Has #MeToo reached the doctor’s office yet?

There’s been some forward movement in parts of the medical community due to #MeToo. Much attention has been given to the high profile abuse case involving Larry Nassar, a former doctor for the U.S. Olympic gymnastics program convicted of abusing more than 150 women and girls, and there’s been recognition of the leniency with which doctors accused of assault are treated (source). There has also been some change regarding laws. Last year California became the first state requiring doctors to inform patients before an appointment whether they have been disciplined for sexual assault or other misconduct (source).

The attention, acknowledgement, and efforts to implement changes are improvements, but the movement doesn’t appear to have had much of an impact on women’s routine doctor office visits. Routine visits to the doctor account for many of the encounters women have with the medical community and yet what happens to women in this context seems to have been largely overlooked in the #MeToo movement.

Women are often vulnerable when they visit a doctor and the context in which screening tests and exams are presented increases this vulnerability. Some women believe they need to do what the doctor instructs them to do and others might be concerned if they aren’t compliant they won’t have their health care needs met. Women who are not going to the doctor for the purpose of a pap test or pelvic exam might find themselves having one anyway because their doctor has told them they should have one or that they need one.

Some doctors use coercive tactics, asking the woman about her last pap test or exam before addressing her health needs, instructing her to undress then quickly leaving the room without giving her an opportunity to speak up, and carrying out the pap smear or exam before attending to what she needs. In these cases women have been given no opportunity to consider options or to decline, instead ending up naked with legs splayed, feet up in stirrups, undergoing an invasive exam that they had no intention of having.

All exams and screening tests are elective; women have always had the right to decline pap tests, pelvic exams, and breast exams. Unfortunately some women remain unaware of this fact. Some doctors fail to disclose the fact all tests and exams are elective and instead present screening as if it were a mandate (source).

Meaningful change could be made if doctors were mandated to start disclosing to women that they have a right to informed consent regarding all screening tests and exams. This would help ensure doctors disclose balanced information about the pros and cons of screening and exams, and enable women to make up their own minds.

The mandate would address the coercion women face, such as some doctors’ tendency to withhold healthcare or medications when women question or refuse pelvic exams and pap tests. Rather than prioritizing pap tests or other invasive exams, doctors would need to disclose balanced information about the pros and cons, invite discussion, and respect the woman’s decision if she decides to decline.

Mandating doctors to disclose women’s right to informed consent would better equip women with the means to protect themselves from sexual abuse when attempting to seek health care. Currently women are often not offered information or a choice, leaving them without any way to protect themselves from non-consensual, penetrative exams.

Until these changes become visible it seems the #MeToo movement has not yet reached the doctor’s office.

More on this topic:
Informed consent for pap smears missing
Pap tests are not mandatory
The other side of the speculum: A male doctor’s point of view
What some male doctors do when women say no
Media messages about screening
Sexual abuse under guise of healthcare

20 comments

  1. The #metoo movement needs to reach the doctors office.

    Dr V. and his practice nurse G.G. are both culpable of sexual assault. In fact all those connected to the NHS cervical screening programme are culpable of sexual assault.

    Historically women were given no choice whether they had smears or not. Like me, they have been tricked, conned or just plain bullied into having smears. The invitations that were posted out made it seem like getting smears was mandatory for all women.

    That is why PHE are panicky about insisting smears are a women’s choice. They know how the programme was operated. It operated like this unquestioned for about 30 years.

    I wonder how many NHS doctors should have their names recorded on the #metoo website. The numbers must be in the thousands.

    • Linda while I agree with everything you said..I think PHE have started announcing it’s a choice and always has been to try and ward off legal action. Yes women have been treated appallingly and we know it but by insisting oh it’s a choice……
      The word is getting out online it’s a choice and a pretty useless test at that
      Someone posted a template opt out letter online
      I think the medics are running scared…

  2. I had an idea for something it might be interesting to feature on this site: do readers have information regarding healthcare providers who *don’t* push paps/pelvic exams, or at least, respect their patients’ decision to opt out?? Is it too optimistic to even imagine that doctors like this exist??

    It might be nice to put together a state-by-state database of said providers. I’ve heard of people in the LGBTQ community putting together lists of providers who they had positive experiences with. This would be the same thing. I have lived in the Boston area for 11 years and have not had any success finding a healthcare provider I can work with, though at the age of 33, I would like to.

