and a great next step to join my colleagues at Equitas, and I really love my work also as an attorney advisor.

Tyler Raible [00:03:21] It definitely sounds like you're something of a rock star in the field. So when it comes to prosecuting sexual assault cases, is there any one particular item that's currently on your mind or something that you're passionate about?

Pattie Powers [00:03:31] You know, Tyler, in my heart, I'll always be a prosecutor, and there are so many important aspects to that work. It is a privilege to work with victims who have had to overcome so many barriers to making that disclosure. And we know that sexual assault is a vastly underreported crime. It also is similarly important to be in a position to hold offenders accountable and to protect the victim and - as well as our community from potential serial offenders. With that said, it also is critically important for prosecutors to draw upon their experience and expertize to take on the tough cases so that they'll be in a great position along with other multidisciplinary professionals to advance justice for victims, for communities and for offenders.

Tyler Raible [00:04:23] One of the topics that has emerged, possibly due to the pandemic, is this concept of sexual assault evidence collection kit that's publicly available and not associated with a hospital or a medical facility. I'm going to be referring to it as an at-home sexual assault kit. Can you talk a little bit about what this is?

Pattie Powers [00:04:38] Sure. And you're correct. There was basically a lot of attention given to this particular facet, beginning with the pandemic, actually. There was a concern on behalf of prosecutors, nursing professionals, as well as other professionals that victims may be concerned about presenting for medical care at a hospital setting, for example, because of their concern with the spread of the virus. And so advocates, as well as medical professionals from around the country, worked really hard to ensure that victims knew that medical care was available and that there were in fact, safe surroundings for medical forensic examinations.
Tyler Raible [00:05:21] What are some of the differences between this kit and what would be available to a sexual assault victim at a hospital?
Pattie Powers [00:05:27] If a victim presents for the care of a medical professional at a hospital, first of all, medical professionals are trained and certified to do this work, and they do it very well and they do it in a very victim centered manner. And that means that in doing their work, first and foremost, their care is for their patient. When a nursing professional or another medical professional meets with a patient, a victim in the legal sense, are going to obtain a medical history, which is very important. They're also going to request a history of the event. The reason why the victim presented for care at the hospital. That's a very important facet of their work because it actually helps direct the kind of medical forensic examination that the professional is going to pursue. They'll also obtain the victim's consent for this examination. And you know that consent may be withdrawn at any point. Medical professionals will also perform a head-to-toe examination where they document any apparent injuries or abnormalities that may be important. They'll also conduct an internal medical evaluation and obtain specimens from the victim's body, if the victim has consented to that, to later analyze those for the presence of sperm or semen or other aspects of forensic specimens.

Tyler Raible [00:06:56] I can imagine that after an assault happens, going to the hospital is already terrifying. So you throw in COVID 19 and it might be in some cases insurmountable. But for those that, you know, attempt this collection of evidence at home, what concerns or cautions do you have about that situation with one of these kits?
Pattie Powers [00:07:12] There are many concerns associated with self-collection. And first and foremost, it's the concern of medical professionals of prosecutors and other professionals as well that the victim be given appropriate support, regardless of when a victim is able to disclose a sexual assault. There's trauma involved with that. And for a

victim to be able to follow instructions and to do this kind of a self-administered kit could enhance that trauma. Victims don't have the same kind of training that medical professionals do. Also, victims would not necessarily be in a position to document other physical injuries that may be on their body as a nursing professional would be able to. Once the evidence is obtained, then the next step would be to properly package it and to ensure that the integrity of the evidence is preserved. And with that said, the environment where the evidence is collected is also important. It needs to be pristine. It needs to be free from any potential contamination. That's another consideration as well. So after the victim collects the evidence, concern has to be brought to the fact of preserving the integrity of it, keeping evidence separate from other specimens. The next step is how that evidence is going to be packaged and where it's going to be stored. A victim, for example, may decide to hold on to those specimens or that evidence for a period of time. That would call into question where the evidence is located and whether there is any potential contamination in that process as well. The next step would be if the victim decides to proceed would be to determine what, if any, crime laboratory would be willing to take this evidence. So there are a number of different features of concern that are associated with it, but I think the principal concern that we need to focus on is that there really should be trauma informed care for the victim, and that isn't always available when a victim proceeds to utilize an at-home kit.

Tyler Raible [00:09:38] So on the topic of victim centered, trauma informed approaches, do you think that an at-home collection kit might make a survivor less likely to engage with the system?

Pattie Powers [00:09:49] That may be variable among survivors, but I would say that the situation of collecting specimens from a person's own body after they have been traumatized by a sexual assault would be very difficult and challenging, and this is being done without training in an attempt to well follow instructions. And I think the facet of needing to obtain specimens from private areas of the body, which is very invasive, would certainly be a traumatic one for victims in this situation.

Tyler Raible [00:10:26] So you mentioned several concerns surrounding the integrity of the evidence, right? So how it's stored, how it's collected, and I would imagine that this would have an impact on the ability to pursue these cases in court when one one of them is involved, right? So how would a person even know about this stuff? Are there resources available that they could better understand the topic?

Pattie Powers [00:10:44] I think that's an excellent question, and professionals around the country, from the medical community, from law enforcement and from prosecution have been addressing concerns with at-home kits, and the hope is that victims before making this kind of a decision would check with service professionals in their communities to obtain additional information about it so that they can truly make an informed decision in this regard.
Tyler Raible [00:11:12] Given these challenges that we've mentioned, is there no opportunity for them to seek justice after that?
Pattie Powers [00:11:17] Every case should be analyzed separately, and there may be a number of different variables among cases that when a victim presents a disclosure in the criminal justice system, brings that disclosure to the attention of law enforcement or to prosecutors, or maybe even through advocacy. I think it's important that all service professionals do everything possible to support the victim in advancing justice. There may

be some difficulties if a kit has been self-administered, whether it was presented to a laboratory that accepted it for testing or whether it was not presented. The next step would be to determine whether it could be tested at a state crime laboratory, for example. But regardless of what the variables are in those cases and the difficulties presented by the self-administration of these at-home kits, I'm certain that professionals, prosecutors and law enforcement and advocates would want to do everything possible to support the victim in the criminal justice system within the requirements of the law.

Tyler Raible [00:12:27] So in your experience, I would see there are a lot of holes that could be poked in a case, right? That uses this at-home kit as its backbone. Do you believe that's the case or is there a way that you could actually go after this and get it to work?

Pattie Powers [00:12:42] Our colleagues, who are defense attorneys, could raise a number of issues, and these issues, of course, would be determined after the prosecutor submits argument and then the court, using its discretion and based upon the law, would render a decision. Some of the issues that could be advanced would be the motivation of the victim in doing their own exam. There could be a request, for example, for the defense to view the area where the examination was performed, and even if a court denied that request, this could still be introduced through questioning at trial. The defense is also going to inquire into the packaging of the evidence. The defense could also certainly argue that self-administration of a sexual assault kit is not known as a national best practice and could present expert testimony in that regard. Further, there's going to be inquiry into if the kit was not immediately provided to a crime laboratory, how was it stored? Where is it stored? Did anyone else have any access to it? Some of these issues may affect the admissibility of the evidence or if the court allowed the admissibility, there could still be arguments about all of these different features of concern that I've mentioned. And when you look at all of the concerns, they would be certainly addressed by prosecutors who'd be committed to advancing justice for the victim, but this would still represent something that a victim has to go through and that again takes us right back to where we started, the necessity for a trauma informed approach to caring for victims.
Tyler Raible [00:14:24] Are there other kinds of services that might be available to them if they were to go to a hospital?
Pattie Powers [00:14:29] I think in most medical communities, when a patient, a victim, presents for care after a sexual assault, there would certainly be an availability of sexual assault advocates, which is a wonderful resource for victims to have that level of commitment supporting the victim throughout the entire process. If a victim, however, were self-administering the at-home kit, there may or may not be access to advocacy at that particular time. So I think that really is a critical lack. The other thing that should be mentioned is when sexual assault nurses or forensic examiners who are medical professionals, when they conduct these exams, their concern is for their patient. They carefully explain every question that they're going to be asking and every act involved with collecting specimens from the victim's body. Consent is obtained for all of this professional activity. When a victim conducts their own exam, there's not an availability of a trusted medical professional to answer questions or to discuss in detail why specimens are being collected. Sometimes there may be a telehealth component in some jurisdictions, and if there is a telehealth component, there may be access to a medical professional.
Sometimes if there is, for example, a videotape of the examination, that could also be subject to a discovery request from the defense. So there really are issues involved in the two basic scenarios that we're addressing.

Tyler Raible [00:16:10] It definitely seems to me that from a legal standpoint, it would be an uphill battle, especially when we get into conversations around, you know, the credibility. And that's one of the beautiful things about having something done at the hospital, right? The person who has professional training would be a little more suited for it, right?

Pattie Powers [00:16:25] Yes, that's another excellent point that we should consider. The medical professional has the training and expertise to conduct the examination, and that is guided by the patient, the victim's statement for purpose of the medical diagnosis. They have the training to do that, and in most jurisdictions, this is known as a statement for purpose of medical diagnosis that the medical professional can testify to at trial. If a victim is self-administering their own examination, they don't have the statement for purpose of medical diagnosis. They have their statement. Now in many jurisdictions, a victim's statement does not require corroboration. Still, what we do as prosecutors, we do offer corroboration on every salient point because what we want to do for the jury ultimately is to recreate the reality of this crime. So there's a huge difference between self-administered and what evidence may be available and having this conducted by a medical professional who's trained and certified to do the work. Another issue might become whether or not any trace evidence has been preserved. If the victim is able to more immediately report a sexual assault, whether or not they have the understanding or the ability to preserve any trace evidence that may be contained within their clothing, for example. This is something that medical professionals are trained to do. Documenting physical injuries is important.
Medical professionals may photograph these injuries, they may also measure these injuries with reference points. Victims who are self-administering this, may not have that training or that capacity and injuries may dissipate over a period of time, so there may not be another opportunity to preserve this evidence, which could be important.
Tyler Raible [00:18:26] There's one thing that we've been dancing around that I'm interested to hear your perspective on. You mentioned early in your introduction the value of multidisciplinary teams. You know, obviously they're crucial. So it seems to me that the at-home kits kind of makes it difficult to have the multidisciplinary team because you're inadvertently eliminating part of it, right?

Pattie Powers [00:18:47] There is a concern in that regard, and I think what best expresses what we're discussing is the reality that the victim is the heart of all of our efforts. It's because of the victim and serving the victim that law enforcement and medical prosecution and advocacy come together to do their best work for the victim. There's a coordination among our efforts to the extent that that's possible given the different professional perspectives. But the victim is at the center of our work. When a victim chooses to self-administer an exam, there really is not the same kind of teamwork, if you will, that is available and certainly supportive of the victim. So another concern really would be not having access to all of the resources that we're able to offer.

Tyler Raible [00:19:41] That's actually a great segue to my next question. So as far as supporting survivors of sexual assault, justice can mean vastly different things to the prosecutor than to the survivor. So how do you align these two perspectives? How can prosecutors support the healing process of survivors and still, you know, get their job done?

Pattie Powers [00:20:00] When a survivor chooses or is able to make a disclosure of a sexual assault and is interviewed by law enforcement and is involved with the prosecutor

as well, who's going to determine charges and help prepare a case for trial, our goals are very similar. It's offender accountability. The prosecutors have the honor of giving voice to a victim's concern. The right to be let alone, to be free from unwanted touching. To support that victim throughout the process. So there really is a similarity of goals and in this way, together as a team, as prosecutors, law enforcement professionals, medical professionals and advocacy professionals, we're there to support the victim through every stage of litigation. Offender accountability and affirming the victim's right to be, let alone, are the highest values for those of us that have had the privilege to work with victims and they're very consistent with the victims goals should they choose to enter the criminal justice system.

Tyler Raible [00:21:10] Patti, the work that you do is incredible, and the passion that you bring to the table is palpable. Are there any final thoughts you'd like to share with our listeners before we wrap up today?

Pattie Powers [00:21:19] Well, first of all, Tyler, thank you for the opportunity to answer some really great questions. I'm really hopeful that we'll be able to share this information with other professionals in the field to build stronger, multi-disciplinary relationships so that we're even more empowered to reach out to victims, to give victims the information that's necessary to make informed decisions and to know that all of us together supporting the victim have is our goal, advancing the cause of justice for victims, offenders and for our communities.

Tyler Raible [00:21:56] What a wonderful way to wrap up. I'd like to thank Patti Powers for sitting down with Just Science to discuss at-home sexual assault evidence collection. So thank you, Patti. I sincerely appreciate you being here today.

Pattie Powers [00:22:07] Thank you.

Tyler Raible [00:22:07] If you enjoyed today's conversation, be sure to like and follow Just Science on your podcast platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOEorg. I'm Tyler Raible, and this has been another episode of Just Science.
Voiceover [00:22:23] Next week Just Science sits down with a panel of experts to discuss at-home kits through a victim centered lens. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.
 

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:19] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode six of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Jay Henry, the former Crime Laboratory Director of the Utah Department of Public Safety. Mr. Henry, an experienced forensic scientist and former crime lab director, understands the complexities that surround the collection and testing of evidence, especially biological samples. Listen along as he discusses the critical role forensic laboratories have in the sexual assault kit testing process, as well as his perspective on the considerations for testing at-home sexual assault kits in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:17] Hello, and welcome to Just Science. I'm your host Tyler Raible with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today, we're continuing the conversation around the at-home sexual assault kits and to help guide us in this conversation, I'm joined by Jay Henry, former Crime Lab Director of the Utah Department of Public Safety. Jay, welcome to the podcast. It's great to see you.

Jay Henry [00:01:35] Thanks, Tyler. Good to be here.

Tyler Raible [00:01:37] First and foremost, I want to say congratulations on your recent retirement, and I know prior to retiring you were a crime laboratory director with extensive and respected service in the field of forensics. So could you tell us a little bit more about your career in the crime lab?

Jay Henry [00:01:50] I began my career with the Sacramento County Crime Lab in 1989, and in fact, one of my first casework assignments was processing sexual assault kits. I then transferred to Utah in '90, worked in the drug section for a while, then I was back in serology testing sexual assault kits and other biological evidence. And in that November, I got the chance to learn DNA typing - the new technology at the time - at the FBI Academy in Quantico. From there, I worked in serology DNA cases for about seven years and promoted to quality assurance in 1997, became deputy director in 2001, and finally laboratory director in 2007. I'm the past president of the Northwest Association of Forensic Scientists and the American Society of Crime Lab Directors, and I retired in January of 2021.

Tyler Raible [00:02:38] After your extensive service, have you found that you're still engaged with the criminal justice system at some level?

Jay Henry [00:02:44] Absolutely. My time of working the bench full-time is over. However, I still enjoy advocating for crime laboratory and forensic science. I still dabble in consulting with investigators and attorneys and try to assist with the occasional cold case. You know, there's still a lot of work to be done out there, and I also enjoy teaching.

Tyler Raible [00:03:03] Jay, I want to dive into the topic of today's conversation because I want to make sure that we can really, really unpack it. So this season has been dedicated to these at-home sexual assault evidence collection kits that are publicly available and not associated with a hospital or a medical facility. We've been referring to them as at-home kits. Jay, could you give us a little background - what is an at-home kit?

Jay Henry [00:03:22] So actually, the topic is pretty new, so I'm still not quite sure how something like this, an at-home kit, would work. What standards, for instance, will the kit manufacturer follow to make sure the correct items for the jurisdiction are included while at the same time minimizing product contamination? The forensic community has spent a considerable amount of time just trying to figure all this out over the years, and like, what is needed in each kit, the quality of the supplies, and the quantity needed. I think at some point there may even be a national standard for the composition of the sexual assault kit or at least minimum requirements, but I don't think we have anything yet. You know, back to the original question, I guess these at-home kits would be purchased by the victim. I guess they would hope for a timely delivery, and then try to collect the sample themselves or have somebody help them. Then, after the collection, they'd have to sort of securely store that kit at their home. For someone that hasn't been trained, a sexual assault kit is a, is a complicated product, and it varies by each jurisdiction. So by each city, county, state, they can each have their own separate sexual assault kit. So they all have different distinctions based on jurisdictional legal precedents and things like that. Each kit is really a box and may include cotton swabs - designated vaginal, cervical, oral, rectal, anal, or body - along with manila envelopes or cardboard swab drying boxes and evidence stickers, all labeled with requirements to collect specific information like location, date, initials, anything unusual about the sample - all of this designed to best document the forensic unknown. Where they're at today because they've been designed and evolved in a way over the years to answer questions about criminal investigations and ultimately to present those findings in court, the kit also contains swabs for the collection of reference or known samples from the victim. In the past, it was a blood tube, and in a cold case, you still may come across a blood tube. Another important swab is the consent partner swab from the husband or significant other. When DNA testing is done, there can be multiple profiles developed with them. Some of them are potentially overlapping. So the purpose of the reference samples, these victim samples and consent partner samples, is to be able to know which DNA profile came from the victim or a consent partner and which from suspect. The focus on this has been for DNA, the collection of DNA. But, you know, it's more than that. You know, when they're designed, there also includes packaging for trace evidence collection. This could be suspect hairs, pubic, head hair, clothing, carpet fibers, and packets for miscellaneous collected debris like soil, plants, cosmetics, lubricants. All of these can be used as good associative evidence, meaning trying to associate the suspect with the victim or the victim to the suspect or the crime scene. One of the concerns of forensic scientists, like myself, is the tendency to want to jump to right to DNA testing and ignore all other potentially probative evidence. Trace and fingerprint evidence, it can be just as valuable, so the goal of any kit should be to solve the case and not just collect and test DNA.

Tyler Raible [00:06:26] Jay, you mentioned that they used to use the blood vial in lieu of the swabs. I was curious, could you tell us a little bit about how the sexual assault kits have kind of evolved over the course of your career?

Jay Henry [00:06:37] In the beginning, we had less swabs and because DNA just wasn't as powerful as it has been, and we never really had any swabs for bodies, but we had tubes for ABO blood typing and gray top tubes for the toxicology samples. And a lot of

those tubes have changed where they're located so that the EDTA tube or the ABO blood typing or the DNA typing blood tube is just kind of disappeared. It's no longer included a part of that because DNA technology has evolved to the point where you can get a great profile from the swab itself. And so we've changed some of our approaches to it and made an emphasis on DNA, but also continue to make room for any sort of trace evidence collection because you don't, again, the goal of the kit is to solve the case, not necessarily to just test DNA.

Tyler Raible [00:07:30] What would you consider to be the major difference between an at-home sexual assault evidence collection kit and one that a person would receive at a hospital?

Jay Henry [00:07:38] Sure. In short, really experience, training, and professional processes. You know, many jurisdictions are similar to my state, but the main difference is that a trained medical professional has access and consulting with their local crime lab will be completing the kit. If you think of the sexual assault kit, it's like a miniature crime scene with potentially 20 to 30 samples collected. In my state, there are statute requirements too that dictate timelines for how long an agency can possess the kit before it's transferred to the crime lab. You know, a system is being created to provide feedback to the victim about the status of their case, which they can check with their computer or phone at their discretion. Also, the system is designed to provide policymakers with feedback on the whole testing program. That is, you know, how fast we are, how fast a crime lab is, the number of kits they've tested. All of this is useful to ensure that appropriate resources are dedicated to the future of this program. You know, finally, a major difference is just the chain of custody because it begins with the nurse, flows through the law enforcement agency, and typically ends with the crime laboratory - a short, succinct, professionally optimized process waiting for court.

Tyler Raible [00:08:45] Jay, it's- it's fascinating that the first thing that you mentioned was the quality of the evidence collection and the, I would imagine, the care associated with it. There are two things that you mentioned that I do want to unpack a little bit. You talked about chain of custody and in quality of evidence collection, so- so could you explain a little bit about chain of custody and why it's so important, especially from a lab perspective?

