Unwanted intimate examinations are a growing topic of discussion. In academic writing on obstetric violence, they are recognised as part of mistreatment experienced by women and birthing people before, during and after childbirth. However, the issue of unwanted intimate examinations extends beyond maternity care.
Marginalised bodies are frequently controlled and violated in environments rooted in power imbalances and patriarchy. We must expand the scope of discussion beyond healthcare abuse, to look at the broader dynamics that underpin infringements of bodily integrity.
Beyond obstetrics: Unmasking routine violations
Unwanted intimate examinations are not limited to obstetric or gynaecological care. In settings like prisons, medical research and training, military service, gender-affirming procedures and even school sports team admissions, intimate examinations are often framed and justified as ‘routine’ or ‘necessary’. Recently, two women accused Mohamed Al-Fayed of requiring them to undergo vaginal examinations before being employed at Harrods. In prisons, invasive body searches may be presented as essential for security, regardless of the autonomy and dignity of those subjected to them. Similarly, in gender-affirming care, intimate examinations may be framed as prerequisites for receiving care, leaving those in need of such care with few real choices. When presented as ‘normal’, these practices obscure coercive dynamics. Presenting invasive procedures as routine or necessary effectively silences those subjected to them and masks the power imbalances at play.
There exists a recurring theme of using context to justify such examinations without questioning the validity of that justification. This further fosters and reinforces a culture of acceptance of infringements of bodily integrity.
Patriarchal power and the regulation of bodies
The power imbalance between the examiner and the examined is further exacerbated by patriarchal structures that privilege institutional authority over individual autonomy. Historically, marginalised groups – including women, LGBTQI+ people and people of colour – have been disproportionately subjected to heightened scrutiny and control over their bodies.
These dynamics are especially pronounced when particularly vulnerable people are subjected to unwanted examinations under the guise of their best interest or safety. Such ‘justifications’ obscure the reality in which those conducting the examinations hold significant control, and the examined person’s autonomy is undermined by a lack of genuine options to avoid the examination. Considering unwanted intimate examinations through an intersectional lens can help illuminate patriarchal influences on the regulation of marginalised bodies.
Unwanted and non-consensual: Moving beyond binaries
One reason to think in terms of ‘unwanted’ rather than ‘non-consensual’ intimate examinations is that consent is sometimes given in less-than-rich ways. Because consent is frequently viewed as binary – either ‘given’ or ‘withheld’– framing conduct as ‘non-consensual intimate examinations’ requires a more thorough exploration of the type of consent that was or wasn’t given. Consent operates on a spectrum, and can be shaped by external pressures. Institutional settings, such as those involving medical professionals, police or security personnel, create environments where autonomy can be compromised when one only looks at the question of whether someone ‘gave consent’. As a result, ‘apparent consent’ for what is essentially an unwanted intimate examination may not be enough to justify the severity of the infringement.
For example, body searches in detention centres or at border control may lead to punitive measures if they are refused. A teenager made to subject to a ‘sex verification’ check by airport security was barred from leaving the airport terminal until the examination had taken place. In such a case, if a person ‘gives consent’ to an intimate examination, knowing refusal will result in punishment, what appears to be consent may actually be coercion. Similarly, intimate examinations framed as routine medical care may foster an environment where refusal is not a genuine option. These examples illustrate how the power dynamics shaping the context of unwanted intimate examinations can expose the limitations of understanding these acts merely through the lens of binary consent. The language of ‘unwanted’ examinations can help draw back focus to the nature of the infringement and how they are presented as justified.
The shadowy boundaries of obstetric violence
Unwanted intimate examinations are part of a continuum of violence rooted in power dynamics. The recent issue of the Journal of Gender-Based Violence, on the shadowy boundaries of obstetric violence, highlights how care can coincide with violence that deeply harms those affected. The issue explores how routine intimate examinations – such as vaginal or rectal exams – can blur the line between care and violation where the examinations are unwanted.
The issue demonstrates how patriarchal power operates in various care settings, including teaching, hospital childbirth, home births and gender-affirming care. These discussions emphasise that unwanted intimate examinations and obstetric violence are not limited to medical contexts but reflect broader systemic violations of bodily integrity.
Continuing the conversation
Further research could focus on non-medical contexts such as detention centres, military settings, ‘virginity testing’ and any situation where intimate examinations take place. These environments present various challenges and could expose further intersections of patriarchy, control and power over marginalised bodies.
Exploring the intersections of gender, race and power can deepen our understanding of the structural factors contributing to unwanted intimate examinations. Expanding the research to non-medical contexts could help illuminate whether, where and how institutional authority and societal norms sustain violations of bodily integrity.
Marthe Goudsmit Samaritter is a Postdoctoral Research Fellow at the Max Planck Institute for the Study of Crime, Security, and Law, and works on technology-facilitated violence, criminal law theory, and personhood. Jonathan Herring is Professor of Law, University of Oxford; DM Wolfe-Clarendon Fellow in Law, Exeter College, Oxford. Camilla Pickles is an Associate Professor of Biolaw at Durham Law School and a visiting associate professor at Wits Law School, and works on obstetric violence and the law.
The shadowy boundaries of obstetric violence by Marthe Goudsmit Samaritter, Jonathan Herring and Camilla Pickles for the Journal of Gender-Based Violence is available on the Bristol University Press Digital here.
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