Experiences of Inappropriate, Disrespectful, or Coercive Health Care: A Study of University Women [A71

Abstract

INTRODUCTION: A number of prominent cases involving sexual misconduct among university-affiliated physicians reveal the need to assess inappropriate, disrespectful, or coercive (IDC) health care experienced by university students. METHODS: We surveyed students at one public university to gather information about their positive and negative experiences while receiving health care. Survey items included questions about respect for the participant’s identity (race, gender, sexual identity) and whether IDC occurred during health care provision. Items queried about experiences with sensitive exams or exams involving the breast, genitals, or rectum. RESULTS: Survey respondents (n=2495) had a mean age of 23 years, identified as female or trans-male, and had experienced at least five relevant health care interactions (76%). Most respondents reported that their needs were accommodated (99%) and their provider made sure they understood their care (98%). However, respondents felt judged about sexual behavior (52%), experienced sexist comments (42%), reported unwanted attention (29%) or advances (23%), and experienced personal calls (1%) from their provider. During sensitive exams, respondents reported that they waited too long while undressed (26%) and were not provided a gown or drape (5%). Alarmingly, respondents reported that sensitive exams were performed without gloves (2%) and experienced inappropriate touch (1%). Finally, 62% stated that they did not know how to report a concern about a provider. CONCLUSION: University students are vulnerable to IDC health care experiences and lack comfort with reporting concerns. These negative experiences reveal the need to improve health professional education, including robust training in cultural safety, professionalism, and trauma-informed care, and to create transparent reporting mechanisms.