Jay Henry [00:09:07] Chain of custody is really just a document handling history of an item of evidence. The purpose is to provide confidence to the criminal justice system - you know, these are the courts and the attorneys - that the evidence has been properly maintained. This is important because, you know, cases can take years to resolve, even decades with cold cases. And so, you know, people's memories fade and change. And so if it's been years before, you know, that the incident happened before the case is actually being tried, you have to have a system in place that's documented all of that so you can have confidence in it. Now, when the court considers this evidence, the attorneys may thoroughly examine each item to make sure that it was one, properly collected. So that means a trained person, typically with authority - so you know, you're looking at traditionally a police officer, detective, crime scene investigator, forensic nurse, or a lab person - they're also going to look to make sure that the evidence has been preserved appropriately, so no contamination with, say, excess moisture, bacteria, anything like that. And certainly, no cross-contamination, such as between victim, consent partner, or our suspect sample - you all want those appropriately collected. And then the evidence has to be protected from deleterious change so that it's not inadvertently destroyed in the handling process. The evidence also has to be documented with a historical log, either

with paper or electronic, that describes who signed for it - that is, who possessed it, how securely it was maintained - like under lock and key, evidence locker, vault, a locked freezer in the evidence room. Each of these storage locations must have like limited access, and anybody that goes in there has to be a need and complete transparency about who had access and when. All these considerations are subject to a rigid cross examination. It's a good practice to have a very short chain because each person that had possession can be called as a witness in court. Most experienced criminal justice practitioners realize that it's a good idea to only be included in the chain unless absolutely necessary. Otherwise, stay out of it. In fact, in the lab, one of the challenges is just getting people to pick up their evidence and return it back to the agency. And even if you have a person from the same department, they won't pick up another colleague's evidence and bring it back because they don't want to get involved in the chain. Most crime laboratory systems have optimized their chain of custody process to keep it as simple and robust as possible. This makes the court process smoother. However, you know, in one case, I spent half a day testifying on the chain of a 1984 cold case. The attorneys were thoroughly evaluating each item of evidence for the integrity of how they were stored and managed. They take this process seriously, and one misstep means that evidence may not be admitted and could mean the end of the case.

Tyler Raible [00:11:55] What kind of problems would you see in terms of, you know, chain of custody as a concept when applied to an at-home kit?

Jay Henry [00:12:01] You know, I was trying to figure out how would I secure an at-home kit in my own home? Do I have a safe to keep it there? Who has access to it? All of these issues can come up in court about, you know, my family members have access, any guests in the house might have access to it. All of those areas are open to scrutiny by the court's systems, and they can be pretty rigid in that. And I've seen cases where other criminal justice practitioners have made just some minor missteps where they didn't follow their procedure - instead of taking it to the evidence locker, they- they put it in their personal locker, forgot they had the evidence on them, then the next day transferred it there. But even though it was in their own personal locker, the judge considered that evidence not secure. And so the evidence was tossed and so wasn't admitted in the court. So depending on the jurisdiction and the court, they can be pretty scrutinizing. So it's something that you really have to take into consideration that any evidence at home, I just I really don't know how you secure it. You know, that's something that's kind of perplexed me,

Tyler Raible [00:13:09] You know, coming from a former lab director, that's really kind of highlights an issue, right. If you can't figure out how to contain it, then you know, I would imagine that somebody who's recently been victimized during an assault would probably have an even more difficult time. And Jay, you also mentioned the- the quality of evidence collection. And from my perspective, it sounds like, especially with DNA, the collection of evidence requires a certain amount of skill. Could you tell us a little bit more about evidence collection and maybe some of the quality concerns you would expect?

Jay Henry [00:13:40] You know, for us, scientists and nurses, we've been taught from the beginning of our education at the university on really how to collect or handle samples. We're always handling something in our lab classes. So for us, it becomes an innate skill that we've developed. But even when we go to work at the crime lab, we're still evaluated on our ability to collect and retain samples and handle samples so that it also becomes even innate for the forensic scientist to be able to handle the sample. It's interesting when we teach technical people, say at our crime scene academies, then so really, we're taking

profession- already professional people with some training and we're giving them more specific training. And it's funny because, you know, some of the basics that we still find we have to teach that we never really thought much about was one, just like how to properly put on gloves without sort of flinging DNA and bodily fluids across the crime scene. The other thing is telling people why they have to wear a mask during collection. For instance, some people just tend to shed more DNA than others. The other aspect is to show them how to use that swab to best absorb as much of the sample as possible without introducing contamination and really minimizing the background. You know, the goal is to collect the whole crime scene sample without adding anything else. So if the sample is deposited on something, we just want the sample itself, not the underlying material that it was sitting on - that's referred to as the substrate. In my 30 years of teaching crime scene responders about sample collection, I found that you just can't talk to them about and tell them about it. You have to provide practical. So we found- we finally ended up doing in our academies is we put bodily fluids on different substrates like blood on tile, seminal fluid on carpet, and required them to collect the sample. It was funny, it is still interesting, even after all that training and collection, they sometimes, they still didn't feel comfortable. So if, for instance, we happened to be on a crime scene together like, say, crime lab people and crime scene people or detectives, a lot of times they'll still defer to us to want to collect that sample. So, you know, ultimately, I really don't know how an untrained victim could optimally collect the sample. You know, it's a challenge we found just to train crime scene investigators and- and police professionals, much less somebody that's never done this type of activity. And the victim is probably, you know, traumatized. So even if you're proficient in the collection of DNA samples, there's also some still some inherent challenges with collecting samples say on yourself or by yourself. For instance, you know, how would you collect a rectal swab? What about like a bite mark on the back? All of these are challenges that I just I don't see how somebody at home using these kits can really overcome.

Tyler Raible [00:16:26] I can definitely see the value of the training, especially when it comes to, you know, something that requires precision. In that same vein, can you tell us a little bit more about what the lab needs in order to receive a kit and then test it?

Jay Henry [00:16:40] Every crime lab has its own procedures, but you know, there's a lot of similarities across the country. You know, I'll just speak from my system and what we used to require. Recently, we started a list of requirements. One was that each kit had to be entered into the sexual assault kit tracking system. This is a system that is separate from our laboratory information management system in that it kept track of the kits by themselves. So number one, it had to be entered into the system. Two, the kit had to be a sealed evidence kit, and it had to be properly documented with appropriate chain of custody. Number three, it had to be submitted by a criminal justice agency like a law enforcement, prosecutorial defense. Basically, a victim can't submit a kit in our system directly to the crime lab, and most crime labs operate this way. Now, we really wouldn't turn a victim away if they approached the crime lab, but I have to say it would really complicate the system. So what we'd probably do is point the victim back to the originating jurisdiction. So the city or the county or that- or the state that the assault occurred and maybe try to hook them up with a victim advocate or something like that and then have them work it out with their investigators and prosecutions and have them submit it to the crime lab. Again, most crime labs need a law enforcement agency to submit the evidence to them. Another item that we need, which is really important, and I haven't mentioned any of this is, is the sexual assault kit report. These are one of the most important features of the kit, and it has to be included with every submission. What this sexual assault kit report is is a standardized report that the crime lab and forensic nurse examiners have

collaborated on to create the best possible format to document the collection, locations, and quantity of evidence recovered from the victim. The nurse uses these forms to document what they collected and from where. The examiner uses the notes to decide what samples to test and what process to follow. DNA testing - I don't really think I need to tell you this - but it can be pretty complex, and there's a wide variety of testing options available from standard short tandem repeat DNA testing to male specific Y-STR tests. Without a proper guide, the examiner won't know which sample to test or if there's something unusual about, say, the contents of the kit. So, for example, is this a bite mark with saliva? Was it a grab mark with touch DNA that, you know, maybe a Y-STR test is a better approach to that sample? Or is it just DNA collected on the outside of the body? Hell, when I was on the bench, again, this was a while ago, but this was still my go-to document. If I didn't have that report in the box or in the kit somewhere, then I would start researching where is that because I wasn't going to start my analysis before I had that document. So really, you have to have this report filled out appropriately. Both the nurses and examiners are trained on this document. I don't think that a victim would be able to do that and give the examiner enough feedback on where to start with the kit. Another requirement is actually more of an encouragement than- we asked for the police report. So this is separate from the sexual assault kit report. The police report is made by the investigator, a responding officer. We use this information with the sexual assault kit to better understand the samples and results that we test, and for instance, an investigator or nurse will sometimes get information from the suspect or the victim that, say, the suspect didn't ejaculate or did ejaculate. And that can be helpful when we're trying to determine what sample to test or why we end up getting a certain result. Our goal really is always to get a probative result. That is, when I say probative, that is test a sample that makes an impact and allow the investigator to make a decision on the case. Ideally, we select the sample allows for the development of a full, non-mixed, unambiguous DNA profile from their perpetrator that we can either compare directly from a swab that the police provide us or enter it into the CODIS database to see if we can develop a suspect. And finally, we need information so that we can, if we have to enter the sample into CODIS, that we can. For example, if we don't have a suspect to compare, then we can enter into this CODIS federal DNA database. CODIS stands for the combined DNA indexing system - it's a network of databases of all the states and is managed by the FBI. So Utah and all the states are tied into the system. CODIS has a lot of rules that have evolved over the years, and we have to follow them. We don't really have a choice. In fact, there's a constant misunderstanding between us and our partners about what DNA profile we can put in and what we can't put in. So basically, to upload a DNA profile, that testing has to be done by an accredited laboratory such as the Utah system. This lab has been pre-approved. Labs- all public labs get pre-approved by the FBI by signing MOUs and all sorts of legal documents. Also, a crime has to be committed. The sample has to have proper documentation, so chain of custody, and it has to point to the putative perpetrator. Now I use that term putative because that's in the FBI rules, and what it means is the alleged, accepted, or supposed suspect. We don't want ever, and we can't, put a consent or victim sample into the database. So that's why we need all of these particular rules.

Tyler Raible [00:22:06] Based on that explanation and my understanding, it seems that there's a huge amount of multidisciplinary collaboration that goes into this, right? So can you maybe elaborate a little bit on how, how important, you know, these good relationships are in this kind of multidisciplinary approach is to work in these kits?

Jay Henry [00:22:25] Yeah. Thanks, Tyler, for asking that. You know, teamwork is critical, and I can't really emphasize it enough on this podcast, how our relationships are with our crime scene responders, our detectives, the SANE nurses - everybody is linked together.

We meet regularly. We have annual updates where we collaborate to make sure the system is operating appropriately. And it's these relationships that allow us to get this information. So for instance, if we didn't have a police report and we needed it, we could contact the agency and they could submit it to us without much trouble. It's this team approach that allows us to get the information that we need to process the kit and also to put it into the- into CODIS and to be able to take this information and solve the case. This didn't happen overnight. All of this work, this took probably, you know, I'd say, you know, 10, 15 years to really develop and get to the point where we're at right now. So it works pretty well. It continues to evolve, and it gets better and better.

Tyler Raible [00:23:35] What's interesting to me is how there's so much value in the- in the network that's associated with it. If a person were to have an at-home sexual assault kit done, and they wouldn't really have that kind of network, couldn't they just pay a private laboratory to test it?

Jay Henry [00:23:50] Well, yes, they could actually have a private lab to test it. Again, I don't know what it would look like, but if you took the kit and the swabs, sent it to a private lab, paid to have it tested, I imagine if a profile was developed great, but that doesn't tell you anything unless you have something to compare it to. So there's really two ways to compare it to. One is you have to have a suspect comparison sample. So to confirm the forensic DNA profile from the kit matches the, again, putative profile, the suspect profile, the private lab needs that sample, and it still needs a chain of custody if we want to do anything in the legal realm from suspects. So for us, for instance, to get this, law enforcement would give a court order search warrant to collect the sample appropriately, or sometimes the suspect will volunteer. And there's a lot of documentation that the police do to ensure that it's documented that the suspect volunteered the sample or, you know, a surreptitious sample is collected - that is, you know, maybe during the interview, the suspect is offered a bottle of water, they use the bottle of water and then that, that bottle is swabbed. But ultimately, no matter where we're at before the match is confirmed, the sample has to be collected from the suspect that has an appropriate chain of custody. This process kind of follows traditional accepted legal practices and anytime we are, we're working with the law enforcement agents, we're telling them, make sure you do this so that we don't have to backtrack and get a sample again and have an issue in court. So all three of these processes will be scrutinized in court and require a certain amount of documentation. So that's the problem here with the private laboratories. How would they get that particular sample for comparison? So that's the first issue. The second one is if there is no suspect, and the idea is to really put it into the CODIS database, the challenge with the private lab is they don't have direct access and can only provide data through a pre-approved agreement with a public crime laboratory. Now, CODIS was originally developed by all the public crime labs for certain uses and can't be used by a private laboratory. So the bottom line is if an individual uses a private lab, that information probably cannot be uploaded to CODIS. Now, there are some exceptions where maybe a public crime lab has an agreement with a private lab, but then that victim would have had to chosen that particular private lab to do that. And so I mean, there's some instances where there might be a workaround, but really, for the most part, I think it's problematic that you're probably not going to get that sample into CODIS working that route. You always have to go through the crime lab.

Tyler Raible [00:26:34] So from your experience, is there anything a crime lab can do or maybe should be doing to message to survivors or even the public about what their options are if they use an at-home kit?

Jay Henry [00:26:46] Well, I think these at-home kits could be a real challenge for crime labs. To me, it seems like, you know, might be a little too early in the development of the issue to have a good approach yet for testing them. I don't really know if a kit shows up at a crime lab, how you would process it. However, like in most situations, I always encourage open communication. So if the victim has used a kit and wants to know the options, they can contact their local crime lab. I found that most labs serve as sort of a hub of information and may be able to point them in the right direction. So the lab may not be able to solve it, but they may able to get you to the right person that might be able to have a solution. Typically, though, they're going to, most jurisdictions are going to point you to the law enforcement agency or the prosecutor of the crime's jurisdiction, and you've got a victim advocate there that also serves as a network that might be able to associate you with the correct person that might be able to describe an approach to testing the kit. Also, you don't want to neglect looking at state agencies for assistance. Some of them have SAKI or the Sexual Assault Kit Initiative personnel, and they might also be able to help.

Tyler Raible [00:27:57] From the lab perspective then, do you suggest that crime labs be proactive and have policies and practices that describe how these at-home kits should be addressed, or maybe what communications they need to conduct with other agencies and stakeholders?

Jay Henry [00:28:12] Well, I found that there seems to be so many issues for laboratories as really it might be hard to be proactive on this one. It may take some time to develop maybe some working groups on it. However, like in my own state, I always encouraged keeping law enforcement and prosecutorial agencies in my state up to date on the issues. For me, the best approach was to stay in touch with them by attending their regular law enforcement meetings and kind of giving them briefings. I would imagine they're probably not aware of the issue because they've got a lot on their plate as well, and they don't really probably appreciate the associated challenges too with it. So bringing this topic to their meetings and talking about it, it's a good reason to engage with them. It's also a reason to kind of revisit some of the CODIS eligibility issues, which any time you bring this up it's typically a hot topic item I found to discuss with our law enforcement partners. So I encourage that. And in fact, with regard to my former job as a crime lab director is I- this was actually one of my favorite duties, was be able to talk and engage with them and provide information to them to, you know, let them be aware of certain situations, so maybe make their job a little bit easier.

Tyler Raible [00:29:22] That makes perfect sense. I mean, if we look at, you know, knowledge is power, then that cross collaboration really kind of makes it easier for everybody to do better, which I think is the- the ultimate goal. We are nearing the end of our time together. So aside from enjoying retirement, what's next for you? Do you have anything coming up that that you're excited about?

Jay Henry [00:29:39] Well, I love the technology advancement in forensic science, and I'm always excited to hear about the cases solved with, say, forensic genealogy or any of the others. So I still enjoy that. But I also keep an eye out for legislation that might try to prohibit the use of new advancements in technology like, say, the forensic genealogy. I'm also thrilled to see the advancements that my colleagues have made in my old lab. I've only been gone a year, but it's just unbelievable what we've been able to do and to see the support and resources that have been put into that system. I'm excited to see the results of that investment.

Tyler Raible [00:30:13] The forensic genetic genealogy is fascinating and as a shameless plug for- for Just Science, we've had a few guests on the show specifically to talk about it. So is there anything you'd like to share with our listeners before we really wrap up today?

Jay Henry [00:30:25] Sure. Maybe just a couple of things. One, I think that I can have a little appreciation, a little bit of appreciation for how a victim might feel that an at-home sexual assault kit would be a choice for them, maybe, especially with how the system might have treated them years ago. But certainly, I wouldn't recommend it now in the present day. We have invested significant resources and time to correct those issues of the past, you know, as best we could. But probably more importantly, we have designed a fantastic victim-centered system that gives best care and options for evidence analysis. You know, for instance, in my state, we have a sexual assault kit tracking system that victims can have access to. And we have many more victim advocates and a lot of highly trained investigators that are specific to sexual assault. You know, finally, I heard that report the other day that a routine kit that is processed in Utah now takes only about 30 days, and that's just a routine average kit. Expedited kits even faster. You know, to have that type of DNA testing done that quickly and have results is amazing. Finally, I'd like to say if I or my family members needed a sexual assault kit collected, I without a doubt would use a SANE nurse examiner and let the kit go through the crime lab. Even though I'm probably still qualified to collect some samples, I wouldn't even consider that. Now, hopefully by me saying that, that lets you know how much confidence, you know, that I have in the system, and I encourage people to use their existing systems.

Tyler Raible [00:31:57] And that's an excellent note to end on. So first and foremost, Jay, thank you so much for sitting down to talk with us about these at-home kits and really providing an illuminating perspective on the crime lab at large. So thank you for sitting down with us and taking the time out of your day to be here.

Jay Henry [00:32:12] You bet. Thanks, Tyler.

Tyler Raible [00:32:14] And for those of you listening at home, on your drive, or wherever you enjoy your podcast content, if you liked today's episode, be sure to like and follow Just Science on your platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:32:34] Next week, Just Science sits down with Patti Powers for her legal expertise on at-home kits. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:18] Welcome to Just Science, the podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research and actionable strategies to improve the criminal justice system. In episode four of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Scott Mourtgos, the Deputy Chief of the Salt Lake City Police Department, to provide a law enforcement perspective to our discussion on at home sexual assault kits. Sexual assault cases are some of the most challenging cases to investigate. Forensic evidence associated with these cases play a key role in resolving these cases and supporting victims of sexual assault. Listen along as Deputy Chief Mourtgos, a researcher and veteran police officer with experience investigating sexual assault cases, discusses at home kits and other strategies to respond to sexual violence in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:19] Hello and welcome to Just Science. I'm your host, Tyler Raible, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today we're continuing our conversation around the at-home sexual assault kits, and to help lead us in this discussion I'm joined by our guest, Scott Mourtgos. Scott is the deputy chief at the Salt Lake City Police Department, a Ph.D. candidate at the University of Utah, and a National Institute of Justice LEADS Scholar. Scott, it's great to see you.
Welcome to the show.

Scott Mourtgos [00:01:44] Thanks. It's great to be here. I appreciate the invitation.

Tyler Raible [00:01:46] We're thrilled to have you here. So you've been involved in law enforcement for nearly two decades, and I know that you're also an investigator on sexual assault cases. Can you tell us a little bit about yourself and maybe your career path to get to this point?

Scott Mourtgos [00:02:00] I was one of those people that grew up wanting to be a cop. I don't have any law enforcement in my family. As far as I know none of my kids are going to continue in law enforcement after me. But I grew up wanting to be a cop ever since I was a little kid and ever since I can remember. So that was kind of always the goal, even throughout college as I went and got my undergraduate degree, and I was lucky enough to get hired here at the Salt Lake City Police Department. One of the advantages of working for a larger police department is the ability to have a lot of different opportunities and do a lot of different things. So, you know, whether that was working in patrol like everybody else starts out at and then working undercover in narcotics, working on a bike squad, working in investigations, specifically special victims unit, which is a lot of what we're going to be talking about today. Just a lot of different opportunities to get a broad view of the policing profession and then as you move up the ranks, just kind of going from there, getting to see how everything works together when it comes to the criminal justice system. It's been very beneficial to get a global view of how things do or don't work together sometimes.

Tyler Raible [00:02:56] Yeah, I can see where that kind of holistic approach could be really beneficial, especially in your current role. So I'd love to hear how you ended up in this discipline specifically, you know, working sexual assault investigation.

