Many doctors are prejudiced about premarital sex that erases stigma attached to intercourse beyond institutionalised system of marriage.
Young women are often put in awkward, embarrassing situations. (Representational image/iStock)
Anamika could feel several stares burning her back as she picked up the phone at the hospital reception.
Seconds earlier, her worst fear had come true when the receptionist, apparently in her mid-40s, called out her name over the murmurs of patients and those accompanying them.
Anamika had heard from friends the horrors of visiting a gynaecologist. She was also told about a young woman, who took additional contraceptive pills and ended up on the examination table with excessive bleeding.
The woman was lectured about the moral degradation of her generation, as she awaited treatment. The woman had not consulted an expert earlier, fearing humiliation.
Anamika sensed trouble when the receptionist called out her name, and asked if she was married. When replied in the negative, she was told that the ultrasound department had refused to conduct a transvaginal scan. She clutched her mother’s hand when the murmur in the room died off, and all eyes focused on her.
The woman was made to explain her condition to the ultrasound department over the phone, while others in the reception listened with rapt attention. No one even whispered, not to miss a single word she spoke. They heard her say that the gynaecologist had recommended the transvaginal scan.
Several pairs of eyes, now in gleeful contempt, followed Anamika as she returned to her seat. In the few preceding seconds, the entire reception had judged her, her “promiscuity”, culture and morality. She sat by her mother, still and silent, her eyes fixed on the floor.
Anamika’s experience was not an aberration. She is one among several Indian women dreading to visit the gynaecologist’s office. Ayesha of Kolkata is one of them.
It was the 32-year-old unmarried software engineer’s first visit to a gynaecologist in Bengaluru, where she has been posted. Ayesha said the gynaec’s questions made her uncomfortable.
“I was asked if I was married. I said no. The doctor then asked me if I was sexually active. I said, yes. The next question the doctor asked me was how many partners I have. I was taken aback and felt so humiliated. How is that connected to the health complaint,” she asked while speaking to South First.
A recurring pelvic pain had taken Ayesha to the doctor.
The doctor lectured her on the dangers of promiscuity and despite Ayesha’s attempts to explain that she has been in a monogamous relationship for years, the gyneac continued judging her character rather than focusing on the medical issue.
Ayesha felt degraded and unheard. “I felt so humiliated that day. I wondered why should the onus be on me to convince that doctor that I am not promiscuous,” she continued.
“Being a gynaecologist, and that too a woman, what was she trying to communicate,” the young woman asked. Ayesha said she was feeling insecure about visiting any gynaecologist and trying to avoid visiting one.
Anamika and Ayesha’s experiences reflect a time warp in which society, including the doctors, are stuck. Women have redefined premarital sex, erasing the stigma attached to consensual intercourse beyond the institutionalised system of marriage.
A quick social media search threw up several such instances in which young women were put in awkward, embarrassing situations. Anamika’s case was highlighted on X by palliative care counsellor and patient advocate, Vandana Mahajan.
Mahajan questioned the ordeal Anamika had to undergo. She highlighted the young woman’s distress and called it a violation of privacy.
She criticised the fixation on marital status and sexual activity, questioning the receptionist’s right to ask such personal questions and why the woman was subjected to such scrutiny despite the doctor’s prescription.
The incident occurred at a reputed hospital in Delhi, Mahajan said. It left the young woman so upset that she refused to return to that hospital.
Confidentiality is at the core of medical practice. Healthcare providers are required to keep the patient’s health information private. However, confidentiality is sidelined when the doctor claims the moral high ground.
A psychologist, who did not wish to be identified, narrated an incident. A Chennai doctor lectured the parents of a 20-year-old woman on morality. The lecture followed after the young woman confided in the doctor that had had unprotected sex with a classmate and was worried about getting pregnant.
“It is imperative that doctors should be sensitive and should know how to handle confidential information,” the psychologist told South First.
While these incidents were reported from cities considered to be keeping pace with the changing world, rural India is not different in handling sensitive health issues of women. It often goes beyond embarrassing the women when the leaked information triggers gossip.
Leela, a 27-year-old unmarried teacher from a village in Karnataka’s Mandya, approached a gynaecologist seeking a pregnancy test. The single woman wanted a medical termination of pregnancy.
