Probed by the State: 'Just lie back and be a good girl'
Mandatory ultrasound laws are "an indignity, an assault, and a trespass...”
Laws requiring mandatory vaginal penetration are about violation, humiliation, infantilization, dominance, and control. They are the stuff of nightmares— state-mandated indignity, assault, and trespass.
⚠️CONTENT WARNING: This newsletter contains discussion of sexual assault and an invasive medical procedure, as well as images pertaining to this procedure. This newsletter may be disturbing for some readers.
The thought of being completely powerless while someone (or some thing) inserts a probe into your body against your will has evoked fear and horror in the human imagination for generations, and has inspired a genre of science fiction. [1] In 1961, Barrney Hill, who believed he and his wife had been abducted by aliens, described being probed by aliens as being like a medical procedure, “but my eyes are closed, and I only have mental pictures… My groin feels cold.” [2] Barney and Betty Hill’s story was adapted into the 1966 bestseller The Interrupted Journey. “Their story includes nude medical exams and invasive probing—an alien abduction scenario many of us recognize from the TV shows and movies of the past 50 years.” [3]
The now-classic alien abduction scenario, inspired by the Hills’ story, includes “bug-eyed greenish humanoids surrounding the subject as she lies on an examining table under a bright light,” often sticking her with needles and probing her against her will. [4] Her powerlessness is palpable.
We find this scenario so spine-chilling, because we all possess a primal fear of our embodied selves being subjected to physical intrusion and harm against our wills by others. We dread the thought of experiencing such bodily violations. After all, “No right is held more sacred or is more carefully guarded… than the right of every individual to the possession and control of his own person, free from all restraint or interference” (Union Pacific Railway Co. v. Botsford, 141 U.S. 250, 1891). [5]
Jarringly, the classic alien abduction scenario has undeniable similarities “to the operating room situation, where surgeons in scrubs and masks hover over the patient and enter her body with tools.” [6] And when legislators enshrine patient powerlessness in the law and mandate the medical invasion of the human body, such nightmarish scenarios come alive.
For over a decade, anti-abortion legislators have been passing and attempting to pass legislation requiring physicians to perform ultrasounds on their patients before terminating their pregnancies. This is despite the fact that studies have shown that “medical evidence for a universal ultrasound requirement [prior to performing an abortion] is nonexistent”; and “while ultrasounds are often provided at the time” an in-clinic, procedural abortion is performed “they aren’t needed.” [7] Importantly, the patient should be freely able to decline or consent to the procedure. Under universal ultrasound mandates, however, a patient’s ability to decline or consent has been completely stripped away.
“The most disturbing aspect of these laws is that in the vast majority of abortions, which occur far too early in pregnancy for an external (‘jelly on the belly’) ultrasound to produce an image, the ultrasound must be transvaginal — i.e., a long wand-like ultrasound probe must be inserted deep into the woman’s vagina.” [8] Under universal ultrasound mandates, enacted by predominantly male legislators, female patients are forcibly subjected to vaginal penetration with an object by the strong arm of the government, without medical justification. After Texas enacted a mandatory transvaginal ultrasound law, one Texas doctor responded “by calling it ‘state-sanctioned abuse’ and indicating his discomfort with the requirement by saying that ‘[a] woman is coerced to do this, just as I’m coerced.’” [9] Such laws force the same kind of intimate violation as the “alien probing” scenario of our nightmares.
In Union Pacific Railway Co. v. Botsford, 141 U.S. 250 (1891), Justice Gray wrote, “To compel anyone, and especially a woman, to lay bare the body or to submit it to the touch of a stranger… is an indignity, an assault, and a trespass...” [10] While this case was not about mandatory ultrasounds, Justice Gray’s words above perfectly encapsulate the intimate violation of the female body that occurs when “a male-dominated legislative body impos[es] mandatory vaginal penetration on a group of women—women asserting their right to control their own bodies by undergoing abortions.” [11] Such laws are “an indignity, an assault, and a trespass.”
