If a patient requests same sex care and a doctor lies to them and performs intimate care, that should be a sex crime

I have always had to sign consent forms when undergoing surgical procedures. If they do something else (cut the wrong thing out) then they are in trouble.

It always comes down to consent.

In the Fife debacle, Sandie Peggie had to disclose her teenage trauma caused by (IIRC) a male doctor examining her intimately and apparently unnecessarily. Other posters chimed in with their experiences of Totally Unnecessary Breast Exams and other situations.

We cannot know the state of sexual arousal of the medical practitioners in those cases. Are we saying that all those patients are incorrect in feeling sexually violated?

I do hope however that even The Right Side of History can agree that if a patient has been deceived into consenting or is afraid to refuse consent, this does constitute some form of physical assault?

I get what you are saying @heroinechic but isn't the logical conclusion that a patient who experiences what she considers to be sexual assault in a medical context, can never get this seen as a crime because nobody can ever prove the state of mind of the assailant?

So it genuinely is all about the overriding importance of the assailant's internal thoughts (or rather what he says they are) and the victim is just the NPC.

@Kucinghitam IMO a soldier assaulting a prisoner of war's genitals is quite different to a doctor carrying out a medical procedure in the legitimate course of their work. The touching of a persons genitals is usually sexual. The touching of a persons genitals by a medical professional, in a medical setting, as part of a medical procedure is for obvious reasons, not considered to be a sexual act even though it involves intimate touching.

Let's look at it like this:

You have two women going for a smear test. Both ask to receive care from a female doctor. One receives care from a woman, and one receives care from a man who believes they are a woman, who doesn't disclose their biological sex.

Both doctors carry out the same medical care, one with informed consent, one without.

Why is one sexual, and one not? Touching doesn't become sexual in nature simply because consent is not informed. The nature of the medical care is the exact same in both scenarios.

How the victim feels is not determinative of whether or not a sexual assault took place. You would also have to evidence that the touching was sexual, otherwise it wouldn't be a sexual offence.

It's a niche situation because in pretty much all other circumstances that I can think of, genital touching and lack of consent would be considered to be a sexual assault. But medical practice works that way. A doctor can literally slice you open and remove an organ in the course of their work and this is not considered to be a violent assault (for obvious reasons). In any other situation, it would be.

@CherryPopShowerGel

Why are you talking about 'trans women' and 'cis' when discussing a patient preference? Have you completely forgotten about trans men?

Or do they not matter because they are biological women?

There seems to be a fascinating disconnect here.

The OP's scenario as I understand it - patient requests same sex care, provider says "yes sure" but then sends opposite-sex practitioner who either disguises their sex and/or tells patient they are same-sex. If subsequent physical interaction goes ahead, either because patient is deceived or because patient is afraid to say no, OP reckons it is sexual assault.

I agree with the OP. My reasoning is that I (on the Wrong Side of History) am talking about the perception of the patient i.e. victim. The victim has not consented to an opposite-sex individual touching them intimately. Being deceived or afraid to object is not consent. To me this is the crux of the matter.

The Right Side of History posters seem to be focussed on the perception of the doctor. The doctor's internal thoughts and/or state of sexual excitement, is what really matters. The patient is merely the substrate for the doctor's choice of actions.

Edit: Just thought of another scenario. Say (e.g. in war situations, we've certainly read of such atrocities) soldiers use objects abuse the genitals of captive opposing soldiers. If we have no data on the internal state of sexual excitement of the abusers, would we say that the abused captives were not sexually assaulted? Because I'm fairly sure that such atrocities have been reported as sexual assault. Anybody care to correct me please?

@Helleofabore I agree with everything you said, I just don't see how it's sexual assault unless there are other circumstances at play I.e recording of the procedure for 'personal' reasons, unnecessary intimate touching with no medical purpose etc.

It's ultimately about deception / fraud.

It's like telling someone a chocolate bar that doesn't obviously contain nuts is nut free when it does have some hidden nuts in it. It's not ok to tell people it's got no nuts in if it has because that's lying / deception / fraud. You're not allowed to do that in law. For most people it probably won't matter, but for some it will and it's not for the person providing the chocolate bar to decide whether those reasons are reasonable or not. They just can't lie. (IIRC NC wrote an article about this comparison but I'm tired and can't find it right now).

I'm pretty sure what Upton has said he'll do is illegal. Let's hope it's tested in a court of law soon.

And yes, there are plenty of women who will actively choose to delay or avoid medical care if the only option is a male HCP and THAT SHOULD BE THEIR RIGHT TO CHOOSE. If someone lies and deceives that takes away their choice.

There is a very clear line with a request for a same sex medical professional and someone who is not the requested sex presenting themselves as fitting the requested criteria.

