What question did this study set out to answer?

This study aims to describe the prevalence of inappropriate, disrespectful, and coercive behaviors during sensitive exams among university students, examining variations based on sexual orientation and gender identities.

April 25, 2026Open Access

A Cross-Sectional Survey of University Students’ Lifetime Experiences of Inappropriate, Disrespectful, and Coercive Behavior During Sensitive Exams

Key Points

This study aims to describe the prevalence of inappropriate, disrespectful, and coercive behaviors during sensitive exams among university students, examining variations based on sexual orientation and gender identities.
Cross-sectional study of 2779 university students at a large public university (US, 2021)
Lifetime prevalence of 13 inappropriate behavior items during sensitive exams analyzed
Statistical analyses conducted using 2-sided t-tests and chi-squared tests to assess associations with sexual orientation and gender identity
Lifetime prevalence of inappropriate experiences ranges from 0.6% to 19.9%; 19.9% reported excessive wait while undressed
Gender minority students had the highest prevalence of IDC experiences, while cisgender heterosexual males had the lowest
Trust in providers during sensitive exams was significantly lower among GM students (30.9%) compared to heterosexual cisgender males (3.1%), P<0.001

Abstract

Study Objective: To describe university students' lifetime prevalence of inappropriate, disrespectful, and coercive (IDC) experiences during sensitive physical exams and explore differences across sexual orientation and gender identities (SOGI). Methods:This cross-sectional study analyzed survey data from a representative sample of students at a large public university (US, 2021, N=2779).Lifetime prevalence of 13 IDC experiences (e.g., painful exams, ungloved exams, attempts to sexually arouse patient) and trust in sensitive exam providers was estimated for the sample and within SOGI groups (gender minority (GM), sexual minority (SM) cisgender female/male, heterosexual cisgender female/male).Item prevalence and SOGI associations were assessed with 2-sided t-tests and X 2 tests.Results: Lifetime prevalence of sensitive exam IDC experiences ranged from 0.6% (took pictures of patient's body without permission) and 2.5% (genital, pelvic, or rectal exam without gloves) to 19.9% (excessive wait while undressed).Significant associations (P<0.05) between SOGI and negative experience prevalence estimates were identified; GM students reported the highest prevalence, and cisgender heterosexual male students the lowest, for all but 1 IDC item.7.9% of students reported not trusting any healthcare providers during sensitive exams with 30.9% of GM students compared to 3.1% of heterosexual cisgender men reporting no trust (P<0.001). Conclusion:GM university students experienced more IDC experiences during sensitive exams and have lower trust in sensitive exam providers than cisgender students, particularly cisgender heterosexual males.Ensuring informed consent, offering chaperones, and clear communication

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