When Medical Protection Comes at the Expense of Patient Care

A Survivor's Perspective on Bodily Autonomy, Medical Neglect, and the Shame of Asking for Care
As a child, my body was violated, exploited, invaded, and exposed in ways no human being should ever experience. I was subjected to sexual abuse, trafficking, and medical experimentation. My body was treated as though it belonged to others, while my own needs, dignity, privacy, and humanity were disregarded.
I had no meaningful choice about what happened to me. And when I actually needed legitimate medical care, I didn't receive it. Around the age of ten, I developed a physical condition involving my labia. I thought I had cancer and even after telling my mother who said it was probably nothing, I lived with that condition throughout my childhood because I was not taken to a doctor for the care I needed. It wasn't until 9 years later when I was an adult that I could take myself to a physician and pay for my own medical expenses, that I finally underwent surgery for a hernia and hydrocele that was large by then. Think about the contradiction.
As a child, my body was accessible to people who had no right to touch it. Yet when my body genuinely needed medical attention, that care was withheld.

Now, nearly fifty years later, I find myself confronting another troubling contradiction. This time, I am an adult. I have a voice. I can make decisions about my health. I can give informed consent. I can ask questions and seek medical attention. Yet when I need a medical professional to examine an intimate part of my body, I find myself wondering why no one is willing to look.

Eight Months of Symptoms, But No Physical Examination
For approximately eight months, I have experienced persistent vaginal discharge and irritation.
I have tried over-the-counter treatments for yeast infections. I have taken prescription medication, including Diflucan. I have also been prescribed an antibiotic in case the symptoms were caused by a bacterial infection. Nothing has resolved the problem. During one appointment, my physician wanted a vaginal swab to test for yeast and bacteria. The nurse instructed me to walk down the hallway to a bathroom, insert the swab into my own vagina, place it into a tube containing a solution, and return it to her. I did what I was instructed to do.
But I remember standing there feeling uncomfortable, uncertain, and somewhat bewildered.
Was I doing it correctly? Had I inserted it far enough? What if I collected the sample incorrectly? Could that affect the results?
I understand that self-collected vaginal swabs can be medically accurate and that many patients may prefer this method. But what troubled me was that I wasn't offered a choice.
No one asked whether I would prefer a medical professional to collect the sample. No one explained why I was being asked to do it myself. I was simply instructed to go down the hallway and perform the procedure. The results came back negative. Yet my symptoms continued.
Over the course of these eight months, despite repeated appointments and treatments, my physician never once physically examined the affected area.
On another occasion, I noticed what appeared to be an unusual bruise or skin discoloration in a private area near my buttock. I couldn't remember injuring myself, and its appearance concerned me. My husband took a photograph so I could show my physician. Rather than examining the area directly, my physician looked at the photograph. I began to wonder whether this was simply how medical care was being practiced. Then another patient who sees the same doctor mentioned a similar lack of physical examination. Perhaps it wasn't just my experience after all.

The Explanation That Left Me With More Questions

Recently, I returned to the medical office because the discharge and irritation had continued. I was also experiencing new discomfort on the left side of my labia, near the location of my past surgery. The sensations included itching, stinging, and discomfort, particularly when sitting or when my bladder pad touched the area.
This time, I saw a female physician assistant. She listened as I described my symptoms, but she did not examine the area either. I finally asked why the medical professionals in this office did not seem to perform physical examinations when patients reported problems involving their intimate areas. I also asked why patients were expected to collect their own vaginal swabs. Her answer surprised me. She explained that medical professionals were protecting themselves from accusations of inappropriate conduct. She told me that even if a vaginal swab wasn't inserted very far, it would probably produce an accurate result. She then described an incident involving another patient who experienced significant pain because she had apparently inserted the swab into her urethra.
I found myself thinking about the implications of what she was telling me. If a patient could make that kind of mistake, shouldn't there at least be a conversation about whether the patient was comfortable performing the procedure? Shouldn't there be an opportunity to ask for assistance? What happened to doctors and nurses giving care to their patients?
She also indicated that unless I was experiencing bleeding, a physical examination would not be necessary.
I wasn't experiencing bleeding but I was experiencing persistent symptoms that had not responded to treatment, along with new discomfort involving an old surgical site. And I couldn't help wondering what might be missed if no one actually examined the affected area.
A vaginal swab can test for certain infections. But it cannot visually identify every skin condition, tissue change, lesion, or other physical abnormality. I wasn't asking for an unnecessary procedure. I was trying to understand what was happening to my body.

