Inside Campus Sexual Assault Rights, Resources, and Response After Trauma

Hello, and I'm your host, Dr. Val DeCrowder, also known as Dr. V, Board Certified Emergency Room Physician committed to empowering you with life-changing health information. Our topic today is beyond the Cornell 7: sexual assault, legal obligations of schools, and your health options. I felt compelled to do this show for a number of reasons, and I want to share with you all why I wanted to do this show today. First of all, is over my career I've probably seen hundreds of sexual assault cases that actually come through the emergency department that I've been responsible for taking care of and doing forensic exams on. A lot of people don't realize, but when sexual assault cases are reported, they report to the police station, but they also uh report to the emergency department. And they will often be, if they go to the police department first, they will often be told to go to the emergency department first and then to actually come back to the police station. I also started the first sexual assault nurse examiner program in the state of New Jersey, which then got replicated throughout the state of New Jersey. And lastly, I am an alumni of Cornell University. And it pains me to see my university go through this, but I hope it comes out on the other end healthier and safer for students and faculty alike. Today I'm gonna also have joining us um a guest, Attorney Ellen Ardley. She is one of the top civil rights attorney in the country. She is the managing partner at uh Myrie and Scalett Law Firm, and she previously was the Assistant Vice Chancellor for Civil Rights and Title IX at University of Missouri. So let's get started. As a note, before we begin, today's show could be triggering. It includes frank discussion of sexual assault. And if you need to talk to someone right now, the National Sexual Assault Hotline is open. It is a 24-7 hotline, and the phone number is 1-800-656-4673, which stands for Hope. Now, as you may have seen on the news, uh a 20-year-old Cornell University student said she was pressured to take alcohol and also uh ketamine and then sexually assaulted by multiple men. Last month she filed a lawsuit against Cornell, the Chi the CHI FI fraternity, and seven of its current and former members. Um the men are now in public called the Cornell 7. All seven of these men deny wrongdoing, and as of today, no one has been criminally charged. Um I think what is also important is while I was putting this show together, there were two other cases that also actually have recently been reported in the news. Um, and that is a sexual assault case in the University of Chicago that involved two female friends who intervened while their friend was being sexually assaulted at a fraternity house. And there is also uh students at the Fashion Institute of Technology in New York. Uh two students there were sexually assaulted and drugged with fentanyl, and one ended up dead. So this is really, really an important topic. Um, these cases raise questions far beyond uh just what happens at one campus. Um and it, you know, I want to discuss today things like what does a school really owe a student who reports sexual assault and what happens uh in the hours afterwards. So if we first just talk about, you know, how does this actually, you know, what is the prevalence of this? The Association of American Universities um actually uh did a survey of 181,000 students and 33 schools. They found that 13 percent of all students experienced non-consensual sexual contact by force or while unable to consent since enrolling. For undergraduate women, it was one in four, and for men it was about seven percent. The highest risk is in the freshman year, with about sixteen percent of undergraduate women reporting that in their first year of college they experienced non conception non-consensual sexual assault. Among women who stay in college for four years, about one in three have this experience. Most students never report it to the school or to police. And the number one reason they cite is that they didn't really think that it was serious enough. 66 percent of students believe their school would take a report seriously, but among those who were assaulted, about 45 percent believe that if they reported it to their school, their school would not take their complaint seriously. So with this, I want to bring in uh our civil rights attorney, attorney El Ellen Eardley, to help understand, you know, what what what's happening out here on school campuses, what are some of the obligations of the school, what are the rights of the student? Um, and then after that, I'll take you a little bit into the emergency department and what occurs there. All right, Ellen, are you here on line one joining us?

Hi, Dr. Ree. Thanks so much for having me today.

Yeah, so tell us a little bit. Let's start off first with you know, what is Title IX and why do people talk about Title IX when sexual assaults occur on campus?