Scott Mourtgos [00:03:08] I don't remember specifically wanting to work in the special victims unit field when I first became a police officer. You know, the goal was always become a police officer. And then I was there and it was great. I was living my dream. But then as you work through patrol, you know, one of the great things about patrol is you're exposed to a bunch of different variety of situations, and you can kind of get a feel for something you want to have a bigger impact in. And fortunately or unfortunately, depending how you look at it, you know, I had the experience of responding to calls that dealt with child victims. And so that's initially what drove me to wanting to work specifically investigations in the special victims unit area. Some of the, if not the most vulnerable population when it comes to victimization. You know, I had a strong desire to work in that particular field and provide justice to child victims and so that's really kind of what drove me into the special victims unit. But then as I got into that investigative field, the way we do it here, and every agency is different, of course, but the way we do it here in Salt Lake City is, we don't separate out investigators from child crimes and adult crimes. You work both, right? So when it comes to sexual offenses, you'll work sexual offenses against children, you'll also work sexual offenses against adults. And so I naturally began working those crimes as well. My views on how to investigate these crimes certainly have evolved over the years. One of the moments that really stood out to me in my special victims unit career was a sexual assault case, was a young 18 year old female who was raped at gunpoint and working through that entire process, I'd had other sexual assault cases before that I worked, but at least in my experience, most of them got pled out if they were charged.
Rarely did I go all the way through the process through a trial, but this particular case went all the way through a trial. And just seeing firsthand the difficulties personally for a victim that has to go through the entire process. Not only from the initial interaction with the patrol officer, but then interactions with me as an investigator. Then the multiple steps throughout the court process, whether it be a preliminary hearing, motion hearings and then finally culminating in a trial where, you know, the defense is going to ask these questions regardless of who the individual is, it's just how our system works, but seeing how difficult and the fortitude that is needed for a victim to go all the way through the process. It was really eye-opening to me, to be quite honest, and it had an impact on me. And in this particular case, the individual was convicted of the crime, and afterwards, you know, I went up to tell her congratulations, and I really admired her for what I saw her do to get to this point, you know, and she just immediately walked up to me and gave me a big hug, thanking me for all the effort I had put into it. It was one of those moments that you don't often get in law enforcement, where you get to see something all the way through and feel some appreciation from the person you were actually able to do something positive for.
And it really had kind of an impact on me and how I do these cases and why I feel they're so important to handle correctly and improve upon when we can.
Tyler Raible [00:06:07] That's such an incredible story, and Scott, your position is fascinating because you have this experience as an officer and as an investigator, but you also have this academic component. I want to know a little bit about, you know, how did you decide to go down the Ph.D. route? And then can you tell us about what being a LEADS scholar is?

Scott Mourtgos [00:06:25] I actually get asked that question quite a lot. So, growing up, I didn't really enjoy high school all that much. I was a good student, always has been a good student. I've been blessed with that ability. I actually didn't think I needed to go to college

because I wanted to be a police officer. But you know, you can't be a police officer until you're 21 and so I ended up going to college and getting into a criminal justice program at a local university here, and I just fell in love with school. Like, it just finally clicked for me. I enjoyed everything about it. I really enjoyed learning and studying what I specifically wanted to learn more about and study. Once I graduated and became a police officer, I always knew I was going to go on and get a graduate degree. So about 10 years into my career, I started a master's program in forensic psychology, and during that I had a really good advisor and ended up doing a research project that just really kind of turned me on to the research aspect of criminal justice studies. I just really enjoyed it. It's a lot like being a detective. I also really enjoyed the data analysis part of it. And so from there, I just knew like, alright well I'm hooked, I want to go do the Ph.D. route now. But it's been extremely advantageous not only for my career, but I think also for being a positive influence in the profession. Which kind of leads us to the LEADS scholar part of the question. The LEADS scholar program is through the National Institute of Justice where academically minded practitioners working with the National Institute of Justice to further research in policing.
There is a history of policing research, but when it comes to the grand scheme of things, we know much less about what does or doesn't work in policing than we do in a lot of other academic fields. The LEADS program is trying to marry together a practitioner focus with a research focus, which I think is a really good idea because one of the things that drew me back into academia was is I would read some of these journal articles and look at and go, well that's a great study, but that's not what I recognize as my reality being in the field, doing this work. And so I think if you can bring a practical viewpoint to the difficulties of law enforcement and how that aligns with different theories and assessments of what works and doesn't work, I think it is only better for everybody involved in that particular field.

Tyler Raible [00:08:33] Yeah, I love that. One of the things that the Forensic Technology Center of Excellence really focuses on is that transition from research to practice. So I assume that being a researcher who is fully immersed in the field of study itself probably gives you a really robust understanding of the gaps. Is that fair to say?
Scott Mourtgos [00:08:50] Yes, I would say that's fair to say. I think often policymakers want to advance a certain policy because they believe that's going to solve problem X, Y or Z. And it's all very well-meaning, but if they're not in the weeds of how a certain process actually works, it's very easy to look over, well, it's not going to work because of this reason, or it's not going to work because of this reason. One of the examples I can give you is, you know, several years ago, locally it was mandated to move to a mandatory sexual assault kit processing policy, whereas before it was left up to the discretion of the detectives. My views on this have evolved over time for reasons we can talk about. I do advocate for mandatory testing policies at this point, but at the time when this was being set up initially, some of the pushback that was given was is well, that's not going to increase arrests because the presence of DNA or the absence of presence of DNA doesn't prove a case one way or the other. It was being pushed forward as a solution to increasing arrests and prosecutions for sexual assaults and in my view, that wasn't the solution. It was a solution to other problems, but it wasn't a solution to increasing arrests or prosecutions and luckily, I had the academic skills to be able to evaluate that policy afterwards, and that's what we found. It didn't really make a change, which is good in and of itself, though, because now we know, OK, well, this is advantageous for other reasons like linking cold cases together, which I think is the primary reason at this point why I strongly advocate for mandatory policies, but if you want to move the needle on additional arrests and bringing justice for victims with sexual assault offenders or increase prosecutions, that in of itself is not going to move the needle. At least it didn't in our experience, as well as other areas that have studied that same policy move.

Tyler Raible [00:10:35] Scott, correct me if I'm wrong, but I think that Cuyahoga County was one of the regions that saw an increase in kind of making connections with the cold cases. But it sounds like that's not necessarily, as you put it, moving the needle for new cases is that correct?
Scott Mourtgos [00:10:49] It certainly wasn't in our experience and in the other studies I've seen as a prospective tool, they have found the same thing. It just really didn't make a difference one way or the other. If anything, it actually depressed some of the metrics by which we would hope to improve upon, such as arrests or whatnot because once you flood the system with all these additional test kits and cases moving forward in the system, if you don't staff and fund everything else that goes along with that, whether it be crime lab, investigatory resources, policing resources, et cetera, the system quickly becomes overwhelmed and people can't keep up with that particular volume. With the Cuyahoga County experience, Dr. Rachel Lovell is involved heavily in that particular area, and I've had conversations with her about this because they had a different experience than we did and, you know, from our conversations, I think there's specific reasons for that. And we have had success here linking old cases together through this mandatory process, which again, I think is well worth the effort and the resources to make mandatory testing policies a reality. But if we're looking to move the needle on future cases, it takes much more than simply saying we're going to test all sexual assault kits moving forward.

Tyler Raible [00:11:59] Excellent. Thank you. We actually had Dr. Lovell and Mary Weston, both of Cuyahoga County, on the show to talk specifically about their test all approach and it was fascinating to hear, but there's been this increase and there's a lot of talk around this concept of an at-home sexual assault evidence collection kit. It's a publicly available kit, not associated with a hospital or any sort of medical facility. And in this season, we've been calling them at-home sexual assault kits or at-home kits. Before we really dive in, could you share a little bit of your perspective on these at home kits?

Scott Mourtgos [00:12:30] Yeah, from an investigative perspective, I remember when I first heard about it. It really kind of took me back. I really couldn't understand where the idea for these would be coming from. And, you know, I'm looking at it from a particular perspective, and I'm sure there's perspectives in which people see these as being advantageous, but if I'm looking at it simply from an investigative standpoint, I see them as extremely problematic for several reasons. The most significant reason from an investigative standpoint is we simply can't use the results from them in the investigation process. I mean, there's a very defined process for biological evidence being collected, being packaged and stored correctly and being passed through from the SANE nurse that collects it, to the police department that is then receiving it, to the crime lab, who then tests it, to the worker within the crime lab that then ostensibly is going to put it on the CODIS database. Every step has to be accounted for and it has to be done in a particular way in order for it to be used in a court process. If any of those steps along the way aren't meeting the standards for which has been set, we simply can't use it. And so it's giving victims of sexual assault, in my opinion, a sense of false hope where they're thinking, I'm collecting this evidence and it can be used in the process for holding a perpetrator accountable and it simply cannot from an investigative standpoint, and so I do see them as extremely problematic,

Tyler Raible [00:14:00] Scott I definitely appreciate the clarification, and as a point for our listeners, Scott, you and I are going to be using the terms victim and survivor kind of

interchangeably. So from your perspective, then what would you consider to be a major difference between an at home kit and the one that somebody would receive at a hospital?
Scott Mourtgos [00:14:20] Well, as far as the specific differences between - I know home kit and one that's used at a hospital as far as the actual collection aspect of that, a SANE nurse would probably be able to speak to that more thoroughly than I can, but I can tell you the difference between those two from my perspective on the receiving end as an investigator from that. It's not simply about obtaining some swabs for DNA evidence or other sort of biological evidence that we could use in an investigation. There's much more to us receiving one of those kits in the investigative process than what we use them for. It's not just about obtaining biological evidence, and as I stated before, even if we were to obtain that biological evidence from an at-home kit, we wouldn't be able to use it in an investigative capacity anyways. But beyond that, SANE nurses will speak with the victim in the case, right? Those statements that we get during that medical interview helps inform our investigation moving forward. It's not we just get a box and then send it off to a crime lab. We actually get an actual report which details events leading up to the assault, what occurred during the assault, what occurred after the assault, and that very much informs our investigation as we put it together moving forward and what we need to follow up on. It also documents injuries well beyond biological evidence. Injuries such as bruises, lacerations, contusions, what have you on extremities, but it also can include injuries to the genital area that can't be seen unless a medical exam by a medical professional is actually done. And you know, case in point, the case that I told you about at the beginning of this podcast about my experience going all the way through with this victim through a trial, I very much credit the SANE nurse that testified in that trial as really sealing the conviction there because of how they were able to speak to injuries to that genital area that we never would have known about or even been qualified to discuss, quite honestly, because I'm not a medical professional. It was extremely powerful testimony, which is another reason to have a SANE nurse doing this collection process rather than simply an at-home kit, because then they can come in and testify to the medical aspect of what they're finding and then passing on to us in the investigative process.

Tyler Raible [00:16:34] To me, it definitely seems like a properly collected kit is of paramount importance in the investigative process. And you mentioned that it does allow the SANE, the sexual assault nurse examiner, to provide some expert medical testimony. What other roles does the kit play in the investigation of a sexual assault?
Scott Mourtgos [00:16:53] So it's not only just about evidence collection. Now certainly that's a primary concern of mine as an investigator, but I also recognize there are other aspects that are important well outside of the actual investigation itself. There's health care provided during these examinations. There are concerns often from victims about obtaining a sexually transmitted disease, possibly getting pregnant from the assault, depending on how it occurred, and then at least locally, I would assume it's similar in other parts of the country that I can only speak for here locally, when a sexual assault kit examination is done in the hospital with a SANE nurse, there is also a rape recovery victim advocate provided at the same time to assist the victim during this, you know, obviously traumatic period and providing additional follow up resources for counseling or what other help they might need to start moving through this process and dealing with the trauma that's come along with this particular incident.

Tyler Raible [00:17:50] Yeah, it really echoes a lot of the sentiments that we've had from other guests where this network of trust and having supportive people around you really, really helps with the healing process and with victim engagement and law enforcement. So

if a person were to have an at-home kit done, what complications might this cause for the investigation itself?
Scott Mourtgos [00:18:11] It's hard state the amount of complications that it would cause. I mean, certainly there wouldn't be any blame conveyed. I mean, we would certainly take that kit and book it into evidence. But unfortunately, that's probably where it would stay.
The crime lab has very strict policies about the evidence it can and can't collect, and if it's not coming from a certified individual that is qualified to collect biological evidence in a manner that is forensically sound and not introducing contamination, whether on purpose or inadvertently, they're not able to accept it because the chain of evidence has been broken at that point. We cannot account for every step from collection to crime lab. We cannot account for that evidence during that entire period. So not only would the crime lab not be able to accept it, it certainly would not be qualified for being entered into the CODIS system to look for possible DNA matches, which is very strictly regulated. So again, while we would take it and certainly be understanding of how that occurred, it really, from an investigative standpoint would not be useful to us. And one of the problems that arises with these sorts of issues is that the evidence collected during a sexual assault kit examination, it's transitory in nature. We can't go back and get that evidence again just because of the realities of how bodies heal, and biological evidence operates. So locally here, typically, what we tell victims is as long as you report to a hospital within five days of the sexual assault, there's exceptions to this obviously, given certain circumstances, then we can still conduct a sexual assault kit examination. But once it's passed that five days, unfortunately, we can't go back and redo it. We can't go back and get that evidence that could be the driver behind us being able to move forward, holding somebody accountable for the assault.
Tyler Raible [00:19:59] There are a couple of things that you mentioned that I want to dive into a little bit further, if that's OK. You mentioned chain of custody. What is chain of custody and why is it so valuable?

Scott Mourtgos [00:20:08] I mean, in its simplest form, the chain of custody is just this idea that in order to be able to introduce something in court, we have to be able to account for it from the collection point along the entire way and be able to attest to the fact that no one has somehow contaminated that evidence, whatever that evidence is, whether it be biological evidence or otherwise. And so that's the idea behind chain of custody. From the point of obtaining the evidence, which again, it's not just obtaining it, it needs to be obtained in a certain forensically sound manner to reduce contamination at the collection point, which again, why it's so important to have a sexual assault nurse examiner do this rather than the at home test kit, but from that point of collection all the way to it being introduced in court, whether that be an investigator taking it out of evidence and taking it to the crime lab, the crime lab opening up the kit and doing what they need to do as far as testing procedures go and then resealing it. If we can’t account for that every step of the way, we can't say that we know this is uncontaminated evidence. And if that's the case, the court will not allow it being introduced as evidence.

Tyler Raible [00:21:13] You did mention that CODIS eligibility does kind of come into play. Is the chain of custody kind of part of the determinant of CODIS eligibility? Or is it the quality of the sample collection? What's the kind of driving factor here?

Scott Mourtgos [00:21:27] So I'm not going to be able to give you every single point as far as the actual eligibility factors, because there's practical considerations, which we're talking about the chain of evidence and then there's also markers within the sample itself

that determine whether or not the crime lab will actually place it into the CODIS database. But one of the practical considerations that's made when determining whether a sample can be placed on CODIS or not is whether the DNA profile that we're entering into CODIS is from a known sample and the way that we're able to determine it's from a known sample, is it being collected by a qualified person to do it in a forensically sound manner, and then being able to track the chain of evidence all the way to the point where it's submitted to the crime lab and then put up on to CODIS.

Tyler Raible [00:22:07] Excellent. Thank you for the clarification. I was hoping you could tell us a little bit more about the investigation process kind of top down, start to finish how it looks.

Scott Mourtgos [00:22:15] Sure, I'd be happy to. You know, obviously there's idiosyncrasies to every investigation, but I'll give you the broad general outline here and also recognizing police departments are different based on size, right? Like I work for a fairly large organization of around 600 officers, so we're very specialized as far as what we do, whereas in a rural police department, maybe five officers, that officer is going to do all of what I'm talking about here and not specialize it out to detective units or whatnot. But the way we handle it here locally is that typically when somebody calls and makes a sexual assault report, their first interaction is going to be with a patrol officer. The patrol officer is the one that gets dispatched to the original call, and they'll go speak with the sexual assault victim and just get a very preliminary statement. Like what we've trained our officers to do is not dive into the well, what about this? And what about that? And what about that? Because of problems with memory recall following a traumatic incident like that and what they're going through at the time, we don't want victims to feel like they're being pressured to answer every minute detail. So we've trained our officers to just get a very general outline of the allegation and then also focus on what we call the three S's: the scene, suspect and safety. Is there a scene we can go to, to collect evidence beyond the sexual assault kit that will be collected by the nurse examiner? Is there a suspect that we can go get hands on right now? Not always, but typically speaking, the sooner we can get hands on a suspect, the better chances we have of resolving this case, which is the case in most investigations in my experience. And then also we want to make sure they're safe returning back to wherever they came from. Do they live with the suspect or is an acquaintance where we're not worried about having the victim go home? So that's what the patrol response is. Then they'll write up the report. Sexual assault kit examinations can take up to five hours sometimes, and so typically the SANE nurse will call back to our police department when it's completed and either the same officer if they're still on or a completely different officer if shifts have changed, will go get the sexual assault kit and book it into evidence. When the initial officer writes up the report, it then gets forwarded to our special victims unit. So a detective will be assigned from our special victims unit, which will then do two things, they'll read the police report and they'll also read the report from the sexual assault kit examination and at that point, they'll also reach out to the victim to come in for a much more thorough, in-depth interview after they've had some time to kind of work through some of the processing of what had occurred. Based on what that interview brings out, there'll be other interviews done regarding how many other witnesses there are, also interrogations if we can grab a suspect and have an interview in that manner. The kit will also be submitted to the crime lab for serology as well as DNA analysis and then, depending on what evidence comes back from all of these things going on, there might be additional follow up, there might not, but when it's all done, then the detective will sit down with the prosecutor at our local district attorney's office, review the case with them, and then the prosecutor will make the determination of whether they're filing charges or not. That's the basic outline from start to finish.

Tyler Raible [00:25:07] From your experience and your perspective, is there anything that law enforcement agencies can do or should be doing to engage with sexual assault survivors or even the public in general about any options they might have if they used an at home kit? Or do you have any advice that you would offer someone who's used an at home kit and doesn't really know what to do now?

Scott Mourtgos [00:25:27] I would say this, as far as someone who's used an at home kit or if one was used, still make the report to us as soon as possible. If too much time hasn't gone by, we still might be able to have an official sexual assault kit performed. Obviously, circumstances are going to dictate that, but I would still say the sooner you can contact law enforcement, the better chances we have of collecting the evidence we need to be able to move forward in the investigation. And then I think it's also important because I think one of the ideas behind a stay at-home kit is that some victims don't want to speak to law enforcement, which I understand. You know, I fortunately, have never been in that circumstance myself. I can imagine a world in which I would not want to talk to law enforcement after that happened to me, either. So like, I get that and our agency gets that and Utah actually has the ability for a no report sexual assault kit to be obtained from a SANE nurse. So a victim, if they don't want to speak to a law enforcement officer for whatever reason, they can still go get a sexual assault kit done. They can go to the hospital, a SANE nurse will come out, collect the evidence, they'll still call the police department and turn the kit over to us because we need that for the chain of evidence and then, let's say one month, two months down the road, the victim decides, you know what? I do want to move forward with this case, then they can call us at that point, but we have the evidence to move forward. Whereas two months down the road, if they didn't go get that done, we can't go back and obtain that evidence. So again, time is of the essence when it comes to sexual assault kit collections. So regarding what law enforcement agencies can do, you know, several years ago where this really became a topic here locally, and this is when the move to a mandatory sexual assault kit testing policy was enacted here, it did make our agency take a real hard look at what are we doing? What could we be doing better? You know, I think often blame is laid at law enforcement's feet for some things, and rightly so in some circumstances, but I do also think that, you know, there are other parts of the criminal justice system that need to be tweaked in order for better success in these cases to occur. In my personal view, specifically, that's at the prosecution level. But that's another conversation. But in that review, we did recognize that you know what? There's one specific area where we really could be doing better. And what we noticed is when you're working sexual assault cases, one of the biggest problems that we have in being able to move forward with the case is after that initial patrol interview, we have a high turnover rate in victims engaging with the process. They either tell the detective that they don't want to move forward with the case, or they simply just won't answer the telephone calls or knocks on the door. And there's a whole host of reasons for that. You know, there's no blame being placed here. I can understand why that might be the case. But as we started looking at our own agency and why that might be occurring, because we were seeing a lot of turnover in victim engagement at that - directly following that initial interaction with a patrol officer, we realized some of the reason that was occurring is because of the type of interactions that were occurring at that initial level. Patrol officers, if they respond on a robbery call or a burglary call, or any other sort of call, like they want to know about every specific detail about what happened and when questions are asked in a very direct manner, it can really come across as accusatorial sometimes, especially to a sexual assault victim who just went through this horrific ordeal. Their mind isn't quite right at that moment in time and so they're just giving the officers their best response in that moment, which might not be a direct representation of reality of what happened during the

assault, which, you know again, is not their fault, but then that comes off as well, that doesn't make sense to the patrol officer, so they keep diving into it more and more and more, and it just becomes very accusatorial and we saw that over and over again. So myself, along with a colleague, put together a training program, and we trained our entire police department across four months, saying, this is what we want from our initial patrol response. When you make contact with the victim, express empathy, right? I'm sorry this happened to you. And then just to ask them simply open-ended questions. Tell me what happened and then just let them tell you what comes to their mind about what happened. We don't need to get into the minute details that will come out during the investigatory process with a follow up interview a week or so down the road with a detective that's specifically trained on trauma informed interviewing practices. And then again, the three S's: the scene suspect and safety. That's it. That's all we want you to do when you're having this initial interaction. And our hope was that this would lead to better interactions where a victim didn't feel like they were being accused of doing something wrong or maybe being dishonest and I think importantly, if an agency decides to do this, you use specific examples from your own agency, which is what we did. We combed through police reports and took excerpts out of questions that were asked of victims by our patrol officers and when you put it up on a big screen and say, this is what was asked. It's really kind of an aha moment for officers as you start talking to them about it and they get it where in the moment where they're just doing what they've always done, it might not register with them. And so we were able to train our whole department. We ran an evaluation, which has now been published in journal Criminal Justice and we saw a 32% increase in victim staying engaged in the process following that initial interaction with patrol officers. Now, obviously, turnover is still higher than we would like, and so we're always looking for ways to do things better but, you know, a 32% increase just based off a simple intervention, a four- hour training of this is how we want you to talk to victims of sexual assault, it was was really substantial for us here.