When Fear of Accusations Changes Medical Care

I want to make something very clear. My physician has generally listened to me, offered choices, and treated me respectfully during the approximately two years I have been his patient. I am not suggesting that he or the physician assistant deliberately mistreated me because of my history of sexual abuse. In fact, from what I was told, their approach appears to apply to patients generally. And that is precisely what concerns me.
If medical professionals are avoiding intimate examinations because they fear accusations, what does that mean for the patients who need those examinations?
I understand that medical professionals deserve protection from false accusations. Their reputations, careers, and livelihoods matter. But patients' health matters too. There are safeguards available: informed consent, clear explanations, professional documentation, chaperones in the room, and the opportunity for patients to request another provider.
Why should the answer be to avoid examining an intimate area when an examination may be medically appropriate? And what happens when a condition that requires someone to actually look goes undetected?
We live in a world where countless survivors of sexual abuse have struggled to be believed. Children and adults have reported abuse only to be dismissed, silenced, blamed, or ignored. Institutions have sometimes protected perpetrators or their own reputations while victims were left carrying the consequences.
So when I hear that medical professionals are reluctant to examine patients because they fear accusations, I cannot help but recognize a painful irony.
We have spent generations fighting for people to take sexual violations seriously. But protecting against the possibility of misconduct should not result in patients being denied appropriate medical examinations.
Both concerns deserve to be taken seriously. Protecting patients from abuse and protecting medical professionals from false accusations should not be competing priorities. There must be a way to do both.
Two Extremes of Protection — But Where Is the Accountability?

There is something about this entire experience that troubles me far beyond my own medical concerns. It is the way our society can go to two completely opposite extremes, yet somehow the people who need protection, justice, and appropriate care can end up paying the price in both situations.
For years, I have spoken out about the sexual abuse, exploitation, and trafficking of children and adults. I have listened to survivors describe the unimaginable things that were done to them, the courage it took to speak about those experiences, and the devastating realization that the people responsible were sometimes protected by the very individuals and institutions that should have held them accountable.
We have seen perpetrators shielded by families, organizations, institutions, and people who would rather protect a reputation than confront the truth. Survivors are questioned, discredited, silenced, or left fighting for years to have their experiences acknowledged. Some never receive justice. Others never even receive an apology.
The people who committed the violations are sometimes protected from accountability, while the people who were violated are left carrying the consequences.
And now I find myself looking at what seems like the opposite extreme.
Instead of people being allowed to violate someone's body without consent, medical professionals are apparently becoming so concerned about being accused of inappropriate touching that they may avoid examining intimate parts of the body even when a patient has a legitimate medical concern and is willing to consent.
Once again, the professional or institution is being protected. But what about the patient?
What about the responsibility to provide appropriate medical care?
What about accountability when symptoms continue for months, treatments repeatedly fail, and no one physically examines the area where the problem exists?
I am not suggesting that these situations are morally equivalent. Sexual abuse is a deliberate violation of another human being. A medical professional choosing not to perform an examination may be acting out of caution, following an office practice, or making a clinical judgment. Those are very different circumstances.
But the question of accountability connects them in a way I cannot ignore.
At one extreme, people can be protected from accountability for touching bodies they had no right to touch. At the other, medical professionals may be protecting themselves from accusations by avoiding examinations they have a responsibility to consider. In both situations, the person whose body is involved can be left without the protection or care they need.
How did we get to a place where protecting people from potential accusations can become more important than determining whether a patient needs to be examined?
Why does the responsibility seem to fall so heavily on the person seeking help?
As a child, I was expected to endure what others did to my body. My suffering was not treated as something that demanded intervention or accountability. Even when I had a medical condition that needed attention, I was left without care until I was old enough to obtain it myself.
Now, as an adult, I am doing everything I was unable to do as a child. I recognize that something is wrong. I make the appointment. I explain my symptoms. I follow the recommended treatments. I return when those treatments don't work. I ask questions. I am willing to give informed consent for an examination.
And still, I am left without answers.
It feels as though the responsibility keeps being handed back to me.
Collect your own sample. Take your medication. Come back if it doesn't improve. Describe what you are experiencing. Show us a photograph.
But who takes responsibility for determining what is actually wrong when those approaches are not resolving the problem?
Who is accountable for making sure a patient receives an appropriate evaluation rather than simply another attempt at treatment?
I am not asking anyone to perform an unnecessary examination. I am asking why an examination is apparently being avoided when symptoms persist and there may be a medical reason to perform one.
There is a profound difference between protecting medical professionals from false accusations and allowing that concern to become a reason for withholding clinically appropriate care.
And there is a profound difference between respecting a patient's privacy and leaving that patient feeling as though the intimate parts of their body are too risky for anyone to examine.
We cannot correct one injustice by creating another form of neglect.
The answer to sexual misconduct is accountability, informed consent, professional boundaries, and appropriate safeguards. The answer cannot be to make patients responsible for navigating medical problems without the examinations they may need.
A medical professional deserves protection from false accusations. A patient deserves protection from inappropriate conduct. And both deserve a system where medical decisions are guided by the patient's health rather than fear.
I have spent years advocating for survivors whose bodies were treated as though they had no rights.
I never expected to find myself asking a different version of the same question:
When everyone is so concerned about protecting themselves, who is taking responsibility for protecting the person who came asking for help?
Because protection without accountability can become another way of abandoning the very people who need care. And I know what that abandonment feels like.

