Gender Preferences in Gynecological Care

Patient Preferences and Clinical Implementation

• Women who prefer a female gynecologist/surgeon generally prioritize the surgeon's gender, and this preference is driven by embarrassment during intimate examinations and the ability to communicate more easily, particularly for procedures involving the genital area 1
• History of physical or emotional abuse significantly increases the likelihood of preferring a female provider, making this a critical screening consideration 1
• 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
• 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
• Transgender and gender-diverse patients have low confidence that healthcare workers understand their needs and fear encountering prejudice, making respectful inquiry about preferences essential 1, 2, 3
• 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 3
• Respecting gender preferences reduces anxiety and embarrassment, which are primary barriers to seeking gynecological care and can negatively impact the surgical experience 1
• 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

Special Considerations

• 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 1
• 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
• 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 1, 3

Honoring Patient Gender Preference in Gynecologic Surgery

Introduction to Trauma-Informed Care

• Trauma-informed approaches must be utilized in perioperative care, particularly for patients with PTSD or abuse history, as the surgical environment can trigger significant emotional trauma, according to the Mayo Clinic Proceedings 4

Psychological and Clinical Consequences

• Failing to respect gender identity and preferences leads to avoidance of necessary medical care, with 23% of transgender patients not seeking care when needed due to fear of mistreatment, as reported in the Mayo Clinic Proceedings 5
• Disrespecting patient preferences damages the patient-provider relationship and can lead to loss of patient retention, particularly when gender identity is not acknowledged, as noted in the Journal of the American Medical Informatics Association 6

Reporting and Accountability

• Reporting serves multiple purposes: it creates accountability for the specific incident, prompts institutional policy review, protects future patients from similar experiences, and reinforces that patient preferences around intimate procedures are not trivial requests but fundamental aspects of respectful, trauma-informed care, according to the Mayo Clinic Proceedings 5