For what it is worth, random information re a rape kit, in general not specific to this case …
Some medical staff who do rape and other such exams will not do it if they believe it will cause (or even is causing) more trauma.
The exam can be painful. It can be triggering.
A full exam includes evidence collection procedures for the victim’s entire body. Meaning disrobing and standing on a large piece of paper while being photographed and touched by people you’ve never met before. To capture bruises, fibers, dirt, leaves, etc. evidence. It’s not quick. (Exam-givers do have the option to limit the exam.)
The victim did not ask to be in this situation. At the time of the rape their control of their own body was taken away. And now because their body was invaded once, they must allow another intrusion? Possibly by a stranger if their own doctor is not available timely? Sometimes the victim can feel emotionally as if they are still not in control of what is happening to them. Some say that physically/emotionally it feels as if they are being raped again.
In some jurisdictions, exams are performed by mandatory reporters who are required by law to notify law enforcement. The exam triggers an investigation including police interviews of the victim, which can be re-traumatizing. Investigation procedures will reveal the events to certain family and friends. It has to be assumed that some will not resist the impulse to gossip.
I can only imagine the emotions of a 14 year old whose horse-oriented social milieu will be turned upside down if/when this information gets out, which it will if the exam triggers mandatory reporting. She has to decide now. She can’t take a few days to process it. She never dreamed she would be in this situation. She is completely unprepared for the aftermath of this deeply traumatizing situation. She has to be feeling that if this gets out, her normal life will be over. Her friends will want to ask questions she isn’t comfortable discussing. The horse people will know. The horse kids will take sides, with her or with BE. She may be convinced that she will never again feel comfortable in the barn or around horse people. And her school friends are likely to know as well.
What I imagine: Her frantic parents on the phone to a few closest friends and family, maybe to the rape crisis center, maybe an anonymous call to LE, asking for their experience and their advice. Wanting to understand the ramifications before they make a critical phone call or ER visit that will trigger a new set of events, after which there is no going back. The parents and their daughter learning for the first time about what a rape kit entails, and maybe about mandatory reporting and investigations. Maybe hearing from friends who they know are rape victims themselves to learn about their feelings and their advice.
I don’t know why so many people think that crime victims go through this orderly step-by-step law enforcement process as they have seen on tv. Real life is not like that, at all.
The article linked below discusses some pros & cons of performing a rape kit.
If, like the majority of survivors, this patient chooses not to report her assault, performing the exam might be a second non-consensual invasion of her body, as well as an unnecessary collection of evidence. This runs counter to the dictate “do no harm.”
The primary reason not to conduct the exam is the value of autonomy (right to self-determination), which means patients must consent to receiving medical care.
https://emoryhealthdigest.emory.edu/issues/2018/spring/medical_ethicist/to-test-not-to-test/index.html