Pelvic Exams and Consent

Pelvic exams are an important part of health care — your doctor checks that your reproductive organs are healthy. But sometimes the line gets blurry and an exam is performed on you without your consent.

Currently, 21 states have banned pelvic exams on unconscious patients without patient consent. But Kansas and Missouri are not among them.

1. They’re a form of sexual abuse

Sexual abuse is any unwanted sexual contact that is obtained by force, threats or when the victim is unable to consent. It can be physical, emotional or financial.

Sexual abusers cross all socioeconomic, educational, gender and age lines. They can be intimate partners, friends, family members or strangers.

They can also be other people in a position of power over a person, including employees or volunteers. It includes a broad spectrum of intrusive behaviors, from voyeurism and verbal comments to forced pornography and the intentional insertion of objects into a body part without the consent of the victim.

A nonconsensual pelvic exam is an act of sexual assault and a violation of patient rights. It can be especially harmful for LGBTQIA+ individuals or survivors of sexual violence. It can also be triggering for those who have been in a relationship where they have not received a fair amount of trust. It can make them more likely to experience stress, anxiety and depression.

2. They’re a form of child abuse

Informed consent is a crucial step in any medical procedure. It requires a conversation between a doctor and patient about risks, potential outcomes and treatment options.

But what happens when a doctor or medical student performs an exam on a patient without their consent? It’s a violation of their autonomy and rights.

And, it can be extremely traumatizing for patients who find out postop that they’ve been subjected to this nonconsensual test.

It’s also a violation of the ethics of medicine. The American College of Obstetrics and Gynecology has called on doctors to only perform pelvic exams on anesthetized patients if they get informed consent from the woman ahead of time.

This is why legislators in 21 states, including Missouri, have passed laws that prohibit these intimate exams without consent. These laws rely on the opinions of medical associations like ACOG and the American Medical Association, as well as the testimony of survivors like Weitz.

3. They’re a form of exploitation

In 2011, the American Congress of Obstetricians and Gynecologists stated that pelvic exams on anesthetized patients should only be performed with specific informed consent obtained before surgery.

Despite this, a survey of 101 medical students from seven American medical schools found that 92% had performed pelvic exams on unconscious patients without patient consent (ELLE magazine 2019).

These practices are a form of exploitation: They deprive a woman of her bodily autonomy and robbing her of her right to choose how her body is used for treatment.

While many medical associations have spoken out against this practice, they have yet to compel hospitals and clinics to change their practices.

For example, in 2019, Yale Medical School reportedly warned lawmakers against legislation requiring that they get explicit consent before performing pelvic exams on anesthetized or unconscious patients. And a recent survey of gynecologists found that many continue to perform pelvic exams on unconscious patients. They also believe that these exams help medical students learn how to examine their own bodies.

4. They’re a form of discrimination

While medical students are taught that pelvic exams are a standard part of their training, they are often practiced without consent from women. It is legal for them to do so in all but six states, including Illinois, according to Robin Fretwell Wilson of the University of Illinois at Urbana-Champaign.

Informed consent is a process of communication between a doctor and patient — not just a signature on a form. Failure to get informed consent violates a patient’s autonomy and rights, and can damage their trust in healthcare providers.

For survivors of sexual assault, a lack of consent can feel like an invasion of their body. This is why they can be triggered by pelvic exams, said Marissa Hoechstetter of Northampton.