“Mandating transvaginal ultrasounds — something that can be traumatizing and anxiety-inducing, especially for young women and abuse victims — has no medical backing.” [12] In Health care for female trauma survivors (with posttraumatic stress disorder or similarly severe symptoms), the authors explain that medical professionals should “avoid retraumatization whenever possible” and call attention to the fact that “transvaginal tests and procedures, such as transvaginal ultrasound, can be extremely difficult for women with PTSD, particularly abuse survivors.” [13] the authors write, “Performing transvaginal examination without explicit permission is traumatizing and may trigger dissociation” (emphasis mine). [14] Dissociation “is an alteration in the usually integrated functions of consciousness, memory, identity, or awareness of body, self, or environment. In this psychological state, the patient becomes mentally removed from the immediate reality and begins to relive the previous traumatic experiences or becomes flooded with feelings about this event.” [15] Forcibly subjecting any patient, especially a sexual assault/abuse survivor, to vaginal penetration with an object is state-sanctioned abuse; it is “an indignity, an assault, and a trespass.”
Some rape survivors refer to these laws as a kind of rape— a rape commitment by the state. Reacting to a Mississippi bill requiring transvaginal ultrasounds, survivor Cristen Hemmins declared, “Penetration against your will is penetration against your will… The one and only reason such a thing is being called for is to humiliate and punish women who need a medical treatment– abortion. The government has NO PLACE mandating such. As a rape victim, I find this bill insulting and maddening. The men who are mandating this, and any woman who defends it, has no respect or sympathy for rape victims, nor faith in a woman’s ability to make her own decisions” (emphasis mine). [16] Another survivor wrote, “[T]here has been an outcry of ‘state mandated rape’ from women who don't understand why they should be subjected to a physically and emotionally taxing procedure without medical necessity, because their legislators want them to. Proponents of these bills roll their eyes at what they view as a hysterical overreaction, but what is rape if not exerting power over someone by penetrating someone without their consent?” (emphasis mine). [17]
“Rape has been described as an act… to ‘subdue, humiliate, degrade, and terrorize’ a victim. ‘Humiliate’ and ‘shame’ are two words most commonly used by critics of these [mandatory ultrasound] laws to describe [the laws’] goals and practical effects. It is generally accepted that the abortion process is already emotionally trying; adding the condescension and intrusion of state-mandated transvaginal ultrasounds will likely result in the patient’s humiliation and degradation. Further, just as rape serves to ‘subdue’ a victim, these ultrasounds are similarly meant to subdue the women seeking abortions by convincing them not to exercise their” agency and choice. [18]
In an analysis of universal ultrasound mandates, Humiliation, Degradation, Penetration: What Legislatively Required Pre-Abortion Transvaginal Ultrasounds and Rape Have in Common, author Kelsey Anne Green notes that, like rape, universal ultrasound mandates are a denial of and disrespect for a person's independent agency, bodily autonomy, and bodily integrity, and has traditionally relied on the infantilization of women. [19]
“First, when considering a woman’s ability to make personal decisions, ultrasound legislation parallels rape’s denial of autonomous decisionmaking in two ways: by taking away the woman’s decision regarding whether to have the vaginal transducer placed inside her body by paternalistically implying that she was not capable of making the decision of whether to carry the pregnancy to term without legislative interference. Through their insistence that a woman undergo a medically unnecessary, invasive ultrasound, legislators ignore her personal maturity and rationality. In this way, legislative intrusion in the abortion process through required transvaginal ultrasounds is disturbingly similar to rape.” [20]