    • I would *LOVE* to have something like that available! I’ve had a few doctors in the past who saw me for something specific, or followed me for something specific, who never pushed paps (I left the question on the form blank, and they didn’t ask). Much more often, when I leave it blank, I have paps pushed on me to the near exclusion of the problem for which I came in. Look: If I wanted a Public Service Announcement about paps, I’d turn on a TV or pick up a pamphlet. If I’m seeing a doctor, I want something treated – not an unreliable test for a rare cancer hard-sold to me, along with the provider’s insistence that they have some right to get into my pants without my consent – using coercion at least.

      It’s not practical to see every provider in your area! A city such as Boston has plenty of providers, certainly, but multiply that out by about $150-$200 per visit, that’s a big chunk of change with a lot of aggravation. If you live in a rural area, such as I do, I don’t have nearly as many to choose from, but I’m looking at anything from 30-70 miles one-way to see them, with all the time, expense, and the cost of the visit. The alternative is to leave my diabetes untreated, and die a pretty gruesome death within 5-10 years.

      • BTW: I made a mistake. The reply below is me BH, the original poster of this comment. I accidentally put my email in the name field.

    • Just wanted to pipe up here. I’m in the US by the way. My last birth was a home birth, and during my pregnancy I discovered, much to my pleasant surprise that at least two midwives in my area do gentle smear tests for any woman that might be worried about cervical cancer or interested in that test. They offer self-testing first, but if you opt to have them do it, I know for a fact that they are truly good at what they do. I had PTSD from my first pap and pregnancy (both happened at the same time). I didn’t think I would get a cervical exam during my home birth, and the midwife said it was unnecessary and optional. Towards the end, after a long labor I opted for one. She was amazing, just amazing. I could never imagine a hospital doctor being so sensitive and humane. So people like this do exist, who do their job as a caregiver by actually giving you a choice and care. It would truly be amazing to have a database for people and doctors like that, as well as you say, a list of ones that are horrible! I’ve sworn off paps myself, I’d rather die of cervical cancer than suicide, but I know plenty of women who still do get these tests.

  3. Somehow, my original reply to this got deleted.

    I meant to write that I agree it would be very difficult to formally survey all providers in any area. I meant that maybe this site could informally ask women to write in with their informal experiences about how they were treated in various healthcare settings in regards to paps/pelvic exams and publish a compilation of responses.

    I actually got this idea from a post on a site called “Fearless Formula Feeder”–not looking to get into a debate about breast/bottlefeeding but keep in mind that some women with body image/trauma issues may have the same anxiety around gyn exams as they do around breastfeeding, particularly as it is coercively pushed in modern maternity wards. The site had a list state-by-state of various hospitals with reader comments about whether or not their feeding decisions for their children were respected. I was thinking this could be a similar thing.

  4. If anyone here is following “The Handmaid’s Tale” TV show, the most recent one (Season 3, Episode 9 “Heroic”) has June, our heroine, really pushed off-center when she’s in the hospital under orders to stay with someone who is brain-dead until her baby comes. It’s become obvious that women, especially handmaids, are nothing more than life-support systems for a (functional) reproductive system in this dysphoric near-future – which has all women pitted against each other by roles and competition for positions to which they are assigned. After the baby is born by C-section, the woman, who is apparently brain-dead, is essentially forgotten – taken off life support, and minimally cared for since she’s not dead.

    She is sitting in this hospital room, and a lot of little girls go by. Eventually she talks to one, and she finds out in another conversation that the girls are there for their menarche exam – which includes medically deflowering the girls who’ve passed menarche. From talking to the girl, her goal in life is to get married and have babies. Note that having babies has become a problem in this society, presumably from the nuclear fallout they’ve experienced, but they cannot test the sperm count of the men. June has decided that saving children from this life is to become her goal in the future.

    It’s clear to me that the menarche exams happen in wealthy countries today – people are encouraged to bring their preteen and teenaged daughters for “exams” even before menarche – but the pelvic exam is supposedly “usually” left until later. They’re still examined and seen as far as how far into menarche they are – or are not. I don’t see much of a difference.

    Oh yeah, the handmaids are ritually raped monthly by their assigned “commander” and his wife – they’ve got nothing to say about their bodies either, and are pregnancy tested a few days later, and given a proscribed prenatal regimen. Again, I don’t see this as much different than reality – even though you’re supposed to be able to give “informed consent” – but that won’t stop them from harping and pressuring you when you seek any other medical care – ignoring the problem for which you’re there.

  5. So another perverted doctor has been outed. There was an article on the news last night featuring a doctor called Manish Shar. Apparently this dirty old man has been performing dozens of smear tests and two finger rapes on all of his female patients, including young teenagers. He has been convicted of 23 accounts of sexual assault.