If the situation is explained that there is no same sex doctor available and the patient makes the choice on the doctors available, fine. The issue is when a male presents themselves when a female health carer has been requested.

This negates consent.

No male person should be touching a female patient without consent if that female patient has requested a same sex health carer.

A lot of comments from people who have not had trauma and can’t see the problem. Its a very different world they live in to mine and many others.

No, it’s clearly not about medical provision is somehow sexualised. It’s about informed consent.

I read 'the bloody thread' . I see a bunch of statements rooted in the idea that medical provision is somehow sexualised. It's not.

I merely set out my personal view, if it's not yours that's fine, we're allowed to differ.

Another one where the point has whooshed way over the head. Read the bloody thread.

Personally, I only care about the qualifications and competence of the practitioner.

For example, if someone is cutting me open and reconfiguring my internals I want to know a) they've done it before - a lot, and b) that it was successful in almost all cases.

Those are the things that affect the chances of continuing a full life and, to me, that's what matters.

When I'm ill, the sex, gender, race, religion, colour, age or any other characteristic of the people working to make me well is of zero interest, but everyone is entitled to their own priorities.

@smallchange I disagree a man pretending to be female in an a exam absolutely needs to make that known.

Otherwise just don't be trans and go into health care. I'm sure many will be safe but looking at all the predatorswho deliberately infiltrate gym clubs, scouts, football, dance, and all the rest id prefer to err on the side of caution in medicine when people are at their most vulnerable.

@Rainandgame it's a bit like the priesthood we believe they are somehow unsexual.

I've had a male doc examine my privates and I was OK with that because I know him.

I had a strange consultant examine my uterus.

I had another strange consultant examine my uterus with a female trainee and he made me feel extremely uncomfortable.

If I thought a woman was examining me or my dds and turned out to be man id go berserk.. It's a violation.

I don't see how most male doctors don't get turned on some of the time, it’s just not talked about and appears to be taboo and women traditionally don't like to think about it. So there is several difficult issues here separate from each other.

Nothing would be suddenly switched on its head. OP is proposing to make this a sex crime, and by virtue of it being a sex crime, there would need to be some element of sexual touching, or it would need to be of a sexual nature. This is a common limb to establish in order to prove a sex crime has been committed (alongside lack of consent and no reasonable belief of consent). Without the sexual element, it would not be a sex crime.

Doctors carrying out intimate medical procedures in the course of their work is not inherently sexual even though it is intimate.

For this to work, you'd need to:
a) propose that trans doctors are incapable of carrying out intimate medical procedures without it becoming a sexual act for them (noting that where a patient consents it is not an offence, they have simply consented to the sexual activity); and
b) examine why a trans doctor carrying out an intimate procedure is inherently sexual whereas a doctor who does not consider themselves to be trans carrying out the same medical procedure is not inherently sexual.

I'm not saying that I support it btw. IMO the patient's dignity and choices should be respected. I just don't think it's sensible to make it a sex crime because although a patient might feel violated, there's no reason to think that the deception is sexually motivated, or that a trans person cannot carry out these procedures without it being sexual in nature.

I actually would go as far to say (even though it won’t make me popular) that men should not be up in there for all the reasons crime statistics reflect. It’s a no from me due to this.

are you being deliberately obtuse or are you really that dense?

If Beth ever becomes a GP, there will be a number of patients who like me choose a female name from the list to take a gynae issue to (our gps seem to come and go quite frequently so there's only 3 GPs. there I know, 2 of them blokes). So I pitch up at my precious appointment to see Beth, enter the consulting room and ... Agh, then what?? I actually genuinely can't think of a proportionate way this could be handled fairly and transparently. In the moment I might start saying something about my hayfever or bad back, neither of which are at all bothersome, then start all over again with another doctor.

I'm afraid the uncanny valley thing that TIMs have going on makes me more uncomfortable with them than I am with "regular" men. So that's probably discrimination on the grounds of their PC. But it's how I feel.

If you're a health professional then you need to put the patient first. That includes accepting that consent is worthless if the patient doesn't have the full facts.

If a patient doesn't ask for single sex care then fair enough, I'm not saying someone has to announce their trans status at every patient interaction, although I do think there are some situations where a female carer may be more likely to be assumed and the safest course of action would be to disclose, but if they do ask for single sex care and you don't disclose or lie then you have performed that procedure without proper informed consent.

And if you're a health professional and you can't see how serious that is, you're in the wrong job.

If concealing ones true sex means your patient cannot give informed consent, then health workers either tell the truth and accept some patients saying no thanks, or they find another career, where informed consent isn't an issue.

You just be honest, you say you are a man who identifies as a woman. Then the patient knows and can decide if they want same sex care. Why is honesty and truth so hard?