Tyler Raible [00:30:51] Yeah, Scott, you're right. That 32% is a - that's a huge number. And I was reading through the article this morning and I thought it was fascinating how it was kind of a direct application of applying trauma informed interaction, you know, based on the initial contact. I was a little curious, could you tell us a little bit more about the training program that you developed? So what kind of coursework did you include? What did you - I mean, you mentioned that you were showing, you know, some interactions on a big screen, but what else were you going over? What kind of topics were included in the training?

Scott Mourtgos [00:31:20] Yeah, so one of the things that we really wanted to hit home on is, is everybody needs to get out of this mindset of the stereotypical sexual assault. The stereotypical rape where a woman is thrown down in some back alley somewhere and raped by a complete stranger. Does that occur? Yes, it occurs, but that is by far the minority of what sexual assaults are. But I think, you know, in general, that's what people have in their minds when it comes to a stereotypical sexual assault. So, you know, we open up the training with a case review of an incident from our own department that, just based on the initial statement, most cops are going to look at and go, no, no way. And then we walk them through the investigation step by step by step and show how every single concern that they had based off of that initial statement because of a poor interaction between an officer and the victim, was explained and was explained correctly throughout the investigation process and like yeah, this happened, and we have incriminating statements now from the suspect and was eventually charged and prosecuted and convicted of this crime. And so we try to set up this environment of you cannot make an accurate assessment of whether this occurred or didn't occur based off of

that initial interview. So just get that out of your mind. And again, I think it's important that we're using circumstances specifically from your own department because it makes it much easier to buy in and see what we're doing here locally. And then we go through what are perceived as paradoxical responses from victims in these cases time and time again, which it took me a good year of being a sexual assault investigator to start recognizing myself like, this happens all the time. If this is happening all the time, is it really paradoxical or is this the norm, right? But if nobody's ever explained that to somebody, they're not going to know that. And then we also try to find a way in which we can explain why you would be seeing these responses in a way that makes sense to officers. And so we compare the responses you see from victims of sexual assault to the responses in the cognitive and behavioral reactions that officers experience during deadly force encounters and how they're extremely similar. And that puts it in a context that makes sense to officers. At least it did here when we did our training program. And then we walk through why it's important to use open ended responses and why you don't want to start coming across in an accusatorial manner and this is the way we want you to conduct yourself during this initial interview and then walk through that entire process. You know, we didn't shy away from the fact that, you know, we had some pretty startling interactions with our own department to go over with them. Which again, you take 10 steps back and look at it two years down the road, you're hard pressed to find an officer, including the officer that had that interaction, which we all reached out to them before to make sure they're OK with us sharing it, can't really justify two years after the fact being removed from the moment of it. And so those are all the topics that we really tried to hit on. And again, it was successful.

Tyler Raible [00:34:09] For those of you listening at home, the article is "Improving victim engagement and officer response and rape investigations: A longitudinal assessment of a brief training." It's in the Journal of Criminal Justice. I highly recommend to go out and read it. It is fascinating just to really see the impact that this trauma informed training had. And I know that part of our listenership includes a significant amount of law enforcement professionals. So, Scott, do you have any suggestions for other investigators or law enforcement personnel on how to implement trauma informed practices when engaging with survivors?
Scott Mourtgos [00:34:41] I think first off, there needs to be an honest self-assessment. Now, to be fair, we were forced into an honest self-assessment of what was occurring, which is frequently the case. Hindsight is 20/20. Ideally, we would have done that ourselves before we were dealing with the issues that we were dealing with. And I think just being open minded to new information and new education. Policing is an ever-evolving field. I've been doing policing for about two decades now and I look back to how I policed even as a patrol officer 20 years ago, to how policing as a patrol officer now has changed in just a short amount of time I've been doing this profession. It's constantly evolving, and we have to be willing to accept that as time goes on, we learn more about how to do things better and being open to that. Like, if we're having these negative experiences, nobody's doing it maliciously. I mean, at least hopefully, right? Nobody's doing this maliciously. Just recognizing that we could be doing this better is not a criticism. It's just making sure you're providing the best service and the best chance at justice for a very vulnerable set of victims who very rarely get justice. So if we can improve that even by a few percentage points, we're doing something good, we're doing something worthwhile and we should be looking to continue to do that. And I think the other take home is, is that education works, right? I mean, you have to have that self-assessment. I do think it's important that the education component, the training component comes from a trusted person within the department. I do think that's something we had going for us. It wasn't some outside company coming in, and I'm not saying that that's a bad thing, but I do think there's a

difference, especially when you're training police officers who can be a difficult population to train for any police trainer, they will tell you the same thing, and that's not in a pejorative sense, it's just police officers are skeptical in general, and I think topics are more well received by trusted individuals within the agency that know what the culture there currently is and the difficulties of these cases because they've done it themselves. But again, the fact remains that the education works. You know, we're lucky to have Dr. Brad Campbell of the University of Louisville. He's currently in the process of trying to replicate there the success we had here, and we'll see if that holds up. But I think, you know, the two primary lessons to take away, at least what I would suggest from an organizational level is one, be open minded to actually critiquing yourselves and when you find that something could be improved upon, don't take it as an affront. Take it as an opportunity to improve and provide more justice to individuals who historically have not been able to get a lot of justice in these particular cases.

Tyler Raible [00:37:07] I really appreciate the nod towards the kind of ever evolving discipline and as a former educator, I really appreciate hearing that education works. Unfortunately, Scott, we are nearing the end of our time together. So what's next for you?

Scott Mourtgos [00:37:21] So one of the things I'm really excited about to see where it goes here locally, if I remember correctly, don't hold me to this date, but I think it was 2015 where we made the switch over to a mandatory sexual assault kit testing policy. As part of that policy movement, we had a decent amount of old cases that hadn't been tested over the years. And so part of that policy change was to go back and test all of those old cases as well, which we have been getting those results back now over the past year to two years at this point, and we're getting hundreds, hundreds of DNA matches. And I was lucky enough when I was promoted to lieutenant to be able to have an opportunity to go back and run the investigations division here and have a chance to change some things that I wish would have been changed back when I was a detective actually doing the work. And one of the things that I did at that time was, within our special victims unit, set up a cold case unit for these sexual assault cases because we have to do something with these hundreds and hundreds of cases. We owe it to the victims to do something with those cases if we have evidence now that can be followed up upon. And so those cases are now just starting to make their way through the justice system. So I'm excited to see where that goes. And then just also, I would be remiss if I did not mention the hard and dedicated work that all the detectives, not only in my agency, but I know everywhere put into these investigations. I will always and forever advocate for investigators that do the work investigating sexual assault crimes, whether it be against children or adults. It takes a special individual to be able to work in that environment. Day in, day out, hundreds and hundreds of cases every single year. And I think it's important that we recognize that. I think it's important that we support them. And I think it's important that we give them the resources that they need to be able to give the best chance at justice to these victims that they're trying to help. Rather than laying the blame at individual officers’ feet, what are we doing as a system to make sure that they can be successful? Are we staffing special victims units appropriately? Are we funding our crime labs appropriately? Are we working with our prosecuting agencies to make sure that prosecutions are occurring when cases are turned over to them? All of those things are essential components driving whether or not an individual is held accountable for one of these actions. Not an individual detective who is often overwhelmed and trying to tread water. So I think it's important, at least for me, to acknowledge the hard work and dedication of all of those women and men, and at least hearing it from me if they actually listen to this podcast that I appreciate their work and everybody else should as well.

Tyler Raible [00:39:47] Scott, I think that's a great note to end on. I'm constantly impressed with the people that we have on the show and all of the just incredible work that's being done out in this arena. So thank you so much for being here and for taking the time out of your day to have this very important conversation with us.

Scott Mourtgos [00:40:03] Well, thank you very much for the opportunity. I really appreciate it. As I've heard other guests talk about on your show, you know, it's a multi- disciplinary approach. And if law enforcement isn't being included in these conversations, we're missing a critical component. So the opportunity to come and speak with you as far as from an investigative standpoint, I very much appreciate it. And again, thank you for having me.
Tyler Raible [00:40:22] Absolutely, it was a pleasure. For those of you listening at home, on your drive, if you enjoyed today's conversation, be sure to like and follow Just Science on your platform of choice. For more information on today's topic and resources in the forensic field, remember to visit ForensicCOE.org. I'm Tyler Raible and this has been another episode of Just Science.

Voiceover [00:40:40] Next week Just Science sits down with Jay Henry to provide a laboratory viewpoint on at home kits. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.
 

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:18] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode four of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Laurieann Thorpe, the Executive Director at Prevent Childhood Abuse Utah, to continue our discussion on at-home sexual assault kits. Prevent Child Abuse Utah is a nonprofit organization dedicated to educating the public on preventing and responding to child sexual abuse. Listen along as Executive Director Thorpe discusses her career in childhood abuse prevention and response, and whether she believes at-home kits should play a role in addressing child sexual violence. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:16] Hello and welcome to Just Science. I'm your host, Tyler Raible, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today we'll be continuing the conversation around at-home sexual assault kits and their impact on younger survivors. To help guide us in this discussion, I'm joined by our guest, Laurieann Thorpe, Executive Director of Prevent Child Abuse Utah. Laurieann, welcome to the podcast. It's great to see you.

Laurieann Thorpe [00:01:37] Thanks for having me. It's my pleasure to be here.

Tyler Raible [00:01:39] So, you are a highly respected subject matter expert in the field of pediatric medicine, child abuse, including sexual abuse cases. I know that you wear many hats, so can you tell us a little bit about, about what you do?

Laurieann Thorpe [00:01:51] So my role, Tyler, I'm the Executive Director of Prevent Child Abuse Utah. We have Prevent Child Abuse chapters across the nation. So, I work out of the state of Utah and my expertise is really in prevention of child abuse happening in the first place. So we try to really be ahead of trends and think about how to strengthen families to prevent child abuse from ever happening. So, that is most of my work, and why I'm very concerned about this topic.

Tyler Raible [00:02:19] Excellent. And that's one of the reasons that we're thrilled to have you on the show. We spend a lot of time talking about after care, investigation, and stuff of that nature, but we don't really have a lot of content on prevention, so it's- it's fascinating and I'm- I'm excited you're here. How did you get started in this?

Laurieann Thorpe [00:02:36] Prior to my work with Prevent Child Abuse Utah, I worked with the Division of Child and Family Services, and in my work there, I felt compelled to- to not only work at administrative level, but also on the front line so I became a foster parent. And I think the number one thing that drove me then from there to prevention is thinking about how can we really protect these kids from this happening in the first place? Because that is where we can really have an impact. I think it is so difficult to heal from trauma afterwards. I'm not saying it's impossible. It certainly is. And I've seen incredible resilience with the kids that have been in our home and the ones that have, have remained

permanently through adoption. And I think I just want to be part of the work that's protecting children from any and every angle. So that's what brought me to prevention because I feel so hopeful about the possibility that education and specific services can strengthen families in a way that really protects children.

Tyler Raible [00:03:42] I really appreciate that because it's, it's a great example of both walking the walk and talking the talk. So you mentioned education and services. I'm- I'm assuming that's kind of what Prevent Child Abuse Utah does - can you tell us a little bit more about the organization itself?

Laurieann Thorpe [00:03:56] I'd be happy to. So we have several programs that we run as an organization, some that I'm, well, I'm passionate about all of them. That is why I have the job. But some of the things that we really work on, we believe in home visiting for families. So we work with families who need extra support, and some are at-risk families who meet specific guidelines, but any family who wants home visiting can receive that depending on resources available in their area. So we are really passionate about providing home visiting because it really strengthens parents and gives them solid information about child development and appropriate discipline techniques. And just all kinds of, it just gives them so many tools, and it is an investment in their ability to parent, and we see such incredible outcomes for families who participate in home visiting. So that's a big win for us. We love home visiting. We'd love to see the ability to have that expanded across the nation, so that any family who would like that supportive service can have it. We love home visiting. We do a lot of outreach efforts just with educating the community. We wanna help parents understand how to talk to their kids, specifically about child sexual abuse, but about all forms of abuse, right? We need parents to be empowered and understand what they need to do and how to- there's a little bit of a fine balance, especially when talking to kids about child sexual abuse, because you have to be careful to eliminate shame and be able to educate at the same time. And so because you never know if it's already happened, so you have to be able to approach it in a way that kids don't feel more worried or blame themselves when an incident of sexual abuse has happened. So we really work hard to empower parents to understand the ways to approach their kids so that it's not scary and terrifying for kiddos and there isn't any shaming going on. We also work directly with kids and do educational programs to help them understand what child abuse is and that they have a right, and to listen to what feels okay to them and to report until they get help.

Tyler Raible [00:06:08] It definitely seems like the scope is pretty broad, but all of them sound, you know, exceptionally important. So this is, purely conjecture, I don't have anything to back this up, but I imagine that, you know, the, let's say, child rearing techniques, you know, raising children have changed dramatically over the years. So, there's probably like some breaking up of negative cycles and, and all that fun stuff too, right?

Laurieann Thorpe [00:06:31] One of the things that we find that's really interesting is that there tends to be a stigma against parents asking for help, which doesn't make any sense, because why would anyone who hasn't been a parent understand how to parent? There's this idea that once you have kids, you should just know what to do. But there's also, universally, I hear from parents, you're just gonna let me take this baby home from the hospital? I have no idea what I'm doing here, right? And so, we've really tried to step into that space and provide information and not just information, but really solid support, because sometimes as a parent, what you need is someone to say, that was a great job. You did that so well. Did you know that kids need that, and this is why, and this is why

you're helping them with that development. That level of expertise and having someone in your home saying, well done mom or dad, is such a big deal, and it shouldn't be embarrassing to ask for someone to be able to provide that feedback for you. In every other function in our lives, we get that kind of feedback. A lot of what parents receive is just sort of a negative social feedback about when things aren't going well, or you're not doing a good job as a parent, but you don't necessarily get that encouraging messaging from the beginning or a handbook. So I like to say that home visiting is a parenting handbook. So anyone who's looking for something like that, that's, that's where to find those answers.

Tyler Raible [00:07:58] I love it. So I can imagine that having a program to kind of enhance your support network is probably incredibly beneficial.

Laurieann Thorpe [00:08:06] Absolutely. And we just are so excited to be on the front lines of that work because when we can strengthen and support families to be strong in the first place, then child abuse and neglect never happens. I mean, it feels a little hard to quantify sometimes, because how do you show that you did something that was invisible? But that's exactly what we want, because when we're successful, kids have happy childhoods. And parents, you know, the stressors that they're under, when they feel supported and when they have resources to navigate the difficult things that come at them in life, then they are successful parents. It's just a natural outcropping of being able to have those social connections you mentioned that they need, and to have all of their physical needs met and their children's physical needs met. It's really a phenomenal work to be part of.

Tyler Raible [00:08:58] It definitely sounds like it. I'd like to transition our conversation here a little bit to really get into the, the bulk of today's topic. When we think about sexual assault cases, I think there's probably a tendency to kind of think about adult cases, but it's no mystery, sexual assaults occur against children as well. So before we really dive in, could you tell our audience, you know, besides the age of the survivor, how do child sexual assault cases differ from adult cases?

Laurieann Thorpe [00:09:25] Well, child sexual abuse cases, I think, are, maybe one of the nuances is simply the age, right? So, so there's no question, there's no, he said, she said. There's no, we know that if the child is younger than the age of consent, it's absolutely illegal. We have probably a more significant rate of non-reporting with kids than we do even with adults. We know that sexual assault is significantly underreported just in general, but with kids, what we find is that kids don't know. They don't know that what is happening to them is wrong or isn't what everyone is experiencing. If you think back on your own childhood, you can think of examples of something later as you grew up that you realized was odd, but you just took it for granted that everyone was experiencing the same thing. Just a silly example. I have two aunts and an uncle that were single that all lived together, and I thought everyone had two aunts and an uncle that were single and living together. I just thought that was how the world worked. And we see this all the time with the work that we do with kids, that until someone says to them, no one should be touching you this way or exposing you to this kind of imagery or asking you for photos of this kind, they don't realize that that experience is unusual. And so, so I think that's definitely one of the differences and nuances between, that we want to help kids understand and that it's a parent's responsibility to help their kids understand that it is not okay for those lines to be crossed and how to help them once that's happened.

Tyler Raible [00:11:10] You touched on this a little bit, and I, I think that since the- the range of- of ages is dramatic, how would something like their developmental stage of the survivor play into this?

Laurieann Thorpe [00:11:22] The developmental stage of the survivor, I definitely think impacts the understanding that a child may have about the appropriateness of what's happening. The younger the child is, or especially in the- kids with disabilities really are often targeted for child sexual abuse because they may be non-verbal or because they might be older, but they don't understand what's going on. So as a child develops and ages, then their understanding evolves. And, you know, by the time that they're teenagers or, or younger adults, they do understand, okay, what's happening to me isn't okay, or what happened to me when I was a child wasn't okay. You know, one thing that we see that's common is that the younger ages that experience child sexual abuse, as they get older, they're more likely to become victims of child sex trafficking. It's most often the case, that they will be abused by someone they know, whether that's sex trafficked or sort of a traditional child sexual abuse case. So all kids are at risk all the time. But as I think maybe as they, as they grow, those are some of the nuances of how the danger evolves.

Tyler Raible [00:12:32] So now that we've covered kind of the differences between child sexual assault and adult sexual assault, this season we've been- we've been talking about these at-home sexual assault kits. It's this- this concept of a- of a sexual assault evidence collection kit that's publicly available and intended for use at home, and it's not associated with a hospital or medical facility. Now, I know there's some legislation in Utah relevant to, to the topic, and I was hoping you could tell us a little bit about- about House Bill 168 and maybe some of the concerns or cautions you have surrounding these kits.

Laurieann Thorpe [00:13:05] So this was a legislative bill that came before the Legislature last year. We're about to go into our next legislative session, and they're, the sponsor from last year because of the outcome from last year, is not re-sponsoring the legislation this year, which is unfortunate. But yes, the bill was to ban the sale of these "do-it-yourself-kits", the at-home sexual assault kits. I have some very specific concerns, but I think as a state in general, there were- there were definitely concerns about how this would impact survivors and the ability of prosecutors to prosecute sexual assault cases. We're very concerned specifically as an organization about these sexual assault kits and the risk that they represent to children. There are broader, more sweeping reasons why the kits present danger to the broader public, but we'll just focus on what that means for kids. One of the things that we're concerned about is that, is abusers having access to these kits and having that be one of the ways that they abuse kiddos, right? We can see it being appealing to child sexual abusers. And so we're definitely, we're concerned about that. We're concerned about parents who receive disclosures of child sexual abuse. It is devastating for parents to receive a disclosure of child sexual abuse from their children, and it is often the case that parents will default to disbelief. And so one of our primary concerns is that in those circumstances, a parent may try to get a hold of one of these kits to prove or disprove the allegation that their child is making. And then using the kits will be its very own form of child sexual abuse. So this is not something we want to have happening. And then we're also concerned about as a child ages, we're concerned about parents or anyone who might want to use the sexual assault kits as a virginity test. And that's a real concern, too, because we do see in some communities and cultural traditions that value virginity, again, using the kits or requiring kids to use the kits will be sexual abuse.

