When Sonia Singh, the owner of a digital startup, was diagnosed with a urinary tract infection (UTI), she was told by her gynaecologist that it was probably because she used public restrooms. But since she was unmarried, the expert “never enquired about my sexual health to investigate if it could be something because of it”, said the 32-year-old.
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Sonia added that she, too, did not ask any questions fearing she would be “judged if I mentioned I was sexually active”. “But, not learning about other possibilities, just because I was not married and was assumed to be not sexually active, was very risky for me. What if I was infected with a sexually transmitted disease (STD)?” she said, adding that the medicine prescribed also did not totally alleviate the symptoms. “It was only after I got married a few months, and consulted another gynaecologist (who asked about my marital status) who gave me an ointment, did it heal,” she shared.
But why do gynaecologists ask about the marital status of women during treatment?
It is common for women when visiting a gynaecologist to be asked if they are married. While the question may seem ordinary to a married woman, it is likely to make an unmarried woman, who may be sexually active, a little uncomfortable.
“When we were taught how to take the history of a patient, we were told that being married meant being sexually active. So, if a married woman complains about a delayed period, the first thing that comes to our mind is that she may be pregnant, but if the woman is unmarried, we might run tests for hormonal imbalance,” said Dr Surbhi Singh, a gynaecologist and president of Sachhi Saheli (NGO), affirming the fact that gynaecologists asking about the marital status of their patients is not uncommon.
Recently, Twitter also erupted in a debate around the same — why do gynaecologists ask about the marital status of patients, instead of simply asking if they are sexually active?
Taking to the microblogging site, a user, @dr_veeprakash wrote: “All these lovely ‘woke’ women tweeting about being offended by the question, ‘are you married,’ asked by their ObGyn, let me tell you something as a doctor. Marital status is imperative in the diagnosis and treatment of a patient, especially in OBG”.
In the subsequent tweet, she added: “Asking whether you are married isn’t always the same as asking whether you are sexually active. We know what kind of history we want. Wherever required, we are more than comfortable asking whether you are sexually active on when your last period was.”
Dr Vee Prakash further said that “Marital history becomes important, especially in cases of infertility, family planning, STDs etc. For eg, I would offer more permanent contraception to a married couple who have completed family/don’t want kids vs temporary in unmarried ones/ married desirous of pregnancy.”
Concurring with her, Dr Ritu Sethi, Senior Consultant- Gynaecology, Cloud Nine Hospital said experts ask for the marital status just to “ascertain if a woman has a single or multiple sexual partners. This is because there are some gynaecological conditions which are likely to be more common in women who have multiple sexual partners, for instance, pelvic inflammatory disease”. She added that marital status also comes into the picture when “we need permission to do certain procedures”.
She added that a sexually active woman is prone to be infected with HIV/AIDS, chlamydia, hepatitis B, fungal infection, and excessive vaginal discharge. “Similarly, in the treatment of PCOD, before giving oral contraceptives, which help treat the disorder, I will recommend lifestyle changes to keep under check in case a woman is planning to get pregnant. I will advise unmarried but sexually active women to take the oral contraceptive pill. Also, I will tell her that the pill will protect her from unwanted pregnancy but will not provide protection against STDs,” Dr Ritu added.
Talking about her experiences of visiting a gynaecologist to ascertain the reason behind her irregular menses, Parveen Khan, a 28-year-old PR professional, told indianexpress.com that she was asked about her marital status. “After marriage, I visited a gynaecologist when I didn’t get periods for over a month. Besides inquiring about my marital status, she also asked questions about physical intimacy, and if I wanted to get pregnant,” she said, adding that since she wanted to plan a family, the doctor prescribed some fertility medicines.
Dr Surbhi said, ‘sexually active’ is a relatively new term in medical parlance. “While we can openly talk about it in cities like Delhi, in smaller cities and towns, it is not common and we still go the conventional way,” she told indianexpress.com. “Also, single women are considered to be virgins by gynaecologists. While we presume a married woman to be sexually active, unmarried women are often considered sexually inactive,” she said.
Dr Surbhi added that they “live in denial” and want to “implement what we have learnt and seen”. “I have realised, we should not judge patients as per our criteria or social norms”.
Agreed Dr Yuvraj Singh, M.D Obstetrics and Gynaecology, Medical Director of Nimaaya- Center for Women’s Health, and co-founder of Ortus Medcare LLP, who said that “although not completely, [doctors] can’t deny the fact that women do get judged by some gynaecologists”. “Sometimes patients prefer not to be asked about their sexual activity directly, and prefer an indirect approach,” he added.
“Hence, the gynaecologist fraternity needs sensitisation in the manner that they have to be non-judgemental,” said Dr Ritu.
Dr Yuvraj Singh feels there is a small number of gynaecologists who might judge due to a lack of sensitisation and sometimes, proper communication. However, most of them are empathetic. “This generation of doctors, in my opinion, is much more sensitised and aware of the way to approach a patient,” he added.
“A lot of gynaecologists are now coming out on social media, talking about sexual health and against the myths and stigmas. There are these outreach programmes, where gynaecologists go to different sections of the society in collaboration with NGOs and government bodies to talk about women’s health and tackle the misinformation,” Dr Yuvraj said.