[Content Notice: Sexual Assault, fatphobia]
The following is a first-hand account of mistreatment on several levels at the hands of a medical provider via Ania of Scribbles and Rants, a blog where she, along with her partner Alex, sheds insight onto matters as diverse as skepticism, feminism, disability, and the relationship between being an atheist and a person of color. I had the pleasure of meeting her at Eschaton last year and was impressed with her courage, passion, and intellect. I am even more impressed now.
When I was 18, I was assaulted by a doctor at the university clinic.
I had gone in to get tested for bacterial vaginosis. I was in love and wanted to make sure that I didn’t smell strange if the chance to have sex ever came up. The first doctor at the clinic was very kind. She opted not to use a speculum since I was a virgin, just like every other doctor I had seen for a vaginal issue until that point. I got a call a few weeks later to come in to get my results. The doctor who saw me then was someone I had not seen before. Before she even got to the test results, she began laying into me about my weight. She told me I was morbidly obese, that diabetes must be causing the smell. I was maybe 40 lbs. heavier than my optimal weight for my height. I didn’t know what fat shaming was then, but I tried standing up for myself, letting her know that my cholesterol, blood pressure, and blood sugar levels were all perfect.
The facts didn’t matter to her. She had decided that I didn’t meet her standards of fitness and that the best way to deal with it was to make me feel horrible about myself. Finally, we got to the results: I did not have BV. She asked me why I had come in to check on it, and so I told her. Unexpectedly, she offered to take a look. I was shocked, but I accepted her offer. I was worried and she was a doctor. She had to be professional, right?
As I sat on the table, getting ready for the exam, I looked over at her and asked her not to use the speculum. I was a virgin, I told her, and the other doctor said it wasn’t necessary. Then, I lay down on the cold table. There is vulnerability in that statement. Everything about the doctor’s office is about power. You sit, while the doctor stands above you. You are naked, while they are dressed. You are in pain, afraid, vulnerable, and they hold the answers. Everything about the doctor-patient relationship reinforces that power dynamic. I was vulnerable on that table, exposing my private parts to a doctor who had already wounded me. She had already established her power over me, so I knew that my request was a supplication. It was her power to grant it.
But she didn’t.
As I lay there exposed on the cold table, worried about whether or not I was normal, the doctor violated my request. She shoved an unlubricated speculum inside me and opened it to its widest setting. I can’t even remember what came next. I do remember the pain. I don’t remember walking out of the clinic. I do remember trying to rush back to my dorm; I didn’t want to cry in public. I looked for the room of the person I trusted most on campus but he wasn’t home. In my search for him, I ended up in a room with some people I vaguely knew. I broke down crying. I told them what had happened. I was bleeding, I was sure of it. I felt torn. But I was crying about the fat shaming, had every instance of it having happened flying through my brain.
I was lucky in some ways. The people I barely knew, who comforted me as I cried, said all the right things. They told me what happened wasn’t my fault. That what she had done was wrong and that I was right to be upset. Not everyone is so lucky. But I didn’t want to listen. I wasn’t prepared to face that what happened to me was assault, so instead, I concentrated on the fat shaming. I convinced myself that the assault was no big deal.
Years later, when I lost my virginity, I postponed getting a pap smear for two years. Normally, you are expected and encouraged to get one within a year of becoming sexually active, but I didn’t want to be in that vulnerable position again. Moreover, I became more sensitive to fat shaming. I lost my temper more quickly whenever my weight was mentioned. It tinged all my interactions with doctors. If they brought up my weight, I found it more difficult to trust them or found myself reacting negatively to the rest of the appointment. Every time a doctor failed to listen to me, it felt like another betrayal.
Everything came to a head when my GI made the decision to send me to the weight management clinic. The morning of the appointment, I woke up in a panic. My heart was beating like crazy. I was sweating. I couldn’t focus my mind. I found myself sitting in a corner, rocking back and forth and crying. I couldn’t understand why.
All I could think about was that doctor, her cold hands, the pain of the rough plastic edges as the speculum entered me, the stretching-tearing feeling of it being opened. I couldn’t get the feeling of betrayal, of being violated, out of my mind. Superimposed over those feelings was every instance when a doctor refused to listen to me, all the times when I’d had to be vulnerable with a doctor and had that vulnerability rewarded with pain and betrayal.
When I realized what was going on — a panic attack — I took some anxiety medication and tried to calm myself down. I spent my day curled around myself, trying to hold myself together, as I watched the clock tick down to my appointment. I was terrified. I didn’t know what would happen when I went into the clinic.
Throughout my struggle, I realized that what I had thought was no big deal had actually been affecting my interaction with doctors for years. Suddenly, I was facing the truth: What had happened to me was a big fucking deal. I had been assaulted. By a doctor. By a member of society that I was supposed to be able to trust implicitly. By a person that everyone expected me to trust. Not only had my body been violated, so had my ability to trust that doctors had my best interest at heart. What’s more, the violation brought on the realization that I was very much a member of a vulnerable population: people with disabilities are among some of the most at risk for sexual assault.
Sexual assault is about power. It is about the perpetrator feeling like they have power over the victim. It is not about sex. The inclusion of my genitals in this assault was incidental. The doctor in question wasn’t trying to get any kind of sexual thrill or fulfill a sexual desire. Who I was didn’t matter. She just needed to assert her own power over someone else, and I was the lucky victim.
If you asked her, she probably would have no idea that what she did to me was assault. She might make excuses about how she thought that the use of a speculum was necessary. She might say that she is a doctor and I am not, and that she knew better than I did. It doesn’t matter what she would say. The simple truth is that I made my boundaries clear and she violated them. The fact that she did so without even the courtesy of using lubrication (standard in those types of medical procedures) is just icing on the cake. To her, it didn’t matter if I felt pain. I wasn’t a human being in that moment. I was at her mercy. She was the one in charge and she could do whatever she wanted to me without fear of consequences. To her, what I wanted didn’t matter. And that is what makes it assault.
Assaults by doctors, unless sensationalized and existing on a large scale, rarely get talked about — and are sometimes even trivialized. We as a society put great faith in doctors. We don’t want to face that the people responsible for our health and well-being might be as human as the rest of us. We don’t want to address the fact that power dynamics that are enforced as severely as those between patients and doctors puts everyone at risk of abuse. We especially don’t want to talk about doctor abuse, because in doing so, we risk being lumped in with conspiracy theorists that take things too far and condemn the medical profession altogether. As an advocate of evidence-based medicine, it’s difficult to draw attention to abuses perpetuated by doctors and still defend medicine as a profession.
And yet, drawing attention to this abuse is very important. When someone is hurt so personally by a doctor, it can be easy to lose faith in the entire industry. Being violated by a doctor does more than affect you psychologically, it can also put your health at risk. It can make you afraid to be vulnerable with doctors again. It might mean that you try to protect yourself by keeping things to yourself that the doctor should know about. But more importantly, talking about doctor abuse is essential to help victims know that they didn’t do anything wrong and that they are not alone.
Whenever I discuss what happened to me, someone always feels the need to mention that the doctor might not have been thinking about consent but might have simply decided that using a speculum was necessary. Who was I, as an untrained patient, to decide what equipment the doctor needed or didn’t need, they ask? I have questions of my own. If doctors know better, does that mean they have the right to ignore the boundaries I set for myself? Does that mean that I have no say in what happens to my body? And if so, is my body really mine? What about your body? And where do we draw the line?