What a remarkable story and perspective. We have a lot of work to do as physicians to improve healthcare for every patient, and recognizing aspects of our culture that need to change is the first step. Misogyny in our field is deeeeeply rooted. Keep going, Dr Zha.
I’m so grateful to both of you doing this work on here! Sharing your perspectives, pushing back against misogyny and ableism… it’s wonderful. We need the physician and patient perspective to go hand in hand!
Thank you so much for this absolute gift of an article - it came at the exact perfect time for me. I so appreciate you articulating the struggles that uterus owners endure having control over their own bodies.
We must do better - too many of us have these stories and not all will have a happy ending
Thank you for sharing my article - I so appreciate it! It’s fascinating to contrast a patient & physician experience and see so many similarities. We really have a lot of work to do with respect to how we treat uterus owners!
I almost shared my own male OB GYN experiences here but decided not to. I have so many of them but it's just too frightening and discouraging. Thank you for shining a light onto this overbearing, bullying testosterone-filled MD attitude while women are in such desperate, vulnerable health situations. 🫶
I had horrific menorhaggia. Like almost died from low blood iron multiple times over a decade horrific because I couldn't get a doctor to actually do anything.
At 27 I finally managed to find a GP at my practice who took it seriously and sent me to a specialist. Who was, naturally, a man. Who ignored that I was (and am) a sex-repulsed asexual, who never wanted kids, and told me 'when you'll hit 30 you'll want a whole brood' and basically harassed me into having a mirena. Which is a TERRIBLE idea for people with depression, or anxiety, or ADHD, or on the spectrum... All of which I am. He also completely ignored that I'd had a rupture in my uterus as a teenager that had almost taken me out again with sepsis, because he 'didn't have access to the files' he refused to even believe I'd needed emergency surgery. He saw the scar, assumed it was an appendix, and that was it.
It wasn't until the damn thing was scheduled to come out that I discovered I should never have had it, and thankfully I was taking the first steps in transition and got some specialists who were actually women and willing to listen, that I got the ablation that wound up changing my life. The entire nearly twenty year experience was filled with invasive procedures, painful ultrasounds, being gaslit and ignored by men (who I pledge to never, ever be like, amen) who thought they knew better, and constantly told that potential children were more important than my life or mental health.
I don't talk about this much, for obvious reasons. But I feel like I'll be understood here. Thanks Dr Zha, for helping me feel comfortable enough to talk about this, and being the kind of doctor who wants to fix this broken system.
Wow, thank you so much for sharing your story here. I’m so honored you feel safe to talk about your experience here. There is so much to unpack!
This idea of “you will regret not becoming a mother” is biodeterminism and ultimately patriarchy. Ultimately it’s rooted in the 3000 year old idea that the uterus is a baby hungry and sex hungry internal animal, which wanders around to cause trouble until it contains a baby.
Your story is exactly why we don’t call uterus owners women because not all those who have them identify as so! I get so much push back when I use this term. This is again bio determinism and a narrow view of genders.
And so much so much more! I’m sorry my words pale compared to your experiences! And yes you are understood here! 🥹🩵
My husband had a vasectomy in 1978. I decided to get a tubal ligation the same year. We had a girl and a boy. I was done. The physician thought at 23 I was too young. I required my husband’s written permission. I have never regretted it.
This is beautifully written. I'm in tears. I'm so sorry Julie. I'm so sorry uterus owners. I'm a uterus owner, too and the more I read and hear stories like these the angrier I get. I used to think people were overreacting when they said women were treated differently. As I've gotten older, I see it with my very own eyes. I feel it. I dread it. We are taught at such young ages that we don't matter, that we overreact, were too emotional, etc that we can't even see the misogyny at that time. We don't understand what women are facing until we get older and have to experience it ourselves. It's just so sad. We live in a man's world. We are only here to give them life, give birth to them and that's it.
