Kannalmozhi Kabilan By Express News Service CHENNAI: Are you married?” Three different gynaecologists, three different hospitals and three different reasons for the visit. And yet, this was the question put in the place of “Are you sexually active?” If you had thought that a place of science, facts and primary medical care would not descend to euphemisms, think again. For the other question that comes up at these visits is, “Was there any contact?” Did my vagina get a call from ET, you ask? No, doctor; not since he went home. For 27-year-old Apoorva Mohan, it did not just stop with the assumption that she not being married meant she was not having sex. “I visited a gynaecologist for a general check-up after I became sexually active. They had their sneaky question about marriage to determine if I was having sex. When I clarified that I wasn’t, there was shock and judgement written all over the doctor’s face. Then she went on to tell me that it’s not good for me and there are so many problems that come with being sexually active before marriage. Was that not why I was there? To make sure there was no problem?” she recounts. There is so much reluctance to talk about sex in general, says Sushmitha Ramakrishnan. When she was diagnosed with chickenpox and asked her doctor if it can be sexually transmitted (for the reactivation of pox, shingles, can be transmitted that way), all the doctor had to say was, “You’re not married no? You don’t have to worry about it.” But the issues with gynaecologists are not restricted to single women, says Apoorva. An active voice on Twitter, Apoorva has stated on her profile that she’d help anyone seeking abortion or related medical care — putting them in touch with the right doctor, taking them to the clinic or just being there to hear out their fears. This attracted plenty of vile from the general populace but she has also had several women (strangers) reach out to her when in trouble. “A 30-year-woman told me about how she wanted to get an IUD, because she was not ready to have a baby just yet, and her husband and his family were not supportive of the decision. When she went to her gynaecologist, the doctor refused with the claim that the husband had to be present for it,” she says. Insensitive theories Decisions about what goes into the vagina come with a whole host of unscientific theories too. “Even when I had a fibroid in my uterus, the gynaec refused to give me a transvaginal scan. There’s this reluctance because I was not married and they were worried about the hymen breaking!” reveals Christine*. She remembers a tweet she came across that said that a young girl who went to her gynaecologist about the pros and cons of using a menstrual cup was told it was just an excuse for girls to insert something in their vagina because they want to be sexually active. The doctor even went on to suggest that the girl’s mother get her married if she wants sex, she recalls. The insensitivity increases manifold when the patient is a woman with disabilities, notes advocate and fellow at International Disability Alliance Amba Salelkar. “When women with disabilities present with some uterine condition, gynaecologists are happy to suggest they get a hysterectomy. Why do you need a uterus in that sense is the reasoning. There is some inherent ableism and moral policing that comes in,” she notes. Provisions and interventions While the world of adults has its own problems, their underage counterparts may just have it worse. The provisions of Protection of Children from Sexual Offences (POCSO) Act mandates that the gynaecologists report any underage sex (even if it is consensual) as rape. Even as minor girls have their own reservations about seeking medical care, such blanket laws only serve to alienate them further and render all possible intervention useless. Here, there is little that the gynaecologist can do to protect their patients. “In many jurisdictions, there is a difference between sexual contact between adolescents with a two-year age gap and that between a 13-year-old and a 30-year-old. The major issue with POCSO is that it does not create that difference. This makes it very difficult if you are a 16-year-old girl who is sexually active with your 18-year-old boyfriend. You have young adults who are actually in need of advice on birth control but they do not get that. The minute they try and reach out, they open themselves up for being involved in criminal proceedings,” explains Amba. There is the need to go back to what medical ethics is all about — to doing no harm, she suggests. “If a medical practitioner is confronted with a situation where a 17-year-old is pregnant, the question is: where does the harm lie? It is possibly doing more harm than good if you are reporting her and her underage boyfriend. That is the dilemma that exists. At the same time, it is true that in many cases where doctors are made aware of violence against young children. I’m talking about children as young as five years old being taken to the hospital and they have injuries consistent with sexual violence. That is when the doctor can raise an issue. In that way, the practitioner is in the best place to judge the situation. You also do not have services backing up this mandatory requirement. If you had a system that is more child-friendly — one that enables the child’s participation in the process and also considers the family’s comfort — that would make sense. At the same time, the medical practitioner should not be held liable for taking a call to not report a particular case (of course, they should be held responsible if they were covering it up). Often, it is the parents who trigger the mechanism after they get to know about their children’s sexual activity. We need to look at whether it makes sense to have this blanket provision or if there is some nuance we can bring into this,” she offers. The bigger picture Archanaa Seker, writer and gender rights activist, suggests that there is the need to look at the bigger picture if we want to address the problems we have with all things gynaecology. “We need to build a culture where girls and women are taught to take their reproductive health seriously and they get to a place where if you have a vagina, you have a gynaecologist. You should have a gynaecologist that you can go to as much as you would with a general physician or dentist. Right now, women go to a gynaecologist only when there is trouble or they need an abortion. The latter is a very dicey situation to start things with. Many clinics do not even perform medical termination of pregnancy. Then the doctor too starts on the wrong foot, wondering if this were your first time and what could your history be,” she explains. Gynaecologists often walk into the clinic as mothers, fathers, aunties and uncles too, with their moral baggage, she points out. But given that they are supposed to be people of science, there is the need to hold them accountable for straying away from their role as a medical care provider, she adds. “How do we hold them accountable? Women who go to a gynaecologist and have a bad experience would only tell their friends. These friends will tell others and that is how we get information — through the whisper network. There are a lot of steps that we have to go through before we can hold the doctors accountable for their work. There are good gynaecologists in the city but they are very rare and very difficult to find. Perhaps, we can begin by celebrating the good ones. This may help build a collective of gynaecologists who are judgement-free and provide the care that is best for the patient. This may help bring out others like them,” she suggests. *Name changed on request

Stay updated with all the Chennai Latest News headlines here. For more exclusive & live news updates from all around India, stay connected with NYOOOZ.