Incidence of sexual abuse within health care is estimated to rival levels found within the church and other major institutions, but people who are sexually abused by doctors and other health care workers within the context of health care are faced with many unique barriers that are not present in other settings. Some of the barriers include difficulties distinguishing what constitutes sexual abuse, a decreased ability to prevent sexual abuse from occurring, and a lack of support and justice for instances when sexual abuse has taken place.
Recognizing sexual abuse
Recognizing sexual abuse within the context of health care can be difficult. It can be difficult to distinguish between health care and sexual abuse when routine examinations involve genitals and other sexual areas of the body. But it is the very nature of these exams that places doctors and other health care workers in a privileged and unique position to disguise sexual abuse as something else. For example, doctors are able to perform exams such as vaginal/rectal/breast exams when they are medically unnecessary, and to then defend their actions by claiming they were being “thorough”, or that they were done for the woman’s own good. And it can be very difficult to prove otherwise except in rare instances. For example, Dr. Stanley Chung was brought before the College of Physicians and Surgeons on allegations of frequent and unnecessary rectal and vaginal exams on women, some of whom were virgins.
It can also be difficult to determine when the line from appropriate behavior to inappropriate behavior during an examination has been crossed, especially if the sexual act is subtle. For instance when the doctor’s hand brushes against a breast as if by accident, or the doctor’s fingers linger a bit too long inside the vagina during a bimanual exam. In these instances the woman only has her hunches and instincts to support her suspicions. In other cases it is fairly obvious when the line has been crossed, such as instances where it is obvious that exams are not medically necessary. For example, a commenter on this site stated: “When I was thirteen my mom suspected I might have a kidney infection and took me in to see a urologist. He told me to cross my arms over my head, held my arms down, removed the paper shield and did a breast exam on me while I was fighting against him.” April 4, 2013 at 4:23 pm Clearly a thirteen year old girl would be considered as not being at risk of breast cancer. Another example is the court case of Wasserman versus Ms. Gugel:
Ms. Gugel alleges the doctor took her into an examination room and sexually assaulted her upon the conclusion of his “consultation only” appointment. The doctor claims the alleged sexual assault was actually part of a legitimate medical examination, even though he had already examined her the previous day . . . The doctor also contends the alleged sexual assault was part of a legitimate examination despite his not wearing examination gloves, his smelling his finger after using it to touch Ms. Gugel’s vulva and inserting it into her vagina, and his subsequent sexually harassing phone calls to Ms. Gugel, which were recorded.
Prevention
Preventing sexual abuse within the context of health care can be difficult. Many women have the reasonable expectation they will be able to trust their health care providers and sexual abuse is not something that is likely to be on a woman’s radar. However, even when distrust of a health care provider is present, the lack of informed consent involving intimate examinations provides little opportunity for a woman to avoid them. In fact, the current situation in women’s health allows for coercion to the point of bullying and the withholding of medications and other health services when women wish to decline pelvic exams/pap tests/STD testing. The power imbalance that is already present in the doctor/patient relationship becomes even more pronounced when a woman feels pressured into invasive exams or is unaware she has the right to say ‘no’, and the opportunity to prevent sexual abuse becomes extremely remote. In addition, the coercion that is the norm in women’s health care allows increased opportunity for predatory behavior and sexual abuse on the part of doctors and other health care providers.
Lack of support and justice
The effects from having been sexually abused by someone in a position of trust can be devastating. Dr. Gerald Monk, a professor at San Diego State University, states “Patients can feel especially violated in the context of health care. Not only do patients anticipate being safe and secure, they expect to be healed. Following an adverse medical event, a patient may experience a lifetime of heartbreaking anguish and suffering.” Juan Mendez in his work with the Human Rights Association compares some unnecessary medical procedures to torture and states, “medical care that causes severe suffering for no justifiable reason can be considered cruel, inhuman or degrading treatment or punishment, and if there is state involvement and specific intent, it is torture.”
Some women who have been sexually abused by a doctor are not even sure what to call it, and in fact sexual abuse when committed by doctors is assigned special terminology and renamed as “medical misconduct”. When some women attempt to seek help they are often met with a white wall of silence and discover that denial and persistent altercation of the facts are prevalent. Sanda Rogers, University of Ontario law faculty, in her discussion of failed promise of reform regarding sexual abuse by health care professionals, states: “Patients report abuse. The evidence is there, as is the evidence that abuse is seriously under reported. The legislation provides the health disciplines with the tools necessary to respond to the abuse perpetrated by some members. Instead, the College of Physicians and Surgeons and other Colleges, have failed to ensure that complainants are provided with the support necessary to assist them to survive the process of complaint, investigation and hearing. The drop off rate on complaints by the CPSO, and by other Colleges, is such that almost no complaints and few complaints of sexual misconduct and abuse proceed to a full hearing. Each stage of the process favors the professional and undermines the complainant.” Sanda also states that complainants who were interviewed by the College members found the complaint process “an amplification of an already traumatic experience“.
