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Groton residents advocate for ban on non-consensual pelvic exams

A measure to prohibit the practice of performing unauthorized pelvic examinations on sedated patients has come before the Connecticut General Assembly's Public Health Committee again, and advocates hope that, unlike last year, the bill makes it out of committee.

As part of a hearing on 14 bills Monday, the committee listened to testimony on Senate Bill 243, which states that a licensed physician or medical student may perform a pelvic exam on a patient under deep sedation or anesthesia only with informed consent of the patient or a legal representative, if the exam is within the scope of the procedure being done, or if it's required for diagnostic purposes.

Studies and reports indicate that medical students have historically performed pelvic exams — sliding one or two gloved fingers into a patient's vagina to check for a cyst or other issue — at teaching hospitals as part of their training.

Last month, The New York Times wrote about an Arizona nurse who got a pelvic exam without her consent in 2017, which brought up memories of her history of sexual abuse.

In a survey of 101 medical students across seven American medical schools last spring, ELLE magazine found that 92% reported performing a pelvic exam on an anesthetized patient and, of that group, 61% said they performed the exam without explicit consent.

In the article, three Yale School of Medicine students anonymously spoke of performing pelvic exams when they didn't know whether consent had been given or were certain it hadn't been. Yale said it is its practice to obtain consent at the preoperative visit with the gynecologist.

Proponents of the bill in Connecticut point out a patient under anesthesia wouldn't know if a pelvic exam is done unless informed afterward, and medical students may be too fearful to speak up, making it difficult to know if or when this happens.

The bill didn't make it out of committee last year because legislators felt a ban was covered under existing medical assault laws and saw no evidence the practice was happening in Connecticut.

Rep. Dorinda Borer, D-West Haven, commented that the Public Health Committee often passes bills that are proactive.

The language was changed only slightly since last year, but Rep. Christine Conley, D-Groton, said she is working with the American College of Obstetricians and Gynecologists, Planned Parenthood and Yale School of Medicine on other changes.

She wants the bill to be more specific about emergency procedures. For example, someone could be in a car accident and arrive at the hospital unconscious, and it turns out they're pregnant.

The bill currently refers to "female patients," and Conley wants the language to be gender-neutral, to include people who have uteruses but don't identify as female.

Whereas last year's bill had only two co-sponsors, Conley is one of 25 co-sponsors this year. That includes 23 Democrats and two Republicans — Sen. Rob Sampson, R-Wolcott, and Rep. Craig Fishbein, R-Wallingford.

Conley pointed out that nine states have banned the practice, and similar legislation is pending in 15 other states.

"Having a non-consensual exam violates every component of trauma-informed care: trust, empowerment, choice, collaboration," said Kathleen Callahan, community programming and development lead for the Connecticut Women's Consortium.

A vocal advocate for the bill is Groton resident Terry Tsang, a drug development director at Pfizer. In written testimony, Tsang called the practice of non-consensual pelvic exams the equivalent of sexual assault and questioned, "Why not ask first?"

It is the opinion of the American College of Obstetricians and Gynecologists that pelvic exams performed solely for educational purposes should only be done with specific consent. In written testimony with the Connecticut State Medical Society, the group opposed the bill.

"We fully support the need for providers to have an explicit conversation as part of the consent process, addressing the importance of pelvic [exams under anesthesia] as part of the procedure," they wrote. "However, it is our view that government attempts to mandate specifics of medical practices, especially regarding informed consent processes, can set ill-advised precedents."

UConn Health does not have any concerns with the bill "as it codifies our current practices," OB-GYN professor Dr. Molly Brewer said.

e.moser@theday.com

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