I am a woman. I live in the United States. And I do not have access to safe and dignified healthcare.
Sadly, that is not an uncommon scenario. However, you may be surprised to learn that I live here – in Connecticut.
Our state is one of 31 in which it is legal for medical students and trainees to practice pelvic and rectal examinations on anesthetized or unconscious patients without our direct and informed consent.
When we sign on the dotted line of a consent form, our bodies become fair game for poking, prodding, and penetration by students and trainees. There is language in those consent forms regarding student involvement in care, but it is typically vague and buried in the text. Having reviewed numerous consent forms, I have yet to see one that mentions pelvic or rectal exams specifically.
Every year since 2019, legislation that would ban this practice and require direct and informed consent from patients before our bodies are used for the practice of intimate exams by students has been introduced in our state’s legislature.
Opponents of this legislation have claimed there is no evidence that this practice even occurs in our state. According to them, that makes it unnecessary. However, Lori Bruce – a Yale bioethicist – has confirmed, “from national survey data as well as local focus groups,” that it does, in fact, happen in Connecticut. A 2019 article by Dr. Jennifer Tsai further confirms it, even providing testimony from Connecticut medical students who have conducted these exams without the direct and informed consent of their patients at the behest of their clinical supervisors.
In light of this evidence, this legislation is sorely needed if Connecticut residents are to be able to seek needed healthcare safely and with dignity.
I myself am a survivor of exploitative medical teaching practices. As a child, I was brought to a Connecticut teaching hospital for treatment of a skin condition. There, I was forced to show my naked body to physicians-in-training at every appointment. Sometimes, they photographed me – without my clothes on. What in any other circumstance would be considered child abuse was suddenly considered acceptable because it was being done by medical trainees for educational purposes. But that did not change the impact. I walked into that hospital healthy except for a superficial skin condition. I walked out with PTSD. And more than two decades later, seeking healthcare in our state remains a risk for those of us who do not want our bodies used for teaching purposes without our direct consent.
Currently, we technically can edit our own consent forms to explicitly prohibit intimate exams by students and trainees and hope that our wishes are respected. Unfortunately, many people are unaware that they have this option.
Individuals – including myself – often experience being rushed to sign consent forms without reading them. Others are unaware – because of the vague language in current consent forms – that this practice even exists. It would never occur to them to specify they do not want their bodies used for intimate exam practice by students, because those “in the know” simply do not specifically disclose that this might happen. And many believe they do not have the right to refuse student exams or involvement in their care. They think that if they seek care at a teaching hospital – even if it is the only hospital available to them – then they are obligated to allow students and trainees to observe and even actively participate in their care. That is simply not the case.
Access to safe and dignified healthcare is a human right. We are not required to trade our bodies for access to that care. And with teaching hospitals the only option for many people – either because of location or because of specific, specialized healthcare needs – it is erroneous to assume that we imply our consent to be used as human teaching tools simply by seeking care in one.
In 2019, a Connecticut teaching hospital submitted public testimony in opposition to SB 16 – the first iteration of the proposed consent legislation. Instead, they recommended a reliance “on medical societies to establish…standards for obtaining consent.” All you have to do is look at my story and the stories of other survivors to see that those standards, set behind closed doors without the input of the people they impact or that of our elected representatives, do not protect patients.
Some opponents of legislation to ban non-consensual intimate exams by students and trainees argue that the situation is being “blown out of proportion.” One medical student asserted “there is no scandal – poorly informed activists and media outlets are seeking to invent one.” We – myself and everyone else fighting for this consent legislation – are not “poorly informed activists.” We are survivors. We are concerned citizens. And we are human beings, who are demanding that the law recognize and protect our right to make choices about our own bodies.
This fight has been a long one but powerful one. Earlier this year, I worked with Warriors C.A.R.E. to launch a petition on Change.org. There are now over 107,000 signatures from people in our state and outside who stand in solidarity with our state’s residents in demanding justice and protection for us when we are at our most vulnerable.
With the 2022 legislative session now underway and the newest iteration of consent legislation now before the Public Health Committee for consideration, I am hopeful that this is the year we will finally get that justice and protection.
Livia Fry of Stratford is an Activist/Organizer/Advocate with Warriors C.A.R.E.