A Cross-Sectional Survey of University Students' Lifetime Experiences of Inappropriate, Disrespectful, and Coercive...

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).

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 (eg, 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 cisgender female/male, heterosexual cisgender female/male). Item prevalence and SOGI associations were assessed with 2-sided t tests and X² tests.

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 < .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 < .001).

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 are critical to build trust and ensure continued healthcare engagement and positive long-term health outcomes, particularly for SOGI patients.