Sure, absolutely. I think a lot of people hear about Title IX and they think about girls and women in sport. Because for many years, uh after Title IX was passed in 1972, that was the way in which it had made the most difference, or at least one of the most visible differences for women and girls in education, and that was by elevating access to sport programs in federally funded educational programs. Um, but Title IX was in the background doing all sorts of other things after it was passed in 1972, giving women and girls better access to financial assistance, to graduate programs, to schools in general. And it's a really simple piece of legislation or law. It basically says that no women, no one, no person, um, and that's an important point, no person should be denied access to federally funded educational programs because of sex. Um so it's a really simple civil rights law that says sex discrimination shouldn't be occurring in university or school programs. And really, I would say over the last 20 years, there's been a lot more attention to obligations that schools have to prohibit sexual harassment. Um, and sexual assault is probably the most egregious, definitely the most egregious form of sexual harassment. And um so schools under Title IX generally have an obligation to um end and prevent sex discrimination on their campuses, and that includes sexual assault and rape.

So so so you you so Title IX even though we saw benefits in sports for women, it protects male students, female students, it it protects everyone on campus. Is that is that my under is that is that my understanding?

Yeah. Okay. Yeah, that's absolutely right. It's a it's a neutral law. It doesn't protect a particular gender. It says that there should not be sex discrimination. There shall not be sex discrimination in federally funded educational programs. And most uh schools and universities uh accept federal funds in some way. So that's why Title IX is just generally considered to apply to nearly all colleges, universities, and K-12 schools.

So can you talk a little bit about, you know, what what jumps out at you when you hear about these cases in the news? What what what actually, since this is really your area of expertise around protecting and making schools safer, what jumps out at you when you hear these cases?

Well, unfortunately, as you were sharing at the top of the show, um, what jumps out at me is that we live in a rape culture, unfortunately. And it's devastating for young women and girls. Uh it was my experience when I worked at the University of Missouri as a Title IX coordinator and was in touch with professionals who are Title IX coordinators across the country. That what we're really experiencing and continue to experience is an epidemic of sexual assault and sexual violence against women. And that's part of the broader societal uh acceptance of violence towards women, discrimination against women and girls. And uh I think we're really at a turning point again, an opportunity at least for a turning point again, to open up conversations with young boys, um, young children early on about respect, about um treating one another with care, about um speaking up when we see that something is wrong, um, and uh holding others accountable and talking to the folks on campus and the police who can support students when something like this happens. I think the one in four statistic for college-aged young women is probably pretty accurate, if not even under-reporting of uh sexual assault. We know that sexual assault tends to be under-reported because of the stigma. Um, and uh I guess the last thing I would say is that many people don't realize that as part of the implementing regulations of Title IX, each school is required to have a Title IX coordinator. And that person is responsible for coordinating all anti-sex discrimination efforts at the institution. And that means including ending and preventing uh sexual assault and rape across campus. And I would want any student who's stepping into a new college campus to know about the Title IX coordinator, to know the website for that school's Title IX coordinator, because that's going to be the place that will provide the most resources for reporting sexual assaults to the school, for getting in contact with the local police, for being in contact with a sexual assault advocate who can provide counseling services and maybe go with a student to an emergency department like yours.

So so let me ask you this. If I were taking like my child to different college campuses, you know, what sort of things should I look for to know that they ha they are doing well and at protecting their students or they're not doing well? Like how I guess I I'm this is not, you know, usually when we actually look at colleges, we're trying to decide, you know, do we want to go to an HBCU? Do they have our major? Do they not have our major? Do we not want to go to an HBCU? Where is the campus? In the city, out of the city? Um there's all sorts of things that people consider, but I don't think this is something that's really on people's radar when they actually begin to look at choosing a school. What sort of things would um what sort of things did you find from your work at University of Missouri that really made a difference positively in a school environment and keeping it safe for all of the students?