I'm so glad there are doctors like you and like the gynecologist I saw for my voluntary sterilization. She did ask me, "Let's say you meet someone, and you love him so much, and he wants one baby...?" I don't remember my exact response, but I wish it had been, "Isn't that like asking, 'Let's say you meet someone, and you love him so much, and he wants a woman with one leg...?'" However, that was basically ALL she asked me in the way of "what ifs," and with no further ado scheduled my procedure. Further, I'm in the habit of requesting my medical records on paper when I have an interaction with a clinic, doctor, etc. Those records show her averring that I was given "extensive counseling." I was well aware at the time that I had it easy, and my heart goes out to the uterus owners (and former owners) in this story, in the comments, and who are in neither but represented by those who are. With doctors like her and you on our side, more and more "extensive counseling" is going to start looking like, "You're sure? Okay then." Just like it does, I assume, for testicle owners.
(And, hopefully as a leavening for the blowback you said you get, I really appreciated the term "uterus owner." I'm somewhere between cis and trans, so that's one term I can actually fully identify with, as long as I've still got mine -- and I didn't realize the "odds" were so low! It feels a little like reclaiming something like "spinster," since so often that organ is treated like it's the only important thing about us... more like we're "uterus ownees.")
WOW, thank you for the comment. It gave me a lot to think about.
First of all, "Isn't that like asking, 'Let's say you meet someone, and you love him so much, and he wants a woman with one leg...?'" You are a genius LOL! I wish you did say that. But you didn't say it perhaps you knew the gynecologist asked the question genuinely from a "are you sure, ok" perspective.
And we are more like "uterus ownees"!! Once again. You are a genius.
I have a condition common to introverts that I've heard described by the French prhase "l'esprit d'escalier" (apologies to anyone who actually knows French if I spelled that wrong). Translation: "staircase wit," -- i.e., the experience of leaving the party and going "shoot! THAT'S what I should have said!" The one-leg thing was something I came up with long after the moment of salience.
The gynecologist was sincere, and I have no issue with a mandate for SOME counseling for women (or men, or nonbinary folks, or owners of whatever organ) seeking an elective permanent (or relatively so) surgical intervention. Informed consent should always be the norm. But the idea that this hypothetical man should get his way with my life and body was laughable at best.
Thank you for reading! Sometimes I feel kind of crazy: in the rooms I am complicit to the system that works against women, and out of them I write furiously against the stuff!
This is all very true. The iPLEDGE program was driven on one hand by the pharmaceutical companies looking to minimize their potential multimillion dollar liability exposure for ANY birth defects when there is a history of Accutane use, and on the other hand by the anti-abortion movement feeling, not necessarily inaccurately, that they were preventing abortions. Home pregnancy tests are now apparently acceptable in some circumstances but the program remains intrusive and draconian.
As women, we experience medical prejudice all our lives. In the 80s, a female OBGYN told me to “work on my marriage” when I shared that I was desperately unhappy and my husband was emotionally abusive.
In the late 90s, I had another female OB tell me abruptly that I had fibroids and needed a hysterectomy. I put it aside because she scared the shit out of me. I was in advertising sales, and was scared to take time away from my job.
I was finally able to find another OB, who was male (back then and now I think it’s creepy that men choose OB as a specialty) we discussed a uterine fibroid embolization. My insurance company wouldn’t cover the MRI to determine if I was a candidate for this option (I had good insurance at the time), because back then it was considered an experimental procedure. There was a risk of uterine necrosis, necessitating a hysterectomy in case this happened. I had a hysterectomy shortly thereafter. I was 42. Never had kids and didn’t want them. My long-winded point is if they had covered the MRI for the embolization, and I was a candidate, I would not have needed major surgery, including having an organ removed. My fibroids were large, shifting around my other organs, and I may not have been a candidate anyway. But I never got the chance to find out.
Also, at least back then, many female doctors were indoctrinated in medical school to follow the patriarchal system of caring for female patients.
God, I'm so sorry your husband was like that and even sorrier someone who should've had your back was so terrible to you. My mother worked in pathology for an ObGyn in the 80s and 90s and has some absolute horror stories about the attitudes towards women in abusive relationships... Nobody should have had to deal with that, ever.
What a remarkable story and perspective. We have a lot of work to do as physicians to improve healthcare for every patient, and recognizing aspects of our culture that need to change is the first step. Misogyny in our field is deeeeeply rooted. Keep going, Dr Zha.
So deeeeply rooted! We have to be able to do SOMETHING in our practices, no matter how small those things are....
I’m so grateful to both of you doing this work on here! Sharing your perspectives, pushing back against misogyny and ableism… it’s wonderful. We need the physician and patient perspective to go hand in hand!
