Policy Gaps in Sexual Assault Medical Forensic Care: A 50-State and Territory Review of Health Care Provider and...

To assess jurisdictional policies specifying: (a) which health care professionals are authorized to perform postsexual assault medical forensic exams (MFE); (b) whether specialty training is required; (c) restrictions on patient transfer when lacking sexual assault nurse examiner (SANE) or specialized response; and (d) whether telehealth to increase access is addressed.

Reviewers conducted a systematic search of regulatory language related to MFEs across all U.S. jurisdictions between August 2023 and October 2024.

Nearly half (45%) of U.S. jurisdictions do not legislate or regulate the type of provider who may perform a MFE. Of those that do, only eight (14%) identify SANE among authorized providers.

This policy review reveals inconsistencies across U.S. jurisdictions regarding provider authorization, training requirements, and access to MFEs. Without regulation, survivors face inequitable access to care nationwide, underscoring the need for strengthened state-level policies that standardize access and establish funding for consistent care standards.