This week on 51%, we bring you the first part of a two-part series on rape and sexual abuse. Host Jackie Orchard visits the crime victim services unit of a hospital to learn about what’s involved in a forensic rape exam. And a counselor tells us what recovery looks like after an abuse.

A warning that today’s program contains details and subject matter than may not be appropriate for all listeners. We’re going to be discussing sexual assault for the next half hour.

Grace Coons is the supervisor of the forensic examiner program in the Crime Victim Services Unit at St. Peter’s Health Partners. Standing in the emergency department at Samaritan Hospital in Troy, New York, she opens a rape kit to show me the envelopes and instructions inside.

I have to say, imagining going through the steps as if I were the patient – a genital swab, photos of bruising, DNA samples, and recounting the story for the advocate or the nurse to hear – it seems overwhelming. But Coons has a very confident air about her. Like a mom you would call late at night if you were in trouble – and she would swoop in and make it all OK.

For good reason. Coons has been an examiner for about four years and has seen hundreds of patients for varying types of abuse. Coons is a nurse practitioner and manages about 38 per diem nurses. They take varying shifts to administer forensic examinations for victims of rape and abuse. And the amount of abuse patients they see is… upsetting.

“This year, we're actually averaging approximately 40 per month,” Coons said. “Last year total, our program saw 280 patients. So far, at the close of May, our program was at 215. So we're almost double the volume of last year, just with this year.”

Coons says it’s nearly impossible to identify trends of who gets raped or abused.

“There is no set demographic,” Coons said. “It can happen to male, female, transgender, all ages, we see basically from infant all the way to elderly folks in their 80s. So there's a very wide range of our patient population. So it's not a specific demographic, or race or anything like that.”

Coons says they see patients for all types of abuse, not just sexual. Usually children come in because of a domestic violence incident.

“We could see them for a physical assault, we could also see them for a sexual assault exam,” Coons said. “So it might be something that is either known and so we are collecting evidence for a known sexual assault, or something that is presumed or that there's a hunch, you know, that something just doesn't seem right. Maybe somebody heard something or, you know, their genitalia has suspicious redness, you know, when an unusual bruise… or a child just not acting right and the parent or guardian wants the child checked out. Sometimes we can also see pediatric patients because of CPS involvement and CPS is requesting the exam.

Coons says her department is trying to set standards for domestic violence patients across the state, hoping New York will develop a set evidence collection kit for domestic violence examinations.

“In New York State, there is a set kit which would be used for any sexual assault patient throughout the state,” Coons said. “So if you were seeing here or Buffalo, you know, anywhere from corner to corner of the state, then you would have the exact same evidence kit collected for you. But those standards don't exist for domestic violence patients. There's also not a reimbursement process for domestic violence patients. So that would have to go through that individual's insurance at this point, whereas someone who were sexually assaulted, can have their services, free of charge in your state would pay for that. So we're looking to kind of set some standards and best practice protocols for New York State.”

Coons says Crime Victim Services also sees patients who are victims of general physical assault, human trafficking, abuse, neglect, and elder abuse. But most patients are sexual assaul