non consensual pelvic exams
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Medical Rape And The Need For Systemic Change

It has taken me a month to finish this blog post because I have been sitting with so many complex personal feelings and systemic concerns . It has activated deep rage about broader scale injustices as well as personal memories of outrage in my own family.

The subject matter my podcast guest A’magine and I focused on during our discussion about her documentary is justifiably dysregulating and I also wanted to digest some of my communities’ reactions to this information being shared before responding. Reading this could be activating so please choose wisely when to read it. Maybe put some sand bags on your feet, breathe deeply into your belly, have your dog close by, an Epsom salt bath waiting or arrange a call with a dear friend afterwards. Believe me, I had to have plenty of those conversations.

To heal the collective, we must first heal ourselves. Otherwise, what we dissociate from and/or deny in ourselves (or in others) creates blind spots and avoidance as well as prevents us from being able to see what is around us that needs our attention.

I felt rightfully agitated watching At Your Cervix, a documentary film by A’magine, about non consensual pelvic exams given to unconscious patients, who are receiving non related surgeries at teaching hospitals. Afterwards, I was eager to make the reality of this practice known to more people so it can stop. 

After all, awareness is the first step towards changing anything personally, socially, politically, and systemically even non consensual pelvic exams. If we do not turn towards something, acknowledge it as actively occurring or that it is possible, and know what our choices are, we can’t give consent, prevent it, or change an outcome.

Inside dual (black and white) thinking lives a binary that leaves everything that happens in the gray out of the picture and out of consciousness. This conditioned (and conditional) way of thinking creates denial of the complexity of humanity. Either something happened or it didn’t; a person is good or bad. If I haven’t experienced it, it must not have occurred. Yet, that is not the case. Just because your priest or biological father didn’t molest you, most of the world can now acknowledge it frequently happened globally, in the past, and continues to be a problem in the present.

And we urgently need new frameworks to be able to see things differently than we are trained to see them. We are always trying to make sense of the world around us and fit experiences and information into the reference points we have been taught. Once we have these frameworks, we look for familiarity to confirm that it is actually true. If we do not find that, then we may likely reject this new information. We want proof of our reality to be confirmed, otherwise, it feels too confusing and dissonant. It is easier to just say, “No, that isn’t true, that doesn’t happen.”

I watched a documentary about Ted Bundy, who was considered dreamy by female onlookers during his trial even as the details of the rapes and murders were described. Were these women able to hold both and or were they miraculously able to deny, not hear or see the facts? How many times do we need to hear on the news that the latest serial killer or kidnapper was nice and quiet and kept to himself? You can be a nonintrusive, even good neighbor, and also be a sociopath. 

We reduce and oversimplify to protect ourselves. We want to think we have control of the people around us. We know how things work. We know what to expect. We want to be seen as the “good guys” if the choice is either good or bad.

Out of a desire to increase awareness among doctors, psychiatrists, and psychotherapists, who work with survivors of trauma, as I do, I shared information about At Your Cervix on a ketamine-assisted psychotherapy listserv that I am on. Some of the responses from doctors were disheartening. One could think that this is a pre-filtered group of people who would want this information, care about injustice and abuses of power, especially inside the systems they were educated in. It was too close to home, apparently.

If you approach the world through a dualistic lens—to accept and acknowledge this reality among doctors and doctors in training, means you are either good or bad, and all doctors take an oath to do no harm, so this surely is not possible. This must be a practice in the past, must be done in less sophisticated hospitals, must be truly rare. Unfortunately, all they had to do was watch the film and read peer reviewed research to know this is a very active practice that is legal and continues to be done even in states where it is not legal.

To deny, dismiss and minimize is often the first response of a parent when a child comes forward to share they have been sexually abused by someone else in the family. I have firsthand experience with this in my own family. I have sat with clients eight hours a day for 20 years and can attest to this fear-based reaction inside their families too. This is what “we” do to rape victims who choose to go to court. This was also the response for generations when people accused priests of sexual assault and continues to be the argument of people who do not believe cognitive bias plays a role in police brutality.

