When Medical Providers Abuse, Healthcare Orgs Must Take Action

Contributed by Mary Haggerty, JD, for RAINN Consulting Group

In the 1800s, Dr. J. Marion Sims, an American physician known as the father of modern gynecology, forced experimental surgeries on enslaved Black women without anesthesia. 

These women, and so many other Black women during this time, were subjected to painful procedures without any medical benefits. Because of their racial status, their consent and suffering were invisible and inconsequential to the broader medical community.

Systemic Abuse in U.S. Healthcare

A long history of racial and sex discrimination in the United States has laid a foundation for systemic abuse in our modern healthcare system. 

A 2016 Atlanta Journal-Constitution investigation found that sexual abuse perpetrated by medical professionals is a rampant issue in the United States and that medical professionals too frequently avoid any accountability. According to the AJC:

When a physician is the perpetrator, the AJC found, the nation often looks the other way. Physician-dominated medical boards gave offenders second chances. Prosecutors dismissed or reduced charges, so doctors could keep practicing and stay off sex offender registries. Communities rallied around them.

Exposing the Problem

Investigations like this one, in addition to high-profile cases like that of former USA Gymnastics team doctor Larry Nassar, have helped expose the presence of sexual abuse in American healthcare. While Larry Nassar was convicted in 2016, it was the testimonies of his victims at a Senate hearing in 2021 that brought the issue of sexual abuse perpetrated by a medical professional into the public eye. 

But this moment was also indicative of a broader issue: systemic failures in both the legal system and medical institutions to prevent abuse, hold perpetrators accountable, and protect victims. Healthcare providers and companies must go far beyond what is legally required and accept responsibility for preventing abuse. 

Hurdles, Hoops, & Obstacles for Victims

Navigating the legal system as a survivor of provider-perpetrated abuse is deeply challenging. 

As far back as colonial law in the 1600s, our legal system has only recognized sexual abuse as “actionable”—meaning, a valid case for a lawsuit or prosecution—when the case met various, often unrealistic criteria. These criteria were frequently unattainable or didn’t reflect the realities common to so many survivors of sexual abuse, such as:

• The abuse had to be perpetrated through physical violence or force. In reality, sexual violence often occurs through emotional coercion and manipulation.

• The victim had to have fought back. In reality, it’s very common for the physiological response to trauma to include freezing up and not being able to move or speak.

• The victim and perpetrator had to conform to specific societal roles and dynamics. For example, common law (from the 1600s until reforms began in the 1970s) stated that only men could assault women and that husbands could not assault their wives. In reality, sexual violence occurs within a variety of relationship dynamics, including marriage, and can be perpetrated by individuals of any sex. 

Hidden Abuse

Sexual abuse perpetrated by medical professionals often occurs in healthcare contexts; perpetrators may mask the abuse as being part of a medical procedure. As a result, it is often not recognized as a crime in the law, or the law frequently fails to capture the nuances of this form of abuse, especially when it is seen as normal. One example of this is involuntary pelvic exams, which have been a common practice in medical training for years. 

Inadequate Reporting Timelines

Getting justice can be daunting and full of obstacles for victims, particularly given the sensitive nature of the case and the high potential for public scrutiny. Most states have statutes of limitations ranging from one to five years, which give victims a very limited amount of time to file a medical malpractice claim.

Lack of Evidence

Unlike malpractice cases involving surgical errors or misdiagnoses, sexual abuse may not result in obvious evidence or be provable through typical medical records or tests. 

Healthcare providers are often trusted implicitly by patients. The combination of abuse by a trusted authority figure and fear of not being believed can cause victims to delay reporting. This makes it harder for sexual assault forensic examiners to collect physical evidence, like DNA, which is ideally collected within 72 hours of the incident before it starts to degrade. 

Trauma

Victims of sexual abuse in medical settings may also face significant emotional trauma and fear of retaliation, making it incredibly difficult for them to make a report or engage in the legal process effectively. These issues are compounded by other injustices such as racism; for example, the increased barriers Black women face in disclosing, reporting, and seeking justice for sexual violence are exacerbated by the racialized history of medical abuse that also contributes to contemporary health disparities. 

Progress Is Possible

In recent years, advocates have increasingly recognized the need for legal and social reforms to address sexual abuse within medical settings. 

RAINN is one of many organizations that has called for reforms such as: 

• Clearer guidelines on appropriate conduct for healthcare providers
• Improved training on recognizing and reporting abuse
• Better support systems for victims who come forward

Progress has been made because of national coverage of high-profile cases like Nassar’s, social reform initiatives like the #MeToo movement, and advocates working tirelessly for change. 

Successes (So Far)

Lawmakers in many states have successfully advocated to extend or eliminate statutes of limitations for medical malpractice claims related to sexual abuse, allowing victims more time to seek justice. 

In 2024, RAINN worked with the Health and Human Services Department as they released guidance that “advises teaching hospitals to obtain written informed consent from patients before they undergo sensitive examinations while under anesthesia, like a pelvic, breast, rectal, or prostate exam, for teaching purposes.” RAINN supported this guidance and has worked to pass laws enforcing the new standard in several states. 

Compliance Is NOT Enough

The legal system, rife with challenges, is not the only avenue for survivors to find accountability. Medical establishments can make a difference by effectively working to prevent and respond to sexual violence. 

If healthcare professionals are going to change their industry, they will have to take an approach that goes beyond the bare minimum of legal compliance. Providers, administrators, hospitals, and other institutions can create a safer medical system by:

1. Using a Trauma-Informed Approach

Medical professionals should incorporate knowledge of how trauma affects victims’ behavior and memories into their interactions with patients. Creating a safe, empowering environment increases the likelihood that, if an incident occurs, victims will feel able to seek help. It also reduces the risk of retraumatizing survivors throughout their experience obtaining medical care. 

2. Adopting Victim-Centered Policies & Procedures

The process of reporting sexual abuse is daunting for survivors. Still, healthcare providers can mitigate this stress by ensuring their sexual abuse response policies and procedures take into account common concerns, fears, and barriers faced by victims.  

3. Requiring Ongoing Education Regarding Sexual Abuse

In order for professionals to respond appropriately to victims of sexual abuse—with empathy instead of judgment—they must have a strong understanding of how sexual abuse happens and how it shows up in the context of medical care. 

4. Building a Sexual Abuse Response Infrastructure

Institutions such as state medical boards and hospital systems should have a sexual abuse response infrastructure. This includes crisis and reporting hotlines, therapy funds, and other victim services built into the organization. Building this infrastructure requires robust funding for state medical boards and medical oversight efforts. Because of how pervasive this issue is, large-scale institutional and policy-driven changes are necessary. 

Prioritizing Prevention

It’s clear that our legal system needs serious reform to better prioritize the rights and well-being of victims. In the meantime, healthcare organizations and professionals must go beyond what is required by law and invest in sustainable efforts to prevent sexual abuse.