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Feminism: Sex and gender discussions

US teaching hospitals are allowing medical students to perform pelvic exams on unconscious, unconsenting women? [Edited by MNHQ]

158 replies

SonicVersusGynaephobia · 21/09/2018 21:09

And it's perfectly legal in most states.

This is in America, not, as far as I know, in the UK. But I'm completely gobsmacked and really upset. I don't understand how this is allowed.

bust.com/feminism/195099-public-exams-anesthesia.html

" Did you know that doctors and med students are allowed to practice pelvic exams on patients who they are under anesthesia for unrelated surgeries? Did you know that they do not need to ask first, or let them know after if it happened?

I first heard about this phenomenon on the Throwing Shade podcast when Erin Gibson, author of the new book Feminasty, brought it up as her women's topic of the week. Erin read a report from the NYU Ethics Division detailing this ongoing practicing and continued to rant about how gross it is. I immediately started asking my friends if they knew about it. The responses to whether or not they knew was mixed, but the responses of disgust were consistent. I started doing further research and found that this practice is shockingly widespread.

It is very common for teaching hospitals around the world to have med students “practice” performing pelvic exams on a surgical patient while they are under anesthesia without their consent, or even knowledge. According to Medscape, oftentimes, multiple med students will practice on the same patient. In the US, non-consensual pelvic exams are legal in every state besides Hawaii, California, Illinois, and Virginia.

Phoebe Friesen, a medical researcher, published an article called "Educational Pelvic Exams On Anesthetized Women: Why Consent Matters" in which she studied the phenomenon. She noted that in 2005, a study at University of Oklahoma “found that a large majority of medical students had given pelvic exams to gynecologic surgery patients who were under anesthesia, and that in nearly three quarters of these cases the women had not consented to the exam.” She also states that “the vast majority (72–100%) of women say they expect to be specifically consented for an educational pelvic exam performed while they are under anesthesia” and that many women “said they would feel ‘physically assaulted’ if not consented.”

According to Medscape, a 2007 study done in Canada found that 72 percent of med students admitted to having done a pelvic exam on an anesthetized patient. A common argument for these non-consensual pelvis exams made by doctors is that many patients would say no—which is really a further reason for why they should be asking. If patients are not willing to be used as test subjects, medical school should hire people to practice on who are informed and willing.

Lauren Dobson-Hughes, an activist and former president of Planned Parenthood, wrote a thread on Twitter about this epidemic. She said that after there was media coverage about this happening, many people came forward about unexplained internal bruising and vaginal pain after undergoing an unrelated surgery. She heard anecdotally from many others saying their demands for their own medical records had been blocked or redacted as hospitals attempt to cover up their rape-y practices.

In 2013, writer Tasneem published a personal essay on XOJane about how she suspected this had happened to her but she has no way of knowing. She double checked the fine print in what she signed before her surgery to make sure she had not unknowingly agreed to it but there was nothing. She writes, “Why wouldn’t they just ask me if they could try it out while I was conscious, I wondered? I am a sexual health activist, and I’d love to help people get better at giving pelvic exams!” She called her doctor to ask him directly and, “he responded brusquely that he does so many surgeries that he could not say for sure whether or not it had happened.” She then asked if it is something he’s done in the past with medical students and he said yes. She filed for an investigation with the patient advocacy center of the hospital, but she never heard back.

This widespread use of patients' bodies is intwined in the sexual assault epidemic we are seeing rise to the surface with the #MeToo movement. It is a further assumption that any body that is not cis and male is open for invasive practice without question. If you live in a state where this is legal, which is very likely since that includes 46, pressure your legislatures to change that."

Livid.

OP posts:
arranfan · 21/09/2018 22:59

I'm guessing no one ever performed "practice" prostate exams on unconsenting unconscious men?

Oddly enough, I did ask this of someone who confessed that he'd performed his first few pelvic exams on anaesthetised women and only realised just what he'd been complicit in many years later. Having said that, he looked baffled that I'd even asked the question about prostate exams.

SonicVersusGynaephobia · 21/09/2018 23:02

It was emphasised that they only did this to married women or those known to have had prior sexual experience.

In some ways, that actually makes it worse; it feels like a very considered value judgement on which female is fair game for sexual assault.

OP posts:
user1457017537 · 21/09/2018 23:07

Cosmopolitan did an article on this about 20 years ago. You know you had to remove your underwear before an op even if it was an op on your foot, this was the reason and medical students used to examine women whilst they were unconscious. Fuckin unbelievable that women were regularly sexually assaulted in hospitals in the UK

stillathing · 21/09/2018 23:08

This makes me feel so sick. What do you think would convince men (obvs namalt) that women are actually people?

frogintheTyne · 21/09/2018 23:09

user - that makes me feel physically sick all over again.

PatchworkGirl · 21/09/2018 23:12

This is shocking. It might be less convenient but I don't believe for a second that they couldn't get enough people to consent if they just asked. I'd consent, in normal circumstances. I imagine that people who wouldn't have very, very good reasons to refuse (which makes this even worse).

Wrathofjurgenklop · 21/09/2018 23:13

I am shocked.

So I understand it is no longer happening in the UK.
Then lately, I notice in the news, I seem to hear of a lot more people being put into an induced coma after an accident or illness.

Okaay, there are new procedures developing all the time.
But sometimes I just wonder...

Patients have a right to respect and integrity at all times.

PatchworkGirl · 21/09/2018 23:13

*and providing I was conscious.

arranfan · 21/09/2018 23:17

Bear in mind that these assaults were carried out (in the UK) and presumably are carried out still in the US in front of all of the staff present in the surgical theatre.

Just think of the number of people who didn't protest or raise the issue of consent.

