Charts Unwritten

“She was just visiting home for winter break.”

I hear some version of that sentence every January. And every time, it stops me. Maybe it’s because there’s an illusion of safety in coming home, or a cultural script that says college-aged people are immune to harm — resilient, responsible, self-sufficient. But what I’ve seen as a Crisis Volunteer Advocate tells a different story: January brings a wave of young survivors into emergency rooms, often shaken, alone, and unsure of what comes next.

Winter break is supposed to be a pause, a recharge. But for many young people — especially women and LGBTQ+ students — it can also be a time of unexpected vulnerability. Assaults happen during nights out with high school friends, at house parties where someone spiked the drinks, or in homes where boundaries were never respected to begin with. Sometimes the assailant is a family friend, a neighbor, or a cousin. Sometimes it’s a partner they’ve been trying to leave.

The pattern is subtle, but it’s there — a seasonal surge of pain hidden under puffy coats and polite reunions.

The January Spike: Why It Happens

Every winter, emergency departments see an increase in sexual assault cases among young adults, particularly college students. A few reasons contribute to this rise:

• Disrupted routines: Winter break changes everything. No campus security, no peer safety networks, no dorm RAs.
• Alcohol and drug use: Parties around New Year’s often involve heavier drinking and lower inhibition, increasing the risk of assault.
• Reunions with old social circles: These familiar-yet-distant relationships blur trust boundaries, making it harder to detect red flags.
• Undiagnosed mental health struggles: Depression, unresolved trauma, or social isolation can also increase risky behavior or reduce self-protective instincts.

There’s also the psychological pressure of “starting the new year right.” People push themselves to be social, to say yes, to ignore instincts. They feel like backing out of a plan makes them a buzzkill. But safety should never be sacrificed for the sake of not ruining the vibe.

A Night That Changed Her Year

One case still sits with me. A college sophomore came into the ER alone, mascara smudged and hoodie pulled tight around her face. She’d gone to a New Year’s party with people from high school — nothing unusual. But someone handed her a mixed drink, and the next thing she remembered was waking up in a car with her clothes disheveled and no idea how she got there.

She didn’t want to tell her parents. She didn’t want to ruin anyone’s reputation. She wasn’t even sure she had the right to be there.

But she came.

She came because something in her said, This isn’t okay. And when the Sexual Assault Forensic Examiner explained her options, I stayed by her side as her advocate. She didn’t cry until the end — when the paperwork was done. However as I handed her a warm blanket and told her she had done the brave thing, she just said, “Thank you for not rushing me.”

Winter Safety Tips for College-Aged People

Here are some practical safety tips that I’ve learned from both survivors and safety professionals. These are not guarantees — no one is ever responsible for preventing their own assault — but they can add a layer of protection when you’re navigating winter break social scenes.

• Share your location with a trusted friend or family member when you’re heading out.
• Set up check-ins: Have someone text you every hour or two. Even a simple “you good?” can make a difference.
• Avoid drinking to your limit — especially if you’re in an unfamiliar environment or don’t fully trust the people around you.
• Use shared transportation (like Uber Pool or Lyft Shared) and avoid getting into private cars with acquaintances or strangers when impaired.
• Skip public transit late at night if you’re alone, especially in unfamiliar areas.
• Plan your exits: Always know how you’ll get home before you go out — don’t rely on someone else to offer a ride.
• Bring your own drinks to house parties and never leave your drink unattended.

For Families: How to Create Safe Conversations

Families can play a key role in preventing harm and in making it easier to come forward if something does happen. Here are some ways to support young adults during break:

• Don’t assume safety just because they’re home.
• Ask how they’re feeling: Really listen.
• Normalize check-ins and boundaries. Let them know it’s okay to change plans or say no to things.
• Keep lines of communication open. Say: “If anything ever happens, even if you’re unsure about it, I’m here. No judgment.”

The Role of Emergency Medicine

Winter is also a time when emergency physicians and advocates need to stay vigilant. Clinical signs of assault are not always obvious. Survivors may present with vague symptoms: nausea, dizziness, pelvic pain, or anxiety. They may hesitate when asked direct questions or deflect when asked about alcohol use.

In my experience, the best providers are the ones who create a calm, nonjudgmental space. They don’t push. They offer options. They make it clear that the survivor can say no to any part of the exam, the report, the process. That kind of trauma-informed care can make or break a survivor’s long-term relationship with healthcare.

We Can’t Assume Safety — We Have to Build It

One of the most harmful myths is that safety is the default — that danger is the exception. But in January, I see clearly how that narrative fails.

Safety is not a setting. It’s a structure. It’s something we build through proactive conversations, advocacy, and creating options for those who need them. For every college student who walks through those ER doors, shaken and unsure, I want them to find care that says: You’re not alone. You’re not to blame. And you are not broken.

Final Thoughts

New Year’s is often about goals: health, fitness, career. But I think safety should be a goal, too — not just for individuals, but for institutions. What would it mean to treat safety like a shared resolution?

For me, it means continuing to show up on-call. It means pushing for trauma-informed medical education. It means helping young people understand that saying “this doesn’t feel right” is reason enough to act.

Let’s make this January not just a time of reckoning, but a time of resilience.

— Advocate in Scrubs