Content warning: this article discusses sexual violence and abuse to the extent of figures and survivor experiences of healthcare environments.

I have experienced or witnessed something traumatic


The #CheckWithMeFirst campaign first and foremost is about survivors of sexual violence and abuse and aims to improve accessibility and experiences of survivors in healthcare. This is because - although they are more likely to experience physical health conditions such as lung disease, arthritis, chronic pain, risk of cancer and heart disease - many survivors struggle to attend medical appointments, with some avoiding them all together due to their trauma.

Essential procedures such as cervical smears, mammograms and prostate checks can all be extremely triggering for someone who has experienced sexual abuse, rape or assault. Many people who have survived sexual violence or abuse develop post-traumatic stress disorder (PTSD) with some developing a variation of this called Complex-PTSD.

A key symptom in both of these trauma disorders is avoidant behaviour, or avoiding places and activities that might trigger a flashback. For many, the experience of being at a doctor’s surgery, a dentists, or the hospital can resurface feelings and images from the abuse, rape or assault they experienced.

As such, Survivors Trust have identified an important opportunity to ensure survivors are being considered when NHS professionals are being trained. This week, Survivors Trust are inviting London-based NHS professionals who work directly with service users (both within and outside of mental health services) to become ‘#CheckWithMeFirst Champions’ when they attend a free, CPD-accredited online workshop, as well as being able to access an online suite of resources, tips and exercises.

The workshop will help to raise awareness of the challenges faced by survivors of sexual violence and abuse when accessing healthcare, with a focus on ‘small actions’ that healthcare professionals can take to improve the experiences of survivors.

Why #CheckWithMeFirst?

‘One in six people across the UK will experience rape, sexual abuse, or sexual assault in their lifetime.’

How we discuss sexual violence and abuse, especially rape and child sexual abuse (CSA), has improved vastly over the past 10 years. As a society we have made some important improvements in how we discuss victims and the language we use when discussing these topics.

However, it is still a common misconception that experiences of sexual violence and abuse are uncommon. In reality, it is sadly very common. The Office of National Statistics reported that the Crime Survey for England and Wales in 2020, estimate 3.1 million people have experienced sexual abuse before the age of 16.

The same survey also found that abuse was most likely to have been perpetrated by a friend or acquaintance.

With this understanding, that sexual violence and abuse is actually a fairly common human experience, it is important to understand how many people this might prevent from accessing healthcare when they need to.

Elements to healthcare appointments such as invasion of personal space, intimate examinations, feeling out of control, a perceived power dynamic between healthcare professional and service-user, clinical or directive language and even smells might all trigger feelings associated with trauma, or be particularly distressing and anxiety inducing.

Simple adjustments in how healthcare professionals speak to, behave and carry out their procedures can relieve a lot of anxiety and distress for survivors.

On the Survivors Trust campaign website page, they set out key campaign goals:

  • 'To build understanding of how the experience of rape or sexual assault affects how someone accesses or disengages from healthcare services.'
  • 'To give NHS professionals in London the tools and confidence to provide a trauma-informed, empowering approach to provision of care, regardless of whether or not someone has disclosed sexual assault.'
  • 'To empower survivors and let them know that they can take control of their healthcare without having to disclose sexual assault experiences if they choose not to.'
  • 'To build confidence for NHS professionals in responding effectively and sensitively if a person under their care discloses sexual assault to them.'

One simple change Survivors Trust highlight as being essential in this training and learning is to be clear with patients around what the procedure is, what will happen, each step and also to ask for consent during every step of the procedure.

The campaign name, #CheckWithMeFirst comes from this central principle. Putting the survivor in the drivers seat, so to speak, to be able to say yes or no and to give them all the information about the procedure before it starts, giving them the opportunity to raise elements they might be anxious about etc. will make these procedures feel all the more accessible to survivors.

Why is this change so important?

The impact of trauma, especially sexual trauma, is wide reaching. In fact, research on the impact of sexual trauma on neural pathways and structures and on the immune system, has increasingly found that survivors of CSA are three times more likely to develop serious physiological diseases such as lung disease, as well as eight times more likely to develop cancer. While survivors of rape, abuse and sexual assault are more likely to suffer from PTSD or CPTSD than the average person.

It is essential that survivors experiencing difficulties with their physical and mental health feel more able to access support, treatment, and essential procedures.

The phrase ‘trauma informed’ has become widely discussed over the past two years, with the Covid-19 pandemic shining a light on how many of us, either directly or indirectly, have been negatively impacted by the pandemic.

There are few other topics of discussion where this has become so pertinent. Being trauma informed, in the ways that Survivors Trust outlined, especially when offering clinical examinations and procedures, is essential in ensuring all survivors and all people feel comfortable seeking help when it is most necessary.

Fay Maxted, OBE and Chief Executive of The Survivors Trust has said:

“Many survivors choose to avoid health treatments and appointments because they are afraid of being examined. Trauma reactions such as flashbacks and panic attacks can turn even simple appointments into a nightmare experience for someone who has been sexually violated. We know from our workshops that NHS practitioners are often surprised at how seemingly small changes can make a world of difference in how victims of sexual violence experience healthcare. We want our #CheckWithMeFirst campaign to promote fear-free access to healthcare for survivors and at the same time encourage a supportive trauma-informed work environment for NHS staff.”

To find out more about the #CheckWithMeFirst campaign you can read the Survivors Trust’s full dedicated page here, as well as signing up to Thursday the 10th of February’s online workshop if you are a London-based NHS professional here.

If this article has impacted you and you need some support, Survivors Trust have a FREE helpline you can contact at certain times between Monday and Sunday. Call them on: 08088 010818 and find out more about their helpline here.