The issue of sexual assaults on American Indian women has become one of the major sources of discord in the current debate between the White House and the House of Representatives over the latest reauthorization of the landmark Violence Against Women Act of 1994.

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“We should never have a woman come into the office saying, ‘I need to learn more about Plan B for when my daughter gets raped,’ ” said Charon Asetoyer, a women’s health advocate on the Yankton Sioux Reservation in South Dakota, referring to the morning-after pill. “That’s what’s so frightening — that it’s more expected than unexpected. It has become a norm for young women.”

The difficulties facing American Indian women who have been raped are myriad, and include a shortage of sexual assault kits at Indian Health Service hospitals, where there is also a lack of access to birth control and sexually transmitted disease testing. There are also too few nurses trained to perform rape examinations, which are generally necessary to bring cases to trial.