Well, first they'd want to know what the prevention efforts are of that particular institution and how uh the school is engaging students, faculty, staff in those prevention measures. Um and what I believe, and I think a lot of uh professionals in this area, including doctors, is that we have to really get to the root cause of sexual assault to prevent it. And that means talking early and often about sex, about uh desire, about respect, about what our boundaries are. So there are there are many really excellent programs that schools can offer in terms of education, peer-to-peer education, or um education from uh a trained facilitator in either um interrupting bystander uh behavior, engaging in active bystander um uh actions to stop sexual assault if you think it's happening or could could be um coming down the pike. Um and then also uh creating a culture of respect for women and other people on the college campus. Um there are a lot of programs that uh both fraternities and sororities can um have hosted on campuses across the country to really emphasize the importance of creating this culture. Um and then there's some promising research about um a program called Flip the Script or EAA, which really um talks about empowering young women to think about what their um sexual desires are, what their limits are, what their boundaries are, and how to speak up um for themselves in situations where um societally and culturally we may have told women that they shouldn't um be speaking at all. And I want to be clear when I'm talking about this program that it's not something that I'm saying is uh ever a survivor's fault. But we do want to make sure that our schools and our our communities are empowering young women with the information they need to make decisions that are best and healthiest for them.

Well, Ellen, I want to thank you for uh joining for joining us today. Um you you really provided us sort of some things to think about that I think that a lot of students and parents may not necessarily think about when their children go off to um college. I agree with you um that we really have a a rape culture in the in the United States where we've actually really had little accountability. I tell people all the time, just look at the look at the Epstein files. There's many people in there that could be charged and have not been charged. I mean, it'd be great if we got the rest of the file, but even with what we have, we haven't really done that much. I want to thank you for joining us today, Ellen. Thank you very much. Thank you so much. And speaking about the about the culture of a a university, I want to actually just share with you guys a letter that over 200 faculty wrote as a letter to the Cornell students. And I'm not gonna read the entire letter, I'm just gonna read a couple of paragraphs. And it says, Over the past two weeks, we have been reckoning with the university's failure to prioritize our your safety and well-being. We are outraged at the horrific events that transpired at the fraternity house by systems that failed Jane Doe at every level, by the wider culture of sexual assault plaguing our campus, and by the structural violence that allows it to continue with impunity. We are incensed by the administrative's active and ongoing role in fostering that culture, concealing its working and protecting its perpetrators. At the same time, we apologize for not doing enough as faculty to hear you and create spaces where you feel safe and share your experiences or to intervene in existing campus structures. By structural violence, we mean that this incident is not a one-off problem, but rather an indicative but rather indicative of an epidemic at Cornell. In the long term, we commit to foster collective spaces for conversation and dialogue at every level of university life. We commit to collaborating with student organizations on a vision for structural change and to work with ensuring those changes occur. We commit to educating ourselves and our faculty about university procedures, campus and community resources, support and advocacy organizations that are independent of Cornell. We also commit to engaging all possible avenues of faculty governance to make Cornell safer, including through reforms of the Title IX process, which Ellen just referred to, campus discipline and Greek life. Cornell University is not a single entity, it is a community of students, faculty, and staff gathered from around the world. As a collective, we can work to reclaim our voice and use it to challenge and change what is wrong with our institution. We are proud of Jane Doe for being immensely brave and the student journalist who helped bring her story to public life with the courageous expose Cornell Won't, we will. So when patients come in with uh sexual assault, it is really, really important that they actually come to the emergency department as soon as possible. And I can't r overemphasize that. Um there are a lot of things that we do in the emergency department that are really time dependent. And that's how come when they when people go to the police, they'll often be sent to the emergency department and then go back to the police after they're at the in the emergency department. So when sexual assault cases come into the emergency department, medical safety is first. We're obviously checking for injuries, any sort of trauma, strangulation, or any sort of things that may have occurred, any sort of uh impact from drugs or alcohol. Um there is usually a private room that uh the patient is given and with an advocate. So several nurses, as I uh several hospitals uh have a sexual assault nurse examiner that may be called in, and this is available 24-7. I know at my hospital. Um they can also have a family advocate that can come in. It's really important that the patient realizes they are in control, right? We we get consent