"When I was raped it totally changed my life. I thought that in a year’s time I would be better. I thought that it was a time-limited thing and that there would come a point when I would somehow magically forget it. But that didn’t happen."
Pavan Amara was raped when she was in her late teens. Although counselling and support groups helped her deal with her emotions in the immediate aftermath, in the years to come the experience affected her in ways she never could have imagined.
Amara, now 28, found it difficult to go to her GP in her early twenties and almost impossible to endure a smear test when she hit 25. Her sex life became unrecognisable to what it had been before she was raped, but she couldn’t find anyone offering the practical advice she needed.
So Amara, who is a nurse, set up My Body Back (MBB) - a London-based organisation to help women reclaim their bodies after sexual assault, both in terms of their sexual relationships and their healthcare.
Before the attack, Amara says she felt "quite carefree about sex", but afterwards she felt vulnerable.
"I felt like someone had taken me from my own body and put me in another one, because everything felt so different," she says.
"It really affected things to the point where even if a friend of mine would touch me on the arm it would make me flinch."
Fast forward a few years and thanks to the "brilliant" counselling provided by North London Rape Crisis and the relentless support of her friends, Amara felt emotionally ready to have sex again, so she decided to go back on contraception. She hadn’t reacted well to taking the pill in the past, so her nurse recommended she have the coil fitted instead. However, the invasive nature of the coil-fitting procedure proved extremely traumatic.
"I found the procedure really triggering. I did tell the doctor what had happened and although he was very, very nice, there was no specialised training that he’d had," Amara says.
"I felt cheated in a way. The fact that I had been raped in the past - somebody else’s action - was putting me at risk of becoming pregnant. I felt like I was losing control over my body again, but in a very subtle way that I don’t think many people think about."
It wasn’t the first time Amara had felt unable to access the healthcare she knew she was entitled to.
For years she avoided going to her GP because the clinical nature of the doctor’s surgery reminded her of the forensic testing she went through after she was raped. She also found the doctor-patient power dynamic difficult to deal with.
At 25, she knew she should go and have a smear test. Despite building up a relationship with the nurse and booking a double appointment, the visit gave Amara more unwelcome flashbacks.
When she got home, she looked for support online and googled phrases such as "smear test after rape", "sex after rape" and "doctors after rape". While she couldn’t find the advice she needed, she did find forums of women talking about these issues.
Amara started commenting on the threads and contacting women through social media. She arranged to interview 32 women about their experiences because she thought it would help her better understand her own feelings.
Little did she know these interviews would turn her life around.
In 2015, around ten years after her rape ordeal, Amara launched MBB, which is made up of two main components: Café V, which offers women tips for enjoying sex after rape, and the MBB clinic, a specialist centre offering cervical screening, contraception and STI testing to women who have been sexually assaulted.
Many of the 32 women Amara interviewed told her they also avoided going to their GP, particularly if they hadn’t chosen to report the rape, as they feared being "found out".
Each of them also said they’d had difficulty relating to sex after rape. Some feared penetration while others couldn’t reach orgasm because they "felt guilty about enjoying sex again".
Worst of all, these women felt there was no one offering practical solutions to these problems.
"It’s almost like we’ve only just started talking about female sexuality anyway and we’ve only just starting talking about rape, so if you combine both people really don’t want to listen," she says.
There was one woman in particular who made Amara realise she wanted to set up an organisation to help.
"This woman estimated that she’d slept with over 100 people in the three years since she’d been raped. She’d actually lost count," Amara says.
"She was on the pill but apart from that she didn’t use any contraception so she was at risk of STIs.
"She was trying so desperately to reclaim her body again after being raped and that was the way she felt she was doing it. I just thought there should be so much more for her out there."
In March 2015, Amara held the first Café V at a sex shop called Sh! in Hoxton Square, London.
During the monthly sessions, the shop closes its doors to regular customers and sex experts come in to offer practical tips for women who have experienced sexual assault.
The sessions cover everything, from tips on masturbation after rape to how to enjoy BDSM if you’ve experienced sexual assault.
"It’s a really happy atmosphere and it’s fun. What I didn't want it to be was depressing, I wanted it to be a bit like a party," Amara says.
The sessions are catered to all women, regardless of their sexuality or gender identity, and are very much led by the attendees - women can email questions they’d like the experts to answer ahead of sessions.
"We’re currently putting together a feminist porn list which is something the women said they wanted," Amara adds.
"A lot of aspects of mainstream porn, if you choose to watch it or read it, can be very triggering. The document will have a list of films, websites and books, what it’s about and any potential triggers."
Since its launch, around 300 women have attended Café V with some travelling from as far as Ireland to attend sessions. Around 40 women attended the first session and the small shop was very overcrowded, so women wishing to attend now have to book a place in advance. Amara closes booking after 15 people have signed up and the remaining women get put on a waiting list.
Last October, a few months after launching Café V, Amara opened the MBB clinic with a team of female staff in an unused area of St Bartholomew's Hospital.
The clinic offers cervical screening, STI testing, and contraception advice and fitting. Because the clinic is only available to women who have experienced sexual assault, the patients don’t have to go through the trauma of explaining themselves to a doctor who may not know that they have been raped, meaning an element of pressure is automatically eliminated.
At the start of the appointments the women have a consultation where they discuss what they don’t want to happen during the procedure.
