Sexuality and Women’s Health

 OB GYN deals with sexuality, reproduction and a part off the anatomy that many would call politically incorrect. The same kind of denial came with the Dark Ages with religious taboos. Especially, in the Arab World; doctors we’re prohibited from seeing or touching a woman, and women were considered private chattel. Today, we share much of the same as in the Dark Ages. Women become more insistent on examination through their clothing and hyper vigilant for opportunity to complain of sexism, and to join with  the same political subordination and ignorance as in the Dark Ages. Humor is taboo. 

Professional insurance premiums reach unsustainable levels. Female OB GYN specialists solves one problem but that eliminates half or more of the profession. Then too, an equal opportunity policy for nursing assistance and dictations from both insurance companies, hospital employers and HHS cause many physicians to leave the specialty, or for Family Physicians to avoid the field. Reluctance to make professional decisions and guidelines leads to unjustifiable C-Section rates.

Midwives fill the gap for easy delivery multips but fall short with sudden emergencies and GYN issues. The US perinatal mortality rate reflects the political correctness problem, but OB is only a part of primary care for the broad tapestry of women’s health. 

In teaching physical exam to first year medical students, I found that the syllabus required the same identity for women in the sexually active, reproductive and gynecological years as for anyone else; just fine for training algorithm doctors, but way short for women’s health. An appropriate heading for all women should include age, date of the last menstrual period, gravity and parity, abortion and if appropriate, possibility of pregnancy and sexually active or not. If this relevant information gets buried in the past medical history, the diagnosis can be lost while still checking all the boxes. The art of medicine in all issues of sexuality, function and dysfunction for both sexes requires love and humor, with the possible exception of cancer. Humor in medicine is not sexist. All this seems self evident, but much of our common sense seems lost in favor of political correctness, guidelines and corporate profit.