Gender Preferences for Surgical Team Members in Gynecology
Women who prefer a female gynecologist/surgeon generally do not extend this preference to the entire surgical team, including technicians and nurses, though the surgeon's gender remains the primary concern. 1, 2
Evidence on Patient Preferences
Surgeon Gender Preferences Are Strong and Specific
Approximately 45-52% of women prefer a female gynecologist/surgeon for intimate gynecological procedures, with only 4.2% preferring a male provider, while the remaining 43-50% express no gender preference. 2, 3
The preference for female providers is driven primarily by embarrassment during intimate examinations and the ability to communicate more easily, particularly for procedures involving the genital area. 1, 2, 4
History of physical or emotional abuse significantly increases the likelihood of preferring a female provider, making this a critical screening consideration. 1
Limited Evidence on Surgical Team Gender Preferences
Research on gender affirmation surgery—arguably the most intimate surgical procedure—found no preference for gender-concordant surgeons or surgical team members, despite the genital nature of the surgery. 5
Studies examining patient preferences focus almost exclusively on the physician/surgeon gender rather than the broader surgical team (nurses, technicians, anesthesiologists). 2, 6, 4, 3
Gender preferences are strongest for health professions engaged in intimate and psychosocial health problems (gynecologists, general practitioners) but virtually absent for more "instrumental" health professions like surgeons and anesthesiologists. 4
Clinical Implementation Algorithm
Pre-Operative Screening
Incorporate gender preference questions into routine pre-procedure screening questionnaires using non-gendered, inclusive language that specifically asks about the surgeon and, separately, about other team members. 1
Ask sensitively in a private environment with clear explanation that the question helps ensure patient comfort and reduces anxiety during vulnerable procedures. 1
Document the preference clearly in the medical record where all perioperative team members can access it to avoid repeated uncomfortable conversations. 1
Pre-Operative Consent and Communication
Before sedation, explicitly inform the patient of all personnel who will be present in the operating room, including their roles and genders, particularly if staffing differs from stated preferences. 1
For patients with history of abuse, pregnancy-related gender dysphoria, or transgender/gender-diverse identity, provider gender preference becomes even more salient and should be prioritized. 1
Special Considerations for Transgender and Gender-Diverse Patients
Transgender and gender-diverse patients have low confidence that healthcare workers understand their needs and fear encountering prejudice, making respectful inquiry about preferences essential. 7, 1
Use the patient's chosen name and pronouns throughout all interactions, avoiding "outing" patients by using birth names in public spaces like waiting areas. 1
Allow transgender masculine patients to wear chest binders into the operating room and remove them only just before induction, with immediate availability in recovery. 7
Common Pitfalls to Avoid
Do not assume that a preference for a female surgeon automatically extends to all surgical team members—the evidence suggests these are distinct preferences, with instrumental roles (anesthesiologists, surgical technicians) generating minimal gender preference. 4
Do not omit asking about preferences simply because accommodating them may be difficult—documenting the preference demonstrates respect for patient autonomy and allows for future accommodation even if immediate accommodation is impossible. 1
Do not assume preferences based on demographics alone—approximately 43-50% of women express no gender preference, and individual variation is substantial. 1, 2, 3
Avoid focusing solely on the surgeon's gender while ignoring the patient's broader comfort needs—creating an open, inclusive environment throughout the perioperative period matters more than team member gender for most patients. 7, 1
Quality of Life and Satisfaction Outcomes
Respecting gender preferences reduces anxiety and embarrassment, which are primary barriers to seeking gynecological care and can negatively impact the surgical experience. 1, 2
Female physicians use more patient-centered communication styles, which increases patient satisfaction regardless of the specific procedure. 6
When transgender persons receive medically appropriate, affirming care that respects their preferences, they experience improved mental health, reduction in suicide rates, and lower overall healthcare costs. 1