The #MeToo movement is a high profile movement that sparked discussions regarding sexual harassment in several industries. Since then, medical organizations have updated their codes of conduct to reflect an intolerance of gender based harassment and sexual harassment in the workplace. However, these policies often do not address instances of sexual harassment in which the patient is the perpetrator, known as patient perpetrated sexual harassment.

Patient perpetrated sexual harassment is unique to health care and poses significant consequences to the health care professional's well-being. This form of harassment has been reported by 27% of physicians, regardless of gender, ¹ and has been associated with burnout and suicidal thoughts. ² Urology, unlike other previously studied medical specialties, may pose a unique risk to patient perpetrated sexual harassment as a significant portion of urological practice includes the medical and surgical management of sexual function or conditions of the genitalia.

Figure 1. Responses to “Have you ever been sexually harassed by a patient in a medical setting?”

To our knowledge, this is the first study to address patient perpetrated sexual harassment of urologists. Considering its negative influence, we sought to characterize the prevalence of patient perpetrated sexual harassment of urologists. We assessed demographics of urologists most impacted, characteristics of harassing behaviors, and the impact these behaviors may have on urologists.

We anonymously surveyed urologists through organization listserves via an e-mailed weblink, from which we received 190 responses. Approximately half of the urologists responding to this survey experienced patient perpetrated sexual harassment and certain demographics may be more likely to experience this phenomenon than others.

More than 1 in 10 respondents reported being impacted negatively as a result of patient perpetrated sexual harassment. Overall 49.5% answered yes to the prompt, “Have you ever been sexually harassed by a patient in a medical setting?” Respondents who answered yes were more likely to be residents/fellows compared to staff/attendings (p=0.004), female (p <0.0001) or younger (age 40 or younger compared to respondents who categorized themselves as age 41 or older, p=0.001, fig. 1).

Figure 2. Examples and frequency of patient perpetrated sexual harassment.

Examples of patient perpetrated sexual harassment included being asked on a date, receiving compliments about one's face and/or body, receiving inappropriate comments about touching the patient's genitalia, prolonged embrace and being touched inappropriately by the patient. Almost 10% of respondents reported having been touched inappropriately by a patient, and 34% reported that patients had made inappropriate comments about the urologist examining their genitalia (fig. 2). As a result of these harassing behaviors, 11% of respondents reported feeling unsure of themselves and 13% reported feeling violated.

The findings of this small survey study only scratch the surface of patient perpetrated sexual harassment of urologists. We hope that these results serve as a springboard for future discussions. Robust investigation is warranted by organizations, such as the American Urological Association, to include questions on patient perpetrated sexual harassment in future census surveys so that we can, on a larger and more generalizable scale, characterize the experiences of urologists and assess the impacts of those experiences. Ultimately, understanding the scope of the problem and those at risk can guide in developing protocols on how to best address patient perpetrated sexual harassment of urologists.