The Geopolitics of “Rape Kit” Protocols

Abstract

This article contributes to historiographies of forensic medicine by examining late twentieth-century women’s rights activism for new clinical standards on medical forensic exams for sexual assault (commonly known as “rape kits”). I argue that three features of these exams distinguish new standards of care from older practices in forensic medicine: the addition of specialized medical care to evidence-collection routines; attention to psychological trauma; and the creation of specific protocols to standardize, professionalize, and guide routine administration of the exam. To illustrate this shift, I follow “rape kit” protocols that emerged within nursing in the United States beginning in the 1970s, to their uptake and codification in international guidelines, to more recent attempts to adapt them for use in conflict zones. New clinical guidelines transformed the “rape kit” into an assemblage of instruments, medical routines, and new ways of thinking about sexual assault. The rape kit assemblage simultaneously became a traveling technology of care and a technology of governance and law. In practice, however, as new standards were implemented more widely, tensions between medical care and evidence collection emerged. At the intersection of law and medicine, distinct logics and assumptions came together, positioning not only medical and legal professionals, but also patients, in the unenviable liminal zone in which care and justice met and produced friction. This comes across clearly from an analysis of their use in the eastern region of the Democratic Republic of Congo, where mass rape had taken place. In this context, political turmoil and war conditioned the delivery of health care and, by extension, the liminal zone between medicine and law that standards for post-rape care occupy. Investigations of mass rape threatened to contravene confidentiality of medical records and expose health workers and patients to retaliation from suspects, renewing controversies surrounding the feasibility of aligning the institutional logics of medicine and law in this way.