Many rape survivors seek help from the legal and medical systems post-assault. Previous studies have examined how social system personnel treat survivors, but less attention has been paid to how survivors attempt to shape their interactions with these systems. The purpose of this qualitative study was to examine rape survivors’ agency—the active process in which they engaged to alter their experiences with the legal and medical systems. In-depth face-to-face interviews were conducted with 20 female rape survivors who had contact with the police and a Sexual Assault Nurse Examiner (SANE) program. Analytic induction was the guiding analytic approach. Findings indicate that this group of survivors engaged in three agentic processes in their interactions with the legal and medical systems: compliance in order to increase the likelihood their case would achieve what they deemed to be a successful outcome, defiance through noncompliance in order to protect themselves from further harm, and defiance by challenging the response to their case in order to alter the response to their case. Based on these findings, possible strategies for facilitating survivors’ participation and agency during their help-seeking experiences (e.g., systemic changes to empower survivors, improving the responsiveness of system personnel to survivors’ needs) are discussed. Implications may be of particular interest to rape-victim advocates and legal and medical personnel.