“Similarly, these laws place impermissible pressures and constraints on women seeking abortions, thereby denying them their freedom. By requiring the performance of a medical procedure, legislatures are shackling both doctors and patients to a practice that has no proven benefits… By conditioning abortion on a transvaginal ultrasound, the state is constraining the actions and choices of women (and their doctors) in a manner that results in unwilling vaginal penetration. This bears an eerie resemblance to cases in which doctors, lawyers, teachers, and other people in positions of power conditioned their services or aid on submission to sex. External pressures to submit to unwanted penetration amount to rape; in this way, mandatory transvaginal ultrasounds are comparable with rape.” [21]
“Finally, rape violates the bodily integrity of a victim by denying her control over her body. The penetration of a woman’s vagina is an invasion of her body, whether it is penetration by a penis for sexual satisfaction or penetration by an object for political reasons.” [22]
Green concluded that “legislation requiring vaginal penetration in order to access a women-specific medical procedure has the same roots, goals, and effects as rape, because the purpose, practice, and harm of imposing the procedure on women seeking abortions carries the gravity and social significance of rape.” [23]
Wyoming is now the latest state to foist this “indignity, assault, and trespass” onto its residents. A bill sitting on the governor’s desk would mandate an ultrasound be performed on abortion patients at least 48 hours before terminating a pregnancy. [24] The legislation’s universal ultrasound mandate makes no exception for sexual assault/abuse survivors. HB 0148 states:
Not less than forty‑eight (48) hours before a pregnant woman procures the drugs or substances for a chemical abortion, before a physician or pharmacist dispenses the drugs or substances necessary for a chemical abortion or before a pregnant woman undergoes a surgical abortion, the physician or pharmacist shall ensure that the pregnant woman receives an ultrasound in order to determine the gestational age of the unborn child, to determine the location of the pregnancy, to verify a viable intrauterine pregnancy and to provide the pregnant woman the opportunity to view the active ultrasound of the unborn child and hear the heartbeat of the unborn child if the heartbeat is audible. The provider of the ultrasound shall provide the pregnant woman with a document that specifies the date, time and place of the ultrasound.
During debate, Sen. Chris Rothfuss several times expressed concern about the bill on the Senate floor, but to no avail. “Are we the state of Wyoming mandating by law a transvaginal ultrasound?” he asked. [25] “It seems like that’s a little beyond what the state of Wyoming should be requiring of a woman through legislation under any circumstance if it’s against their will.” [26]
Sen. Fred Baldwin questioned, “Is this an unfunded mandate?... Who’s going to pay for the ultrasound?… It won’t be covered by insurance because it’s not medically indicated.” [27] In response, Rep. Martha Lawley claimed the solution is for patients to go to one of Wyoming’s ten non-licensed “crisis pregnancy centers” for a “free” ultrasound. [28] But these centers pose serious health risks, especially regarding transvaginal ultrasounds.
Just last year, a Kentucky nurse brought nationwide attention to the public health risks (including the possibility of spreading sexually transmitted diseases to pregnant people) posed by crisis pregnancy centers (also called pregnancy resource centers). She pointed out that the crisis pregnancy center where she volunteered “was using an expired disinfectant to sanitize an essential piece of equipment for early-pregnancy ultrasounds: the transvaginal probe.” [29] Furthermore, “researchers have warned in recent years,” that the kind of disinfectant that the center was using “doesn’t kill the human papillomavirus, a widespread and potentially deadly sexually transmitted infection responsible for more than 90% of cervical cancers, as well as cancers of the genitals and throat.” [30]
Unfazed, legislative supporters of the Wyoming bill paternalistically insisted that it’s for patients’ own good for the government to forcibly subject them to vaginal penetration by probes, against their wills, without any medical justification for doing so and without any means to pay for it, which would send low-income patients into unregulated crisis pregnancy centers where their health may be compromised. [31]
The claim that this bill is for women’s own good and to protect women’s safety is merely a new spin on an old anti-choice tactic of using invasive and expensive ultrasounds as a barrier to abortion.