The Shame I Never Expected to Feel Again

What has affected me most deeply is something I did not anticipate. Shame. Not because I believe there is anything shameful about my body or about seeking medical care. But because this experience has stirred feelings connected to a childhood when my body was treated as though it had no value beyond what others wanted from it.
As a child, I was exposed when I should have been covered. Touched when I should have been protected.
Invaded when I should have been safe. My privacy was stolen. My boundaries were disregarded. My right to decide what happened to my own body was taken from me. And when I needed medical attention, my needs were ignored.
Now, as an adult, I have worked to reclaim what was taken. I have learned that my body belongs to me.
I have learned that I have the right to say no. But I have also learned that I have the right to say yes. Yes, I want medical attention. Yes, I am willing to be examined. Yes, I am giving you permission to look at the area that is causing discomfort. Yes, I want to understand what is happening to my body. And yet, I found myself feeling embarrassed and ashamed for wanting someone to examine me. How strange that feels.
For years, I endured unwanted exposure and violations of my body. Now I am experiencing discomfort and uncertainty because the medical examination I am willing to receive is not being offered.
I spent my childhood having no choice about who touched my body. I should not have to spend my adulthood feeling ashamed for asking a medical professional to examine it.
There is something profoundly painful about that contradiction. It reaches into places that years of healing have helped me understand but have not erased. It reminds me of what it felt like to have needs that nobody considered important enough to address. And although I know my current medical providers are not responsible for what happened to me as a child, the emotional impact of this experience is real.

Trauma-Informed Care Is Not the Absence of Care

We often hear about the importance of trauma-informed medical care. For survivors of sexual abuse and trafficking, that matters tremendously. A medical examination can bring back memories of exposure, helplessness, pain, or violations of bodily autonomy. Some survivors may find intimate examinations extremely difficult. Others may avoid them altogether.But not every survivor responds the same way. And that is something medical professionals need to understand. For some survivors, being offered the opportunity to collect their own sample may feel empowering. For others, having a medical professional perform an examination respectfully, with consent and appropriate safeguards, may be exactly what they need.
Trauma-informed care is not about assuming what a survivor can or cannot tolerate. It is about recognizing that the survivor has the right to participate in decisions about their own body.
It means explaining what is medically recommended and why. It means offering choices when choices are available. It means asking permission before touching. It means respecting a patient's decision to decline.
But it also means respecting a patient's willingness to consent. There can be something deeply meaningful about experiencing an appropriate medical examination after a history of sexual violation. To have someone explain what they are doing. To be asked whether you are comfortable. To know that you can ask them to stop.
To have your body treated professionally and respectfully rather than as an object for someone else's gratification.
To experience the difference between being violated and being cared for. Those differences matter.
And they can matter enormously to someone who has spent years reclaiming their humanity.

