Say “obstetrician-gynecologists” — ob-gyns — and most people will tell you that such doctors only treat women. Men can also need to see a gynecologist to treat anal cancer, though. The number of cases of what is considered a rare disease has been on the rise, especially among both men and women who have been infected with H.I.V. Anal cancer is usually caused by the human papillomavirus (HPV), which is sexually transmitted.
Many gynecologists were shocked to learn that, if they treated men, they could lose their board certification. Without this, doctors can lose their jobs.
Back in September, the American Board of Obstetrics and Gynecology announced that, with a very few exceptions, its members could only see women and that they could not use techniques developed to screen women for cervical cancer to test and treat men with anal cancer. In a fortunate turnaround this week, the board reversed its earlier directive and said that its members can treat men for anal cancer and for sexually transmitted diseases.
Gynecologists like Dr. Elizabeth Stier of the Boston Medical Center are relieved at the board’s change of policy. Stier’s more than one hundred male patients certainly are, as are her research colleagues. When the board announced its directive, a major clinical trial whose goal is to find out how to prevent anal cancer and which had received $5.6 million in federal funding was just about to get underway. Stier and the director of the planned study had appealed to the obstetrics and gynecology board. Unless the study was carried out, “some of the best qualified, most highly skilled doctors” in the U.S. would not have been able to treat male patients in great need of care.
The board had argued that obstetrics and gynecology be “restricted to taking care of women” and, specifically, “problems of the female reproductive tract.” Dr. Larry C. Gilstrap, the executive director of the American Board of Obstetrics and Gynecology, noted that, since 1935, it has been the only gender-specific one of the 24 medical specialties recognized in the United States.
Dr.Gilstrap also said that too many of the organization’s members had begun to turn to “moneymaking sidelines,” including testosterone therapy for men and liposuction and other cosmetic procedures for both women and men.
The board’s reversal of its own directive is more than welcome. As Dr. Mark H. Einstein, a gynecologic oncologist at Montefiore Medical Center in the Bronx who, like Dr. Stier, had been forced to stop treating his patients, said in the New York Times, “Cool heads have prevailed. This is the best decision for our patients.”
An issue that still requires much more consideration is, as Feministing points out, the care of transgender patients. The American Board of Obstetrics and Gynecology did announce some years ago that gynecologists should “prepare to treat transgender patients.” Based on its original directive that gynecologists could only see women — that it is a medical speciality “restricted” to treating women’s reproductive health — the board showed that it has ”given little thought to anyone existing outside of the gender binary.”
Trans and gender non-conforming persons encounter multiple obstacles to acquiring health care. Feministing cites the results of the National Transgender Discrimination Survey, according to which 19 perecent of respondents said they had been refused care because of their gender identity. 28 percent said they had been “subjected to harassment in medical settings, with even higher reported incidences of treatment refusal and harassment in trans communities of color. ”
Almost a hundred years ago, it was certainly a huge step forward for the medical profession (after centuries in which women’s bodies were considered to be “deformed” men’s bodies) to acknowledge that women have medical concerns specific to their gender. We now understand that there are not only two genders. Medical professionals must catch up to the realities of society and the needs of individuals today.
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