As a result, doctors and other health care providers are often left free to continue abusing for years even after complaints against them are made. Dr. Alan Cockeram and Dr. George Doodnaught are just two examples of cases where many women filed complaints and they were ignored.
Sexual abuse under the guise of health care presents many barriers and can have devastating effects. Sanda states that “Abuse in the guise of care, enabled by professional status, access and patient vulnerability and dependency, is an insidious and terrible breach of trust and an unconscionable and violent abuse of power and authority“. Women are often placed in positions where they are vulnerable and left with limited resources to protect themselves from sexual abuse by health care providers. The women who have been abused and who find the courage to complain are led through a process that often only fails them. In addition, women who have been faced with such experiences are left in a place where health care can be viewed as a threat to their personal safety and psychological stability. In other words, these women are left to cope in a society where health care, for them, does not exist.
forwomenseyesonly 
Linda, Ada is right! And you are fantastic, getting out there, helping other women and supporting them. Thinking of u x
Thank you friends. This is a great site with brilliant people. I don’t know what I would do without it.
linda,
I am not sure if you’ve had the chance to check out the web site of Medical Patient Modesty (http://www.patientmodesty.org), a non-profit organization that I founded. I also developed the web site, Sexual Misconduct By Doctors (http://www.sexualmisconductbydoctors.com). What kind of book are you writing? Are you from the UK? I am based out of US. I appreciate your contributions here.
Misty
Hi Misty. Thank you for the invite to your sites. I will deff go on them. My book is about my experidnce of smear tests. Its taking ages to write tho as i gave to do loads of research to make sure its right. Plus i get very down alot, so have breaks. Since the invention of kindle we can all put books online. You could even use your own blogs and create a theme round it. Its away of getting our message to a wider audience and to make some money.
There is a book on medical privacy called ‘my angels are come’ by art stump. I thought i might call mine ‘my angels are raping me’
They must be very worried about the future of their programme! With the NHS in crisis can they really afford silly money on their unwanted programme? Women are rejecting it and are not being bullied this time into complying. Is the tide turning??
I really hope by the time my daughter is 25,the pogrom will have been discontinued and women will either be offered self testing kits or will be able to request testing if they want it.no more “invitations “!
Hey everyone, I haven’t posted here for a while, I hope everyone is doing well!
Wanted to post this story about a doctor who allegedly assaulted 23 different women: http://www.dailymail.co.uk/news/article-3302318/GP-groped-23-women-breast-examinations-jury-hears.html
“Prosecutor Mark Fenhalls QC told Luton crown court today: ‘The women were not his full time patients at his general practice.
‘They were all prospective or current employees of the ambulance or fire service, who were sent to him for the medical examinations. The assaults were subtle and carefully designed by the defendant to appear as part of the examinations. The defendant was taking advantage of young women who were desperate to pass the medical and give themselves the best possible chance of getting a job.
‘Dr Lewis used the pretext of breast examinations and hernia checks to provide cover for the assaults he committed.’
One woman, who was then 18, alleged he removed her bra without warning, was told to lower her jeans before he slid his hand in her underwear. He looked into her thong and asked her to cough. Then, dressed only in her thong, he asked her to bend over for 10 seconds while he said he was checking her ‘spinal alignment’.
A woman paramedic, who was then 24, alleged: ‘He said “I just need to check for a pubic hernia” and put his hand in my knickers. The bra was removed to check for sites of potential cancers … polishing headlights springs to mind rather than the normal breast exam. He massaged my breasts while I am lying flat on my back.'”
If these things are true, I hope the devious, perverted, opportunistic little man gets locked up for a long time!!
Poor girls. Hope they’re okay now.
Not for nothing, but I’d think THEORETICALLY these guys would bust him up & maybe get a little creepy. Like a bunch of firemen just hauling-off & beating the fuck out of the guy- spaknings might be involved.
Read this article. Notice some of the assaults took place WHILE a nurse was present. Also, note, the patient and doctor were screened from the nurse by the “modesty screen.” I find this disturbing.
Reminds me here about the stupid “privacy tarp” we’re provided. This only serves to provide a barrier so we can’t see how doc is molesting us. Neither can hubby or advocate unless they physically view to the side or over the doctor’s shoulder [how many doctors (male) will say it makes them uncomfortable?–if unchallenged they develop a mindset that while in “his” exam room he’s superior to the husband. I don’t think this is a stretch in some of these ego minded god type men who couldn’t get laid otherwise]. Another problem is that docs can use that tarp to take pictures or explore more than they are supposed to examine.
Virginity testing is taking place in testing in Sweden, this misogynistic practice is another example of the lack of respect for women’s privacy and bodily integrity by health practitioners in so called progressive countries.
http://girlsglobe.org/2015/10/29/our-bodies-our-rights-virginity-testing-in-sweden/
The article doesn’t specify, but I wonder if there are any specific ethnic or cultural factors involved in those requesting virginity tests…….
