Should a gynecologist inform a female patient who prefers a female gynecologist that male healthcare providers may be assigned to provide intimate care during her gynecological surgery?

Should Gynecologists Inform Patients About Male Healthcare Providers in GYN Surgery?

Yes, gynecologists must explicitly inform patients who have expressed a preference for female providers that male healthcare personnel may be assigned to provide intimate care during gynecological surgery, and this disclosure should occur before sedation with documentation of the patient's consent if staffing differs from their stated preference. 1

Ethical and Legal Foundation

Respect for patient autonomy is a compelling reason to honor gender-based requests for healthcare providers. 2 When a patient has already communicated a preference for a female gynecologist, this documented preference creates an ethical obligation to:

• Ask about gender preferences during pre-operative screening using non-gendered, inclusive questionnaires 1
• Document the preference clearly in the medical record where all team members can access it 1
• Before sedation, explicitly inform the patient of all personnel who will be present in the operating room, including their roles and genders 1
• Obtain explicit consent if the staffing differs from the patient's stated preference 1

Why This Matters for Patient Outcomes

The evidence demonstrates that failing to respect stated preferences directly impacts quality of life and healthcare engagement:

• Women demonstrate strong same-sex preferences for intimate procedures, with 90.8% preferring same-sex providers for gastroenterology office visits and 92.3% for colonoscopy 1
• Embarrassment is the primary driver for women's preferences, particularly among those with higher education levels 1
• History of abuse is a critical factor, with both men and women with a history of physical or emotional abuse being significantly more likely to prefer a female provider 1
• Respecting preferences reduces anxiety and embarrassment, which are primary barriers to seeking care for intimate health concerns 1

Implementation Algorithm

Step 1: Pre-operative Assessment

• Incorporate gender preference into routine pre-procedure screening questionnaires in a non-gendered, inclusive format 1
• Ask sensitively and in a private environment, providing clear explanation for the relevance of the question 1

Step 2: Documentation

• Record the patient's preference in the medical record in a way that future healthcare staff can access it to avoid repeated uncomfortable conversations 1
• Information about gender preferences should only be shared with those for whom it is relevant and with patient consent 1

Step 3: Pre-operative Disclosure

• Before any sedation, explicitly review all personnel who will be present, their roles, and their genders 1
• If male providers will be involved in intimate care and this differs from the patient's documented preference, obtain explicit informed consent 1
• Document this conversation and the patient's response 1

Step 4: When Accommodation Is Not Possible

• Efforts should be made to accommodate the request if possible 2
• However, if it is not feasible for a woman obstetrician-gynecologist to provide care because of staffing or other system constraints or patient safety concerns, accommodation is not required 2
• Patients have the right to decline care and may choose to seek care elsewhere if their requested healthcare provider type is not available 2
• The patient must be informed of this limitation before proceeding, allowing them to make an autonomous decision about whether to proceed or seek care elsewhere 2

Critical Pitfalls to Avoid

Do not assume that because a patient has not explicitly objected to male providers in the operating room, they have consented to their presence. The patient has already documented a preference for female providers by choosing a female gynecologist. 1

Do not wait until the patient is sedated or in the operating room to disclose the gender composition of the surgical team. This violates informed consent principles and removes the patient's ability to make autonomous decisions. 1

Do not omit asking simply because accommodating the preference may be difficult. Documenting the preference allows for future accommodation and demonstrates respect for patient autonomy. 1

Special Considerations

Creating an open and inclusive environment during surgical procedures is important, as undergoing surgery can be a vulnerable time for any patient. 1 This is particularly salient for:

• Patients with a history of physical or emotional abuse 1
• Transgender and gender-diverse patients, who have low confidence that healthcare workers understand their needs and fear encountering prejudice and discrimination 1
• Patients for whom pregnancy and gynecologic procedures can exacerbate gender dysphoria, anxiety, and depression 1

Institutional Responsibility

Institutions and medical clinics should have policies and procedures in place for managing patient requests for women obstetrician-gynecologists, and patients should be made aware of these policies preemptively. 2 These policies should:

• Include information about whom to contact for assistance and how to document the encounter 2
• Be accessible and familiar to physicians and trainees 2
• Balance patient preferences with educational opportunities for all medical trainees, regardless of gender 2