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

[SonicVersusGynaephobia]

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.

If I understand your point correctly

It will have been a practice from back in the day when doctors were male and akin to god and women were property.
Then it will have been "normal" and continued for decades without anyone thinking to question it
Until someone did and then eventually there was a consensus of opinion it was banned.

Or, am I missing something?

"I'd like to know who initially authorized it in the UK, if it was ever challenged prior to the policy being changed, and if so who vetoed the change at the time and if they're still working"

"Whilst I saw this done in gynae theatres in the early 80's I have never seen it done elsewhere and it has long since been consigned to history"

The 80s is not long ago at all!

Fwend and Johnny

I believe you both. xx

And for what it's worth, I think it is a criminal act.

Canada banned this / it came into teh open and people were trying to ban it recently I beleive.

I'm sure it goes on all over the world.

To add.

Many HCPs don't talk about it out of fear for their livelihoods.

Just because you haven't seen it in (you are not omnipresent iused) doesn't mean it never happens.

Thinking about this I seem to remember that it wasn’t just in theatre prior to or during the operation. I think it may have been going on in recovery as well so that may have been where say a tonsillectomy patient was examined. The article did say all women having ops were subjected to the examinations not just gynae ops.

Yes. I want to know if anyone tried to get it stopped before it eventually was stopped and, if someone overruled them, who did so. Mostly because if people who actively defended this rather than passively going along with it are still practicing I think potential patients have the right to know who those people are.

(Given that we have someone here who suspects that it happened to her in the 90s I'm also not really buying the idea that the entire medical profession suddenly realized that women are people in say 1984 and stopped doing it.)

I think the article was from the early 90s as I remember I had just had an op and was so appalled.

AAK - upthread I posted a link to an item from 2003 that said 1/4 students at Bristol Medical School reported that they were unhappy that consent had been obtained appropriately.

So not so long ago even from the perspective of people who think the 80s was practically the dark ages.

No I'm not omnipresent Placemats and I'm not in a position to comment on practices abroad.

However I feel confident it hasn't been widespread outside of the UK and outside of gynae theatres for the practical reasons I listed.
I worked in theatres in the late 80's and never saw it happen. However I did see an anaesthetist pop a particularly juicy spot on a woman's back as she was being rolled onto the trolley, proudly announcing what a favour he had done for her. The theatre sister tore him to shreds and he narrowly missed a formal complaint. Lots of women work in theatres and would never allow this to happen.

I don’t know about women not allowing examinations to happen. Presumably if it is being done by medics in an operating theatre or recovery setting you may think it’s part of the procedure. Would anyone really have gone up against the teaching staff and consultants and risked their jobs. It was a practice for years and yet no one came forward.

Sorry, I meant not widespread within the UK/NHS

Is / was there a minimum age on this?

I was in and out of childrens hosp with multiple GAs between age of 12 and 16 in the 80s.

"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.”"

Let's be clear this is rape in many countries and assault by penetration in the UK (same severity crime as rape).

A person or people putting fingers and / or objects into a woman's vagina when she is unconscious is a sex offence.
As it's a hosp I suppose they can get consent in advance.
However without it, this is a sex offence. Obviously.

When I was a midwifery student in 1988, our senior tutor told us she had challenged this practice in our hospital a few years earlier. Successfully and bravely, because midwives only got grudging acknowledgement from doctors and management.

She was a star. I will name her because she was a star who is no longer with us.
Professor Dora Opoku.

Thank you Dora Opoku.

@fwend a sticky gel-like substance on your thigh, and potentially soreness, may be due to the diathermy pad which is often placed on the thigh and can be sore when removed.

When I was a student doing my obs and gynae attachment about 17 yrs ago we did examine women under anaesthetic but only those having gynae procedures, only those procedures where this type of examination would be done as part of the procedure anyway and only with consent. It was only a particular examination, as it’s one that can be quite uncomfortable whilst it’s being done - speculum examinations and how to do smear tests and so on we were expected to do as part of our gp rotation, the same with prostate/testicular examination.

One consultant used to get his students to examine gynae patients, none of the others did when I was in theatres. The sister in charge in the Obs and Gynae theatres I worked in challenged it. And the consultant (who was a a vile man) reported her to the Chief Executive. She stood her ground despite him making her life very difficult, and it was stopped. I'm not going to name her fully, because she wouldn't like that and I know she is still around. Mary, you were a brave woman for doing what you did.

Fwend said she was 16 and in to have her tonsils removed. She woke up sore and bruised and sticky. This is serious assault.

Even if you were in for a gynae procedure does that mean it’s ok to perform other intimate examinations on you. A PP said about paramedics practising intubating patients who were unconscious, sometimes brutally and several times. Who authorises this. After my emergency crash cesearean I had a sore throat and a slightly chipped front tooth but they were fighting to save my babies life and mine. It’s not acceptable to do this to the same patient over and over.

Fwend said she was 16 and in to have her tonsils removed. She woke up sore and bruised and sticky. This is serious assault.

I think what those of us who worked in theatres are saying is that there may be reasons other than a sexual assault for what happened. The stickiness is most likely due to the diathermy pad. Without knowing details about the bruising, and I'm certainly not going to ask, it isnt possible to say whether there was a reason for this. Patients who have their tonsils out are at risk of bleeding into their airway post op. Sometimes we had to turn patients onto their sides very quickly to keep them safe after a tonsillectomy. Maybe that is what happened. It wouldnt excuse any bruising, but it would explain it.

I think those of us who worked in theatres are really struggling to understand a scenario whereby patients undergoing surgery for something unrelated would be vaginally examined. Putting it bluntly, there wouldnt be time, the patient wouldnt be in the correct position, it wouldn't enter the head of medical staff in other specialties to suggest it, and students wouldnt be doing gynae at the time so they wouldn't ask. Patients in theatre arent left alone for a single second, and it would be rare for there to be fewer than 2 or 3 staff members to be present at all times caring for the patient. I worked in theatres for many years and underwent several procedures myself. I am certain my dignity was maintained and no-one even uncovered part of me unnecessarily. I really hope that Fwend was treated the same way and that there is an explanation other than assault.

I know a doctor who was forced to do this in Ireland. She objected (being the sixth person to have a go) but was told in no uncertain terms that it wasn't optional.

Washedwithrain

With all due respect, you dont't know when this posters friend had this happen (could be decades ago) nor do you know which country (although I assume UK as well).

Certianly it WAS common practice here until relatively recently and is still common practice in many countries all over the world.

If a woman says she has unexplained bruising, soreness and lubrication INSIDE her vagina when she has gone in fro a tonsil op then it's a massive benefit of the doubt to say it is DEFINITELY something else that has happened.

Does anyone know if there was a minimum age on this practice, or is in countries where it is still allowed?

Just because you never witnessed it doesn't mean it didn't happen.

I've never been raped by a stranger but that doesn't mean it doesn't happen.

I've never witnessed a Tsunami, but that doesn't mean it doesn't happen.

I have seen someone throw themselves on a train line and commit suicide. There were at least a hundred people on the platform - overground. However when I tell people this all of them are thankful they have never seen anything like that happen despite every one of them having visited London.