Tyler Raible [00:15:29] Laurieann, it really sounds like there are some, some major threats that these kits kind of pose to supporting child survivors. Is it fair to say that, that these are potentially problematic?

Laurieann Thorpe [00:15:42] I believe it's an understatement to say that. I believe that these kits pose a secondary risk to kids who have experienced child sexual abuse, right? That in the use of the kits, they will be doubly victimized or in the case where they haven't been sexually abused, these kits might be used as tools to sexually abuse in the first place. So I think that there's no question in my mind that the kit posed a threat to children.

Tyler Raible [00:16:10] Laurieann, you mentioned a few of these types of issues, and I was hoping we could unpack them. So I think you mentioned, concern about the kit as a tool for perpetuating abuse, parents kind of taking matters into their own hands to maybe invalidate or deny a disclosure. So let's, let's unpack these a little bit.

Laurieann Thorpe [00:16:28] These are concerns that I have about how the kits could be misused. When a child is sexually abused, ninety percent of the time, it's by someone that the child knows and trusts. So that is 90 percent of the time that the parent usually knows and trusts the individual, right? So their first instinct when they know and trust someone is to think the child maybe misunderstood or to say, mmm, you know your uncle, that's my brother. He would never do that, right? And that's just an example. And so, when that's the circumstance, I worry very much that parents who don't believe would say, you know what, I know about this thing, I'm just gonna jump over to the pharmacy and grab one of these kits and we'll see. We'll see if you're telling the truth. And that is so problematic, and I think that really adds some harm to harm. So that's definitely a concern. And then, of course, the virginity test is, is another, you know, breach of trust between parents and child, where we're saying, we don't believe you, we don't trust you so let's check. You've seen how parents will say, okay, we have drug tests available to us, so we're gonna do at-home drug testing. It's the same kind of theme, right? You know, as a family, we have this value of virginity until marriage or what- or whatever. You can fill in the blanks a little bit on that. So we have the ability to make sure you're telling us the truth on this thing. And I think that that, that is, is a pretty big concern for me.

Tyler Raible [00:18:07] The kit sounds like it may compound the- the traumatization. Is that- is that fair to say?

Laurieann Thorpe [00:18:14] Absolutely. Because when there is an incident of child sexual abuse, there's a breach of trust, right? And that is when you do the work of healing from sexual assault, that is a pretty big obstacle. So then to compound it, you know, in the, in the last examples of parents kind of becoming involved and potentially misusing these kits, then you compound that with another breach of trust, you know, another sexual abuse incident. So absolutely, because it, it double victimizes the kiddos.

Tyler Raible [00:18:44] We talk a lot about being victim-centered and being trauma-informed. If you were to, to give some advice to a caregiver, a parent, or your, you know, any adult who suspects that a- a child is being sexually abused, what would- what would you advise to be the correct course of action, instead of these kits?

Laurieann Thorpe [00:19:03] So first of all, as with all sexual abuse reporting, the number one thing is to default to belief. Believe the child from the beginning. That is critical to their- when we talk with survivors, they talk about that moment of disclosure and we coach parents how to put away their disbelief and suspend their reaction, because it's hard to

receive a disclosure. But doing something like this, [gasp] ohhhhh, uh-uh, or no, no, no, no, you misunderstood, does so much damage as well. So, so we really talk with parents about the way to be trauma informed is that when a child talks to you about this, you put away your reaction until later. You get to have that. I mean, it's a big deal when a child talks to you about this, that, and you, you love the child and you want to protect them and you're having your own feelings about, I didn't protect them, right? Or, no way would my husband or, you know, someone that I love do this to you. All of that has to be put aside during that conversation. And then the child has to be reassured that you will be protecting them from that ever happening again and that you, you believe them and you're gonna move forward together and you, you will keep them safe. So those are kind of the key things to help a child in the moment of disclosure.

Tyler Raible [00:20:34] Excellent. Thank you. And in the, in kind of a similar vein, as far as supporting the children, in particular the survivors of sexual assault, I imagine there's, there's got to be like a pretty good list of preventative procedures. Could you talk a little bit about some of the things that you would recommend, that either caregivers engage in or even, you know, maybe, maybe older children who are a little more cognizant of what's going on?

Laurieann Thorpe [00:21:02] We talk with parents about making sure that they talk early and often, earlier than you want to and more often than- than is comfortable. We talk all the time about getting comfortable being uncomfortable in this conversation with kids. The number one thing that parents can do to protect and prevent child sexual abuse is talking with their kids early and often, so that kids understand what's happening before it happens and can tell quickly or get out of the situation if possible, right? It's never the child's responsibility, so we have to be careful about the way that we talk to kids about it, right? On a really fundamental level, we talk to kids about listening to their "uh-oh" feeling, "say no" and "go tell", right? But kids need to understand that although they have the ability to say no, if they don't, it's not their fault. Right? And so that needs to be part of the conversation from the beginning with parents. And it's part of healthy sexual health development, right, is talking to kids, helping educate them, it's a really critical part of a parent's role. And there are great resources out there for how to walk through these conversations in a way that will be really relationship-building and help to protect kids. So, earlier and oftener, get comfortable being uncomfortable, always use correct anatomical body language, and normalize the conversation around sexual health. It really helps too, to have a good idea, know and understand what is sexually appropriate for the age of the child, and that will help you understand what terminology to use with the child as well. If you know that it's perfectly appropriate for them to be sexually curious in this way at this age, then you can have a conversation about that and talk about, okay, this is, it's appropriate for you to feel this way right now, and this is how we do this in a socially acceptable way. Um, or this is why you're feeling that way for a time that will come later. Right? So that you can really set up a good framework for kids about sexual health that is devoid of shame and helps them understand from the beginning that you are a person that's safe to talk to about this, in case anything ever happens.

Tyler Raible [00:23:26] It really sounds like there's, there's this significant level of trust building and avoiding these kind of victim-blaming tendencies. Do you have any resources that you recommend to kind of implement some of these, these things that you were talking about?

Laurieann Thorpe [00:23:40] We are currently working as an organization on a parent kit that parents can use with tip sheets to talk to kiddos, and a book that goes along with that

to kind of read side-by-side with, with the child and scientifically approved things that we really feel good about giving to parents, so that they can navigate these conversations. We're still working on making those available, but, but we are actively working on that. Some resources that I really like are Prevent Child Abuse America, Prevent Child Abuse Utah, and then we, there's also Darkness to Light is a website that has some really good information about child sexual abuse and how to talk to kids. And there's also some website resources called hot chocolate talks, and those are some really fun ways to introduce the topic and moments when you can catch parent and child interactions, where it's a good time to kind of sit down and naturally bring these things up and be able to process those with kiddos. But I would say this is not a rule of thumb, and not something I have read anywhere, but I, I really think that if you think that you're talking to your kids often enough, then up your game and do it more often than that.

Tyler Raible [00:24:51] I love it. I can, this is a complete aside, but I remember, you know, when I was a child, my parents having "the talk." And I think the talk was 15 minutes, one time. So yeah, I can imagine that this additional, maybe multiple additional levels of, of engagement and re-engagement on the topic is probably long-term gonna be really, really beneficial to, to healthy development.

Laurieann Thorpe [00:25:18] It just, you can't overstate how important it is to be that safe person for a kid. One of the things we talk to kids about is identifying at least five people that they do trust, that they can talk to in case anything ever happens to them. And you've got to get a pretty deep bench to get to five, right? We got, we got parents and teacher, and then we still got to get two more, right? So we really try to help them identify, and then we say over and over, keep asking for help until you get help. That's something that's really important because research shows that a child will generally have to disclose, I'm forgetting the exact statistic, but I think three times before they're believed. So that is an important element to cover with kids to make sure that they have a lot of people that they can trust so that if one doesn't believe, they can go to the next person.

Tyler Raible [00:26:11] I think that's excellent advice. And- and Laurieann, we are kind of nearing the end of our time together, so I- I wanted to know what's next for you. You mentioned these parent kits. Is there anything else coming up that you're excited about, any projects or events that you might wanna give a shout out to?

Laurieann Thorpe [00:26:28] We are really excited about the kits so, you know, listeners, stay tuned and we'll get those, we'll get those going soon. I think in the state of Utah, we're really excited about expanding the ability and accessibility for home visiting. And I think in, in the nation, that's a conversation that's happening too, that we want to make home visiting more widely available and really just help parents to understand it's okay to need some help and there is help available. So you don't have to feel like you got to do this all on your own, or do it, you know, with only the help of Instagrammers - nothing against our influencing friends - but there is some idea that we should be perfect without any education or training to even be good. Nope, we can put down the idea that we need to be perfect, and we can get better if we seek help.

Tyler Raible [00:27:21] I love it. Laurieann, you've mentioned Prevent Child Abuse Utah. I'm guessing, and I'm sure you can correct me if I'm wrong, that this is a national effort. So in that vein, are there any final thoughts you'd like to share with our listeners?

Laurieann Thorpe [00:27:35] One final thought that I wanted to highlight is just that across the nation, if one of your children does experience child sexual abuse, there are

child advocacy centers across the nation that specialize in forensic interviewing for children. They have specialized technical equipment that actually is really cool for kids, that doesn't require an invasive assault kit like the ones that will be available. They can do it with non-touch, and they can do the exams, and they can take care of your kiddos in a really specialized way. So I would highly recommend that you look into those child advocacy centers, and then they can hook you up with resources for counseling and therapy and whatever your child needs as they go through this process.

Tyler Raible [00:28:18] Excellent. Thank you. And with that, we do have to wrap up the episode. So first and foremost, I'd like to thank Laurieann for sitting down with Just Science to discuss at-home sexual assault kits and their impact on child victims. So, Laurieann, thank you so much.

Laurieann Thorpe [00:28:32] It was my pleasure. Thanks for having me.

Tyler Raible [00:28:34] And for those of you listening at home, on your drive, or wherever you listen to podcasts, if you enjoyed today's conversation, be sure to like and follow Just Science in your podcast platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:28:54] Next week, Just Science sits down with Scott Mourtgos, the deputy chief of Salt Lake City Police Department, to provide analysis on at-home sexual assault kits from a law enforcement perspective. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:19] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode three of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Dr. Toni Laskey, a professor of pediatrics at the University of Utah School of Medicine and the division chief of the Center for Safe and Healthy Families at Primary Children's Hospital. According to the Centers for Disease Control and Prevention, one in four girls and one in 13 boys under the age of 18 will be a victim of sexual abuse over their lifetimes. Listen along as Dr. Laskey discusses her work in child abuse pediatrics, her outlook on sexual assault response for victims under 18, and her perspective on at-home sexual assault kits in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:21] Hello, and welcome to Just Science. I'm your host, Tyler Raible, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today, we'll be continuing our conversation surrounding at-home sexual assault kits, and to lead us in that discussion, I'm joined by our guest, Dr. Toni Laskey, professor of pediatrics and division chief medical director of the Center for Safe and Healthy Families at University of Utah and Primary Children's Hospital. Welcome, Toni. It's great to have you on the podcast.

Toni Laskey [00:01:47] Thanks, Tyler.

Tyler Raible [00:01:48] Toni, you're a highly respected subject matter expert in the field of pediatrics and child abuse, including sexual abuse cases. So I know that you're involved in a variety of initiatives. Can you tell us and our audience a little bit about what you do?

Toni Laskey [00:02:02] So first and foremost, I'm a pediatrician. I actually have no interest in taking care of grown-ups unless they're directly related to me, and I need to provide life-saving measures. But when you're a pediatrician, you obviously take care of children from birth to 18. Sometimes we go a little older than that if the child has late developmental issues or other issues that they had during childhood that still need some pediatric care after they turn 21. But the subspecialty of pediatrics that I am trained in is something called child abuse pediatrics. Child abuse pediatrics is an area of medicine that specifically focuses on identifying child abuse and neglect, as well as recognizing things that look like that but aren't actually.

Tyler Raible [00:02:48] In the vein of child abuse and neglect, I'm assuming there's something to do with levels of concern. Can you talk a little bit about how you go about discerning this or the value that this- this sub-specialist field really, really brings to the table?

Toni Laskey [00:03:01] It's really important to recognize that if you provide medical care for children, you have to have an understanding of child abuse and neglect, and what your role as a health care provider is, which is recognize what may be abuse or neglect. Report

your concerns as you're mandated by law to do, but it's also to know what resources are available to you to help figure out cases that are maybe a little bit harder. So some children have very clear signs that are unambiguously inflicted trauma, but other cases have things that could be confused for abuse. So a child abuse pediatrician's job is to work as a member of a larger team that's both health care providers and what we call our community partners - so law enforcement, Child Protective Services - to help figure out what has happened, and if it is abuse, we need to take certain steps to protect a child from further injury or further harm. And if it's not abuse, we need to make sure that the system stands down because that child is already safe from their caregivers, but they might have a medical condition that needs to be addressed.

Tyler Raible [00:04:09] So it sounds like it's a matter of looking at patterns of injuries, you know, is this- is this broken arm a result of abuse or did they fall off a trampoline?

Toni Laskey [00:04:18] Yeah. And likewise, with sex abuse. I mean, sex abuse is hard when you have a child who is maybe pre-verbal and is having behaviors that are causing concerns for the caregiver. So they don't, they don't know like why is my child doing this? And they bring it up with their pediatrician, and their pediatrician might not have adequate training to be able to answer that question. So we're a resource to help in the evaluation of kids who are demonstrating signs or symptoms that might suggest that they've been sexually abused.

Tyler Raible [00:04:51] To me, it seems like this is invaluable work. So how did you get started in this field? Were there any moments or events within your career that- that drove you to this point or to this sub-specialization?

Toni Laskey [00:05:02] I always knew I wanted to be a pediatrician like literally since elementary school because I just love kids, and I was always the mother hen that would be micromanaging small children on the playground. But the reality is, is during medical school, you get exposed to lots of different types of medicine, and adult medicine was very clearly not something I was interested in. But by that same token, I knew that I wanted a little bit more variety in my day than just what we call general pediatrics, which is when you go see your regular pediatrician to check on growth and development and see if your kids got an ear infection or whatever. And so I had the opportunity to work with a child abuse pediatrician when I was in medical school and see how every day for her was something different. And that was, that was really attractive to me - the opportunity to have such a positive influence at such a really difficult time for a family can be very gratifying.

Tyler Raible [00:05:56] Yeah, I can imagine you were, you are going to be present in a situation where a family really needs you. So there's- there's, you know, an immense amount of value, and I could see it'd be very, very satisfying.

Toni Laskey [00:06:06] One of the things that's also really important is is that I feel like understanding the medical world is very difficult for those outside of it. So you have people that are all working on a- on the same case together and have to understand the medical component. And some doctors aren't very good at communicating with non-medical people, and so, you know, law enforcement or child welfare or attorneys are sometimes intimidated by having a conversation with a doctor who they know is going to talk way over their head and not slow down, and, you know, assume that everybody is on board with what's being said. So I really enjoy the opportunity to teach different people about what different medical things mean and don't mean. And so that's- that's an integral part of my job.

Tyler Raible [00:06:51] I know that you're part of this, this Intermountain Primary Children's Center for Safe and Healthy Families. Can you tell us a little bit about this organization?

Toni Laskey [00:06:59] It's an organization I'm really proud of because it's an example of the good things that can come when people come together for a mutual cause. So I work for the University of Utah and I work at Intermountain Health Care's Primary Children's Hospital, and in every other arena in the state, they're competitors, except in the care of children. Both Intermountain Health Care and the University of Utah mutually support the Center for Safe and Healthy Families so that we can mutually care for the potentially abused child without concern about where is this kid and what health care system are they in? So together we have a child abuse program that is at Primary Children's Hospital, and we provide both medical evaluation and mental health services for children who have experienced trauma. So those two services together are also around the entire state of Utah at our Children's Justice Centers so that we can provide the best care as close to the patient as possible.

Tyler Raible [00:08:01] It is great to see competitors unify on such an important conversation and I guess goal. So I do want to kind of use that to segue into the bulk of our conversation. But before we really dive into today's topic, I want to set some background. Toni, oftentimes when- when we think about sexual assault cases, we might think about almost exclusively adult cases. But obviously sexual assaults occur against children as well. So can you tell us, besides the age of the victim, how do these cases differ?

Toni Laskey [00:08:32] Child sexual abuse is different in that the people who often perpetrate this are somebody in the family or closely related to a child in their social circle. So the reality is is that there's differences based on age - school age children are exposed to different risks than preschool children and different than a teenager. So we have to think about sort of the age and developmental status of the child. And when I say child, it's really important to recognize that I mean, anyone under the age of 18, because while my teenager certainly wouldn't be happy if I were referring to him as a child, the reality is is that until you reach 18, the laws of the state identify you specifically as a child. So just to be clear, child and teen in my mind are in the same category. So the numbers that we have about sexual abuse victims are based on research that either capture cases that we know about now because a child has told somebody that it's happened or they come from adults being interviewed about things that happened in the past. So what that tells us is we know some idea of how often this happens, but we probably don't have a full idea of how often this happens because there's no way to know for sure unless somebody tells us. And that- that really means that the problem could be a lot bigger than we realize.

Tyler Raible [00:09:59] I mean, when you- when you put it in that light, it's a little overwhelming. So one thing that you said that kind of stuck out in my head is it seems like there are kind of three different, for lack of a better word, categories. How do they actually break down within that subgroup?

Toni Laskey [00:10:12] I mean, medically, we think about it in those sort of broad categories of your pre-verbal, so you're not able to tell us that something has happened and we're responding to either behaviors or symptoms or sometimes even witnessed events. So that's- that's in the youngest kids. And in those cases, the kid's never going to be able to tell us what happened. Then you have school aged kids, which remember you

can't really lump a kindergartner in with an eighth grader - they're fundamentally different and so sort of the things that happen to them and how they tell us about those things are different. But broadly speaking, sort of school age is a category. And then there's the category of adolescent, which, of course, most adolescents are in school, but again, their relationships with peers or in other outside of the home activities that might have less parental supervision, like sports or camps, things like that, expose them to different risks also. So broadly speaking, yeah, three groups that I think of.

Tyler Raible [00:11:13] Excellent. Thank you for the clarification. I do want to talk a little bit about some of the statistics, some of these numbers. I know that there's definitely a significant amount of research. Can you shed a little light on, on any of the statistics surrounding child sexual assault so we can really kind of start to unpack the severity of the problem?

Toni Laskey [00:11:31] Sexual abuse and sexual assault are sort of two phrases that we sometimes hear. An assault tends to refer to events that we think of like rape in an adolescent, for example. We rarely use sexual assault terminology associated with younger children. But sexual abuse and sexual assault are in the same category, so I sometimes will use those interchangeably. So some of the statistics that we have from research suggests that one in four girls and one in 13 boys will be a victim of child sexual abuse over the course of their lifetime. You know, and if you think about that one in four, that means you absolutely know somebody in your life that has been a victim, whether or not they've shared that with you. So that's- that's really important to, to recognize. And another statistic tells us that of women who will be victims of sexual assault over the course of their entire lifetime, one in three will have had that happen between the ages of 11 and 17 so while they were a child. And men who will be a victim over the course of their lifetime, one in four of them will have it occur between the ages of 11 and 17. If you think about what it means to you developmentally to have that sort of thing happen while you're still developing an understanding of like who you are in the world and what your relationship is to other people, I mean, think about what kind of long term impacts that has.

Tyler Raible [00:12:54] This trauma probably doesn't even resurface for- for many years, you know, depending on the age of the survivor.

