Rape survivors often speak of two versions of themselves: the person that existed before the rape, and the one that exists after.
The aftermath of sexual assault introduces a whole world of unfamiliar anxieties and fears into the the victim's life and can have an overwhelming impact on body image and sexuality. It's so easy to become severed from your past life, to be unable to recognise you were were before. Not being defined by what has happened to you is incredibly difficult – impossible, even. After all, the violence of rape removes the sense of security, control and autonomy you have over your own body.
After Pavan Amara, 27, was raped as a teenager, her relationship with her body and the very idea of sex changed forever. "It changes the way you feel about yourself," she tells me. "You can't walk past a mirror. You don't want anyone taking photos of you and you don't want to look back at photographs."
Amara's world grew smaller after her attack. She found it very difficult to be in crowds – "I felt very physically vulnerable, even in a crowded room" – and found herself unable to go to the doctor. "It reminded me of the forensic testing that you have to have after rape so I stopped going completely," she says. "I did not want to be touched again."
The pain and trauma of rape radically altered Amara's relationship to sex. "It makes you feel like you don't have freedom [over that] anymore. After rape, you have the knowledge that sex could be potentially used as a weapon against you."
Amara's experiences are echoed in the words of many rape survivors. The road to recovery after being raped – both psychological and physical – is paved with internal battles with body image, health and the ability to find true intimacy with anyone ever again. When it comes to having sex again, Amara says it's not just a question of "emotional trust" dissolving, it's "physical trust", too. Essentially, if your body has been damaged by sexual violence, it may not be able to respond to anyone's touch – however comfortable you feel with them – for a very long time.
Rape is far more widespread than many care to admit, or even know. Every year, 85,000 women in England and Wales are raped. 400,000 women are sexually assaulted. Perhaps most staggering, though, is that 90 percent of these rapes are committed by known men. In other words, somebody who the survivor has already been in contact with, trusted and perhaps even loved.
One in five women in Britain has experienced some form of sexual violence since the age of 16, but when you consider the vast numbers of rape survivors won't report the crime to the police – perhaps through the fear of not being taken seriously, that they might be in one of the police force areas that only takes one in three rape cases to court, that their attacker won't be justly prosecuted or that they'll be accused of "crying rape" – the reality is that the figures are probably higher than we'll ever know.
The road to recovery after being raped – both psychological and physical – is paved with internal battles with body image, health and the ability to find true intimacy with anyone ever again.
Despite the fact that hundreds of thousands of women are sexually abused, harassed, stalked and threatened in their homes and workplaces each year, so many of us continue to think of rape as something that happens to somebody else. In doing so, we continue to turn a blind eye to the indelible impact it has on survivors.
"This is to do with society's myth about rape," says Amara, "which is that, when it happens, you go through this legal process and then it's all over and you're just meant to get on with your life". This could not be more removed from reality. "It affects you for years – or even decades – afterwards but women are just expected to live with that".
Amara, who is now a student nurse, received counselling after she was raped, which helped when she was "in a really bad phase". But after the course of therapy ended, she had to "go back to doing normal things". To navigate day-to-day life with a heavy, frightening albatross on her shoulders. On the surface, her life had regained normality. But the relationship with her own body was still defined by fear. Left feeling lost and isolated, she went in search of communities or services that could help her with these feelings that wouldn't go away. Typing "rape, sex, body image, scared of doctor" into Google, she found nothing even remotely useful: "I found individual posts on threads of people feeling similar ways but nothing else."
It was then that Amara thought she ought to start something new. "I looked for support but it just wasn't there. I knew I'd have to take it on myself," she says. So, last August, she decided to take the leap and set up My Body Back, a project that helps survivors of sexual violence address any conflicts surrounding their sexuality, body image and healthcare, on their own terms.
Amara approached 30 other female rape victims across the country to ask how they felt and how their issues were being addressed. Very quickly, her own conflicts were echoed. "They not only said it affected their image of their body," she explains, "but lots of women also said, like me, that they didn't go to the doctors for cervical or STI testing because they didn't have control in those situations."
Many women also detailed how being raped had a dramatic impact on their experience of sex – or their ability to engage in it at all. "Some women were blacking out or vomiting after sex, while others had repeated flashbacks," says Amara. "And many women were unable to have orgasms at all. If you're tense, you obviously can't orgasm, because you can't let go."