She underwent the procedure, oblivious to the fact that the attenders at the hospital had found a piece of spicy news. The news spread in the village, and the teacher soon became the butt of the joke that left her unable to face her students.
These experiences are not isolated incidents. They reflect a broader issue within the healthcare system. They underscore a troubling gap in patient care, where personal bias often overshadows professionalism.
Gynaecologists South First spoke to, admitted that such instances often occur in some hospitals. It affects the patients’ trust in healthcare providers, besides discouraging them from seeking proper medical assistance.
Hyderabad-based Gynaecologist and Laparoscopic Surgeon Dr Rooma Sinha said patients should be handled with love and respect. Gynaecologists should provide them with knowledge on safe sex.
Meanwhile, Dr Shaibya Saldhana, co-founder of Enfold India, an NGO dealing with child rights, said gynaecologists should accept that today’s young people and unmarried women are sexually active.
“Professionals should be respectful of their choices. The bias towards unmarried women, women who are not cis het, or who have different sexual orientation or behaviour, is obvious among many gynaecologists,” she said.
She said gynaecologists judge women’s choices of getting married, having children or terminating a pregnancy. It is partly a reflection of the majoritarian patriarchal views which are insidious in India and also the fact that medical education in the country does not impart gender and diversity awareness to doctors.
Dr Shabiya added that the doctors have also developed an environment which is inherently paternalistic, non-patient-centric, and sometimes disrespectful to patients.
Problem is not just with unmarried women, even young adolescents face this issue. Agreeing to this, Dr Preeti Galgali, paediatrician and adolescent counsellor, concurred that awareness of being sensitive and sensible should start at medical colleges.
“Adolescent girls visit me with sexual-health-related or gynaecological issues. I advise them to see a doctor, but they refuse, due to the stares and stigma of being looked down on with suspicion,” she said.
Dr Galgali said even ayahs gossip among themselves about young girls visiting gynaecologists for either termination of pregnancy or any problems related to sexual health.
“Training for being sensitive and understanding the approach needs to be imparted to even receptionists, technicians at scanning centres and labs. There have been cases where the patients are laughed at, mocked for getting pregnant outside marriage, or even lectured on morality. This should change,” she further said.
She added such instances would make many women feel insecure, and forcing them to avoid seeking help for any gynaecological issues or look at alternative treatments which could be dangerous.
Meanwhile Dr Shalini VL, physician, who serves at Hassan District Government Hospital said gynaecologists, especially in government set -ups with crowded out-patients department are often insensitive towards such patients.
“If it’s a case of pregnancy due to rape or sexual assault, etc., the doctors are caring and are sensitive towards the girl,” she said.
“However, if a woman in a live-in relationship or an extra-marital affair seeks abortion then the doctors are scared that it might become a medico-legal case. However, it is important to be sensitive to these issues as the number of such cases will increase in future,” the doctor added.
Dr Shalini, however, felt it necessary to ask some uncomfortable questions like knowing their marital status, suspect if it is pregnancy related, if they are sexually active, if they have used a contraceptive, etc. But it is also important to make sure that the woman/girl feels safe and her privacy is respected, she added.
Dr Hema Divakar, of the Divakar’s Specialty Hospital in Bengaluru and the division director wellwoman healthcare at the FIGO (International Federation of Gynecology and Obstetrics), pointed out some serious issues. While there is too much focus on caring for pregnant women, the pre- and post-pregnancy periods are neglected by the women themselves, their families and society.
FIGO is an International Federation of Gynecology and Obstetrics of 138 countries.
However, she added that gynaecologists are gradually changing their mindset towards unmarried women. Educational needs and career opportunities are shifting the age of marriage towards 28-32 and even 35.
“There are quite a large number of women who come with a variety of gynaecological problems. It is our duty to be practical, non-judgmental and supportive. It is important to empower the woman with advice regarding contraception, sexually-transmitted diseases, responsible behaviours and when to seek care just in case when the contraceptive fails and related issues,” Dr Divakar said.
Gynaecologists would not be responding uniformly to such situations, Dr Divakar attributed it to the socio-cultural differences in which the gynaecologists were brought up, and their age.
She argued that more or less gynaecologists in the metros are used to the pre-marital pregnancies but in smaller towns it may not be the case.
“But it is high time that gynaecologists accepted the reality and behaved compassionately and developed good communication skills,” she added.
(Names of women have been changed. Edited by Majnu Babu).
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