Toni Laskey [00:13:01] Yeah. And you know, sadly, we don't have broadly available trauma therapy services available to victims. You can get better, and you can get past this. But until we have services broadly available and recognized as being an important part of the healing journey, we have people that grow into adulthood and have to deal with this forever.

Tyler Raible [00:13:22] One thing that- that we touched on a little bit, and I want to make sure that we're very clear, is the difference in terminology between child sexual abuse and child sexual assault. Is there a major distinction to be made and if so, what is it?

Toni Laskey [00:13:36] There are technical definitions that, for example, the Department of Justice uses in crime reporting statistics, which is always interesting when the legal world has different language than the medical world. So sexual abuse is the inappropriate touching or exposing a child to sexual activities that are inappropriate for their developmental age and comprehension. Sexual assault we tend colloquially to think of as somebody has been raped. So there are definitely situations where a teenager could be sexually abused by a caregiver - they're inappropriately fondled or they're forced to

participate in the production of child pornography - but we wouldn't typically think of that as sexual assault. It's horrible. It's bad, but it's something sort of categorically different.

Tyler Raible [00:14:27] Perfect. Thank you for the clarification. One thing we've talked about in previous episodes in previous seasons is this distinction between victim and survivor in terms of terminology. So is this the same case with children? Do you use victim versus survivor? Is there a preference?

Toni Laskey [00:14:43] It's interesting because survivor is a- is a term of empowerment that says I am not a victim of my perpetrator forever, and I fully embrace that concept. That is a really important concept because if you always see yourself as a victim, it's difficult to turn the corner and move forward with meaning. So I completely embrace that concept. But when we're dealing with children, it's important to recognize that they've been a victim of an adult who has done this to them, and at some point, they will become a survivor. But while I'm dealing with them, while they're going through this process as a child, we refer to them in pediatrics as victims. But that's not meant to take away from the fact that they will be able to regain control and move into a survivor position later in life. But for pediatrics, we tend to refer to them as victims.

Tyler Raible [00:15:36] That's perfect. Thank you for the clarification. For the remainder of today's conversation, we'll use the word victim because that is the appropriate terminology in this- in this capacity. Toni, I want to talk a little bit about the role of forensic evidence in these cases. So I imagine it's got to be difficult to interpret.

Toni Laskey [00:15:50] Not just to interpret, but to even recover. So the child's body is physiologically different than the adult body. So if you think about the changes that puberty brings, some of those include the pH of the genital tract changes, the biological flora - so just the microorganisms that live in the genital tract - those change when you go through puberty. The hormonal changes that your body goes through changes how your tissues look and respond to different types of things. So all of those things play a significant factor in our ability to successfully recover forensic evidence from a pre-pubertal body. So anybody that hasn't started going through puberty yet, we automatically are at a disadvantage for getting forensic evidence off of the body.

Tyler Raible [00:16:39] And that makes perfect sense. Is there a risk of, I don't know if cross-contamination is the right word, but I mean, if you look at children who are being diapered - is there a risk that you're going to find skin cells that aren't related to an abuse?

Toni Laskey [00:16:53] So that's an excellent question. When you have a teenager telling you what happened, you know, we know what to look for and we- there's really no reason for somebody else's DNA to be in their private parts unless there was contact there for a sexual purpose. In a child, particularly a pre-verbal child, pre-verbal children largely are in diapers, and there's toileting care that you have to do in order to provide appropriate care to a child that age. So obviously, semen and saliva don't belong there - if you found that, that's a problem - but what does touch DNA in the diaper area mean, particularly if it's somebody that provides care for that child? So if it's dad and you find his touch DNA in their diaper area and that's all you find like, how do you interpret that? Because we don't have research that says what normal touch DNA transfer is in those types of situations.

Tyler Raible [00:17:50] And that highlights the value of your subspecialty, right, to try and interpret and understand how this evidence might be there?

Toni Laskey [00:17:57] Yes, because if it's there and there are significant injuries or, for example, a sexually transmitted infection - that totally changes everything, right? And so those are medical things that we are looking for. Are there injuries? Is there an infection? But if you just take the DNA itself, that's not standalone enough to answer the question did something happen to this child?

Tyler Raible [00:18:21] Excellent. Thank you. Toni, I want to get into the topic of today, but it's this concept of a sexual assault evidence collection kit that is publicly available and not associated with a hospital or a medical facility, and we've been referring to them as at-home sexual assault kits. So can you talk a little bit about what this is and the kind of impact that they might have from your perspective?

Toni Laskey [00:18:44] Yeah, the development of this is really disturbing for those of us that provide medical care for- for this particular population. Frankly, I was completely surprised when I heard that this was coming onto the market. I couldn't imagine what the niche was that it was filling. I've heard that they were designed to provide some measure of control back to a victim of sexual assault or allow them to make choices that work for them. But something we say in pediatrics all the time is children are not small adults. So things that may be thought of in one way for an adult really does not immediately transfer to the pediatric population. A teen might have a body that looks like an adult, but by definition, because of their age and frankly, their developmental status, they need to be thought of and treated differently than adults.

Tyler Raible [00:19:38] And that makes perfect sense. There's a fundamental difference. So when it comes to collection, then, what kind of impact does this have?

Toni Laskey [00:19:46] Well, you know, the problem I have is that I think people misunderstand the effort that goes into doing forensic evidence collection correctly. This isn't as simple as like taking a Q-Tip from your bathroom and swabbing an area that you think is- is potentially going to have evidence on it. The amount of attention to detail that has to be spent to do this correctly, it's labor intensive. It requires a significant amount of training. There are important safeguards that have to be put into place while you're collecting the evidence to ensure that you're not contaminating that evidence. So it is an extremely meticulous process that has to be done with absolute attention and care. And after the evidence is collected, it has to be handled in a way that would guarantee that there is not tampering with the evidence. Because if you've gone to the trouble of doing it right, you want to make sure that it goes from the victim to the crime lab without tampering in between.

Tyler Raible [00:20:48] Right, there are all sorts of things that could go wrong. On the same topic, do you think there's a significant possibility for retraumatization? You know, if a child's been abused, been assaulted, and now they have to go through this invasive process with a- with a parent or a caregiver, like is it possible to retraumatize the child?

Toni Laskey [00:21:07] Yes, I really believe that there is. One of the things that doctors and nurses who do this type of medical care are trained in is being victim centered and trauma informed and being able to recognize what does this child who has had this experience and is at this developmental level, what do they need right now to prevent furthering the harm? And so we are trained to be responsive to the cues that they're giving us, whether those are nonverbal or things that they're saying. And there's also a process that we have to think about about how do we collect this in a way that doesn't cause physical pain and make sure that the child understands we're doing this to help them. So

imagine that you are a school age child and you have told your mom that something bad has happened to you, and your mom says, OK, then you know, we need to do this. Lay down. Take your pants off, and I'm going to swab you. Like, what message does that send to a child? Whereas as a medical provider, I think children by and large understand I'm going to the doctor, I'm going to the hospital, I'm going to see a nurse. They're going to do medical things, and it has a different connotation. I just think it's really confusing for kids to sort out, like, why do I have to take my pants off and have my mom swab my private part? That doesn't make any sense.

Tyler Raible [00:22:35] Right, I mean, as a child, if you go to the doctor, you expect to be poked and prodded. Maybe not necessarily that same behavior from a- from a parent or a caregiver. So Toni, what are some of the differences between this kit and say what would be available to a child sexual assault patient at a hospital?

Toni Laskey [00:22:52] I think a really important distinction is when you go to a health care setting to have an evaluation after a sexual abuse or sexual assault, the provider that's seeing you is doing so much more than just collecting forensic evidence. What we're doing is we're ensuring your physical and mental health and collecting forensic evidence. When I say we're ensuring your physical and mental health, we're doing a crisis assessment. What is your level of trauma symptoms right now? Do I need to get a crisis social worker involved? Are you actively suicidal? Are you experiencing trauma symptoms, and I need to get you hooked up with the trauma therapist sooner rather than later? Medically, I'm thinking about, have you sustained an injury that I need to document because that injury could be corroborative to what you've told us has happened. So I have, as a medical provider, a responsibility to do a complete physical exam on a patient and document findings that I see. Then I'm also thinking about could you have gotten a sexually transmitted infection, or if you're a teenager, could you have gotten pregnant from this event? And if that's a possibility and you're within a certain timeframe, then I can give you medicines to prevent those things from happening. So I'm literally preventing something worse happening to you after this bad thing has already happened. So after I've done all of those things, then I'm also collecting forensic evidence, which is part of a bigger puzzle.

Tyler Raible [00:24:25] Can you tell us in general what happens when a child or a teen comes into a medical facility after disclosing abuse or assault?

Toni Laskey [00:24:32] After they've come in, depending on where they come into and what resources are available in the state, ideally, a health care professional, either a doctor or a nurse, who is specially trained in caring for children who have had this happen will come and sort of assume the responsibility for this patient. So they're going to work with the child. And if their parent is there, sometimes teens do or don't have their parents with them, we're going to work with them together to figure out what do we need to do? So what has happened to you? When did it happen to you? Because that's going to tell us what we need to do immediately versus what do we have some time to do later. And then we're going to- we're going to start a process of thinking about how do I meet your needs right now? So like I said before, we're going to do sort of a trauma screening to figure out, is there active suicidality or a potential for self-harm right now? Then we're going to get some urine and blood samples. We're going to do a complete physical exam. Sometimes, if they have their clothes on that it happened, we'll take the clothes into evidence and provide them with new clothes. And then we're going to figure out what parts of their body do we need to collect evidence from?

Tyler Raible [00:25:44] It certainly seems like it's a more involved, thorough process, and it's being done by a professional, so the quality of the work is going to be likely superior than an at-home kit. In that vein, what cautions or concerns do you have related to the use of these at-home kits, especially in relation to child sexual assault cases?

Toni Laskey [00:26:04] Boy, I really have a lot of concerns. One of them is this failure to recognize that as a child, there's a legal mandate that law enforcement or child welfare be involved in these cases - like this is not something- sometimes you'll hear people be like, oh, I'm not going to press charges. If you are under the age of 18 and this has happened, the law says that law enforcement and/or child welfare has to be notified. If the health care provider, for example, would not notify law enforcement or child welfare, they actually would be breaking the law and there's criminal penalties associated with that. So we're thinking about how do we help ensure that this doesn't happen either to you again or to anybody else again? So we have to- we have to make that report. Then there's the problem of if the child were to have an at-home kit done, what is the admissibility of that evidence? Everything tells us that that evidence is literally going to be thrown away because its integrity cannot be ensured, and the integrity starts at collection and it ends at processing at the crime lab. If you cannot say that this was collected in a forensically sound way by a trained professional who followed all of the guidelines, and then they sealed the evidence up in the way that they're trained to seal it up, and there's a chain of custody saying every single person that has touched that evidence between the body and the crime lab, it's not going to be used in court. So God forbid that patient actually did have forensic evidence on them, that might be our only proof that something happened, and now it's inadmissible in court. So now we have taken an opportunity away from that victim for getting justice.

Tyler Raible [00:27:50] Right? I mean, I can imagine a scenario where a savvy defense attorney could get that just removed immediately.

Toni Laskey [00:27:55] Yes. And you know, in Utah, you so rarely see the defense bar and the district's attorneys on the same side of anything, and they both were testifying against at-home kits because neither side wants these in court because we cannot be sure that they are done properly. And the only way that forensic evidence is of value is if it's done properly.

Tyler Raible [00:28:20] So something that's been brought to my attention was the possible use of these at-home kits by adults who may be responding to a very distressing or desperate situation. Can you talk a little bit about these types of issues?

Toni Laskey [00:28:33] Given the stats that we talked about earlier, we know that many, many adults have had a trauma history themselves, and sadly many of them have not had access to trauma therapy when they were children or teenagers. So they might still be dealing with trauma in their own life. And they could misinterpret things that their child says or a behavior that they have and interpret it through their trauma lens and see the possibility that their child might have experienced something like they experienced. And in that light, they may choose to do one of these at-home kits thinking that they're helping their child without quote-unquote exposing them to the trauma of going to the hospital and having an evaluation. And the reality is, is that we don't know what that means for that child. If that child truly is a victim, they've now not had access to trained professionals who can help them. And if this thing really did happen to them and there was evidence, we don't have it, so we can't make sure that that person doesn't hurt this child again going forward. So my concern is, is that when we have parents trying to do this, they're out of the

parent swim lane now - they're in my swim lane and they're potentially harming their child when they were trying to help. And I don't think any parent wants to harm their child when they think they're trying to help. The other sad thing is, and this is a commonly held myth, is that this is going to be the answer. And what we know is the answer is rarely in the forensic evidence. The answer is in the professional evaluation that goes alongside the evidence collection. So the professionals who are trained to talk to children in a developmentally appropriate way and understand what has happened to them, and the professionals who are trained to understand what a finding on a child means or what a behavior that they're exhibiting means. So if we think that doing the- the at-home kit is going to give anybody that answer as to whether or not this bad thing happened, the reality is, is it's not. And if there was an answer to be had, the child didn't have access to those resources.

Tyler Raible [00:30:55] So Toni, I ask all these questions because I want to know your opinion. Is it fair to say that these at-home kits could pose a real threat to supporting child victims of sexual assault and abuse?

Toni Laskey [00:31:08] Yeah, I really think they will. This is very much a field of medicine that developed because we wanted to make sure that people, whether they're children or adults, who have experienced a horrific trauma that nobody should ever have to experience, have victim-centered, trauma-informed care. And we all have committed our professional lives to that. And when you have something that removes a potential victim from those services, I think we're all really worried about the harm that's going to come from that. So it's across the board, medical professionals like nurses and doctors, victim advocates, defense attorneys, and prosecutors - we all are very concerned that this is a harmful product.

Tyler Raible [00:31:56] So then in your opinion, what do you think is the correct course of action for someone - caregiver, parent, other adult - who suspects that a child is being sexually abused?

Toni Laskey [00:32:05] One of the things that I talk about when I do education for, for example, teachers or coaches or parent groups is believe. Children rarely lie about this and believing a child is known to substantially improve their long-term outcomes. So believing might be hard because it's a horrific thing to hear. But if you can believe, then that child stands a chance at being kept safe. So one of the things I tell caregivers because I'm a pediatrician is, you know, Mister Rogers always said, find your helpers. So you may not know what to do, do with this information because this is really awful. You just heard this bad thing, and, you know, what do I do with it? Find your helpers. So your response should be, I am so sorry that this happened to you. I'm so glad you told me because I'm going to help you, and your help may just be getting them to the right person. You don't have to do everything yourself. You know, not everybody knows how to handle this. So your help is finding the right person. In all 50 states, there is a legal mandate for everyone who is concerned about abuse or neglect to make a report to either law enforcement or child welfare, and that starts the ball rolling about getting that child the help and services that they need. So believe and then find who's going to help.

Tyler Raible [00:33:28] Of course, you can't expect a teacher to be an expert in approaching the subject but having the resources in place to get the help that the victim, the survivor needs is important. Do you have any- do you have any recommendations on who do they call? Who do they contact? Where can they find these resources?

Toni Laskey [00:33:45] Well, we all know Google is, is the keeper of all knowledge, so you can always Google in your state. You can call 1-800-4-A-CHILD, which is 1-800-422-4453. That's a national resource that will help figure out what the resources are specifically in your community. And you can also Google something called the children's advocacy centers, and you would find that by looking for the National Children's Alliance. When you do that, those are actually places that are around the country - there's over 900 of them now - that have been specifically set up to provide services to children who've been sexually abused. So it's a place that they can get medical care or get a referral to a place that can give them medical care. Law enforcement and child welfare work together in these settings to provide child-centered care, and they provide victim support services. So that's a really valuable resource. So another resource that's really helpful in cases like this is one called RAINN network, which is the Rape, Abuse, and Incest National Network. So R-A-I-N-N, and you can google that online, and I found that to have really useful information.

Tyler Raible [00:34:59] Thank you for sharing those. We'll make sure to include the link for National Children's Alliance and the- the 1-800-4-A-CHILD on the landing page for this episode just in case. So, Toni, as far as supporting children victims, can you talk about some of the positive actions that you would recommend in the kind of support capacity?

Toni Laskey [00:35:18] Again, believe is my take home message - you've got to believe a victim who shares this with you. What we know about victims of sexual assault, and this is- this also applies to adults, telling something like this to someone else is really hard. And the way that children developmentally think about this sort of thing is they think it's their fault that this happened, and that holds true for teenagers, that holds true for littles. They think that this is their fault. So when they tell an adult and the adult doesn't believe or doesn't respond in a way that makes the child feel like they're believed, that reinforces that this is something that you brought on yourself. And what that means to a child is that their ability to see a path forward, it just it closes. So we have examples of children who told a teacher, for example, and the teacher didn't believe them and said, well, if it happens again, let me know. The child often has been told by their perpetrator no one will believe you if you tell them, and they've just had that reinforced. So they choose not to tell, which means they remain in a victim capacity because they can't tell anybody. Or worse, they might not be a victim of that perpetrator anymore, but they might become a victim of someone else later in their life, but they've already had the foundation laid that if you tell, that nothing happens, nothing changes. So I can't emphasize enough believe, and tell a child, I believe you, and I'm so sorry this happened. I want to help you. That's empowering. And that leads to resilience. Another really important thing to remember is it's not your job to interrogate. You're not trained in talking to children about this. You don't know what questions are important or what questions might actually be harmful, either to the investigation or to the child because they're not trauma-informed. So don't start playing 20 questions. The child shared something with you, and we encourage what's called reflective listening. So they share something with you, and you respond to that by saying, you know, I can see that you're upset. I'm really sorry. This is what I'm going to do to help you or thank you for sharing that with me. This is not your fault. I'm really glad you told - you were very brave. Those sorts of things are helpful as opposed to starting to ask questions. And then the final most important step that you can do to make a difference in the child or a teenager's life who has shared this with you is making the report, calling CPS or calling law enforcement - whatever the- the laws in your state are or whatever is easiest for you. That is the next best step that you should take after you've believed them, because now you're starting a process that's going to start them towards healing.

Tyler Raible [00:38:03] Thank you so much. I mean, there are so many things that just that resonate.

Toni Laskey [00:38:07] You know, one of the things that I worry that adults think about when they're- when they're dealing with this is like, oh my gosh, this is so awful. And there's no hope. I think what I want adults to hear today is, is that there is hope. Children can recover from this. We know that bad things happen to kids, but if we take the right steps and put effort into the healing process, and sometimes it's long, and sometimes it's bumpy, but there is hope and you can be OK and you can go on to have normal relationships and not have this be an everyday part of your life. But on that same token, we sometimes have adults who are like, it would be better if you forgot about this. So just- we're not going to talk about it, and they constantly are shutting their child down who's trying to talk about it. And the way that children interpret that is that this is shameful and something bad about you that you should keep inside because nobody wants to hear about it because it's something bad about you. That's, I mean, kids are very egocentric, and I mean that in the psychological way, not the negative association way. Children feel like the way that adults respond to them are because there's something wrong with them. So when you tell a child, you know, we're not going to talk about this, you know, let's just forget about it. Children don't forget about it. They can't move on unless they are able to process what has happened. And trauma therapy is the answer to that. So really working with your victim advocates and child welfare to figure out what are the resources in your community to get your child the services that they need after this thing has happened to them?

Tyler Raible [00:39:45] Are there any final thoughts you'd like to share with our listeners today before we wrap up?

Toni Laskey [00:39:48] I really want people to know that, you know, obviously this is a difficult subject for people to think about because, you know, sexual abuse is scary on its face and should never happen to anyone. But then when you consider it in the context of a child, that just takes it to a whole new level. And so sometimes people have a hard time processing that sort of difficult material. But I really want to make sure that people hear that there is hope for people that have had this happen, and we all, everybody in society plays a role in keeping children safe and know that there are people who literally commit their lives to taking care of children and people that have had this happen so that we can turn the path that they're on in a more positive direction. So ask for help, don't go it alone, and believe children.

Tyler Raible [00:40:36] I'd like to thank our guest today, Dr. Toni Laskey, for sitting down with Just Science to discuss supporting child victims of sexual assault, to discuss these at-home kits. Toni, thank you so much for being on the episode.

Toni Laskey [00:40:47] Thanks, Tyler. I appreciate the opportunity.

