Sexual assault and rape

If you are in danger or have been injured, call 911 in the US or your local emergency number now.

If you are thinking about suicide or feel unable to stay safe, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the US. In the UK and Ireland, you can call Samaritans on 116 123, free and at any time.

If the assault happened recently, consider seeking medical care as soon as you can, even if you don't have visible injuries. A hospital emergency department or specialized sexual assault service can treat injuries, offer emergency contraception and testing or prevention for sexually transmitted infections, and, if you choose, collect forensic evidence. You can usually have this done without deciding yet whether to report to the police.

Many areas have rape crisis centers or sexual violence hotlines staffed by trained advocates who can explain your options, go with you to appointments and support you through each step. You are in control of what happens next, and you don't have to go through it alone.

Sexual assault and sexual violence cover a range of acts that happen without freely given consent. These include rape, attempted rape, unwanted sexual touching, being forced or pressured into sexual acts, and sexual acts with someone who is unable to consent because they are asleep, unconscious, intoxicated or otherwise incapacitated.

Consent must be clear, voluntary and ongoing. It can be withdrawn at any time. Silence, not resisting, being in a relationship or having agreed to something before do not equal consent.

Sexual assault is most often committed by someone the survivor knows: a partner, former partner, date, friend, family member, colleague or acquaintance. Date rape and drug-facilitated assault are examples. Sexual abuse can also be ongoing, for example within a relationship or in childhood.

Legal definitions differ between countries and states, but the emotional impact doesn't depend on legal labels. Whatever happened, and whenever it happened, your experience matters, and support is available.

There is no right or wrong way to react after sexual assault. Common responses in the days and weeks that follow include:

• Shock, disbelief or numbness
• Fear, anxiety and feeling unsafe, even at home
• Shame, guilt or self-blame
• Anger or irritability
• Intrusive memories, nightmares or flashbacks
• Trouble sleeping, eating or concentrating
• Feeling detached from your body or surroundings (dissociation)
• Avoiding people, places or intimacy
• Physical symptoms such as pain, nausea or exhaustion

Many survivors froze or went along with the assault to stay safe. This is an automatic survival response, not consent, and not something to feel guilty about.

For some people, these reactions ease over time with support. For others, they persist and develop into rape trauma responses such as PTSD, complex PTSD, depression or anxiety, particularly after repeated abuse. Some people find that reactions surface months or years later. All of these responses are understandable, and help is available whenever you're ready.

After sexual assault, you have choices, and it's okay to take them one at a time.

Medical care. Getting checked can address injuries and health concerns. Forensic examinations are often time-sensitive, so if you're considering one, try to go as soon as possible and, if you can, before bathing or changing clothes. Even if time has passed, medical care is still valuable.

Reporting. Whether to report to the police is your decision. Some survivors report right away, some later and some never. A rape crisis advocate can explain the process where you live and what support exists if you choose to report.

Support from others. Telling someone you trust can ease isolation. If the first person you tell doesn't respond well, that reflects on them, not on you.

Safety planning. If the person who harmed you is a partner, family member or someone you see regularly, a domestic violence or sexual assault service can help you plan for your safety.

Be patient with yourself. Healing is not linear.

Therapy offers a safe place to process what happened and recover a sense of control. A trauma-informed therapist moves at your pace and never pressures you to share details before you're ready.

Approaches with evidence for trauma after sexual assault include:

• Trauma-focused cognitive behavioral therapy (CBT), including cognitive processing therapy, which helps address self-blame and other painful beliefs
• Prolonged exposure therapy, which gradually reduces the fear attached to memories and reminders
• EMDR, which helps the brain process traumatic memories so they become less overwhelming

Therapy often begins with stabilization: building coping and grounding skills, improving sleep and addressing immediate safety. Later work may focus on processing the trauma, rebuilding trust, reconnecting with your body and restoring relationships and intimacy at your own pace.

A psychiatrist may suggest medication for symptoms like depression, anxiety or sleep problems. Support groups led by trained facilitators can also reduce isolation. Social workers can help with practical needs such as housing, legal support or safety.

Look for a clinical psychologist, psychologist, licensed therapist or social worker experienced in sexual trauma. It's fine to ask about their training and approach, and to request a therapist of a particular gender if that feels safer. If a therapist doesn't feel right, you can look for another.

In a first appointment, expect questions about how you're coping, your sleep, safety and support. You decide how much to say about the assault.

If someone tells you they were assaulted:

• Listen without judgment and believe them
• Avoid questions that sound like blame, such as asking what they were wearing or drinking
• Let them make their own decisions about reporting and treatment
• Offer practical help, like going with them to an appointment
• Look after yourself, too

If a survivor is in danger or at risk of self-harm, call 911 or your local emergency number, or call or text 988 in the US (Samaritans 116 123 in the UK and Ireland).