Why Are Unmarried Women In India Scared To Visit A Gynaecologist?

Anusha (name changed) was in class 12 when she visited a gynaecologist the first time. She has Polycystic Ovarian Disease (PCOD). During the visit, she was given some medication with serious repercussions and she ended up having diarrhoea. According to her, she was not told about any of these side effects. Do you also dread going to your gynaecologist and feel you are being judged for everything you say in front of her? 

When she revisited the doctor and complained of the symptoms and the fact that she was unable to consume food without having the urge to throw up later, the doctor casually said that it is good that she is consuming less food. It will help her lose weight.

"At the second follow up she also sounded happy that I was nauseous and eating less. Why? Because 'starving' myself will help me lose weight," said Anusha. Anusha is a journalist based in Mumbai.  She added, "I already have had a messed up equation with food. Her comment had unknowingly instilled anxiety and at times I starved myself."

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Anusha is thankful that when she visited another gynaecologist, she did not "body shame her at least."

"But I have not been able to connect with gynaecologists that I have visited and feel comfortable enough to discuss my sexual health too." Adding, "A lot of doctors are not comfortable knowing we (read young and unmarried women) are sexually active, and it bothers me. My major fear is being body-shamed which I have faced from most doctors I went to until now. It heightens with gynaecologists," she said.

She has had pregnancy scares too but instead of going to a gynaecologist, she ended up visiting Google to settle her doubts.

Unmarried Women and Gynaecologists

Experiences like these have shaped several young women's perceptions of gynaecologists. There are several young women who agree that their experience also mirrors Anusha's. They agree that they ended up feeling scared or intimidated when they needed medical care. It is an irony that there is an entire branch of medicine dedicated to women's health but women in India feel reluctant to consult one.

Women are also hesitant to share their vulnerabilities with gynaecologists because of the scare that they might end up giving moral lessons, especially with regards to sexual health. Anjali Munda, who is from Dibrugarh in Assam, but currently working as an Intern doctor in Bengaluru, shared one incident where she ended up getting a lecture instead of treatment.

She was in her third year and was having problems with her periods. She was scared because it was just after she had sex. "I was scared to show it at my hospital because I was embarrassed. So I decided to go somewhere else. I went to one of those smaller clinics and there was an old woman who was the doctor there," recalled Munda.

Munda said that the doctor asked her the basic questions. "In case of irregularities in the period, if it is an adult woman then the doctors generally ask about their sex life. She asked me and this one I could not lie because this was why I was there in the first place," she said.

"She asked me where I was from. Once I told her about Assam, her lectures became bigger and more direct. She started saying to you girls you think you can have all the fun. Then she went on to accuse me that I have multiple sexual partners," she said.

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Narrating the incident, Munda added, "She kept asking me if I was married or am I supposed to be married. I told her no and this is when she asked about the boy. I said sorry and that this interrogation is getting very uncomfortable for me and you should not be asking me this. Then she said that I am a shameless person will probably go to hell for all of my sins."

What Do Gynaecologists Have To Say About This?

Dr Somya Gupta, who is a gynaecologist based in New Delhi and has done her residency or MD from Uttar Pradesh agrees with this scare that women have towards visiting a gynaecologist. Dr Gupta said, "Many gynaecologists are unnecessarily prejudiced, use harsh language, are dismissive of troubling symptoms that the patients report, do the intimate examination in a hurried, inconsiderate and painful manner."

She added that the patronising tone used by both male and female gynaecologists can also be demoralising for patients. According to her, the problem is not just limited to the field of obstetrics and gynaecology but persists across the medical branches.

Dr Prakshit Tank, who consultant OB-GYN based in Mumbai and also the treasurer at the Federation of Obstetric and Gynaecological Societies of India agrees with Dr Gupta. "For gynaecologists, in particular, the factor of vulnerability magnifies. It is something related to sexual health or reproductive health which is fairly personal. It is not something that you will discuss easily with somebody. Gynaecologists sometimes tend to be judgemental. They make comments or at times women think that they will make comments. Maybe the old experiences with doctors have not been great," he said.

Dr Gupta added, "Women patients are taken for granted, their rightful symptoms are dismissed and made light of. Since Obstetrics and Gynaecology pride themselves in being a branch dedicated to women's health - it should take the initiative in bringing medical practice in India from out of the Dark Ages and making medicine patient-centric and not Doctor's ego-centric."

Dr Gupta said that there is nothing wrong with engaging in sexual activities out of marriage. Young people, especially teenagers, also do it. They should be equipped with the right knowledge and right medical help.

In developed countries like the UK, they understand the human nature that teenagers are scared and this fear is mainly because of getting judged or shouted at or getting a moral lesson thrown upon you when what you actually need is medical help, pointed out Dr Gupta. They have developed specific guidelines (Fraser and Gillick) for providing abortion and contraceptive medical advice to adolescents including teens below 16 years of age, even without parental consent if the requirements of the guidelines are fulfilled. Dr Gupta said that we too need to develop similar guidelines in India.

"They should exercise their rights and there is no law that says that you cannot have sex if you are not married," said Dr Gupta.

Sexually Transmissible Diseases (STD)

Speaking about the ground reality, Dr Gupta said that the awareness of Sexually Transmissible Diseases (STD) is not much either, especially in rural areas where girls do not have agency. Sharing her experience, she said that many of the girls there cannot read or write and do not have the monetary resources to access help.

Apart from pregnancy, there are so many aspects related to sexual health. "There is a problem that I have seen in a dozen cases of just married women. It was probably their first night after marriage and they come to emergency with heavy bleeding. After examination, we come to know that these are vaginal tears," said Dr Gupta.

She added, "We do find out if there was a force use or some foreign body but mostly it was consensual sex after marriage. The only problem is that both are inexperienced and the only source of sex education in India is pornography, which is very violent against women. They are growing up to think that this is how it is supposed to be and that women are supposed to get hurt and scream in pain. They see sex as pleasurable for men and painful for women. This is not true."

Dr Tank, who has his own hospital and is a specialist in fertility care, said that it’s the younger group, the adolescent, typically college-going students (who have gotten past school 16-17 onwards until they become adults and a little bit financially independent) who are generally a bit shaky. "They do not want to come to doctors; they still have to rely on somebody bringing them to a doctor. That is the group if they have reproductive or sexual health issues, typically we see delays in that group," he said.

However, the situation is not all grim. The younger generation of women gynaecologists is changing the scenes. "For them, in cases of pregnancy, it does not matter if a woman is married or unmarried. They see themselves in those patients. There are so many gynaecologists who are unmarried and might be taking contraceptives themselves or are sexually active and not married. Even in older consultants, I have seen a change. People are more aware that society is changing as a whole and also people are more kind now," said Gupta.

Abortion Care

Dr Tank emphasised how there needs to be a change in abortion care facilities emphasing on the need to sensitise gynaecologists and train them, "To not have judgemental attitudes and not to scare away women who have approached them at this vulnerable time and to provide a holistic approach to the whole problem."