I stood there, an American citizen, sexually assaulted by a government official

It's possible that they think the official is enjoying themselves. That's a real problem, maybe.

And maybe the official is enjoying themselves, which is definitely a real problem.

It's a thorny issue.

Let's say a doctor performs an examination of the genitalia on a patient, without medical necessity. Let's say she does it without sexual intent, for example because she is still in training and wants to practice more on genital examinations (this may not make any medical sense, it's just the example) Let's also assume that we know for sure she had no sexual intent (eliminate mundane evidence matters). She convinces the patient the examination is necessary and he agrees to it. Only later he finds out the examination wasn't out of medical necessity. Is this sexual assault?

I'd argue no, and I'm quite sure the law is on my side (although I don't know how to qualify it in common law terms, at first I thought the mens rea was missing but a cursory web search seems to indicate that this is related to the 'consent' part of the assault charge, and not so much the 'sexual intention'. The literature doesn't seem to agree though).

Yes, it is clearly not about sexuality, but it is a situation where there is a massive imbalance of power. Who is there to verify that your human rights are being upheld?

It is not a situation in which you can complain, even if there was abuse - because you'll miss your flight and look like a terrorist. Then there is the social pressure to conform in front of a large audience of people who you will delay if you do complain. Not to mention the number of uniformed and armed guards present.

If I'm having pain in a testicle, I know that the doctor is going to touch my genitalia. If I'm having pain in my throat, however, I can't imagine a circumstance where a doctor could convince me that he or she needs to examine my genitalia. If the doctor forces the issue, or performs the exam without my knowledge or consent (anesthesia, for example), I'm feel like I'd be able to argue that I was sexually assaulted. The reason is that an exam of that type wouldn't be reasonably expected based on my symptoms. If a doctor had reason to perform the exam, then a) I'd most likely be informed, and b) it would no longer meet your "without medical necessity" requirement.

Also, I really doubt many doctors are in medicine to be able to fondle their patients. I know it's a common joke that men go into gynecology to be able to grope women, but the level of commitment required to get through medical school in order to do it is huge compared to the expected non-medical "benefits." I think there was an AMA on reddit a while ago, and I know I've read articles about this before, which said that you sort of get sick of seeing so much vagina. It's like working at a mint, the sort of person who sees the newly minted cash as cash and not "just the product" after their first week is the sort of person that doesn't keep their job long.

The same can't be said of the TSA. I don't know how apocryphal the references are, since I'm not American, but reddit has me believing that TSA screeners have roughly the same qualifications as the average McDonald's employee. You certainly don't need a college degree to get the job. This leaves open the possibility of people taking the job mainly for sexual satisfaction. Again I'm reference apocryphal reddit anecdotes, but there was a post recently about a guy whose whole strategy for getting through security was to stand directly behind the hottest girls in line, because they tended to be "randomly" pulled into the scan-or-grope line.