Ereshkigal · 21/09/2018 23:23

In some ways, that actually makes it worse; it feels like a very considered value judgement on which female is fair game for sexual assault

I agree. It is worse. Really rapey logic.

OvaHere · 21/09/2018 23:32

I've read about this before. It's truly disgusting and says so much about the lack of medical ethics involved that it either didn't occur to them that it's sexual assault or they just didn't care.

WhatTheWatersShowedMe · 21/09/2018 23:44

Omfg.
I am terrified of being operated on and the thought of this makes it so much worse!!!

LightofaSilveryMoon · 21/09/2018 23:44

Sexual assault of women.

Common practice on an institutional scale.

The concept of women's consent completely ignored.

This is used as a normal part of training.

Sexual assault of women is used as training.

Again.

placemats · 21/09/2018 23:44

Yes, it happens. It really is a disgusting practice. I first knew about it in the mid 2000s. It would never happen with a man.

LightofaSilveryMoon · 21/09/2018 23:49

This is horrific.

redshoeblueshoe · 21/09/2018 23:57

This is sick

SockQueen · 22/09/2018 00:01

When I was a student doing my O&G placement back in 2007, this practice was referred to as something that used to happen years ago, but definitely not then (or now!). We had to get a certain number of pelvic exams signed off, but if we wanted to do them in theatre rather than in clinic, a) it was gynae theatre only and b) we had to speak to the women ourselves and get written consent for it, then show the consent form to the consultant/theatre sister before we could do anything.

WRT taking knickers off, even if the op is on a totally unrelated body part - there's a risk that any synthetic materials can have a build up of static and create a spark/burns when diathermy is used - this is why we ask patients to remove everything, NOT for any other reason.

Outrageous if it is indeed still happening in the US.

MipMipMip · 22/09/2018 00:16

Awful awful awful.

Iused2BanOptimist · 22/09/2018 00:23

Yes this did happen in the past but not for a long time now (in UK) due to understanding of consent and I'm shocked if it is still happening/common place in the US. I would be surprised if it happened anywhere other than gynae theatres however. In gynae the anaesthetised patient is placed in lithotomy position (stirrups) for trans vaginal procedures. There is presumably some pathology or other of interest and learning value to examine.
I question the practicality of performing pelvic exams on anaesthetised women who are not being placed in position and also there is nothing to be gained as presumably they will not have (or not expected to have) any pathology to palpate. Which doesn't in anyway excuse the practice but I am just casting doubt on how widespread it might be.

Washedwithrain · 22/09/2018 00:36

Cosmopolitan did an article on this about 20 years ago. You know you had to remove your underwear before an op even if it was an op on your foot, this was the reason and medical students used to examine women whilst they were unconscious. Fuckin unbelievable that women were regularly sexually assaulted in hospitals in the UK

I worked in operating theatres for many years and I can say that I NEVER saw any woman examined vaginally when undergoing a non-gynae procedure. It just didn't happen. Firstly patients were never uncovered more than was necessary for their particular surgery, secondly they wouldnt have been in the correct position, thirdly, students watching a foot operation would not be learning gynae at the time so it wouldnt have entered anyone's head to say 'Ooo let's do a pelvic exam'. An orthopaedic surgeon would never suggest that. I'd say that is scaremongering nonsense.

However, and its a big however, women undergoing gynae procedures were examined by medical students whilst under anaesthetic. That was considered normal at the time. I know someone who reported a consultant for allowing it to happen, and he made her life absolute hell. She did manage to get the activity stopped though.

shatteredmum1 · 22/09/2018 00:54

It's absolutely true,used to happen here.
I was admitted to a teaching hospital in South London in the eighties
for removal of wisdom teeth.I was approached by a junior doctor
prior to my surgrery and asked to consent to a vaginal examination
whilst under anaesthetic.
Needless to say I refused!!

missnevermind · 22/09/2018 01:10

In the late 80’s early 90’s I had my wisdom teeth out at hospital under a general.
I was told to strip and put the gown on so I did but left my knickers on as I didn’t want to flash my bum.
They were very insistent that I remove them but I refused as they were working on my mouth and I said I couldn’t see any reason for removing them. They were unable to give me a ‘plausible ‘ reason so I left them on and said they could cut them off if it turned into a medical emergency

ScienceIsTruth · 22/09/2018 01:17

Well, they couldn't make it any clearer, could they? This shows exactly what they think of women.

What's that saying?... when someone shows you who they really are, believe them!?

Matcha · 22/09/2018 06:09

God. This has made me feel sick.

I had surgical management for a missed miscarriage, and a med student (UK) asked for my consent to do a pelvic exam while I was under general anaesthetic.

I consented, but afterwards I wished I hadn't. I'd never been under GA before, and it was more upsetting than I realized to think I'd been lying there like a cadavar while people examined me. I wished they'd asked for consent further in advance, so I could think about it properly: I was asked shortly before I went into surgery, so was anxious and upset and had no real headspace for it.

Knowing what it feels like even when you've given consent makes me indescribably angry for all the women who were never even asked.

I hope this becomes a focus of national outrage, but, judging from some of the replies on a previous thread about 'why would you deny medical students the chance to practice on your body?' (in AIBU), there are still a significant number of people who believe a) if you don't allow med students to touch you, you're personally destroying the future of medicine, so b) how dare you be so selfish and c) you don't deserve to benefit from their training, and d) all bodies, but especially women's, are practice equipment for medical professionals. Dignity, personal preference and now consent are optional.

arranfan · 22/09/2018 09:21

SockQueen wrote: When I was a student doing my O&G placement back in 2007, this practice was referred to as something that used to happen years ago, but definitely not then (or now!). We had to get a certain number of pelvic exams signed off

Did you ever follow a similar procedure to ask for consent to conduct a prostate exam - or are urology rotations not mandatory?