Written by Victoria Donkin, She Matters

The study conducted a national quantitative environmental scan between May and December of 2020. Researchers contacted more than seven hundred hospitals and health centres by telephone, asking each facility whether they had SAEKs on site and whether a forensic exam could be performed by trained personnel. Of the institutions reached, 581 confirmed that they could provide emergency medical services relevant to sexual assault care. However, of the 581 centres that stated they provide sexual assault care, approximately forty-one percent of these facilities reported that they did not have kits presently available, relied on police to transport kits from elsewhere, or could not confirm the presence of staff qualified to conduct examinations. Many institutions that did possess kits lacked any personnel trained to use them. Others were unable to state confidently whether kits were stored on site, reflecting significant gaps in institutional awareness and preparedness. These findings demonstrated that the barriers survivors face are not solely geographic or resource-based, but also deeply rooted in organizational knowledge and operational capacity.

What this study ultimately uncovered was widespread structural instability across the country. Several institutions acknowledged having the necessary materials, such as SAEKs on site, but lacked the secure storage conditions, such as lockable refrigeration, needed to ensure evidence integrity, while others had SAEKs but no staff trained to administer them. Compounding these logistical issues is the absence of mandatory SAEK training in Canadian medical and nursing programs, resulting in a chronic national shortage of clinicians capable of performing forensic examinations. These findings illustrated a landscape where even basic elements of forensic preparedness were inconsistent: hospitals frequently lacked clear protocols governing the storage, access, and administration of kits, and many had no reliable mechanisms for ensuring that forensic services were consistently available. Centres were also often unaware of regional alternatives or broader service networks, further highlighting how fragmented and unpredictable the system had become.

The study underscored that nationally, access to forensic evidence collection depended largely on chance: whether a particular staff member was on shift, whether a kit had been replenished, or whether a hospital operator happened to know where services might exist. By quantifying these gaps for the first time, the study established a crucial empirical foundation for understanding how inconsistencies in Canada’s forensic infrastructure directly shape survivors’ ability to seek justice; and how those structural deficiencies fall most heavily on survivors living outside major city centres.

The urban–rural divide is striking: while large hospitals in metropolitan areas often have dedicated forensic programs or 24-hour teams– albeit with long wait times and other inequities– many rural and remote communities have no services at all. Survivors in these regions regularly undertake long, physically and emotionally taxing journeys to access care. Forensic examinations typically last between three and four hours, and wait times in emergency departments can stretch well beyond eight hours. Some survivors have reported travelling great distances only to be turned away due to insufficient staffing or the absence of trained examiners. The time-sensitive nature of biological evidence means that delays of this kind can irreversibly limit the evidentiary options available to survivors.

These systemic inequities were further explored in She Matters’ qualitative study, Does Geography Impact Access to Justice? (2025), which examined the experiences of sixty-two survivors, service providers, and community advocates in Northern Ontario, Northern British Columbia, and Yukon. Using Indigenous Storywork and Indigenous Focusing-Oriented Therapy as guiding methodologies, the study foregrounded the lived realities of navigating the forensic landscape in geographically isolated regions. Participants consistently described forensic care as inaccessible, unpredictable, and deeply shaped by systemic forms of discrimination.

For many survivors, the decision to seek a forensic exam entailed weighing the likelihood of re-traumatization against the uncertain possibility of accessing trained staff. Travel to urban centres was arduous and sometimes dangerous. Survivors recounted waiting in emergency departments for hours while in acute distress, unsure whether a forensic exam would ultimately be available. Others described being told upon arrival that the only trained nurse was off-shift or unavailable, forcing them to return home without an exam despite having travelled significant distances.

Participants also reported interactions with healthcare providers and law enforcement that were marked by stigma, victim-blaming, or disbelief. These experiences were particularly acute among Indigenous survivors, who described instances of racism that further diminished trust in healthcare and legal institutions. Survivors also noted being treated as responsible for their assault, spoken to dismissively, or regarded as burdens to the system. Such encounters significantly influenced whether they felt safe pursuing evidence collection and shaped their broader relationship to the justice system. The lack of forensic suites in rural facilities amplified these issues. Without private, dedicated spaces, survivors were often required to wait in general emergency departments, environments that can be overwhelming, unsafe, and re-traumatizing. Underfunding, staffing shortages, and the low prioritization of forensic programs contributed to these long wait times and inconsistent service availability. These conditions, taken together, demonstrated a forensic system that fails to meet survivors where they are and, in many cases, fails to meet them at all.

