Women who aren't on the marriage-and-pregnancy track often wind up feeling judged and dismissed—and not getting the care they need.
Photo: Stephanie Santillan
Supported by Oscar
When my gynecologist retired more than ten years ago, I started going to another doctor in her practice.
"Still married?" my new doctor asked, walking into the exam room for my first visit with her head buried in a manila folder.
"Nope," I said. "Not married."
"Still with the same partner then?" she asked, not looking up.
"Nope, still single," I replied. Whose file is that? I thought. Do you even know who I am?!
Even though I received mediocre, inattentive care from her, I stuck with her until she, too, left that practice, and then bounced around to a few other providers there for several years. I wasn't trying to have children and didn't think that I had any pressing gynecological concerns, so it just seemed like the path of least resistance to stick it out for the one check-up a year I needed.
After sitting in a waiting room filled with pregnant women, I'd get a brusque and formulaic appointment that consisted of a pelvic exam, Pap smear, and a quick question about birth control, and then I was sent on my way. There was nothing horribly wrong with the care that I got, but having an excellent general practitioner who was extremely thorough and spent a lot of time with me during my appointments addressing my questions and concerns, I suspected that it was possible to be more satisfied with my gynecological care, too. Last fall I finally tried going to an OB/GYN at a different practice, but still wasn't thrilled with my experience there, although I couldn't articulate why.
I'm not the only one who's dissatisfied. Other single women report similar frustrations with a specialty that's largely geared towards delivering babies. Some women reported that their needs had been overlooked; others described being outright shamed, judged, and dismissed.
"I have never found an unbiased gynecologist," says Keri Setaro, a 38-year-old yoga teacher and voiceover actor in Brooklyn. "I've had some that expressed their feelings in a way that made me feel not as pushed, but on the whole, almost every gynecologist has expressed their feelings about having a baby while I was in the office."
Because she'd had a bad reaction to birth control pills, Setaro went to her doctor inquiring about getting an IUD. "He was questioning why I wanted to have sex on an IUD and why I wouldn't want to have a child at my age," she says. "I've had panic attacks because doctors are like, 'Well, you know, you're 38, you should really have a child.' And I'm like, 'Well, I didn't come to you asking about fertility, I came to you asking about birth control.'"
Ashley Strassburger, 32, of Salt Lake City, has also had negative experiences. "It felt like I couldn't get the care I needed as a single woman," she says. Several years ago she suffered from pelvic pain and was going to a gynecology practice to manage it through trigger point injections. One time she thought she was having a reaction to the anesthesia they'd used and called her doctor after-hours, but couldn't get in touch with him.
"I was told that unless I was in labor they couldn't call him off-hours," Strassburger says. "That was how the office policy was set up. So there was no room for me as just a GYN patient. It felt like the business was definitely delivering babies."
She'd also take time off work for her appointments to repeatedly have them cancelled when she arrived because her doctor had left to deliver a baby, with no contingency plan in place for her to see an alternate provider during her scheduled time. "I felt very minimized and dismissed, and like my problems as a single woman were not worthy of their time," she says. "From my experience, in a big way empathy was missing."
Jessica Weiss, a women's health nurse practitioner in New York City, recalls difficulties finding an adequate health care provider when she was a single woman seeking care. "In my 20s, my friends and I all had a really hard time finding a provider that we felt was focused on our care specifically," she says. "One thing we struggled with was a lack of providers who took into account where we were coming from. So oftentimes if I would bring up a concern, I would be embarrassed and struggling to bring it up. And when the provider responded with a short, overly-medicalized answer, that wasn't always what I was looking for."
Weiss recalls, "My girlfriends and I would get together and chat about our sexual issues, but when we were sitting in a doctor's office, it never felt like that was an appropriate place to be discussing those same problems."
Lauren Streicher, associate clinical professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine and author of Sex Rx: Hormones, Health, and Your Best Sex Ever, gave up obstetrics about ten years ago and has since limited her practice exclusively to gynecology.
"It's a problem for a lot of women who are trying to find a good doctor, because with the majority of OB/GYNs, their practice is predominantly pregnant women," Streicher told me. "And when you think about it, women are only pregnant for at most two to three years out of their life, and the other 70-plus years are spent not pregnant. Yet they end up going to a gynecologist who's primarily interested in obstetrics."
Streicher stresses that single women who don't plan on getting pregnant in the near future are much better off going to a someone who does just gynecology.
The practice Weiss is in is also entirely focused on gynecology, with a vast majority of patients in their 20s and 30s. She sees education as an important part of her role as a healthcare provider. "Our sex education and health education in this country is really lacking," she says. "So I find that a lot of young women are coming in with less knowledge about their general anatomy and physiology, especially reproductive physiology, than they would benefit from."
"Obviously nowadays it's less stigmatizing to say that you're sexually active as a single woman, but there's enough stigma surrounding it that I don't feel like people are comfortable talking about issues they might be having sexually—problems orgasming, or the minor things that make sex better," Weiss says. "We rarely get to have a conversation about how to make sex as enjoyable as it could be because there is still enough stigma surrounding sexual activity."
As a single woman, you may not be aware that it's possible to have anything beyond a perfunctory 15-minute office visit involving a routine Pap smear and getting your birth control pill prescription refilled. And you definitely might not realize that issues of sexual function and sexual pleasure could also be addressed at the gynecologist, because they so often aren't.
But Weiss has a more holistic view of gynecological care. She covers the gamut with her single patients, addressing issues of protection with multiple partners, and which forms of birth control work best according to a person's lifestyle. She asserts that if something about a patient's sex life is unsatisfactory, there's probably something that can be done to make it better.
While many single women struggle with feeling dismissed and judged by their gynecologists—for their sexual activity and number of partners, reproductive choices, or the forms of birth control they're seeking—Weiss emphasizes that this doesn't have to be the case and that better care that meets your needs is available.
"There should be no shame involved," she says. "So if you leave an appointment feeling at all embarrassed or ashamed, then it's not the right practice for you."
Photo: Hana Song