The United States has grown increasingly polarized over the past eight years. If politics weren’t enough, COVID and the vaccine added to the black-and-white thinking that has erupted across North America. There is both a heightened culture of fear, as well as a growing culture of awareness and response-ability around shadowy behavior, whether it is sexual assault or police brutality. The systems in play keep a power-over versus mutual empowerment mentality in place.

How many black men need to be killed for people to stop denying police brutality and unconscious bias? How many adults accusing priests of sexual abuse needed to come forward before the Catholic Church actually addressed it and offered reparations, rather than denied it and sent the abusers to a different congregation to offend again?

Anytime people who’ve been victimized speak up, it is met with the same dismissal and denial and takes decades, if not generations, to be heard as valid. #Metoo started in 2006 and didn’t become widespread until 2017. Acknowledgment of pedophilia among priests in the Catholic church started in the mid-1980s and didn’t become a national scandal until early 2002. 

In 2021, 330,000 children were estimated to have been abused within the French Catholic Church over the past 50 years. Remember, this is only in France and doesn’t take into consideration those who are dead, didn’t come forward, or don’t remember. (

When I became a psychotherapist, there was no trauma training required for licensure and very little training around sexuality required. I trained extensively in working with trauma outside of graduate school, and also worked for years as a sex educator before licensure. 

I hope that things have changed. I hope that there is more curiosity and compassion, that basic awareness of a physiological response to trauma, how implicit versus explicit memory works, and statistics such as 1-in-3 women and 1-in-6 men (please note that most people, especially men, do not report sexual assault for decades, if ever) are understood to be conservative.

While some people may be on the ketamine-assisted psychotherapy list to ask purely pragmatic and logistical questions, i.e. about administering dosages, my assumption was most of us are also there to support people who likely have overwhelming histories of trauma, and enough anxiety and depression to bring them to ketamine for relief.

Ketamine is known to cause “k-holes,” which puts people into nonverbal and immobilized states, when administered in high doses. It is dissociative and can help people disconnect from ruminating thoughts and feelings too big to process otherwise. While this can be profoundly healing for some, this immobilized state can also be similar to the frozen state people found themselves in the past, when they were sexually assaulted, leaving them unable to consent or protect themselves.

One psychiatrist said the information about this documentary does not belong on this list. I disagree. Given that we are in a field of healing and treating trauma, and using strong medicines, such as ketamine to do it, it is everyone’s responsibility to be educated about trauma and consent from all possible angles.

I currently have a client who goes into a local clinic for Intramuscular (injections into the muscle which is stronger usually than a lozenge) sessions 2x a week. Beyond an initial consultation, he receives no counseling, is given the shot, and is left alone. No one is holding space or counseling him afterwards. Perhaps this is how the psychiatrist mentioned above administers Ketamine and hence is disinterested in what clients are coming in with and what they are feeling. Sadly, doctors and psychiatrists like this, who do not encourage awareness, support maintenance of systems that do not hold people accountable.

It is for the good of all to be informed and over-educated, especially as it pertains to abuses of power. Just as sexual abuse of power has erupted in other medicine guide communities in the past few years, it is better to address the shadow of a field rather than deny its existence. You cannot prevent something you are unwilling to look at. We all know how denial works in family systems. It is no different in other systems of power, whether that’s the church, medical field, the military, or government.

What comes out in the news is a result of the courageous few who report, as well as the “unlucky” few offenders who are caught. They are not the exceptions to the rule. We can all assume more of the abusive behavior is occurring and we would all be better served through increased awareness and accountability.

The same week that these doctors on this listserv were denying they received this kind of training around pelvic exams, my mom was in town. I shared a memory with her of a time I intervened while my stepdad was choking her. We then fled our home and hid out in a hotel for a week. This is a memory I have, but one my mom mostly dissociated from. She recalled packing the cooler with grapes and being in the hotel, but the details of why we left home were blank. 

I couldn’t forget it, because the rage I swallowed erupted that same day in ulcers down my throat, making it painful to speak and eat for that week. Both those who are abused as well as abusers can block out experiences that are too overwhelming to face. This happens around highly charged traumas, such as sexual assault and abuse, and police brutality, as well as minor incidents all the time.

