No matter why you’re in a hospital, if you’re a patient seeking medical care, the situation can be overwhelming and frightening. You might be worried about survival, long-term risks, or even the cost of your treatment. If you’re someone with a vagina, you might also be worried about having medical students practice pelvic exams on you while you’re unconscious.
Yes. Really.
In 42 states, this is legal. And it’s not the norm to require explicit consent from a patient before this happens, either. ELLE magazine conducted a survey of 101 medical students, all of whom attend one of the seven biggest medical schools in the United States. While it’s a small sample size, it’s worth looking at their findings closely: 92% of the medical students reported performing a pelvic exam on an anesthetized patient. Of those, 61% said they did the procedure without explicit consent from the patient; 49% told ELLE they hadn’t met the patient in question before performing the exam.
If you’re wondering how this is legal, it comes down to that vague language in the paperwork you’ve probably already signed. Many hospitals affiliated with a university have language that refers to medical students being involved in patient care. This can include pelvic exams.
New York recently passed legislation to make it the next state to ban nonconsensual pelvic exams. Other than New York, eight states—California, Hawaii, Illinois, Iowa, Maryland, Oregon, Utah, and Virginia—have already banned them. There’s no federal legislation in place to ban it.
“The patients have no way of finding out what happened during their procedure, and they’ll come out none the wiser,” a fourth-year Yale student said in the survey. “It felt a little weird that I was doing this on somebody anesthetized, but it was the best opportunity I had to practice.”
These exams don’t just happen when a patient is there for gynecological procedures. While that still wouldn’t be excusable, it highlights the idea that many patients probably don’t think twice about the possibility of it happening to them, or that they might need to inquire or specify their consent ahead of time. If you knew you were going to be put under to have surgery on your leg, for example, you probably wouldn’t think to let the attending physician know that you actually don’t want a medical student giving you a pelvic exam while you’re anesthetized.
In an interview with VICE, medical student Savanah Harshbarger, who enrolled in the Duke University School of Medicine in 2016, said, “I estimate that I did about 10 of these exams last year.”
Some universities do outlaw them, but that’s up to them. And again, while this might be the norm within medicine, patients wouldn’t think twice about even asking about it, because it would never occur to them that it might even happen.
This study from ELLE isn’t the first time medical students have been polled about this issue. In the ‘90s, Ari Silver-Isenstadt, who was then a medical student, was so uncomfortable with the practice that he refused to perform the exam in this context. Later, in 2003, he published a study in the American Journal of Obstetrics and Gynecology in which 90% of medical students said they’d performed pelvic exams on unconscious patients.
In a time when we’re talking so much about consent, bodily autonomy, and the #MeToo movement, it’s especially abhorrent that this is so commonplace. Patients may not have the ability to determine whether this has happened to them, as the procedure generally isn’t recorded in their medical charts. Does a patient being none the wiser make it any less of a violation?
Note: While discussions around this subject usually refer to cisgender women, these incidents can involve trans men, non-binary people, those who identify as agender, and so on, which is why gender-neutral language is appropriate.