Given that sexual organs are the weapons of violent assault, it seems a given that the future act of sex will trigger dark and difficult memories of rape for many. As a result, it may be difficult for the survivor to realise that consensual sex with a compassionate partner is different from the rape, when physically, many of the movements are the same. For this reason, masturbation can be a powerful way of reclaiming your body and sexuality after rape. As Amara explains: "In rape, someone forces you to sexually be whatever they want you to be. Masturbation is about taking ownership of all those things about yourself that rape takes away".
While in conversation with fellow rape survivors, Amara also noticed that the women kept referring to themselves as "freaks", "weird", or "abnormal" for feeling the way they did. "It was quite ironic because they were all experiencing the same thing yet none of them knew that others were," she says. "The question that kept going through my head was: 'why wasn't a service of this kind already here?'"
Many of the women Amara made contact with felt like they had been made to choose between their physical health and their mental health in their recovery. Most chose to preserve their mental health and, in turn, "avoided the doctor at all costs". The reality of this was that many women didn't have any kind of STI testing after an assault, presumably through fear of any further intrusion, but were battling daily, hourly, bouts of anxiety as they asked themselves: what if I do have HIV?
One woman even told Amara that she would "rather get cervical cancer than go for a smear test," because it's "like being raped again."
Some women were blacking out or vomiting after sex, while others had repeated flashbacks. Many women were unable to have orgasms at all.
There was one woman, Amara recalls, who even found the well-meaning dialogue of doctors and nurses upsetting, because they echoed the words of her rapist. "She was repeatedly told to "relax" while the nurse tried to insert the speculum during the smear test – something the rapist told her throughout the attack". In the end, she was unable to go through with the test, and has avoided them ever since. Amara mentions another women who opted for a caesarean because, even during labour, she couldn't deal with the flashbacks that came with being touched. Hearing this made my blood run cold.
It is precisely these painful, too often taboo issues that My Body Back hopes to address. And with the help of Rape Crisis volunteers, NHS doctors and nurses, and staff at Sh!, Britain's only female-focused sex shop, the organisation has flourished. In August, they are opening the first cervical screening and STI clinic designed exclusively for women who have experienced sexual violence at St Barts Hospital in Whitechapel, East London. The clinic will be the first of its kind in the world. "It's really sad that it wasn't there before," Amara reiterates. "And it just brings home for me how women are actually treated."
Even though most hospitals and GP practices in Britain come into close contact with rape survivors every single day of the week, there is still a lack of understanding about sexual violence and the nuanced ways in which survivors recover within the NHS. "Everyone I've spoken to in the NHS says, 'I've definitely had patients like this, we see them all the time, but we don't know what to do," explains Amara.
For too long a lack of government funding has meant the long-term psychological impacts of sexual violence have been neglected. The target-led structure and lack of funding in the NHS means doctors simply don't have the time to give rape survivors the support, patience and sympathy that they need during a screening, for example – a procedure that may seem simple to the tester, but wracked with profound mental and physical comfort for the person being tested. Yes, we have crisis services that deal with the immediate aftermath of rape, but longstanding support services are few and far between. In failing to give women the support they deserve, Amara believes, our health service may have hindered the healing process of many women.
This is something women deserve. After sexual assault, you've already been through enough.
All the above is precisely why initiatives like My Body Back are imperative. The clinic will be custom-built to the personal needs, concerns and preferences of survivors of sexual violence. It will offer an introductory session with an advisor, during which time patients can specify what body positions they're comfortable in and which phrases they do and don't want the clinician to use, which, as Amara explains, "enables them to really take control over something that's going to happen to them physically."
Women have control over even the finest of details at the clinic – everything from music is playing to which cushions and blankets are used. Aromatherapy was mentioned, too. More importantly, though, those who feel uncomfortable being examined will be provided with self-testing kits. Women's needs, Amara stresses, "come first."
"This is something which women deserve," she continues. "After sexual assault, you've already been through enough. You don't need to be worrying for ages about whether you've got an infection on top of everything else."
What Amara says sounds like crystal clear common sense. It makes you think: given how prevalent sexual assault is, how have we managed to get this far without such specialist services of this kind? How on earth can women be expected to try and recover after being raped if no one is offering the bespoke support, patience and care they really need? The experience of rape is not a universal. Every woman is different. Every woman will recover differently. But how do we know how to help each individual unless we ask?
This is precisely what makes My Body Back different, so urgently needed – a health centre that will ask women what works for them, not asking them to be malleable to the support framework that currently exists, or, more plainly, "get over" rape like you'd "get over" a broken bone. Because as Amara and so many other victims know, that's an impossible reality.
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