How many of you have had a devastating experience, that the person who hurt you, or the bystander who witnessed it, denied or didn’t recall what happened? The person who caused hurt or harm is not inherently a bad person trying to gaslight (except when they are). Except for cases where abusers are sociopaths, either it was not memorable to them because it was not emotionally charged enough to create a permanent neural pathway, or they felt shame about it and dissociated to get through it. Either way, they tell the story to themselves and others that they believe, “It never happened.”

Four doctors on this list insisted they did not receive this kind of training on anesthetized patients. Maybe that is true, but again, I point to how common it is to engage in things and recall them differently than they occurred if you dissociated to get through them.

 Let’s assume that these doctors recalled their training accurately. I love that there are four of them on this list who were not subjected to this kind of training (and did not subject unconscious patients), but jumping to “I didn’t do that” is like saying, “I’m not a racist. I’m a good white person” in response to a conversation about systemic racism and oppression. How is concern and curiosity, versus defensiveness, not their immediate response?

One doctor doubted that the statistics about the number of students who do receive this training were actually accurate. None of them watched the documentary, but all clearly had a reaction.

For those who want to get in the weeds and argue about statistics, be dismissive, and over-intellectualize, I say “Bless Your Hearts” in the most Southern way possible, because really people, aren’t we beyond that? This condescending and nitpicking behavior walks the well trodden path of systemic racism and sexism deniers.

I have had numerous doctor and nurse clients who’ve survived the harrowing process of medical school. Maybe it’s just the medical staff that find me, given I am a trauma therapist, but what is repeatedly confirmed is that Western medicine is a hierarchical system similar to the military, in which very little is done to address the person with the most power when they are being abusive or inappropriate with subordinates. 

Similar to child sexual abuse cases, retribution is usually feared, which limits reporting. I’m psyched for those who had a different experience in med school. To the doctors who say they did not participate in non consensual pelvic exams, I ask, “What do you want other doctors to know about consent? Clearly you had a better experience.”

Perhaps those who were dismissive were among the elite, resilient beings who didn’t witness or experience abuse within this system. That doesn’t mean it doesn’t happen, and one might say they sound an awful lot like the kid in an abusive family, trauma bonded to their alcoholic parents, who abused their sibling(s), and denied their sibling’s experience because it differed from theirs. Or did it?

A doctor on this list voiced her fear that if practices, such as non consensual pelvic exams given by medical students to unconscious patients, are made more widely known that it could produce even more fear of medicine and people won’t seek necessary care. I get this. It is a valid concern. In her comment, I also hear a fear of guilt by association. 

If people know about this abuse then they will assume we are bad doctors or medical professionals who don’t care about consent. This attitude is dangerous because it supports a culture that allows suppressing people from speaking up to quell others’ fear. A historically similar approach was used to silence and deny abuse within the Catholic Church.

There is fear of change and revolution of old systems. You can choose to fight for things to remain the same, because that is how defensiveness comes across, or you can say one person being assaulted, one nonconsensual exam is one too many.

If you are a medical professional and are having a very big reaction to the information shared on my podcast, or this blog post, and are also unwilling to watch the documentary or go through the data–you are indeed a part of the problem. In fact, if you really are the 16% who did not have to sexually assault patients while they were passed out, I would think you would be even more willing to do something about widening the gap so that 16% becomes 20% and eventually 50% and hopefully 100%, so we make this heinous practice obsolete.

This is more information about the documentary:…/

You can listen to the podcast here:

If you’d like to communicate directly with one of the filmmakers, write to them here:

“Please feel free to pass my specific contact information ( on to any physician who cites their personal experience as evidence that non-consensual teaching practices are not widespread in American medical education. I would be happy to tell them about my experience on the other side of that issue as a patient who was used as a practice dummy without informed consent.

 In my experience, physicians often look back on their own training thinking they have done nothing wrong and caused no harm without realizing the problematic behavior they were engaging in because it was so normalized in their environment, and it is the patients who are left to suffer while they go on to perpetuate the same cycle with the next generation of aspiring doctors.”


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© 2022 By Charna Cassell, LMFT. Licensed Marriage and Family Therapist. MFC 51238.

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