Tyler Raible [00:40:49] And for those of you listening at home, on your drive, or wherever you digest your podcasts, if you enjoyed today's conversation, be sure to like and follow Just Science on your podcast platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:41:11] Next week, Just Science sits down with Laurieann Thorpe, the Executive Director of Prevent Child Abuse Utah, to continue the conversation on at-home

sexual assault kits. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:20] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode one of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Dr. Julie Valentine, a researcher, sexual assault nurse examiner, and the Associate Dean of Brigham Young University's College of Nursing, to discuss the use of at-home sexual assault kits. As a researcher in sexual assault response reform and a sexual assault nurse examiner, Dr. Valentine is a subject matter expert on collecting evidence in sexual assault cases. Listen along as she discusses her work in sexual assault response reform and her perspective on the role of at-home sexual assault kits in sexual assault cases in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:20] Hello and welcome to Just Science. I'm your host, Tyler Raible with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. We're beginning a new season of Just Science today, and for this season, we'll be discussing a new topic in the sexual assault response arena: at-home sexual assault kits. To help introduce the topic and guide us in our discussion today is our guest, Dr. Julie Valentine, Associate Dean and Associate Professor at Brigham Young University in the College of Nursing and a Certified Sexual Assault Nurse Forensic Examiner. Julie, welcome to the podcast. It's great to see you.

Julie Valentine [00:01:50] Thank you, Tyler. Great to see you.

Tyler Raible [00:01:52] So, Julie, you're a highly respected subject matter expert in the field of sexual assault response, and I know that you wear many hats. Can you tell us a little bit about what you do?

Julie Valentine [00:02:01] Absolutely. Regarding my forensic nursing expertise, I am a certified sexual assault nurse examiner with Wasatch Forensic Nurses that covers two of the most populated counties in Utah and remains very busy. I also do research and my research focuses on sexual violence. I have a National Institute of Justice grant to develop a machine learning model to help in decision making on sexual assault kit evidence analysis. And we're currently doing a lot of work in that area, not only in Utah but in a couple other states as well.

Tyler Raible [00:02:45] So of those projects, and anything else really, is there any particular project or event that's currently on your mind or that you're especially passionate about?

Julie Valentine [00:02:54] Yes, a lot of my research regards sexual assault kits, everything from submission of sexual assault kits to what are the DNA analysis findings and what are the predictors that indicate that we're going to get helpful DNA from a sexual assault kit that really will help guide forensic nursing practice and forensic science practice? I'm currently- I've been involved in looking at prosecution of sexual assault cases

in which the victim received a sexual assault kit and wanted to prosecute, wanted to talk to law enforcement, and looking at prosecution rates along with sexual assault kit submission rates. So that- that's a big area for me. Overall, I would say my umbrella is doing research to decrease sexual violence in our society and improve survivor support.

Tyler Raible [00:03:53] Excellent. And that actually provides a very great segue into really the topic of today's conversation. But before we begin, I was hoping you could provide a little recap about what is a sexual assault kit? You know, what's included in the kit? What does the collection process look like? Could you give us a little background information before we- before we really dive in?

Julie Valentine [00:04:12] So sexual assault kits, which oftentimes can be referred to as rape kits, are almost shoe box looking items that are filled with swabs and envelopes and forms and are used to collect evidence following sexual assault. The focus is looking for DNA that is from, we often refer to as, a foreign contributor or not the person or the victim. And along with the sexual assault kits is a very detailed examination form in which the examiner or nurse will complete information about the assault, about the victim, about their findings, everything from injuries to where the evidence is collected and the history of the assault. And sexual assault kits are not just- just made up what's in them. We actually have national guidelines. The most recent national guidelines were published by the National Institute of Justice, the National Best Practices for Sexual Assault Kits: A Multidisciplinary Perspective. And in these guidelines are clear descriptors about what is best practices to include in kits and also guidance for multidisciplinary stakeholders to get together frequently to reflect on what is in the kit. Does recent research indicate that we need to make changes to the kit or changes to our form? So there's a lot of thought and feedback from many in determining what is in sexual assault kits.

Tyler Raible [00:06:01] You said something that kind of piqued my curiosity is - what's in a kit? Is there- are there any movements to standardize kits? I know that there are some states that do it, but is there any traction on trying to standardize across states or nationally or even just in- in your state?

Julie Valentine [00:06:17] Yes, there is definitely a movement to standardize kits, and that's why we have these national guidelines. It will vary from jurisdiction or state to state. In the state of Utah, where I am from, we have a state of Utah sexual assault kit. In other states, there might be changes by jurisdictions. There might be changes state to state. So there is discussion and a movement to standardize, to have a national standardized kit, which certainly would help in disseminating best practice guidelines about what would be included in the sexual assault kits. And overall, the goal is to improve patient care.

Tyler Raible [00:07:04] Absolutely. Patient care is at the core of everything that you do, right? So I think that actually leads into- into the main topic today, and it's something that's emerged possibly in relation to the pandemic. There might be other issues afoot, but I want to talk about this concept of the sexual assault evidence collection kit that is publicly available and not associated with a hospital or medical facility. So we've been referring to them as at-home sexual assault kits as we were preparing for this season. So could you tell us a little bit about an at-home kit? You know, what is it, and maybe why it's used?

Julie Valentine [00:07:39] Yes, to share about an at-home kit, I first want to just reflect a little bit. We talked about sexual assault kits, but let's also talk about the process of evidence collection for a sexual assault kit. And so that gets into talking about a sexual assault medical forensic examination. And we have national protocols for conducting a

sexual assault medical forensic examination and the primary responsibility, the primary goal of these examinations is to provide healing to survivors, and that is accomplished in a number of different ways. First and foremost, survivors are given choice in what they want in the examination process. So a survivor may come in and may not want evidence collected, and that's- the evidence is secondary. The primary focus is nursing care, medical care for that survivor and providing resources to them. So if they do not want evidence collection, we discuss other options for resources. They may want evidence collection but want it to be collected anonymously, which can be done in some states. Or they may have it collected and opt not to talk to law enforcement at that time to give them time to process. So depending upon a jurisdiction a survivor or victim can report at an emergency room, they can report to a clinic. They can call 9-1-1 and report and be referred where to go for a sexual assault medical forensic examination. And different jurisdictions will apply this in different ways, meaning that in some jurisdictions there might be a specific hospital or clinic where they are best suited to care for survivors. In other jurisdictions, like where I work with Wasatch Forensic Nurses, is we're a mobile team and we'll respond to any hospital where a victim reports. So once a sexual assault nurse examiner reports to see a patient, the first thing they do is tell them about their options and choices. And if they decide that they want evidence collected, then the nurse will have them sign consent forms and will complete evidence collection in a sexual assault kit following the protocols.

Tyler Raible [00:10:16] So your insight into this process is fascinating. I think a lot of people, and potentially myself included, see this process as being kind of one way, but it sounds like there's actually a lot more agency involved, right? There's a lot more decision making and opportunities to empower the survivor, the patient. Is that fair to say?

Julie Valentine [00:10:35] Oh yes. One of our goals is to empower survivors. Rape takes away someone's autonomy in every aspect, and to promote healing, we need to provide that autonomy, that choice back to survivors. And so that- that's one of the first things that happens when they report at an emergency room or clinic is given that choice. When we think of the at-home sexual assault kits also have swabs and envelopes, just like the sexual assault kits that professionals use in the health care environments, but they won't have the health care expertise with them in person to collect that evidence.

Tyler Raible [00:11:26] Wonderful. So just to make sure I'm understanding this correctly, please correct me if I'm wrong, the kits will have similar items in them, but it sounds to me that the difference here is going to be working with a- with a professional who can make sure the patient, the survivor, the victim is taken care of. Is there- are there any other differences that I might be overlooking?

Julie Valentine [00:11:47] There are a vast amount of differences between an at-home kit and a standardized sexual assault kit that follows national protocols and guidelines. We discuss when a victim comes in as a patient for a sexual assault medical forensic exam and is met with a nurse, they're also met with a victim advocate, and the victim advocate in most jurisdictions is with the nurse and the nurse provide a healing presence for the survivor. I already talked about that they give them choices, and I always consider as help place them on a pathway for healing. In the examination forms that the health care professional has gotten education on how to complete will be documentation of the assault, documentation of injuries, documentation of medical concerns that we may need to address during the examination that may be exacerbated by this trauma. We also have an expert that will do a head-to-toe examination and do photo documentation and diagram out any injuries. Now, in most rapes and sexual assaults, we do not see serious injuries,

but we do see injuries that many times corroborate the story of what the victim shares with us about the assault. So I have a large database of over 8,000 rape cases, and in this database I have found that over 70 percent of victims have non-anogenital injuries. They are usually on extremities, arms or legs, and they're usually bruises or abrasions. And when you ask the victim about these injuries, they will talk about many times struggling to get away or being pushed. And at some point, many times the protective mechanism of the brain kicks in and the victim oftentimes stops struggling, and then we may not see as many injuries then. But to stop struggling is just the brain's way of saying, we're going to survive and get through this. We see anogenital injuries in about 50 percent of the cases, and forensic nurses and forensic examiners have undergone a lot of education about identifying these injuries and documenting these injuries. We use specific items. One is toluidine dye that helps us to visualize injuries, and we take photographs of those and document those. Some facilities use something called a colposcope, which is almost a magnifying glass to really show that you can take photographs with that will really help to identify injuries. We also will evaluate the need for prophylactic medication to prevent sexually transmitted infections and pregnancy. We screen survivors to see if they need to have prophylactic medication for HIV, which is a huge concern after a sexual assault. And then we coordinate resources with the victim advocate so that when the survivor leaves that sexual assault medical forensic exam, they not only feel empowered and feel like they're starting to be at a place where they can heal, but they have resources to continue that pathway to healing. So with the at-home kits, those in-person services by educated professionals are missing.

Tyler Raible [00:15:44] I mean, that list alone was incredible. So there's something that you- that you mentioned earlier that I want to touch base on. You mentioned that you have a mobile team - how does that work?

Julie Valentine [00:15:56] Yes. So forensic teams oftentimes will be embedded in a certain hospital or clinic. And so if there's a city where it is in that method of embedding it in the hospital or clinic, then that's where survivors or victims are taken for the sexual assault medical forensic exam. In the jurisdiction that our team covers, the two counties, there are a multitude of hospitals. And when we initially started many, many years ago, we were just a one hospital-based system, but we found that victims would report at a hospital several miles away from that hospital and then be told, well, you need to transfer elsewhere for your examination. And they oftentimes wouldn't show up. So we found that our best mode of caring for every patient that reports is to actually travel to that hospital. So we have MOUs with multiple hospitals in these counties, and the forensic nurses take call and have all the equipment and stuff they need in a rolling bag with a camera and a computer for us to do our electronic forms. And when we are called, we respond to the hospital wherever that patient is to provide care.

Tyler Raible [00:17:23] That is truly fascinating. So that's awesome. I am from a small rural town in Ohio, and you know, our nearest hospital is 45 minutes away. So I could imagine that- that in a situation like that, driving 45 minutes to a hospital only to find out you have to go to a different one is probably taxing. Not to mention the fact that there's probably, you know, the difficult decision of actually deciding to go in.

Julie Valentine [00:17:44] Right. And, you know, and then you think they have to just then tell one more person. And so just trying to meet survivors where they report has been really beneficial for our communities.

Tyler Raible [00:17:55] So, Julie, now that we've talked a little bit about the advantages of coming into the hospital and getting the forensic exam in person, I do want to talk a little bit about the at-home evidence collection. So do you have any concerns or cautions about a person attempting to collect evidence with one of these at-home kits?

Julie Valentine [00:18:15] I think when we look at the at-home kits, before I go into the cautions and concerns, we kind of have to consider why these came about. And I really think they came about because many survivors are frustrated, and these grew out of that survivor frustration. And the frustration comes from feeling that their process through the criminal justice system and their healing was not supported. So I think this is really a call for action for all of us that work in this space. And we need to think, how do we help empower survivors? How do we help empower survivors while they also receive professional health care and receive professional evidence collection? I am all for survivor empowerment and my work is dedicated to that. My concerns with the at-home kits is that when I look at the prosecution rates of cases where the victim received a professionally collected evidence kit and said, I want to talk to law enforcement and it was within five to seven days of the assault and we're talking 10 percent or single digit of those cases are prosecuted. I worry that survivors may have this false hope that collecting evidence on their own will increase that ability to prosecute, which we have no evidence that that will do. And in my professional opinion, it will actually be the opposite. So I worry about the false hope that this can give survivors. I really worry that they won't receive the health care and the advocacy that they need. And that's my biggest worry, because I want survivors to heal. I want them to feel empowered and we need to work on that - all of us in this space, in the criminal justice system space, in advocacy, in health care - and consider what can we do to help those victims feel empowered while they still get professional care.

Tyler Raible [00:20:54] I'm at a loss for words because it sums it up perfectly. Helping survivors and victims and patients and making sure that everybody has the health care that they need. The independence and autonomy. Is that maybe a false thought that this at-home kit provides you with that independence and like an opportunity for self-care in against maybe a system that hasn't treated survivors the way they deserve to be treated? I don't- I'm kind of at a loss in that regard.

Julie Valentine [00:21:24] Well, I think the at-home kits, the appeal is that someone can use an at-home kit and not tell anyone. But the negative side of that is that they don't tell anyone and they suffer alone. So when they report for a sexual assault medical forensic exam, they do share what happened to them, to a nurse and a victim advocate who can be with them in person and say, I am so sorry this happened to you. What can we do to help you heal? And that missing component, that saying you can do this alone without having that professional in-person care worries me because sexual assault can be very isolating. In our university, we did a campus climate survey and we asked, one of the questions was if the victims, who they had told about their sexual assault, about their rape. And we found that 24 percent of those victims that reported that they had been sexually assaulted in their life had never told anyone - that the first item that they had ever chosen to disclose this to was to this survey, this campus climate survey. That was one of the most heartbreaking statistics that I read. I don't want anyone to be alone in this process, and I am a firm believer in in-person contact. I think we've seen with the pandemic that not being in-person can be rather isolating. We have this wonderful technology now, but not being in-person can be isolating, and for someone who's recovering from a traumatic event that can be even more isolating.

Tyler Raible [00:23:22] Julie, it's fascinating to me that you bring up this concept of isolation because I think in the last, goodness, year and a half of this pandemic, we've all probably felt isolated in some capacity. So are there any precautions that hospitals are taking to ensure the safety of sexual assault victims or survivors, or to even encourage, you know, reporting and coming in and getting the examination?

Julie Valentine [00:23:43] Yes, with the pandemic, some modifications have been made so that survivors can feel comfortable coming into a health care facility. In some areas, forensic nursing teams have switched from doing examinations in hospitals or emergency rooms to more private clinics. My forensic team was still responding to hospitals, but we also had options. We had clinics that we could go to if needed. All hospitals have taken on immense precautions so that everyone's safe - screening people by temperature checks, asking them if they've been exposed. I mean, health care facilities, everybody needs to be masked and that benefits everyone, including our patients. In addition, when we go into emergency rooms to see our patients, we generally make sure we are masked, any visitors are masked, they are masked, and then we limit the number of people in the room to prevent exposure and also just for the privacy and healing for that survivor. Generally, we can allow survivors to have one support person of their choice in the room during the examination as well, so we weigh possible exposures with also providing that very important emotional support. So health care in general, you know, in many ways, you're probably a lot safer going to a hospital right now than to your local mall. So a lot of precautions are in health care facilities.

Tyler Raible [00:25:29] That is very true. I can't even remember the last time I stepped into a mall. We've covered a lot and I'm curious about the different types of appeals that might be associated with this kit. So is it possible that one of the reasons somebody might opt for an at-home collection kit is just because they don't know where to go?

Julie Valentine [00:25:48] Yes. I mean, many times people don't think ahead of time, Oh, if I were to be raped, what would I do, right? And so we have a lot of resources and, you know, thank goodness for the internet where we can get a lot of our resources. Every place in the country is going to have advocacy services at some level. We also have national advocacy services. We have RAINN. There's a crisis text line. So we want survivors to reach out if they're not sure where to go and find out where can they receive services? The rape crisis lines are open 24/7 and those are confidential reporters, meaning someone can call them anonymously and say, I'm not sure what to do here. So this happened to me. I don't know where to go, and they can give them the options and say, here are places where you can go to receive health care, here are places you can go to receive an examination. And so reach out. There are a number of anywhere from national to regional to local resources for individuals to find that information. And if someone is feeling like I can't even go there, reach out to a friend, someone that you trust and say, I'm not sure what to do and I'm not sure where the help is. And have your friend work with you in finding those resources that you need that support.

Tyler Raible [00:27:27] I don't think there's enough that we could say about finding that support and that that human connection and getting the care that you need. And in that same vein, Julie, can you tell me a little bit about what a TeleSANE option would be?

Julie Valentine [00:27:38] Yes, so TeleSANE is a wonderful new technology where a number of sites in the country are developing TeleSANE processes and teams. And what TeleSANE means is- I shared that we have sexual assault nurse examiners or nurses or health care examiners that have specialized education in working with victims after sexual

assault trauma and knowing how to collect the history of the assault information. How to document injuries, how to collect the evidence. Well, in some rural areas, they do not have that level of expertise. And so TeleSANE has developed and TeleSANE is health care provider to health care provider. So if there's a rural area that does not have expertise in forensic nursing, they can reach out to their TeleSANE provider when a survivor comes in and that forensic nursing expertise will then guide the health care professional in the rural setting about how to approach the examination, what questions to ask regarding injuries, how to document the injuries, how to collect the evidence, what kind of medications should be offered, etc. So it's health care professional to health care professional that has really improved care for survivors in rural settings.

Tyler Raible [00:29:13] So as far as supporting survivors of sexual assault, so far, things that we've kind of brought up in regards to how the pandemic has impacted a lot of this - we have- we have the mobile care units, we have TeleSANEs. Is there anything else that has been kind of brought to the forefront that might be seen as a positive from the SANE perspective?

Julie Valentine [00:29:33] I think the positive, not only from the SANE perspective, but from nursing in general with the pandemic is an increased appreciation of the general public for nurses and that nurses will do whatever they need to do to provide best care for their patients, whether that be a forensic nurse, an ICU nurse, an emergency department nurse, and the list goes on and on. We want to provide patient care. Having patients come in for in-person sexual assault medical forensic exams allows us the opportunity to step in to be a healing presence, to professionally document the assault, to professionally document the injuries, to do photo documentation, and to provide resources to patients to place them on a pathway of healing. So nurses are there. We are there to support the public. We're there for healing and for health. And I believe the pandemic has really brought that to the forefront, that nurses will do what is needed to care for patients.

Tyler Raible [00:30:54] I love that. Unfortunately, Julie, we are nearing the end of our time together. I have to ask what's next for you? You're such- you're such a busy person. Is there anything coming up that you're excited about? Do you have any future projects or events or resources that you'd want to- that you want to plug here?

Julie Valentine [00:31:09] I'm excited about everything. Any research, any work I can do and caring for patients and working to decrease sexual violence. We have three articles that have been submitted and will soon be published about the intersection between mental health and sexual violence. We really see mental illness as a vulnerability for sexual assault, and we want to do a lot more education on that with primary care providers and mental health providers. And that's with one of my colleagues, Dr. Leslie Miles. We also have been working on a research study related to dating apps and sexual assault and have that soon coming out. So lots of plates spinning, but hopefully all to accomplish some good work because that's what it's all about.

Tyler Raible [00:32:12] That absolutely is what it's all about. Julie, is there any, any final thought you'd like to share with our listeners before we wrap up today?

Julie Valentine [00:32:19] I guess my final thought is for listeners that are survivors out there or for listeners who help provide services to providers is to know that what happened to you mattered. And there are a whole host of resources at your disposal, professionals who are ready to help you and to help place you on this pathway of healing and to look for

those resources. Because when people heal, then we're healthier as a whole society and that- that benefits everyone.

Tyler Raible [00:32:58] Excellent. What an inspiring note to end on. Thank you. With that, we are going to close out. So first and foremost, Julie, thank you so much for sitting down with us. I mean, this was a truly powerful conversation. So thank you for sitting down with Just Science to discuss the at-home evidence collection kit. This has been wonderful.

Julie Valentine [00:33:15] Well, thanks, Tyler. Always wonderful to chat with you.