Thank you so much for this absolute gift of an article - it came at the exact perfect time for me. I so appreciate you articulating the struggles that uterus owners endure having control over their own bodies.
We must do better - too many of us have these stories and not all will have a happy ending
Here is The Disabled Ginger's post!! https://substack.com/@broadwaybabyto/p-148058080
Thank you for sharing my article - I so appreciate it! It’s fascinating to contrast a patient & physician experience and see so many similarities. We really have a lot of work to do with respect to how we treat uterus owners!
I almost shared my own male OB GYN experiences here but decided not to. I have so many of them but it's just too frightening and discouraging. Thank you for shining a light onto this overbearing, bullying testosterone-filled MD attitude while women are in such desperate, vulnerable health situations. 🫶
I know right, we don't say what we REALLY want to say -- not without a dirty martini in hand, we don't lol!
I had horrific menorhaggia. Like almost died from low blood iron multiple times over a decade horrific because I couldn't get a doctor to actually do anything.
At 27 I finally managed to find a GP at my practice who took it seriously and sent me to a specialist. Who was, naturally, a man. Who ignored that I was (and am) a sex-repulsed asexual, who never wanted kids, and told me 'when you'll hit 30 you'll want a whole brood' and basically harassed me into having a mirena. Which is a TERRIBLE idea for people with depression, or anxiety, or ADHD, or on the spectrum... All of which I am. He also completely ignored that I'd had a rupture in my uterus as a teenager that had almost taken me out again with sepsis, because he 'didn't have access to the files' he refused to even believe I'd needed emergency surgery. He saw the scar, assumed it was an appendix, and that was it.
It wasn't until the damn thing was scheduled to come out that I discovered I should never have had it, and thankfully I was taking the first steps in transition and got some specialists who were actually women and willing to listen, that I got the ablation that wound up changing my life. The entire nearly twenty year experience was filled with invasive procedures, painful ultrasounds, being gaslit and ignored by men (who I pledge to never, ever be like, amen) who thought they knew better, and constantly told that potential children were more important than my life or mental health.
I don't talk about this much, for obvious reasons. But I feel like I'll be understood here. Thanks Dr Zha, for helping me feel comfortable enough to talk about this, and being the kind of doctor who wants to fix this broken system.
Wow, thank you so much for sharing your story here. I’m so honored you feel safe to talk about your experience here. There is so much to unpack!
This idea of “you will regret not becoming a mother” is biodeterminism and ultimately patriarchy. Ultimately it’s rooted in the 3000 year old idea that the uterus is a baby hungry and sex hungry internal animal, which wanders around to cause trouble until it contains a baby.
Your story is exactly why we don’t call uterus owners women because not all those who have them identify as so! I get so much push back when I use this term. This is again bio determinism and a narrow view of genders.
And so much so much more! I’m sorry my words pale compared to your experiences! And yes you are understood here! 🥹🩵
I pledge to trust women.
<3333
My husband had a vasectomy in 1978. I decided to get a tubal ligation the same year. We had a girl and a boy. I was done. The physician thought at 23 I was too young. I required my husband’s written permission. I have never regretted it.
This is beautifully written. I'm in tears. I'm so sorry Julie. I'm so sorry uterus owners. I'm a uterus owner, too and the more I read and hear stories like these the angrier I get. I used to think people were overreacting when they said women were treated differently. As I've gotten older, I see it with my very own eyes. I feel it. I dread it. We are taught at such young ages that we don't matter, that we overreact, were too emotional, etc that we can't even see the misogyny at that time. We don't understand what women are facing until we get older and have to experience it ourselves. It's just so sad. We live in a man's world. We are only here to give them life, give birth to them and that's it.
Thank you writing this and articulating the issues so well. This should be required reading for all medical providers.
As a retired derm NP I most certainly do not miss the IPledge program.
Thank you for reading! What a useless program, iPledge is!