My thoughts entirely, Hex, but in many countries the pap test becomes a virginity test in kind. In the UK, being a virgin is one reason you can give to a doctor to exempt yourself from having to undergo an “on-the-spot” pap smear if you haven’t been having them. Since most docs think women are lying they might ask for further details of your sexual encounters to know that you have an understanding of the subject. These details are put in your medical notes, and on a national database, and will often be discussed at future appointments. So unless a woman finds out how to opt out of the programme, ongoing virginity questions can be a feature throughout her life. Same thing happens in South American countries, where pap smears are required for civil service careers and military. A woman does not have to be muslim to find her virginity is questioned and can compromise her career or access to healthcare.
Si, this is a great article. I’m going to circulate it as much as possible.
Adawells this is scary! I’ve always answered questions such as “when was your last period? “automatically even if the reason for my consult was not gynaecological. I never thought about it, much less that it was logged on a data base! Why would anyone, other than the individual woman, be interested in such things? Sadly though you’re right, big brother is watching. I’ll be a lot more careful in future!!
http://www.peteraclarke.com.au/2013/12/05/gp-surgery-manager-prosecuted-for-accessing-patient-records/
Have a look at this story about a young admin assistant who seems to have spent a good deal of time reading the medical records of young women. Wasn’t too bothered by the old ladies with their arthritic knees and the like, just the ones of child-bearing age whose appointments would have been about you know what…
From what I have researched about the NHS cervical screening programme, reasons for not taking a smear must also be entered into the patients notes:
thttp://www.wmciu.nhs.uk/documents/Cervical_Cytology_Read_Codes_March_2012.pdf:
The doctor is also under the control of the programme, in that they have a set number of codes to put in and they have to follow you up after a set time, and enter codes for the situation in your vagina at every stage of your life. All on a national database. It’s an appalling waste of time and money.
Uhm no it is not at all a waste of time but matter of biopolitics and governmentality
I noticed a walk in clinic I went to before asked the last pap date and it was on a computer data base. I told them I didn’t have pap smears and it totally stompt the nurse who could not proved with other health questions until a date was typed in. I was like wow.
So you getting healthcare is contingent on providing answers that are deemed applaudable?
What happens if this computer doesn’t get an answer that “unlocks” the rest of its abilities? How does one get past this?
This type of coercion concerns me. If this ever happens to me I am going to sue the Ontario government. I will not be denied medical services because I refuse to participate in cancer screenings or answer questions about my vagina, breasts, colon that do not relate to my current medical need.
By the way ladies my daughter made me a WordPress blog and it changed my gravatar from lilac to this green but really I’m still kat rehman of old!
Well, at least it was actually referenced as something assualtive- instead of just covering for the medical personnel & everything they do.
Hi everyone
I’m reading along but have very limited Internet access at the moment. I’ll be back online later in the week. Linda, I’ll put something together for your book, the only problem for me will be the word limit! Great idea too…
It has been a while since I’ve posted here. I wanted to share a very encouraging testimonial from Really prefer to keep that private (Female Patient) From Minnesota who fought for her rights to have an all-female team and her husband present for her hysterectomy at http://www.patientmodesty.org/testimonials.aspx. Many hospitals will not allow you to have your spouse or personal advocate not employed by the hospital and I am so glad she successfully fought for that. Patients under anesthesia are very vulnerable to sexual abuse because the medical industry basically gives you no rights while you are under anesthesia.
Misty
It sounds like this woman underwent a completely unnecessary hysterectomy.
Hi Misty,
It’s nice to see you. The testimony by ‘Really prefer to keep that private’ is a wonderful success story and I appreciate you sharing it. The staff in the first hospital were not going to allow her husband in the operating room, end of story. Reading about the reaction from staff was awful, especially given the woman’s history. Fortunately your site motivated her and her husband to forge ahead in search of a different doctor and as a result she was spared any further trauma.
I was not clear about the need for a hysterectomy given the information, but that is a separate issue. The fact the husband was with her throughout and her success in stopping the use of sedation, made for a very happy ending!
Your tips for patients, information about Versed and other unnecessary interventions are valuable reading. I agree that patients under anesthesia are very vulnerable . . . and success stories are unfortunately extremely rare. Good for you Misty.
Sue XO
Sue,
That was an encouraging testimony! I definitely wondered why she had a hysterectomy. It was unclear about exactly why she needed a hysterectomy. My article on hysterectomy that her husband apparently found at http://patientmodesty.org/hysterectomymodesty.aspx addressed the fact that about 85% to 90% of hysterectomies are unnecessary. There is a link to article about why hysterectomies are often unnecessary.
Of course, the main thing is I am happy she fought for her rights to modesty and for her husband to be present for surgery.
Misty
How can I be certain?