What Happens When Patients Stop Asking?

I also wonder about patients who are less comfortable questioning their medical providers. What about the woman who has experienced symptoms for months but assumes that if the doctor doesn't examine her, there must be no reason to? What about the elderly patient who doesn't know how to collect a vaginal swab correctly? What about someone with a disability who struggles to perform the procedure? What about the patient who feels embarrassed discussing intimate symptoms and simply accepts another prescription? And what about the survivor who has spent a lifetime being conditioned not to question authority? How many people leave medical appointments with unanswered questions because they assume the professional knows best? I believe medical care should involve partnership. Patients should be able to ask questions without feeling difficult, demanding, or inappropriate. And medical professionals should be able to explain why an examination is or is not necessary without allowing fear to replace clinical judgment. I am not arguing that every vaginal complaint requires a pelvic examination. I am questioning whether avoiding intimate examinations as a general practice is in the best interests of patients, particularly when symptoms persist and treatment has failed. That is a conversation worth having.

We Deserve More Than the Absence of Abuse

One of the deepest wounds inflicted by prolonged abuse is the loss of a person's sense of humanity. When someone repeatedly violates your body, ignores your pain, and disregards your needs, you can begin to believe that your body exists for everyone except you. Healing involves reclaiming that humanity. Learning that your body matters. That your pain matters. That your needs matter. That you have the right to ask for help and expect to be treated with dignity. For survivors like me, seeking medical care can represent something far greater than making an appointment. It can represent the freedom to finally care for a body that was once neglected, exploited, and harmed. I don't want medical professionals to be afraid of their patients. And I don't want patients to be afraid of their medical professionals. I want a health care system where both are protected, where consent is respected, where professional boundaries are maintained, and where patients receive appropriate care based on their medical needs. Bodily autonomy is not only the right to refuse unwanted touch. It is also the right to make informed decisions about the medical examinations and treatments we are willing to receive. I survived a childhood in which my body was treated as though it belonged to other people. I survived years when my medical needs were disregarded. And I have spent much of my adult life learning to speak for myself and encouraging other survivors to find their voices. I never imagined that one day I would find myself writing about how painful it feels to ask for an intimate medical examination and leave without one. But perhaps that is why this experience deserves to be shared. Not because I believe every medical professional is doing something wrong. Not because I think patients should be subjected to unnecessary examinations. And certainly not because I want to minimize the importance of protecting people from sexual misconduct. I am speaking because there is a difference between protecting someone's body from harm and allowing fear of potential accusations to interfere with appropriate medical care. And because survivors know all too well what can happen when someone else's interests are placed ahead of our needs.

My Body Belongs to Me. And My Health Matters.

I am no longer the little girl who had to wait until adulthood to receive surgery for a condition that should have been addressed years earlier. I am a woman who can speak. Who can ask questions. Who can give consent. Who can make decisions about her own health. And who deserves to have her medical concerns appropriately evaluated. I do not want to be unnecessarily exposed. I do not want to be touched without permission. I do not want my history of abuse to define every medical encounter. But neither do I want to feel ashamed for asking a medical professional to examine an intimate part of my body when I am experiencing symptoms that have not gone away. I know what it is like to have my body violated when I had no choice. I also know what it is like to have my body's medical needs neglected when I desperately needed help. Neither experience should be repeated in another form. I want medical care that respects my boundaries without making my body something to be avoided. I want professionals who understand that dignity does not mean refusing to look. Sometimes dignity means looking carefully, respectfully, and professionally because a patient has come to you for help. And sometimes the most powerful words a survivor can hear are not simply, "You have the right to say no." They are also: "You have the right to ask for help. Your concerns matter. Your body deserves care. And you have a voice in what happens next." I spent too many years being denied that voice. I will not surrender it now.

FEELING OVERWHELMED?

Sharri Burggraaf