I'm so glad there are doctors like you and like the gynecologist I saw for my voluntary sterilization. She did ask me, "Let's say you meet someone, and you love him so much, and he wants one baby...?" I don't remember my exact response, but I wish it had been, "Isn't that like asking, 'Let's say you meet someone, and you love him so much, and he wants a woman with one leg...?'" However, that was basically ALL she asked me in the way of "what ifs," and with no further ado scheduled my procedure. Further, I'm in the habit of requesting my medical records on paper when I have an interaction with a clinic, doctor, etc. Those records show her averring that I was given "extensive counseling." I was well aware at the time that I had it easy, and my heart goes out to the uterus owners (and former owners) in this story, in the comments, and who are in neither but represented by those who are. With doctors like her and you on our side, more and more "extensive counseling" is going to start looking like, "You're sure? Okay then." Just like it does, I assume, for testicle owners.
(And, hopefully as a leavening for the blowback you said you get, I really appreciated the term "uterus owner." I'm somewhere between cis and trans, so that's one term I can actually fully identify with, as long as I've still got mine -- and I didn't realize the "odds" were so low! It feels a little like reclaiming something like "spinster," since so often that organ is treated like it's the only important thing about us... more like we're "uterus ownees.")
Thanks for this post.
WOW, thank you for the comment. It gave me a lot to think about.
First of all, "Isn't that like asking, 'Let's say you meet someone, and you love him so much, and he wants a woman with one leg...?'" You are a genius LOL! I wish you did say that. But you didn't say it perhaps you knew the gynecologist asked the question genuinely from a "are you sure, ok" perspective.
And we are more like "uterus ownees"!! Once again. You are a genius.
I have a condition common to introverts that I've heard described by the French prhase "l'esprit d'escalier" (apologies to anyone who actually knows French if I spelled that wrong). Translation: "staircase wit," -- i.e., the experience of leaving the party and going "shoot! THAT'S what I should have said!" The one-leg thing was something I came up with long after the moment of salience.
The gynecologist was sincere, and I have no issue with a mandate for SOME counseling for women (or men, or nonbinary folks, or owners of whatever organ) seeking an elective permanent (or relatively so) surgical intervention. Informed consent should always be the norm. But the idea that this hypothetical man should get his way with my life and body was laughable at best.
Amazing article, thank you.💕
Thank you for reading!!
Wonderful article with so much insight and care. It’s so important and validating to have you share so bravely and honestly! Thank you!
Thank you for reading! Sometimes I feel kind of crazy: in the rooms I am complicit to the system that works against women, and out of them I write furiously against the stuff!
This is all very true. The iPLEDGE program was driven on one hand by the pharmaceutical companies looking to minimize their potential multimillion dollar liability exposure for ANY birth defects when there is a history of Accutane use, and on the other hand by the anti-abortion movement feeling, not necessarily inaccurately, that they were preventing abortions. Home pregnancy tests are now apparently acceptable in some circumstances but the program remains intrusive and draconian.
Depressingly, horrifically true. Excellent, heartbreaking, article.
As women, we experience medical prejudice all our lives. In the 80s, a female OBGYN told me to “work on my marriage” when I shared that I was desperately unhappy and my husband was emotionally abusive.
In the late 90s, I had another female OB tell me abruptly that I had fibroids and needed a hysterectomy. I put it aside because she scared the shit out of me. I was in advertising sales, and was scared to take time away from my job.
I was finally able to find another OB, who was male (back then and now I think it’s creepy that men choose OB as a specialty) we discussed a uterine fibroid embolization. My insurance company wouldn’t cover the MRI to determine if I was a candidate for this option (I had good insurance at the time), because back then it was considered an experimental procedure. There was a risk of uterine necrosis, necessitating a hysterectomy in case this happened. I had a hysterectomy shortly thereafter. I was 42. Never had kids and didn’t want them. My long-winded point is if they had covered the MRI for the embolization, and I was a candidate, I would not have needed major surgery, including having an organ removed. My fibroids were large, shifting around my other organs, and I may not have been a candidate anyway. But I never got the chance to find out.
Also, at least back then, many female doctors were indoctrinated in medical school to follow the patriarchal system of caring for female patients.
God, I'm so sorry your husband was like that and even sorrier someone who should've had your back was so terrible to you. My mother worked in pathology for an ObGyn in the 80s and 90s and has some absolute horror stories about the attitudes towards women in abusive relationships... Nobody should have had to deal with that, ever.
What is this crap 💩? Men who are in medicine need to get a better education about women. As Mao said “Women hold up half the world “.