The objective of Wyoming’s bill “is not to keep women safe.” [32] Rather, the true objective of Wyoming’s anti-choice, anti-autonomy bill requiring “the invasive, time consuming, expensive, and medically unnecessary procedure” is to further the anti-abortion agenda:
by making it impossible to do telehealth medication abortions;
by making abortion more expensive to decrease access to abortions for low-income people;
by increasing the barriers to abortion by requiring an additional, unnecessary appointment for an ultrasound, followed by a 48-hour waiting period before a patient can actually receive the abortion, hoping that these patients (who anti-abortion groups view as flighty) will change their minds;
by funneling patients into anti-abortion crisis pregnancy centers for “free” non-diagnostic ultrasounds in order to receive an abortion, at which point the centers’ staff will bombard the patients with medical disinformation and try to shame patients out of getting an abortion; and
by reasserting patriarchal control over women’s bodies, health, lives, and choices.
The “reassertion of male dominance over women through unwanted vaginal penetration is only part of the patriarchal imposition in the context of mandatory ultrasounds; also inherent in requiring ultrasounds before abortions is the paternalistic view that women undergoing abortions simply do not realize what they are doing or understand the implications of their choices. Legislative insistence on further ‘informing’ women about their unwanted or dangerous pregnancies again asserts the inferiority of women by assuming that they cannot make thoughtfully considered and responsible decisions without governmental interference.” [34]
It's important to note that viewing ultrasounds have little to no effect on persuading pregnant people against abortion. Waiting periods are equally ineffective. “A 2022 aggregation of U.S. studies about ‘mandatory waiting periods’ for abortions found that the delays limited abortion options, increased costs and added other strains to those who have to travel for the procedures. At the same time, it found the delays didn’t cause a significant change in women’s choices” (emphasis mine). [33]
In summary, universal ultrasound mandates have nothing to do with patient safety. These anti-choice, anti-autonomy laws are about violation, humiliation, infantilization, dominance, and control. These laws truly are the stuff of nightmares— “an indignity, an assault, and a trespass.”
Citations:
[1] Lacina, L. (2023, August 1). How betty and Barney Hill’s alien abduction story defined the genre. History.com. https://www.history.com/news/first-alien-abduction-account-barney-betty-hill
[2] Skomorowsky, A. (2024, February 20). Alien abduction or “accidental awareness”? Scientific American. https://www.scientificamerican.com/article/alien-abduction-or-accidental-awareness/
[3] Ibid. 2
[4] Ibid. 2
[5] Union Pacific Railway Co. v. Botsford, 141 U.S. 250 (1891). Justia Law. (n.d.). https://supreme.justia.com/cases/federal/us/141/250/
[6] Skomorowsky, A. (2024, February 20). Alien abduction or “accidental awareness”? Scientific American. https://www.scientificamerican.com/article/alien-abduction-or-accidental-awareness/
[7] Beck, M. (2024, February 29). Ultrasound, waiting-period requirements added to wyoming abortion restriction bill. WyoFile. https://wyofile.com/ultrasound-waiting-period-requirements-added-to-wyoming-abortion-restriction-bill/
[8] O’Neill, T. (2018, January 9). Mandatory ultrasound laws violate women’s rights and bodies - national organization for women. National Organization for Women -. https://now.org/blog/mandatory-ultrasound-laws-violate-womens-rights-and-bodies/
[9] Kelsey Anne Green, Humiliation, Degradation, Penetration: What Legislatively Required Pre-Abortion Transvaginal Ultrasounds and Rape Have in Common, 103 J. Crim. L. & Criminology 1171 (2013).
https://scholarlycommons.law.northwestern.edu/jclc/vol103/iss4/5
[10] Union Pacific Railway Co. v. Botsford, 141 U.S. 250 (1891). Justia Law. (n.d.). https://supreme.justia.com/cases/federal/us/141/250/
[11] Kelsey Anne Green, Humiliation, Degradation, Penetration: What Legislatively Required Pre-Abortion Transvaginal Ultrasounds and Rape Have in Common, 103 J. Crim. L. & Criminology 1171 (2013).
