There is no such thing as an exciting trip to a gynaecologist. Appointments, at the least, involve discussing matters that women track only privately. At worst, there’s a test, a probe, a hasty revision of the right protocol involving panties.
Honestly, there’s enough awkwardness without the doctors sprinkling some of their own. And in India, they seem to heap an unnecessary bit of that awkwardness on unmarried, sexually active young women. Medical professionals, who go through years of training to separate science from faith, fact from belief, are the same people who see a woman as promiscuous or slutty for exploring her desires. These are doctors who will ask for a woman’s sexual history and then shame her for having one.
They’ll judge fellow gynaecologists too. Embryologist Dr Tanaya Narendra, 29, is phenomenally popular on social media as sexual health advocate @Dr_Cuterus. She offers guilt-free practical advice about birth control, sexual hygiene and orgasms. Dr Narendra has also been on the contraceptive pill to help with her endometriosis. She recalls an ENT doctor in Prayagraj who interpreted it to mean that she was sexually active whilst separated from her husband and shamed her for it.
Other doctors seem to offer medical advice devoid of its social and emotional repercussions. Many, who treat patients for polycystic ovary syndrome recommend that patients get married and having a baby as a cure. “They view a woman’s ambition as a medical problem, connecting it to raised testosterone levels!” says Dr Narendra.
{{/usCountry}}Other doctors seem to offer medical advice devoid of its social and emotional repercussions. Many, who treat patients for polycystic ovary syndrome recommend that patients get married and having a baby as a cure. “They view a woman’s ambition as a medical problem, connecting it to raised testosterone levels!” says Dr Narendra.
{{/usCountry}}Gynaecologists don’t just treat sexually transmitted infections, but also life-threatening conditions such as cervical cancer. Even so, there’s historically been little concern for women’s discomfort. “Women and minorities” were mandatorily included in American clinical trials only as late as 1993. Women’s health is underfunded even in rich nations, says a 2020 study by the Gates Foundation. A mere 1% of health care research spending goes toward female-specific conditions not related to cancer.
Within India, doctors shy away from doing invasive tests, such as trans-vaginal ultrasounds, on unmarried women fearing that the procedure may rupture the woman’s hymen . Patients, in turn, have accused doctors of “destroying” their virginity with medical tests. “It’s steeped in regression. But for doctors, it’s also protection from malpractice,” says Dr Narendra.
Some processes are protected by law. In India, a doctor cannot perform a tubectomy (tying of the follicle tubes) on an unmarried woman. But simpler tests, such as pap smears (in which a soft brush takes swabs from the cervix to detect diseases such as cervical cancer), are also frowned upon. India accounts for Asia’s highest number of cases of the disease, with 23%, according to a 2022 Lancet study. Early detection, via a smear, could save many more women’s lives.
Things are improving, claims Vadodara-based gynaecologist and IVF specialist Dr Yuvraj Jadeja, who also practises in Mumbai. “Even a decade ago, women would not voice their discomfort,” he says, “A lot more young women in their 20s now walk into a doctor’s office to understand contraception,” he says.
Gynaecologists are realising that they need to brush up on their bedside manner. Dr Jadeja says that little tweaks such as getting a patient’s consent before touching them, letting them know what is going to happen next, warning them that intimate details will be sought, or just saying “You can stop me if you’re uncomfortable” go a long way.
Many doctors are also hoping that sexual medication is considered a branch of medicine separate from fertility and menstrual concerns. “No one in India specialises in contraceptive advice,” says Dr Narendra.
And doctors need to grow up. “To get an abortion in India, an adult woman doesn’t need anyone’s permission,” says Dr Jadeja. Doctors must stop policing women’s bodies and behaviour. “For procedures such as tying of tubes, family counselling is recommended,” he says.
Here, again, the final call rests with you.