Pelvic exams necessitate physical inspection of the most sensitive areas of a woman’s body. The exams are typically conducted while the patient is awake and consenting at a gynecologist visit, to screen for certain cancers, infections and other reproductive health issues.

But across many U.S. states and medical institutions, physicians are not required to obtain explicit consent for the procedure. Sometimes the exams are conducted — by doctors or doctors-in-training — while women are under anesthesia for gynecological and other operations. Often the exams are deemed medically necessary, but in some cases they are done solely for the educational benefit of medical trainees. At some hospitals, physicians discuss the procedure with patients beforehand or detail its specifics in consent forms, but at others the women are left unaware.

There are no numbers to indicate how many pelvic exams have been performed nationwide without consent, but regional surveys suggest that the practice is not uncommon. A 2005 survey at the University of Oklahoma found that a majority of medical students had performed pelvic exams on unconscious patients, and in nearly 3 of 4 instances they thought informed consent had not been obtained.

Phoebe Friesen, a biomedical ethicist at McGill University, drew attention to the issue in 2018 with articles in Bioethics and Slate, which elicited stories from other women with the hashtag #MeTooPelvic. Dr. Friesen learned about the subject while leading a bioethics seminar at Mount Sinai Hospital in New York, where she heard a narrative from some students that amounted to, “I can put my hand in this woman’s vagina because it helps with my training.”

Sarah Wright, a science teacher in Madison, Wis., said she was given a diagnosis of extreme vulvar sensitivity after a surgery in 2009. She wondered how an operation performed through incisions in her abdomen could have affected her sexual organs, and concluded that either a uterine manipulator was used or a pelvic exam was conducted without her knowledge. So when scheduling another operation with University of Wisconsin School of Medicine and Public Health’s hospital system in 2018, she asked to draft her own consent contract.