Survivors of sexual assault in largely rural and remote Northwestern Ontario face systemic barriers when seeking forensic care, according to a new study led by McGill University researchers.
Sexual assault evidence kits (SAEKs) are used to collect DNA and document injuries following sexual assault. Outside of large urban centres where specialized facilities exist, SAEKs are usually administered in hospital emergency departments. The study found that in rural hospitals, healthcare providers' decisions about whether to administer SAEKs were often shaped by stereotypes and credibility judgments, rather than consistent standards.
"From the interviews that we did, it seems that the person most likely to be viewed as credible and blameless, and to therefore receive a kit, is a white woman who was sober when assaulted, who doesn't know the perpetrator, and who calls police for help," said Kathleen Rice, Associate Professor and Research Director in McGill's Department of Family Medicine and Canada Research Chair in the Medical Anthropology of Primary Care.
"Those who fall outside that 'ideal victim' stereotype risk facing disbelief or discriminatory care," she said.
The study is among the first in Canada to examine how evidence kits are provided, filling a research gap. Most prior work has come from advocacy groups, she added.
Biases shaping care
Sydney Timmermans, a McGill graduate student supervised jointly by McGill and Lakehead University, surveyed hospitals to see which had kits available and staff trained to use them, then conducted in-depth interviews with emergency department staff.
From these interviews, three themes emerged:
- Substance use: Patients who were intoxicated were often dismissed as unreliable.
- Police involvement: If a patient arrived with police support, staff were more likely to see a claim as credible. Those in police custody were often thought to be exaggerating or faking.
- Race: Indigenous women were frequently subjected to racist assumptions and skepticism.
"These findings are troubling but not surprising," said Rice. "What shocked us was how blatant some of these biases still are in 2025."
Because emergency rooms are often the only place to obtain the kits in rural Canada, the findings point to challenges well beyond Ontario, she added.
Call to change how care is delivered
Reliable access to evidence kits is essential, as they can help document injuries, gather DNA samples, screen for infections and, if survivors choose, support legal proceedings, Rice noted.
The researchers call for clearer hospital guidelines and more training to address discrimination in the health system.
"Even those who held discriminatory views wanted more training," said Rice. "That's encouraging, because it shows a desire to do better."
A potential follow up study in Quebec hospitals is now being explored.
About the study
"'Not Without Judgment': Sociocultural Barriers to Accessing Sexual Assault Evidence Kits in Rural and Remote Northwestern Ontario" published in the journal Violence Against Women was authored by Sydney Timmermans, Jodie Murphy-Oikonen and Kathleen Rice.
The study was funded by the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council of Canada.