"Lots of it is talking about triggers and phrases they don’t want to be used. One woman said that doctors in the past had told her to ‘relax’, but 'just relax' was the phrase her rapist had used," Amara explains.
Women also have the chance to talk about any parts of their body they don’t want to be touched, any positions they don’t want to be placed in and any positions they don’t want the clinician to stand in.
"Obviously it has limitations because you do have to be in certain positions to have a smear test or have a coil fitted, but we work together to find a way they feel comfortable," Amara says.
"For example, there was a woman who really didn’t want to have her legs touched at all and you would think that would be very difficult but we did it fine eventually, we found a way."
Most importantly, the usual doctor-patient power dynamic is shifted and the patient gets to decide what they do want to happen.
If they just want to sit on the bed and see what it feels like - that’s fine. If they only get as far as removing one item of clothing, they can book another appointment and remove two next time. The women are always in control.
"A big bit of it is consent, it’s your body and you have every right to be treated how you want. I don’t know why, but that something that seems to be missing in medicine," Amara says.
The women are offered refreshments at the clinic and there are people they can talk to afterwards if they’d like. The MBB clinic has also teamed up with local businesses who offer patients a complimentary massage before or after an appointment to help them have a positive experience.
One person who has really benefitted from the MBB clinic is Lucy*.
Lucy, from London, was raped when she was at university and didn’t go to her see her GP for years afterwards.
"I was 19 and I was really drunk and a friend of mine took me home. I had said no a lot to having sex with him, but he ignored that," she says.
"After that I got into a relationship that I didn’t really want to be in with someone else, then he raped me as well."
By the time Lucy heard about MBB at the age of 28, she wasn’t even registered with a GP.
"I was scared that they would make me do stuff that I wasn’t comfortable with," she says.
"I didn’t want to have to tell them what had happened and I couldn’t bear the thought of having a smear test. I didn’t know how I was going to explain that, so I decided I’d rather just avoid it."
Despite these feelings, Lucy, who now works as an engineer, knew having a smear test was important for her health.
She was nervous before her appointment at the MBB clinic, but says the staff soon made her feel at ease.
"There was no time pressure and I was offered tea - lots of tea - and I felt really comfortable. It was actually a pleasant experience," she laughs.
Lucy isn't the only person impressed with MBB. Women who have come to the clinic or Café V are constantly recommending the organisation to other women who have experienced sexual assault.
As word has spread, women come from as far as Scotland to access the specialised London-based services, sometimes for multiple sessions, which is both time-consuming and costly. Amara is currently looking for a location to run a MBB clinic in the north of England so she can help them more easily.
Although teams at Sh! and St Bartholomew's Hospital help Amara deliver the services, she is single-handedly managing the entire organisation, on top of working full-time as a nurse.
She answers all the emails and appointment requests from women herself and will often complete additional phone consultations out of hours.
"I do feel tired sometimes, but I think it’s important so I just do my best with it," she says.
Rape Crisis estimates that around 85,000 women experience rape in England and Wales alone each year.
The NHS currently has 43 Sexual Assault Referral Centres around the country that offer counselling and medical advice to women.
The Ministry of Justice has set aside a total of more than £4 million per year since 2011 to fund existing female rape support centres.
The Huffington Post UK contacted the NHS to ask whether the specialised services ran by MBB - sex therapy sessions and a specialist cervical screening clinic - could be extended further across the UK.
An NHS England spokesperson said: "Together with other partners, NHSE commissions a network of 43 Sexual Assault Referral Centres around the country, which can provide or arrange access to sensitive and tailored services for those who have been a victim of sexual violence.
"These services include both medical and follow on support, and are open to any survivor, whether or not they are going through the criminal justice system, and on an anonymous basis if the patient wants it to be."
Nevertheless, Lucy is adamant that a specialist cervical screening service like MBB should be available across the NHS nationwide.
"I don’t think we take sexual violence at all seriously enough and the impact it has on women’s lives," she says.
"We just expect women to get on with it, then we’re surprised when they don’t access healthcare in the way that it’s provided, which is often quite uncaring.
"This is a life-saving piece of healthcare that we deserve as women, but we don’t get it. I think it’s disgraceful."
Amara says it still isn’t easy to talk about her experience of sexual assault, but she continues to do interviews with with the media to show other women, like Lucy, that they should never be ashamed of their past.
"The reason why I talk about it is because so many women have this happen but they have to stay quiet about it, and I don't think we should have to," she says.
Today, Amara comes across as bubbly, determined and above all, strong. Surprisingly, she says that listening to other women talking about their experiences of sexual assault is no longer triggering for her.
"Sometimes, especially with younger women in their late teens, I feel like I’m looking at a younger version of myself," she says.
"I look at them and I think: 'I know you think you won’t get through this, but you will, and you’ll have an amazing life.'"
*name changed to protect identity
Links you may find useful
- Rape Crisis services for women and girls who have been raped or have experienced sexual violence - 0808 802 9999
- Survivors UK offers support for men and boys - 0203 598 3898
HuffPost UK is running a month-long project in March called All Women Everywhere, providing a platform to reflect the diverse mix of female experience and voices in Britain today. Through features, video and blogs, we'll be exploring the issues facing women specific to their age, ethnicity, social status, sexuality and gender identity. If you’d like to blog on our platform around these topics, email ukblogteam@huffingtonpost.com with a summary of who you are and what you’d like to blog about