This gap in care has prompted growing interest in alternative, complementary approaches to preserving forensic evidence. One such approach is forensic DNA self-collection, which has been implemented in various forms internationally. In jurisdictions such as Australia and the United Kingdom, “early evidence kits” allow survivors to self collect time-sensitive swabs or clothing samples with guidance from trained personnel. These kits serve to preserve biological evidence in the hours immediately following an assault, particularly in contexts where full exams are not immediately accessible. These models reflect an understanding that evidence preservation and survivor autonomy are not mutually exclusive, and that traditional, clinic-centered models of care may not adequately serve survivors in geographically dispersed populations.

This recognition underpins our federally funded study, Bridging the Gap: Exploring Forensic Evidence Self-Collection for Survivors of Sexualized Violence in Rural Communities. We seek to determine whether self-collection is feasible, appropriate, and responsive to the realities of Canadian legal and health-care infrastructure.

In our proposed model, self-collection would occur within community organizations that survivors already access for safety, health, or cultural support; for example, friendship centres, community health centres, women’s shelters, and similar agencies. These settings would provide survivors with the necessary collection materials, detailed procedural instructions, and assistance from trained support personnel who would be equipped to guide the survivor through the process. Upon completion, the evidence would be stored securely using standardized sealing procedures and transferred directly to police, ensuring that continuity and evidentiary integrity are maintained throughout the process.

The research aims to bring together survivors, legal experts, forensic scientists, law enforcement, healthcare professionals, and community advocates to examine how a self-collection model could be integrated into existing forensic, legal, and clinical systems, and to determine the safeguards necessary for its ethical and evidentiary viability. This work involves assessing the core components of a self-collection protocol, including what forms of evidence should be collected, such as swabs, wipes, and/or urine samples; what step-by-step procedures are required to support accuracy and consistency; and how evidence should be stored and sealed to ensure tamper-evident protection. The study also seeks to identify mechanisms for documenting chain of custody when survivors perform the initial collection, as well as the processes through which evidence can be transferred securely to police or held in safe storage until a survivor chooses to report. Underpinning all of these considerations is an examination of how self-collection can be embedded within trauma-informed, culturally grounded models of care that honour survivor autonomy while meeting forensic standards.

However, the idea of self-collection being explored in the Canadian context has raised legal concerns from the public regarding the admissibility of self-collected evidence. Yet, Canadian jurisprudence provides a substantive foundation for its potential viability. Courts have repeatedly held that evidence collected outside clinical or forensic settings may be admissible if continuity, credibility, and reliability can be demonstrated. In R v Bero (2000), the Ontario Court of Appeal admitted evidence despite gaps in documentation, finding that the continuity of the exhibit was sufficiently explained. In R v Wuol (2012), underwear collected by the survivor herself, later provided to police, was deemed admissible and used in DNA analysis. R v Burman (2015) similarly affirmed that a discarded condom discovered and identified by the survivor could be introduced into evidence when proper continuity was established.

Collectively, these cases demonstrate that Canadian courts are primarily concerned with the integrity, continuity, and credibility of evidence, not with whether a medical professional conducted the collection of evidence. This jurisprudence suggests that forensic self-collection, if accompanied by clear protocols, tamper-proof sealing, and chain-of-custody documentation, could be integrated into the Canadian legal landscape without undermining evidentiary standards. The question, therefore, is not whether courts have accepted survivor-collected evidence, but whether institutions possess the willingness to implement and sustain an approach that represents a departure from traditional practice.

As Canada continues to confront the profound and systemic gaps in its forensic response to sexualized violence, it is essential to consider models that acknowledge the diversity of survivor experiences, geographies, and needs. Forensic self-collection represents one possible path forward; one grounded in legal precedent, supported by international practice, and responsive to the inequities documented in rural, remote and northern communities. While our research will determine the feasibility of implementation, the existing evidence suggests that self-collection may serve as a promising complement to traditional forensic care. In a country where timely access to evidence collection is far from guaranteed, expanding the range of options available to survivors is not merely an innovation; it is an imperative.