https://scholarlycommons.law.northwestern.edu/jclc/vol103/iss4/5
[12] Beck, M. (2024b, March 11). Transvaginal ultrasounds likely required by Wyoming’s new abortion regulations. WyoFile. https://wyofile.com/transvaginal-ultrasounds-would-likely-be-required-under-wyomings-new-abortion-regulations/
[13] Carroll, M. M., & Banks, A. (2022, November 4). Health care for female trauma survivors (with posttraumatic stress disorder or similarly severe symptoms). https://medilib.ir/uptodate/show/110594#:~:text=Performing%20transvaginal%20examination%20without%20explicit%20permission%20is%20traumatizing%20and%20may%20trigger%20dissociation
[14] Ibid. 13
[15] Ibid. 13
[16] Kopsa, A. (2012, February 22). State-sanctioned rape via trans-vaginal ultrasound: A rape victim’s perspective. Rewire News Group. https://rewirenewsgroup.com/2012/02/22/rape-as-sexual-act-it-doesnt-hurt-that-much-and-other-indefensible-right-wing-pus/
[17] When rape and Medicine Collide: A survivor’s story: B. BARCC. (2012, April 11). https://barcc.org/blog/details/when-rape-and-medicine-collide-a-survivors-story
[18] Kelsey Anne Green, Humiliation, Degradation, Penetration: What Legislatively Required Pre-Abortion Transvaginal Ultrasounds and Rape Have in Common, 103 J. Crim. L. & Criminology 1171 (2013).
https://scholarlycommons.law.northwestern.edu/jclc/vol103/iss4/5
[19] Ibid. 18
[20] Ibid. 18
[21] Ibid. 18
[22] Ibid. 18
[23] Ibid. 18
[24] Beck, M. (2024b, March 11). Transvaginal ultrasounds likely required by Wyoming’s new abortion regulations. WyoFile. https://wyofile.com/transvaginal-ultrasounds-would-likely-be-required-under-wyomings-new-abortion-regulations/
[25] Ibid. 24
[26] Ibid. 24
[27] Beck, M. (2024, February 29). Ultrasound, waiting-period requirements added to wyoming abortion restriction bill. WyoFile. https://wyofile.com/ultrasound-waiting-period-requirements-added-to-wyoming-abortion-restriction-bill/
[28] Ibid. 27
[29] Morel, L. C. (2023, February 2). “it’s a public health risk”: Nurse decries infection control at US anti-abortion crisis center. The Guardian. https://www.theguardian.com/world/2023/feb/02/kentucky-crisis-pregnancy-center-anti-abortion-malpractices
[30] Ibid. 29
[31] Beck, M. (2024, February 29). Ultrasound, waiting-period requirements added to wyoming abortion restriction bill. WyoFile. https://wyofile.com/ultrasound-waiting-period-requirements-added-to-wyoming-abortion-restriction-bill/
[32] Beck, M. (2024b, March 11). Transvaginal ultrasounds likely required by Wyoming’s new abortion regulations. WyoFile. https://wyofile.com/transvaginal-ultrasounds-would-likely-be-required-under-wyomings-new-abortion-regulations/
[33] Beck, M. (2024, February 29). Ultrasound, waiting-period requirements added to wyoming abortion restriction bill. WyoFile. https://wyofile.com/ultrasound-waiting-period-requirements-added-to-wyoming-abortion-restriction-bill/
[34] Kelsey Anne Green, Humiliation, Degradation, Penetration: What Legislatively Required Pre-Abortion Transvaginal Ultrasounds and Rape Have in Common, 103 J. Crim. L. & Criminology 1171 (2013). https://scholarlycommons.law.northwestern.edu/jclc/vol103/iss4/5
Totally unnecessary and invasive to say the least. And yes medically unnecessary unless there’s a specific medical reason. If I were a governor and a piece of crap legislation like that came across my desk it would promptly go into the shredder. I hope all governors refuse to sign this type of legislation. If I were the patient being forced into it I would refuse to pay for it especially if insurance will not.
Government especially GOP is inserting themselves where they don’t belong. I hope the GOP will see a massive shellacking in November. They are the party of authoritarianism and fascist ideology. I divorced the GOP 4 years ago.