    The problem with the British Cervical Screening Programme is that it not only has been a perfect cover for perverted doctors but it has actively encouraged this behaviour due to the manner it has been carried out over the past thirty years.

    How many more doctors are out there currently getting away with performing loads of unnecessary smear tests on their female patients to get their perverted kicks.

    I believed Dr V raped me. I was a young woman coming into his consultation room not knowing what he was planning for me. He should have given me the option. he could have said go home and have a think about it. But no. He was determined to do one right there and then. I was like a lamb to slaughter.

    My head spins with the thought it is still happening to thousands of women up and down the country. In fact all over the world. It is a huge big scandal that has been going on for far too long with no end in sight.

      • Should any medic mention smears to me now I’d wipe the floor with them. Should they mention Jade and smears my reply would be…of course! Smears REALLY helped her!!

  6. This screening programme is a pervert’s dream. Opportunistic screening is not only encouraged, it is rewarded and we all know how much pressure is put on us to screen, which in my opinion amounts to coercion and negates consent. Imagine any other scenario where a woman is put under considerable pressure to remove her underwear and let a complete stranger penetrate her body. All done of course for her own good, endorsed by the medical profession, the government and the majority of the brainwashed public.

    • Chrissy and Kat – I’ve been thinking long and hard about this, preparing me for my annual checkup for my diabetes and thyroid issues – wherein opportunistic screening is pushed, to the near-exclusion of the actual issues. Yes, it feels like I should change my name to “the life support system for cervix #814230968” – as that seems to be their interest.

      I’ve got all sorts of information that CC is a rare disorder. Diabetes, OTOH, is in the top 10 causes of death. However, to get treatment, I must submit myself for penetration and groping. If the pap comes back abnormal, I find the follow-on procedures less acceptable – it’s one thing to be penetrated and hurt some – it’s quite another to have them rip pieces of a very sensitive area off without anesthesia, or to have parts amputated. I would expect the pressure and coercion to increase after a pap – with a notoriously-high false positive rate.

      This falls into another area. The first thing I remember about being alive was an act of sexual assault. I had more throughout my childhood, but their “reasons” given went from “This is for your own good – teaching you how to please a man (your future husband)” to “This is chasing the demons out” (as evidenced by screams, from a certified-insane perpetrator) coupled with a hefty dose of “It’s why we feed you” or “I guess I’ll let you live another day”.

      So, while I won’t die of diabetes tomorrow of denied treatment, submitting to it is certainly an implied requirement of getting continued treatment.

      I’ve had a lot of therapy on the topic, and I’m usually more-or-less okay with what happened in the past. A good bit of that CBT I received is based on the fact that I’m an adult now, I can successfully refuse or fight it off, and have legal recourses. If, as they try to present, I have no choice in whether or not they penetrate me with a speculum/fingers, that belies all of the therapy. It was okay while it lasted. As I get older, I expect to be given less choice and more necessity of getting medical treatment. The concepts of bodily integrity, bodily autonomy, consent just fly out the window if I accept that. This takes me to a very dark place.

      The probability of getting CC in a lifetime is 0.65% in the US. I cannot say for sure what the probability is of demons living in my body. I personally don’t believe they exist, but some others put a moderately-high probability on that. Like I can look at the statistics and disbelieve CC is going to suddenly explode in my body, it would be considered pathological for someone to believe demons were taking over their body. With demons, it’s cause for mental health intervention: With CC it’s considered “being responsible”. To WHOM?

      At the same time, if I permit someone to penetrate my body with fingers and or an object (speculum, brush), I will experience it as another rape. According to RAINN.ORG (Rape, Abuse & Incest National Network), about 16% of rape victims attempt suicide over the next year. If we figure about 1/3 succeed, that gives about a 5% chance of dying. OTOH, cancer.gov gives me a 0.05% chance of being diagnosed with CC in the next 5 years and a 0.02% chance of death of CC. And, acquiescing to it one time does not let me off the hook for the next times (okay, 3 years from now, best case). And, we won’t mention the unpleasantness of reliving this over and over, and considering that it WILL happen again.

      Now, I’m an adult and I’m not powerless. Although I’ve spent a ridiculous amount of time researching these things and finding others, I’ve got the ammo now to let them have it when they bring up the pap crap in lieu of actual medical issues. I’ll get them to document that they’ve refused me treatment because I won’t accept an optional cancer screening – involving penetration. Then take it to the media. I wonder how the person on the street will accept it under these terms?

      Note that I’m in the US. That means I’m paying by the minute to let ’em have it.

