On boy doctors, girl doctors, and advocating for my son

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“I hope it’s a boy doctor.”

It was the spring of 2014, and I was walking with my then-10-year-old son from our car to our family health team’s office. Our doctor is part of the Queen’s Family Health team, so we often see residents rather than our assigned physician. For this reason (and because I don’t ask about the schedule when I book appointments), we don’t always know the gender of the person who’ll be providing care on a specific day. (We can always ask to see our doctor, however, I’ve never done this. I’ve always bought into this model of medical education – even before I started working as an educational developer in the undergraduate medical program).

It had never mattered to my son. Until that day in April.

We were heading to an appointment about recurring rectal bleeding. He had first presented with this on New Year’s Day. The digital rectal examination at the child out patient clinic the next day was an uncomfortable experience that he now refers to as “the butt thing”.

If they’re going to do “the butt thing” again today he wants a boy doctor, he said.

“You know,” I said, matter-of-factly (or at least I attempted to be matter-of-fact), “at the Med School where I work they teach boy doctors and girl doctors all the same things. They all learn how to look after everybody.”

“Yeah, I know,” he said. “But if they do the butt thing, I want a boy doctor.”

My son has autism. He’s seen multiple physicians, therapists and interventionists in his short life. Until this point, he had never commented on their genders. This was a new request. I had until his name was called to sort out for myself what I would do.

There was a flurry of news reports the previous fall, in October 2013, about whether patients should have the right to choose their physician based on race, religion or gender. (See here and here for some of this coverage). The news hook was a position statement by The Society of Obstetricians and Gynecologists that argued its members should resist such requests in emergency and other after-hours situations.

Perhaps because the articles were focused on obs/gyn, much of the commentary that followed focused on women, immigrants, and others with religious concerns. I can’t recall any discussion about children and their preferences in the gender of a treating physician. Until that day in 2014, I’d never given it any thought myself. My kids have been “stuck” with whichever family physician I’ve found for us.

Until my son’s request for a “boy doctor.”

Is this a reasonable request? Is my job as his mother to convince him that physicians of either gender will provide him with great care and that he should feel comfortable with either gender? Or is my job to talk with the clinic staff, explain his concerns, and ask to see a male doctor on duty that day?

The resident we were scheduled with that day was, indeed, the “boy doctor” so I was let off the hook of having to ask to have the attending (male) physician replace the other (female) resident. As a woman, as an educator, I’m uncomfortable with the idea of that conversation. As a mother and my son’s advocate, I think it’s something I would have had to do to support him in his request for a “boy doctor” for this invasive examination.

While I was happy to be off the hook that day, I have yet to resolve this conundrum. Is it reasonable for patients (or parents of patients) to make such requests? If gender requests are OK, are other requests OK, too — race, religion, age? Are children a special case?

In my role as an educational developer, I take these mental musings further: What does this mean for medical education? Do our students need special instruction on how to address these patient concerns? Would I have more or fewer reservations speaking up on this for my child if I weren’t involved in medical education? Are there other parents who feel they can’t bring things like this up for other reasons? Is this a problem? How can this be addressed?

These are questions I’ve continued to wrestle with and I suspect I will for a long time. What do you think?

 

 

2 Responses to On boy doctors, girl doctors, and advocating for my son

  1. Bob Reid says:

    The practice of Obstetrics and Gynecology has changed in the past few decades from predominantly male specialty to a predominantly female specialty…..the so-called “pinking of the specialty”. This, in part, has to be due to male medical students encountering women who choose not to have them participate in their care. To understand what factors motivate this attitude Jennifer Racz, while a medical student at Queen’s, conducted a summer student project with me that involved a survey of 683 gynecology clinic patients and 192 secondary school students about their preference for a specific gender in medical students learning to perform intimate (breast and pelvic) examinations. 72.8% (485/666) of clinic patients reported they would accept an intimate examination by a medical student of either gender, compared with 32.1% (61/190) of secondary school students. The proportion of women preferring a female student was inversely related to the number of previous breast and pelvic exams. (J Obstet Gynaecol Can 2008;30(10):910–917). Responses indicated that women with greater exposure to intimate exams realized that it was the quality, rather then the gender, of the doctor that was important.

  2. Rick Rowland says:

    As a clinical clerk in Toronto, I worked with a resident who had applied for a different surgical program but ended up in OB/Gynae. She gave the roughest, most callous pelvic exams I have ever seen. Any woman who thought they would be treated more gently and sympathetically because they had a female doctor was very mistaken.
    As Dr. Reid has reported, the request for a female doctor is mostly based on bias, not on experience. It is a good thing for a young woman to meet a “boy doctor” who treats her with respect, courtesy, gentleness, and competence. It is an equally good thing for a young man to meet a “girl doctor” who shows the same qualities.
    Although I think patients should have more choice that they do in finding a family doctor, I am not in favour of encouraging patient choice based on sex, race, or any of the other grounds for bias.

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