The first step in the examination of a sexual assault survivor is to obtain informed consent. This is crucial to respect the patient's autonomy, ensure voluntary participation, and maintain trust. Without proper consent, conducting any examination or collecting forensic evidence is ethically and legally inappropriate. Informed consent also involves explaining the procedures, their purpose, and possible outcomes to the survivor, thereby empowering them. It lays the foundation for a supportive and patient-centered approach throughout the evaluation process.

Reference: Principles of Forensic Medicine, K.S. Narayan Reddy, 4th Edition.