  7. I am posting up this link to natural treatments for HPV infection because I know so many women are visiting this website stressed out about bad pap test results or just not wanting to even visit the doctor for any reason.

    https://aor.ca/understanding-natural-treatments-for-cervical-dysplasia/

    Some of the ideas people have used was getting the green tea extract cream but couldn’t find it or buy it. For inside green tea extract capsule contents can be put into melted coconut oil and for outside mix it in petroleum jelly. Of course vitamin and other supplements are very important.

  8. It would be nice if something happened and made the area of medicine more transparent and accountable. So far, it is almost exclusively a closed ranks elite club, with very rare exceptions who do speak out, act in the interests of patients and thus actually save lives, not just make money.

    Just in today’s Australian news: it has finally been revealed that one doctor endangered lives of 1500 patients by botching endoscopies and colonoscopies. Medical authorities knew about it since 2018 yet chose to keep the patients in the dark. Thanks to one decent doctor, the botched practice was exposed. Unfortunately, the medical authorities will most likely find 1001 reasons why it’s not the system fault. The negligent doctors will probably live the rest of his life in luxury, while his patients will be suffering and dying.

    So much for cancer screening! Submit to an extremely invasive procedure, get it botched, and then, if you are lucky, the authorities will admit the error and tell you to just undergo the torture again.

  9. If you look at cultural practices reported in the news, it appears that the shoddy treatment of women is endemic across all medical faculties across the NHS.

    The Barrow-in-Furness and Shrewsbury and Telford scandals (where women were degraded, subjected to excruciating and unneccessary pain, and not listened to, during childbirth); the vaginal mesh scandals; cervical and breast screening (not respecting informed consent).

    Even in the rare cases where a pelvic exam may be requested independently of screening by a woman for diagnosing endometriosis for instance, I have read of women being dismissed and told to endure painful periods that interfere with daily lives because “it’s just part and parcel of being a woman”.

    When are the majority of the general public and the pro-screeners going to get it? The medical profession as a whole, is not truly interested in helping women, and that is the truth.

    • “Even in the rare cases where a pelvic exam may be requested independently of screening by a woman for diagnosing endometriosis for instance, I have read of women being dismissed and told to endure painful periods that interfere with daily lives because “it’s just part and parcel of being a woman”.

      I have personal experience with this. I avoided routine doctors visits for years in order to get out of pap smears. The one time I consented to an exam for pelvic pain and irregular bleeding which I let go for a *couple of years* (which I accept responsibility for), I was sent to get two ultrasounds and when nothing showed up, I was basically told that it was “hormones” or maybe I was imagining it. It would have been nice if they could have figured out it was just hormones before they ordered testing–one of the ultrasounds was kind of invasive.

      Needless to say, unless I get pregnant, I’ll never go in for Ob/Gyn care again.

      • I can relate to this too.

        I went to the doctor with irregular bleeding and spotting and asked for blood tests as due to my age I believed it could be hormonal.
        This was refused as being unnecessary and I was told “You are having a smear now”. I had been avoiding smears and they knew this as there were notes on my files that I had refused screening at last visits.
        I felt like I had to have one as I had gone for help. After the smear I was told I would be booked in to a specialist and for a scan. I said a scan was fine and the doctor said ‘You know it will be an internal scan’
        The smear test was normal and I heard nothing more for 9 months. In the end I rang the doctor and said I wanted to go private and have an external pelvic scan only (not the internal one). She said ok but then when I went for the scan they said ‘We have you down for an internal scan as well’. I flat out refused and said I am only having the external one which they were ok about after a little discussion.
        Everything was normal and that was it, no follow up of any kind.
        Just received a text from doctors office that I’m due to come in for a recall smear (?!). Zero chance of that happening as this experience has shown that my doctor just wants to tick off the smear and has zero interest in any other follow up NON INVASIVE support or care.
        Bracing myself for the inevitable follow up call regarding the smear!!

      • Bec – Tell them that after researching all the evidence, you have made an informed decision to opt out of all cervical screening from now on.
        No more discussion required.

        Oh, and you might be tempted to let your doctor know how disappointed you were that an issue that was causing you significant discomfort and affecting your quality of life, was basically ignored and not taken seriously (I know I would be!).

        If your surgery has a website, you might be tempted to leave a review 😉

  10. It would be great if someone made a documentary about the info on this site. Has anyone here contacted any filmmakers? I was watching an interview with Kirby Dick and Amy Ziering who make award winning and high profile documentaries including “The Hunting Ground” and “The invisible War” and “The Bleeding Edge”. They gave an email address at the end of the interview. Would people here be interested in sending them info?

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