Death, taxes and pelvic exams; unavoidable realities for most women. The average woman can expect at least 50 pelvic exams throughout her life. Even more if she has pregnancies, miscarriages or gynaecological problems. Whether you are the Queen of England or using free government services in a bad part of town, it is a similar experience. Naked, exposed, spread open, lit, lubed and told to comply with our doctor’s requests. It is not pleasant but it isn’t a big deal, usually.
Every now and then, a horrific story of doctor-patient abuse makes it to the headlines. For most of us, we thank our lucky stars that our gynae’s are the respectful professionals that they are. But one male doctor confesses that it’s a relationship that shouldn’t be socially sanctioned. His insights into the everyday gynaecological exam will chill anyone who has ever been in the stirrups with male eyes on the other end… He prefers to remain anonymous for obvious reasons.
A chilling confession you won’t forget
“Being in practise, you see a lot of things. I believe this message needs to get out there, to protect women. A male gynaecologist is just like any other man. There is no magic pill that makes us supermen, who disassociate the sexual element of the relationship. No man can just switch his sexuality off. This belief that doctors see so many patients and get tired of it is just not true. Men are programmed for sexual variety, the booming porn industry is proof of that. For most men, sex is like food and other basic functions – it matters a lot.
Don’t think that a male gynaecologist won’t notice if you are attractive, or attractive in his eyes. Obviously, a heterosexual male doctor would prefer a young, attractive patient over an older less attractive patient; but no one will admit it. Attractive patients may get longer consultations and examinations, and sometimes even unnecessary procedures. And it’s almost impossible to tell if you are being exploited. The whole gynaecological exam is a power trip for most doctors – you undress completely for him, follow his instructions and submit to almost anything he ask of you. You would never allow just anyone to do these things to you; and you even pay him for the service at the end – it’s a concept that may be difficult for a woman to fathom.
I know I am not the only male doctor that feels there is a problem in the industry; I’ve had many conversations with colleagues… Trust me, rather see a female doctor.”
As disturbing as this confession is, it’s even more worrying that he isn’t the only male doctor willing to publish a confession of this nature. But let’s explore some of the issues a little more closely.
Sexual Exploitation: definition, examples and confounding factors
There are many ways that doctors can exploit patients. The U.N defines sexual exploitation as, “Any attempted abuse of a position of vulnerability, differential power, or trust, for sexual purposes, including, but not limited to, profiting monetarily, socially or politically from the sexual exploitation of another.” Sexual misconduct in the doctor-patient relationship is strictly governed by a Code of Ethics and the Hippocratic Oath. Sexual misconduct can be very subtle; in some cases it can be impossible to tell if you’ve been a victim of misconduct. Any inappropriate comments of a sexual nature, any inappropriate touching or sexual contact are all grounds for formal charges to be brought against doctors.
And there are plenty of examples of doctors who have crossed the lines and been brought to justice. Most of the everyday sexual harassment charges brought against doctors don’t make it into the news. Every now and then a particularly gruesome story makes the headlines. The John’s Hopkins gynaecologist who photographed hundreds of underage patients with a pen-camera was one story that outraged the world. A bit closer to home, orthopaedic surgeon Johannes Albertus Roux Volsteedt was convicted and sentenced to 8 years in prison after assaulting at least 9 of his patients sexually. In yet another story that caught the world’s attention, a Toronto surgeon abused at least 20 patients while they were sedated for surgery. There are many similar stories.
If one were to take statistics on the subject at face value, it would seem that the vast majority of doctors respect the boundaries. Unfortunately, the statistics don’t take into account the victims who never report the incident or are unaware that it even happened. Sexual crimes are under reported for many reasons. There is often a lack of evidence, and victims tend to be too ashamed to step forward. There is a frightening tendency toward victim blaming in these circumstances. In some cases, patients have no idea they have been exploited. How many doctors are really exploiting patients? We may never know.
In South Africa, the Health Professionals Council South Africa (HPCSA) oversees the conduct of all doctors and is responsible for enforcement within the medical profession. The HPCSA maintains a list of doctors found guilty of misconduct and their respective sentences. In many cases, the doctors receive suspended sentences and are allowed to continue practising.
