Salma R Abdelrahman, Salem K Alketbi
Effective forensic and legal responses to sexual assault require reliable evidence collection and respectful, fair procedures. This exploratory mixed-methods study examined psychological distress, cooperation with forensic procedures, legal-process satisfaction, and contextual experiences among survivors recruited through advocacy and legal-aid networks across multiple Middle Eastern jurisdictions. Fifty adult survivors (34 women and 16 men) completed study-specific single-item ratings of psychological distress and cooperation on 10-point scales and satisfaction on a five-point scale, followed by semi-structured interviews. Quantitative data were summarized. Gender differences were examined using Mann-Whitney U tests, and the distress-satisfaction association was assessed using Spearman's rank correlation. Interviews underwent thematic analysis and integration during interpretation. Mean scores were 7.72 (SD = 1.20) for distress, 6.68 (SD = 1.71) for cooperation, and 3.26 (SD = 1.17) for satisfaction. Satisfaction ratings of 4-5 were reported by 44% of participants, 30% selected the midpoint, and 26% selected ratings of 1-2. Cooperation did not differ significantly by gender (U = 349.0, p = 0.106), and distress was not significantly associated with satisfaction (ρ = -0.11, p = 0.459). Qualitative themes included trauma during evidence collection, shame and stigma, perceptions of justice, professional support, privacy concerns, and service-access challenges. Some male participants emphasized anticipated disbelief, masculinity-related stigma, and social judgment. Cooperation, distress, and satisfaction represented distinct dimensions of survivor experience. The findings support trauma-informed, context-responsive practices emphasizing continuing consent, clear communication, privacy, professional sensitivity, and equitable access while maintaining evidentiary standards.