The Fraught History of the Pelvic Exam

When I was a medical student in the 1980s, the school hired “pelvic instructors” who taught us how to do exams in a painless and respectful way. They even allowed us to perform practice examinations on them.

But at the same time, senior doctors urged me to perform pelvic exams on anesthetized women about to get surgery — women who never gave consent. Indeed, despite decades of objections, pelvic exams without consent have continued to occur, leading the Department of Health and Human Services to issue new guidelines earlier this year that mandate the “explicit consent” of patients…

Click link below to read the rest of this article by Barron H. Letner, 39 September 2024, on STAT10: https://www.statnews.com/2024/09/30/pelvic-exam-exposed-wendy-kline-history-pap-smear/

My response to the editor:

For generations, women’s healthcare in the Western world was shaped not by compassion or collaboration, but by a systematic campaign in which male physicians seized control of childbirth and reproductive medicine. The article fails to acknowledge a critical historical reality: male doctors did not simply “advance” women’s healthcare—they conquered it. They criminalized and persecuted the female midwives who had served women for centuries, branding them as unscientific, dangerous, or even immoral. Many midwives were arrested. Their practices were outlawed. And after forcing women out of the profession, these same men then barred women from entering medical school. When women attempted to establish medical schools of their own, powerful male-led medical institutions shut them down. This was not accidental—it was strategy. These men understood perfectly well that, given a choice, women of the 18th – early 20th centuries would overwhelmingly prefer to receive intimate care from other women.

To justify their takeover, male physicians invented a new cultural narrative: that there is “nothing sexual” about men performing invasive pelvic, breast, and bodily exams on women. This artificial separation of women’s sexuality from their sexual body parts did not arise organically; it was constructed to legitimize male authority and normalize women’s vulnerability. It formed the foundation of a medical culture that was often cruel, dismissive, and traumatizing—especially in childbirth.

I know this firsthand. My first child was born in 1982 at Stamford, CT. I was never told it was a teaching hospital. What unfolded felt like something written by Stephen King. I had no right to informed or voluntary consent. Despite tearful protests, I was forced to allow a male intern to practice a pelvic exam on me—a deeply violating experience for anyone, but especially for me as a rape survivor who had already endured repeated sexual assaults by a 50-year-old GYN in my teens (including naked photos without warning or consent). I experienced what felt like three separate rapes during my labor. At one point, I was tied down on the operating table while a nurse held my shoulders so I could not move. The trauma was profound and long-lasting. I was diagnosed with PTSD because of OBGYN violence.

Across eight births—with OB-GYNs, a family practitioner, certified nurse midwives, and a homebirth midwife—I learned this truth: for many women, even when a male doctor “does everything correctly,” an invasive exam can still feel sexually violating. The medical profession must recognize and validate this reality. Women should not be forced to sacrifice their emotional or sexual well-being for their physical health. It is time to build a healthcare culture where women are offered true choice, true consent, and trauma-informed care that honors their dignity, history, and humanity.