But as the anonymous doctor confesses, even a routine exam crosses lines.
Are most male doctors exploiting their female patients in some way?
There are a growing number of people who believe so.
And they’ve taken to the internet in protest. There are even support groups; like the Yahoo group: “Gynaecology exam: how husbands feel” For them, women who go to male doctors are perpetrating something akin to cheating. Even if nothing untoward happens. These men are devastated that their women choose to see male gynaecologists at all. According to them, even a routine pelvic exam is crossing lines that shouldn’t be crossed. There are also women’s groups who advocate alternative gynaecological health protocols to avoid what they deem as unnecessary and harmful procedures like PAP smears and pelvic exams. ‘Women Against Stirrups’ founder says, “Gynaecology has absolutely no value for women,” she goes on to mention that, “even worse, it harms women emotionally and it robs them from their power.”
In another chilling confession titled, “The Other Side of the Speculum: A Male Doctor’s Point of View” another anonymous male doctor makes a similar confession. His confession also ends with the same warning, “If I were a woman, I would not go to a male doc for such an exam, ever.” He also talks about men being men and how doctors are “only human.” As difficult as it can be to accept; an increasing number of male doctors are using the cloak in internet anonymity to share these taboo feelings with women. They really do believe that women need to be warned.
There’s no denying male sexuality. Even though the old urban legend that men think about sex every few seconds has been disproven, studies still show that men think about sex as often as they think about food and sleep. Roughly every 50 minutes according to a study published in the Journal of Sex Research. That’s the average appointment length.
In a study done in the Netherlands, more than 80% of male doctors admitted to feeling sexual attraction towards a patient. The study concluded that “sexuality does exist in the doctor-patient relationship”.
But doctors are healing professionals
However, it is still impossible to believe that all the comforting things we’ve been told about the sacred doctor-patient relationship may not be true. Doctors are professionals. They see dozens of lady parts every day. It’s hardly like pelvic exams include Barry White and a glass of wine, it’s a bright, sterile situation.
The majority of doctors never cross the line. What they do with their imaginations is their own business. What really matters is that you receive quality care from someone you trust. Even if your male doctor is thinking about sex or getting turned on while giving a pelvic exam; as long as no lines are crossed, that isn’t enough reason to denounce all male doctors. You can’t police someone’s mind.
Has your doc crossed the line?
It is very difficult to know if you have been exploited. If you go in for a sore throat and end up having a vaginal exam (true story) you might suspect something, but generally the misconduct can be even more subtle. If something feels wrong; get a second opinion.
If you have been a victim of misconduct, lodge a formal complaint with the HPCSA. Should a doctor be found guilty, he could face fines, a suspended sentence or have his name struck off the register. If you believe you are entitled to financial compensation for the misconduct, consult with a private attorney in addition to the HPCSA.
Tips for protecting yourself
- Choose a doctor based on personal recommendation: Friends, family and even reviews on the internet are a good indication that your experience will be above board.
- Research any potential doctors: Previous guilty verdicts may not be widely publicised. The HPCSA maintains a list of doctors found guilty on its website.
- Know what to expect: This is especially important if you are having your first pelvic exam. Familiarising yourself with exam guidelines will help you decipher when something is unnecessary or inappropriate. Do your research and know when it is reasonable for you to require a pelvic exam and Pap smear. Current Pap smear guidelines are not as simple as every year.
- Take your partner along: If you are in a relationship, take your partner along on a visit. If the doctor refuses, you know something may be wrong. Any respectable doctor has no problem allowing your husband or boyfriend in the room with you. And the extra set of ears is helpful anyway.
- Ask for a chaperone: Some practises have a nurse or other female assistant who can attend the exam too. Be warned though; if something untoward does happen, the chaperone (under his employ) is likely to side with him. Your partner or a friend is your best bet for an impartial presence in the exam room.
- Choose a female doctor: If it is your preference to be treated by a female doctor, research all female practises in your area.
The doctor-patient relationship is a sacred one, as it should be. Your gynaecologist and/or physical practitioner or even GP, will see you through some of the major milestones throughout the course of your life. It’s well worth choosing them carefully. Only you can decide which doctor you trust and what you are comfortable with.