Tyler Raible [00:33:18] Same to you. And for those of you listening at home, on your drive, or wherever you listen to podcasts, if you enjoyed today's conversation, be sure to like and follow Just Science on your platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:33:39] Next week, Just Science sits down with Monica Gardner to discuss at-home sexual assault kits from a survivor's perspective. Opinions or points of views expressed in this podcast represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.

Introduction [00:00:05] Now this is recording, RTI International Center for Forensic Science presents Just Science.

Voiceover [00:00:19] Welcome to Just Science, a podcast for justice professionals and anyone interested in learning more about forensic science, innovative technology, current research, and actionable strategies to improve the criminal justice system. In episode two of our Perspectives on At-Home Sexual Assault Kits season, Just Science sat down with Monica Gardner, an advocate, a former rape crisis center team advocate, and a survivor of sexual abuse as a child and as an adult, to discuss at-home sexual assault kits from a survivor's perspective. Monica Gardner knows firsthand that healing isn't linear, which is why, as a survivor herself, she made the decision to support and empower others who have experienced sexual violence. Listen along as she candidly shares her struggle with PTSD, the importance of therapy during the healing process, and her nuanced perspective on at-home kits in this episode of Just Science. This season is funded by the National Institute of Justice's Forensic Technology Center of Excellence. Some content in this podcast may be considered sensitive and may evoke emotional responses or may not be appropriate for younger audiences. Here's your host, Tyler Raible.

Tyler Raible [00:01:23] Hello and welcome to Just Science. I'm your host, Tyler Raible, with the Forensic Technology Center of Excellence, a program of the National Institute of Justice. Today, we're continuing the discussion surrounding at-home sexual assault kits. To help guide us in the conversation, I'm joined by our guest Monica Gardner, a sexual assault survivor, a Juris Doctor, and a former rape crisis team advocate. Welcome, Monica. It's great to see you.

Monica Gardner [00:01:43] Thank you. I'm excited to be here with you.

Tyler Raible [00:01:46] So, Monica, you're a sexual assault advocate, survivor, and a Juris Doctor. How do all of these roles work together?

Monica Gardner [00:01:52] Well, most people would assume that becoming a Juris Doctor would lead me to becoming a lawyer, but that was never the goal for me. I went into law school to see conflict resolution from a different perspective than how I saw in my undergrad, and that's where I got an intercultural peacebuilding certificate, and I made plans to start my own nonprofit. But in law school, I chose classes that really set me up for success as an advocate as well. Classes like public speaking for lawyers, domestic violence interviewing and counseling, among others. But I think things really took off for me when the MeToo movement erupted. I came out publicly about being a survivor of childhood sexual abuse and having been sexually abused in a romantic relationship while in law school. It lit a fire under me to see so many others having been touched by this evil. From there, I attended a psychosocial class about issues relating to sexual assault weekly for about three years. And during that time, I started to understand that the nonprofit I dreamed of would help survivors like me, and that was really exciting. I took a 40-hour training to become a rape crisis team advocate and volunteered until my health prevented me. Through all of this, though, I sought healing through EMDR therapy, and I continue to deal with post-traumatic stress disorder, insomnia, thoughts of self-harm, anxiety, depression - at times my anxiety makes me feel invincible and at others vulnerable and exposed. Healing for me has been a very long road that I still walk daily.

Tyler Raible [00:03:39] Thank you for sharing all that. Your experience working for the Rape Crisis Center sounds equal parts grueling and rewarding. Could you maybe tell me a little bit more about that? I mean, the 24-hour, a lot can happen in that 24 hours, right?

Monica Gardner [00:03:54] Yeah, I mean, you're basically on call for twenty-four hours. You have a choice between being there for the primary survivor or being there for the support system. And I always took being there for the support system partly, honestly, because I was a little intimidated, but I was able to talk with supporters. I was able to go to hospital calls. So when somebody gets sexually assaulted, they go to the hospital, and they actually call us to come and be there for these people. My first time going, I was so nervous. The guy that I talked to - it was the father of the sexual assault survivor - he said that he noticed that I was nervous and, you know, wasn't really sure why, but I revealed to him that I was a sexual assault survivor. And I kind of talked him through what he could do to be there for his daughter. And it was probably the best first experience I could have had because he really listened well. We had a really deep discussion for maybe two and a half, three hours. And then when his daughter came out, he was so vulnerable with her and so supportive with her, and it was really touching. So to be there for moments like that, it makes it worth all of the hardship and all of the stress. And, you know, sometimes being triggered by the- by the experience, all of it was worth it.

Tyler Raible [00:05:27] I can imagine that it takes a toll on you, but the value in that service, and while we're on the subject of your- of your work in advocacy, I want to know, have there been any other specific moments or events that have really resonated with you over the years?

Monica Gardner [00:05:41] Definitely. So years ago, I actually started a blog about how I grapple with spirituality and religion as a sexual assault survivor. It was something that I was really struggling with weekly as I attended church. And I thought, you know, there's probably other people out there that feel the same way as me. So between that and generally advocating for survivors through social media, I had people coming out of the woodworks to say me too. Some were so close to me and some were people that I never would have guessed. It's been humbling. I attended a city hall meeting focused on how to help survivors and manage prevention of sexual assault, and I was so struck by the strength of people there who told their stories and then explained how they started programs or found work dedicated to those causes. And I was so inspired, and I think it helps me really realize that I wasn't going to be stuck in a hole trying to dig my way out forever, that I could turn from my own healing and help others in whatever way I wanted. More recently, I was invited to speak in a Utah Senate committee hearing about my thoughts on these at-home sexual assault kits, and it was a very stressful experience again, but every moment was worth it. I emailed with some of the senators and my voice was heard, and this podcast will be another hallmark of my advocacy. So thank you for that.

Tyler Raible [00:07:12] We really appreciate all of the different voices that we can bring to the topic, and yours in particular is- is of paramount importance, both as an advocate and as a survivor. Monica, as a survivor, could you tell us a little bit about the importance of supporting other survivors? Your experience indicates the importance, but I'm hoping you can really elaborate a little more on the topic for our listeners at home.

Monica Gardner [00:07:34] I consider this my life's mission. So many times I hear people say your abuse does not define you. And for me, it does. And I don't consider that to be a negative thing. I think because of my experiences, I'm uniquely qualified to walk into the

darkness with someone who's had similar experiences and hopefully bring some light with me, and it's something I think about every day.

Tyler Raible [00:07:59] Well, I can definitely tell in our conversation today and the ones previous that you definitely bring some light with you. So, Monica, you've hinted at it already, and it really kind of drives home the- the main topic of our conversation today, and it's this topic that's emerged possibly because of the pandemic. It's this concept of a sexual assault evidence collection kit that's publicly available and intended for at-home use. It's not associated with a hospital or medical facility. We've been referring to them in this series as an at-home sexual assault kit. So, Monica, in your opinion, what is the major difference between these at-home kits and a sexual assault kit conducted by a sexual assault nurse examiner at a hospital?

Monica Gardner [00:08:39] Yeah, it's a world of difference. In the hospital, a sexual assault nurse examiner goes head to toe, taking pictures of evidence and collecting DNA in an ordered and particular manner while asking about the details of what happened. Everything is recorded. Clothes are collected for future examination. On top of that, survivors are treated for injuries and offered medication like the morning after pill and others to prevent STIs. An at-home kit would be left up to the sexual assault survivor alone, or maybe, hopefully with someone trusted to take a few swabs of obvious areas and just hope that they get it right.

Tyler Raible [00:09:24] So can you give a little background about these at-home kits from a survivor perspective?

Monica Gardner [00:09:29] Yeah. So as a sexual assault survivor, I think it's easy to see the benefits of an at-home kit, especially if you don't know about the process and the resources at the hospital. I mean, imagine you're- you have just been violated completely and then you're asked to undress and recall the trauma in front of a complete stranger. That's probably the last thing that somebody would want to do at that point. You know, they want a hole up and kind of take care of themselves. So completing an at-home kit gives the survivor a chance to go at their own pace and keep from having to explain the complicated thoughts or questions they have to someone that they don't even know.

Tyler Raible [00:10:10] I think you raise a compelling point, and I'm sure there are people who would opt to use an at-home kit instead of going to the hospital. What do you think the appeal might be for a survivor to use one of these at-home kits?

Monica Gardner [00:10:22] I mean, another reason that they might choose an at-home kit is it gives them privacy. It allows them to take their time in deciding, you know, what do I want to do with this experience that I just had. Instead of possibly talking to law enforcement and going about the stressful route of reporting the incident to law enforcement, it allows them to take time to themselves and decide, you know, what is it that I want to do? What do I need right now?

Tyler Raible [00:10:56] Excellent. Thank you. And that actually transitions well to a thought that I've been having, is that I would imagine these- these at-home kits can become a barrier in the criminal justice system. So how would these kits affect something like maybe chain of custody or something else in terms of working with law enforcement?

Monica Gardner [00:11:13] Yeah, this is the biggest key to why I don't support the sale of at-home sexual assault kits. When a forensic nurse collects evidence, it stays with them

until being handed over to law enforcement, whichever branch collects and stores these kits to be tested. If an at-home kit is used, there is no chain of custody or rather no proof that the evidence was collected in a proper fashion and not tampered with. I can already hear defense lawyers’ arguments that the victim just wanted revenge, snuck into the perpetrator's house to swab for evidence, or even willingly engaged in sexual behavior to secretly gain evidence. And an at-home kit would not be able to stand up to that argument. On top of that, collecting evidence is not as simple as one might think. And without the sterile environment at the hospital, it's really easy to contaminate the samples - another reason courts have to throw out the evidence.

Tyler Raible [00:12:15] Absolutely, right on. I could see the defense lawyer position almost forming without really a lot of effort. And aside from concerns about chain of custody, could you tell us a little bit about maybe access to advocacy support? How would that be affected by utilizing an at-home kit instead of going to a hospital?

Monica Gardner [00:12:33] Something to really consider is how isolating and devastating sexual assault is. Survivors walk away questioning what they did wrong and how they caused the attack. When I volunteered as a rape crisis team advocate, with every hospital call, a pair of us would go to the hospital to support the victim and their family or support person they brought with them during the sexual assault victim's rape kit. We offered access to grants, free therapy, support groups, but most importantly, a voice to say, I believe you. I'm here for you whatever you need. You're in control now. That is really the first step to start healing and start trusting again.

Tyler Raible [00:13:22] Monica, can you tell me why is that initial support so valuable to the healing process? You know, if this is the- the first step to starting to heal, why is that initial support so invaluable?

Monica Gardner [00:13:33] You know, it took me years and years to understand fully that I had been molested and raped as a child, and it took me months after leaving my abusive relationship to realize the extent of his sexual abuse. Like mine, most of these encounters are nuanced and complicated, not a straightforward, violent, you know, stranger of the night type of thing. I had had moments of opening up to people throughout my life that didn't really go well, and I think that's why it's taken me so long to really dig to the root of the problem. We don't want to waste one moment in validating a survivor and helping them start to heal.

Tyler Raible [00:14:15] And I can imagine that the access to therapy really helps with that. Could you take a second to- to maybe elaborate a little bit on maybe the role of therapy in the healing process?

Monica Gardner [00:14:26] Therapy for me has been life changing. I actually do EMDR therapy - that's eye movement reprocessing and desensitization. It's a trauma-specific therapy, and it sounds a little weird because they kind of- they wave their finger in front of your face or you have these little pulsers that vibrate on one side or the other. But it is a way to kind of fast-track your healing. And I think even if you don't do a trauma-specific therapy, being able to talk to somebody who understands what it's like to be a survivor, somebody who's going to be there just for you. It's funny - I was so independent in trying to take care of myself for so long that the reason I allowed myself to talk in therapy was because I said, this person is paid to listen to you. I had to have that excuse. This person is literally paid to listen to you. Otherwise, I wasn't doing it because I was so worried about becoming a burden to somebody else. But I think as my healing has gone on, I've realized

I'm not a burden to anyone and that anybody that would give me that message is not the right person for me to be around because they're probably just uneducated.

Tyler Raible [00:15:43] Absolutely. And the way you were, you're speaking of this independence and of being a burden actually reminded me that in previous series, we spoke to a survivor and she made the comment that her assault didn't affect just her - it affected her family, her friends, her neighborhood. And we know that, you know, sexual assault impacts more people than just the survivor. Would you be willing to tell our audience maybe a little more in that kind of arena?

Monica Gardner [00:16:08] You know, I remember about 10 years ago, shortly after I moved to Utah, hearing that a girl was raped on a nearby walking trail in the middle of the day. I was terrified. I did not take that route, even though it was a beautiful walking area, and I still will not walk outside any time of the day with both headphones in because I want to hear if someone's coming. I carry mace with me, and I've never been attacked by anyone. All of my experiences of violence have been with people that I've known very well. More importantly, though, I can see from my own experience as a survivor that my relationships with everyone suffers and often still do. For a long time, this is common for survivors, actually, I didn't even trust myself. How was I to trust somebody else? I had PTSD triggers come out of nowhere so often that I holed up in my room and I stopped interacting with others. I still do this today if I'm feeling overwhelmed. You constantly worry that you're a burden to others and try to balance your literal survival at times with not trying to inconvenience someone. My close support system is small and carries heavy weights with me, but eventually you're able to be the strong one at times, and it's a piece of evidence of post-traumatic growth where a survivor starts to move from merely trying to survive to starting to thrive. It was a beautiful thing to see after so much pain and darkness.

Tyler Raible [00:17:45] I really liked the thought of post-traumatic growth. You're right, it is absolutely beautiful to see that transition to thriving, to healing. I do want to jump gears a little bit if that's OK. So for our listeners and for myself, I want to make a clarification. If someone went to a hospital for a sexual assault kit, they can have the exam conducted, get the medical attention they need, have access to advocacy, and then they can make the decision as to whether or not they engage with law enforcement. Is that correct?

Monica Gardner [00:18:16] Yes. I wish every survivor would go to the hospital. Even five days later you could still find evidence in some cases but going to the hospital does not mean you have to jump through all the legal hoops of pressing charges. Now, usually they do have the police come so that you're able to make a beginning statement or something, but then it's up to you at that point, whether or not you pursue it.

Tyler Raible [00:18:42] I do imagine that has to be one of the additional barriers is the level of apprehension, fear maybe, of engaging with the legal system, especially after something so traumatic. Is that fair to say?

Monica Gardner [00:18:54] Yeah, definitely. I would think that when you're still questioning what actually happened to you, when you are still confused about everything, you don't want to do something so serious as go through the legal system. Many survivors I've heard over the years will say, you know, I didn't want to ruin his life. He made a mistake. Survivors are the most forgiving and kind people that I've ever met in my life, and it takes them a while. It took me a while again to realize the extent of the abuse that I encountered, and I think being able to have time to process that is really key in being able

to be a successful person in advocating for yourself through the legal system. And I would add to that that recently, Utah dropped their statute of limitations, which means that a sexual assault survivor doesn't have to come within a year of their assault and bring charges. They have a lot more time to process that. And that's really key because healing and understanding that all takes time, and you want to be able to feel powerful if you're going to have to stand across the room from your perpetrator.

Tyler Raible [00:20:17] We've kind of hinted at the need for- for support and advocacy and its value. Do you think that a lack of, of this support is one of the great concerns surrounding the at-home kits?

Monica Gardner [00:20:30] Yes, I think it's a shame that we don't do enough to help survivors understand what their experience is going to be like at the hospital because really like the forensic nurses that do the exam, they do this so much and they've heard so much from people. They have such empathy for the survivor. On top of that, the advocates in the rape crisis team, they have gone through training that for some people rocked their world view. Some people I saw in my group just really shift to an understanding of how serious this issue is, how prevalent it is, and really find empathy for a survivor. So I would just hope that survivors would go and get the hospital examination rather than the at-home kit, and I would say if, heaven forbid, something happened to me and I was assaulted again, I would go to the hospital without a doubt.

Tyler Raible [00:21:32] Monica, do you think that- that the public has access to the information they need to make an informed decision about an at-home kit versus going to the hospital? And if not, then how do we- how do we address this gap?

Monica Gardner [00:21:44] In a word, no. When I spoke at the Utah Senate Committee hearing on this topic and as I listened to the decision makers debate, it seems some of them were of the mindset of like, what harm can it do? And to be clear, at-home sexual assault kits deter survivors from being in an environment where people can actually meet their needs and would be used to collect evidence that would likely not be admissible in court, therefore, providing false hope of legal justice. They should be banned because of the harm it would cause an already vulnerable group of people. I think if lawmakers are unwilling to ban the at-home kits, then they should be covered on every surface with disclaimers that they would most likely not be admissible in any court proceedings and maybe an explanation of what that means for them.

Tyler Raible [00:22:40] I do think it's important to make sure that people have all the information they need. And from an outside perspective, as somebody who's not an advocate, who hasn't really worked in the field, these at-home kits seem to carry an additional level of risk, specifically when we look at retraumatization or, as you mentioned, the- the impact on the investigation. Would it be fair to say that your opinion is that these- these at-home kits pose a real threat to supporting victims?

Monica Gardner [00:23:06] One hundred percent. It's at best a misguided way of trying to lend support that ultimately only brings harm, and at worst, it's predatory.

Tyler Raible [00:23:17] First and foremost, thank you for sitting down with us to talk today, and I kind of want to talk about the future. So I understand that you want to set up a nonprofit that teaches people who have been through trauma and abuse. You want to teach them how to manage their self-care, along with managing and growing relationships with others. That sounds incredible. Could you tell us a little bit more about that?

Monica Gardner [00:23:38] Yes, it's something that makes me excited for the future every time I think about it. My plan is to start by writing a book to explain the material, and then I'll hold weekly seminars to go through the book chapter by chapter. The idea is that you are or have a tree within an orchard. You need things like sunlight for a greater perspective, rain to healthily express your emotions, self-care to make sure that your trunk is strong and healthy, and then each branch of your tree represents a relationship in your life - everyone from your significant other to the cashier at your favorite store - you exchange fruit with these people with the hope of connection, both the seed in the fruit and the seed which starts each new tree - the hope of connection. There's lots more to it, but that's the main idea. I want to have counselors available and mediators. I have a background in mediation, so I'll be happy to fill in those roles. And the last part of the seminar actually teaches you how to teach the material to your children, so you have a common language to use with them. I want it to be very accessible and hope that the idea will translate across cultures. I also recently decided I want to write a children's book about consent starring my cat, Mr. Munch. He's a pretty traumatized kitty and has actually taught me a lot about consent. I think no one is too young to learn about that idea.

Tyler Raible [00:25:09] Monica, we are unfortunately nearing the end of our time together, and are there any final thoughts you'd like to share with our listeners before we wrap up today's episode?

Monica Gardner [00:25:18] I would want to speak to people who are hearing about sexual assault and say that the real change we need is for survivors to be believed. We need to give survivors the capability and the resources to pursue justice, and they're not going to take up that opportunity if they're hearing at every new telling of their story, you know, that doesn't sound like something that would happen. Are you sure? Things like that. I also want to remind survivors and their supporters to be gentle with themselves. There's actually something called a secondary survivor, and that is where the supporter for a survivor starts feeling the same sort of PTSD symptoms because they care so much about the person and it affects them so deeply. I also want to say that healing is not a linear thing. If you are a survivor and you feel like you're taking steps back in healing, you're having kind of these lost days, which are days of PTSD where you can't function - that's normal, and it's OK, and it doesn't mean that things aren't going to continue to get better.

Tyler Raible [00:26:29] And that's an inspiring note to end on. I'd like to thank you, Monica, for sitting down with me and for sitting down with Just Science to discuss the at-home sexual assault kits and the need to support survivors. Thank you for all the work you do, for taking the time out of your day to chat with me. Thank you so much.

Monica Gardner [00:26:45] Thank you, Tyler. I appreciate being able to speak out on this issue.

Tyler Raible [00:26:50] And for those of you listening at home, in your car, or wherever you might be where you like to ingest podcasts, if you enjoyed today's conversation, be sure to like and follow Just Science on your platform of choice. For more information on today's topic and resources in the forensic field, visit ForensicCOE.org. I'm Tyler Raible, and this has been another episode of Just Science.

Voiceover [00:27:13] Next week, Just Science sits down with Dr. Toni Laskey to discuss her work in child abuse pediatrics. Opinions or points of views expressed in this podcast

represent a consensus of the authors and do not necessarily represent the official position or policies of its funding.