| Hello and welcome to Mind the Gap, a newsletter that adds perspective to the week’s gender developments. This week, an old problem and a new controversy. Read on… THE BIG STORY: The problem with judgmental gynaecologists In her first summer break home from the American university where she was studying, K* sought an appointment with a gynaecologist to understand why her periods were irregular. Unlike many doctors, this one skipped the euphemistic are-you-married question and asked directly: “Are you sexually active?” Ok, thought K, so far, so good. Then came the next question: “With goras or desis?” The doctor laughed while asking the question, as if presenting it as a joke would make it less inappropriate or offensive, recalled K. In the backdrop of Roe v Wade there has been no small measure of chest-thumping here in India. The stunning overturning of abortion rights and, by extension, the autonomy of women over their bodies by the US Supreme Court, gave rise to a closer scrutiny of our own laws. But while abortion may have been legal in India since 1971, it’s not always an easy ride as women navigate judgmental doctors. Even a routine visit to a gynaecologist, for many, especially those who are single, can be a minefield. Are you married? In the small town where M lives, everyone knows everyone. If you’re spotted in the market, you can be sure the next door neighbour who saw you will tell your mum. And if you take an appointment with the gynaecologist for any reason, it will most certainly get back to your family, she said. So, M waits for work trips to Delhi when she can make an appointment. At least there, she added, the only problem you have to deal with is a judgemental gynaecologist and not that it will get back to your family. But even in Delhi, “You can see the disapproval when you tell them you are sexually active and especially when you inform them that you don’t have a regular partner,” said M. Top of the list of peeves for unmarried women is the ‘are-you-married’ question as code for ‘are you sexually active’. But social reality is somewhat more complex. For instance, Mumbai-based gynaecologist Dr Parikshit Tank told me his patients seldom come alone. Most are accompanied by a mother, an aunt, elder sister – and sometimes all of them. “She’s not going to be comfortable answering questions about her sexual activity in their presence – even if she’s married,” said Tank. He gets around the problem by asking her relatives to wait while he takes her to a separate examination room where there is a greater degree of privacy for him to get the information that he needs to diagnose her better, he said. “Try asking an unmarried young female about her sexual activity in tier 2 or 3 cities when she’s accompanied by family and watch the chaos unfold. You will be beaten to pulp,” said Srinagar-based clinical oncologist Dr Wajahat Ahmed. Some years ago, he said, a female doctor colleague asked a patient with severe UTI (urinary tract infection) about her sexual history, sparking massive outrage among her relatives who had accompanied her who then marched straight to the head of department to complain that the doctor had called their daughter badchalan (without character). But it’s not always unmarried women. In her mid 30s, L, a mother of two, told her gynaecologist--a busy doctor at a fancy corporate hospital in Delhi--during a routine annual examination that she was experiencing a loss of sexual desire. The doctor was taken aback. “So?” she asked. “You have two children don’t you?” It turned out, eventually, that L had a thyroid disorder, something that a more sensitive doctor could have spotted earlier if she hadn’t been so preoccupied making moral conclusions about sexual desire. Times are changing, but not fast enough For a young woman, going to the chemist to ask for an over-the-counter morning after pill, a DIY pregnancy test or even condoms can be fraught. A friend, then 20-something and unmarried, told me how she had gone to buy condoms from a corner store in Boston. When the man behind the counter turned out to be Indian, she mumbled the word condom and quietly paid up when he handed her a packet of cardamoms. But times are changing, said Dr Tank. An older generation of doctors could be harsh and unsympathetic, he conceded, but this isn’t always true for younger doctors. For many women, this change isn’t happening fast enough. In 2015, Amba Azad put out a call on Twitter for an outsourced list of gynaecologists ‘we can trust’. It isn’t just about patient discomfort over being judged by their doctors, but about accessing healthcare and diagnosis when it’s needed. Unmarried women in India do not routinely go to the gynaecologist for an annual pap smear or check-up. Single women are often denied trans-vaginal sonograms to preserve ‘virginity’. And while abortion might be legal in India, it needs to be seen more through the lens of sexual health and reproductive rights rather than limited to family planning and maternal health, write Sonali Vaid and Sumegha Asthana. [*Names of women have been suppressed out of respect for confidentiality.] P.S: After I submitted this to the editors of this newsletter, I read Nisha Susan’s excellent piece on more or less the same subject in Mint Lounge. | 
