Jump to comment:
- Page navigation anchor for RE: The trauma-informed genital and gynecologic examinationRE: The trauma-informed genital and gynecologic examination
We would like to thank Dr, Gorfinkel and colleagues [1] for bringing attention to the widespread prevalence of sexual violence and the importance of a trauma-informed approach to genital and gynecologic examinations. In particular, we appreciate the authors’ framing of trauma-informed care as a universal approach—to be used with all patients, whether or not they have a known history of trauma.
In September 2021, the Canadian Public Health Association (CPHA) released a tool entitled, "Trauma- and violence- informed physical examinations and STBBI testing: A guide for service providers"[2] as a component of the free, accredited, online continuing medical education course, “Provide safer, more inclusive care for sexually transmitted and blood-borne infections”.[3] The physical examination tool, in line with Dr. Gorfinkel and colleagues, encourages practices that support patients’ sense of safety, autonomy, and dignity during physical examinations. The tool was developed in partnership with Dr. Sadie Elisseou, adapted from her trauma-informed physical examination curriculum for first-year medical students.[4]
The potential for traumatization or re-traumatization during procedures that are widely recognized as “sensitive”—such as genital, rectal or breast examinations—is self-evident, particularly when accounting for the pervasiveness of sexual violence. In publishing this response, we hope to encourage reflection on how a wider range of potentially trau...
Show MoreCompeting Interests: None declared.References
- Gorfinkel I, Perlow E, Macdonald S. The trauma-informed genital and gynecologic examination. CMAJ 2021;193:E1090-E1090.
- Canadian Public Health Association. Trauma- and violence- informed physical examinations and STBBI testing: A guide for service providers. 2021. https://cpha.ca/trauma-and-violence-informed-physical-examinations-and-stbbi-testing-guide-service-providers
- Canadian Public Health Association. Provide safer, more inclusive care for sexually transmitted and blood-borne infections [online course]. 2021. https://learning.cpha.ca/course/index.php?categoryid=13
- Elisseou S, Puranam S, Nandi M. A Novel, Trauma-Informed Physical Examination Curriculum for First-Year Medical Students. MedEdPORTAL. 2019;15:10799.
- Nandi M, Puranam S, Paccione-Dyszlewski M, VanDusen H, Elisseou S. Making universal trauma-informed health care a reality: A pilot initiative to train future providers. The Brown University Child and Adolescent Behavior Letter. 2018; 34(12): 1-6.