for every step along the way, and they can say yes, they want certain things done, and they can say no, they don't want other things done. And so it they really it is up to the patient to what extent a full forensic exam is done, uh testing, as well as any treatment. Usually uh after that, then we actually refer them uh to the police. So let me actually talk about the whole gamut of what is offered. So there are several things. We start off and we uh can do uh HIV, hepatitis B, hepatitis C, syphilis, gonorrhea, chlamydia, and pregnancy testing. One of the things that is really important is um HIV prevention. Ideally, if a patient comes in in the first 24 hours, uh, but certainly even if they come in with the within the three or four days after an incident, um, we can actually put them on Bictarvi. And Bictarvi is a medication that then prevents the transmission of HIV as it as it relates to a sexual assault. We have patients take Bactarvi uh for 28 days. I have actually seen patients who have been are are in hum are in human trafficking situations. Um in some situations, we will have those patients on Bictarvi uh for longer than 28 days because they may be repeatedly being sexually assaulted. Um we also do treatment for uh sexually transmitted diseases. Um that's usually we usually give an injection of a medication called ROSEFIN for uh gonorrhea, as well as give patients a week of uh doxycycline, which is also an antibiotic that treats for chlamydia. We also give them flagell, which treats for trichomonas. There is also emergency contraception. So we ask the patient do they want emergency contraception? Um and this is a series of hormonal pills that actually prevents the implantation. of an embryo or pregnancy as a result of the sexual assault. We also do toxicology testing. So in some situations, the women are concerned that they may uh have been drugged, women or men. And again, I see when I see I say women sometimes, but sexual assault occurs with women or men. So we sometimes have patients that are concerned that they were drugged. And we then can also do urine and blood toxicology testing. I know in the in the Cornell 7 case there was a concern for not only alcohol but also ketamine use. And I've had a lot of people ask questions, you know, when they're referring to K, what are they referring to? Because there's text messages where they're going back and forth and talking about when they snorted K. So K is ketamine and ketamine is a really powerful anesthetic. We actually use it in the emergency department, not in a powder format, but in an IV format and I've used it quite frequently and we use it if we're trying to do a procedure on a patient where we need them to sort of lay still and not experience any pain and but they're not the the the injury is not significant enough to go to the operating room. So examples of that would be a hip dislocation that I might put back into place, a shoulder dislocation that we might put back in place. Those things are done in the emergency department and we use um we use ketamine. Ketamine in a powder format is is a street drug and it actually you know causes confusion, dizziness, loss of coordination, feeling very detached from your body mixed with alcohol it can slow breathing and cause vomiting and choking. So ketamine you'll also hear about ketamine because it is being used for depression and PTSD. And again those are the medically medically necessally necessitated usage of ketamine. So I think that you know you'll see in some of these cases in a lot of these cases there are concerns for alcohol or drug use or drugging of some sort. Now if you actually look at you know the different types of sexual assault and rape there's a lot of different laws that vary from state to state there are different terminologies that people use but I just want to just go into a couple of them. Some people will actually make the distinction of a stranger rape which is someone that the survivor did not know. You may hear some people talk about acquaintance or date rape which is someone that they knew a classmate a friend or a date. You will also hear of people talking about rape occurring during a marriage right um so a lot of people uh used to think that you know you can't rape your wife but that's actually not true. And so you'll actually hear of some people actually talk about even rape within a marriage. There's drug or alcohol facilitated rapes there's gang rape and things where there's multiple perpetrators and there is statutory rape. And statutory rape is where there is a sexual assault with someone that is less than the age of consent. So in statutory rape you know usually one person is below whatever that age of consent is and the age of consent varies by state and someone having uh sex with someone that is below that age is considered rape even if they have agreed to it because there is a general premise that if you are under the age of consent that you are not able to consent. That's kind of like all of the all of the the terminologies that you will actually hear with this. I think one of the the the things that's most important is that you know if this occurs to you or a friend that you actually report this go to the police go to the emergency department first and then go to the police department and also you know look at a lot of the sexual assault resources that are available. There is a RAIN National Sexual assault hotline which is 1-800-656 HOPE which is 1-800-656-4673 you can also text HOPE to 64673 you want to make sure you know your Title IX organization if you are on campus. And then the U.S. Department of Education has an Office of Civil Rights so I wanted to I know this was a difficult topic today and I wanted to make sure we kind of went through what all of this sort of looks like I want to thank you guys for joining us today and stay healthy out there