Ceren Yıldız was 19 when she first went to visit a gynecologist. A young woman with an active sex life, she did not expect the experience to turn into a life-changing trauma.
“During the examination, he looked at my vagina and said, ‘Your uterus is flipped upside down, there are germs everywhere, you’re covered in filth,’” she said. “He said that the hymen was protective against germs, and that I was now vulnerable to all kinds of sexual diseases. I thought I had a serious disease and I was terrified.”
The doctor, a friend of the family, did not prescribe any medication or provide Yıldız with literature on sexually-transmitted diseases. Instead, he contacted her mother.
“When I went home, my mother greeted me crying,” Yıldız said. “My doctor had called my mother and said, ‘Your daughter’s not a virgin.’ She was furious.”
Although a subsequent examination by another doctor revealed no illness, the damage was done.
“Even though I know that was psychological violence, the consequences lasted years,” Yıldız said. “For a long time, I felt like I was getting sick every time I had sex.”
Women in Turkey are often subjected to judgment and shaming during medical treatment, particularly by conservative physicians in public hospitals. These doctors frequently inquire about their marital status as a proxy for asking about their sex life, and have difficulty accepting or talking about sexual activity.
In 2012, Turkish academics Burcu Ertuna and Ezgi Emre launched the Gynecological Violence project to provide a space where women can document such trauma. https://jinekolojiksiddet.wordpress.com/
Post after post describes being judged and belittled because of the prejudice of health professionals and attitudes informed by traditional societal norms. Many women say they avoid seeking medical help or information on sexual health due to this bullying.
Examinations that reduce sexuality to marital status and start with the question ‘Are you married or single?’ set the stage for judgment over their personal lives, in appointments where doctors are reluctant to be direct about the female body.
Işgın Renkligül, a 30-year-old sexually active, unmarried woman, said she felt so judged by her doctor’s question on whether she was married that she denied she had any sexual partners and refused a vaginal exam.
“That question is just wrong,” she said. “The fact that they ask you if you’re married instead of whether you’re sexually active makes you feel like there’s something to be ashamed of.”
Renkligül said her worst experiences had been with doctors at public hospitals.
“I’ve received judgmental looks and comments many times when I said I wasn’t married,” she said, adding that the doctors were often uncomfortable talking about her sex life or providing her with information about sexual health. “How could I be comfortable with someone I feel is judging me? All I want is to be respected when I enter the examination room.”
Although Turkey’s constitution theoretically forbids gender discrimination, in practice conservative traditions and the religious mores of the ruling AKP party take precedence.
For example, although abortion is legal in Turkey, President Recep Tayyip Erdoğan described it as tantamount to “murder” in a 2012 speech. Since then, there has been a de facto ban on performing abortions in many of the country’s public hospitals.
“No wonder in a country where issues about a woman’s body are a matter of the government, doctors are judgmental,” Renkligül said.
Selma Güngör, a member of the board of the Turkish Medical Association, said patients who were treated in this way by their physicians could file a complaint and request an investigation.
“Doctors can’t morally judge their patients,” said Güngör, who added that protections for people of all races, religions, social statuses and sexual orientations were part of the Turkish Medical Association’s ethical code. “That sort of behaviour damages the confidential relationship with the patient.”
Gülnihal Bülbül, an obstetrician-gynecologist, said she was aware of the problem of gynecological violence, adding that the behaviour of doctors who shame their patients went against medical ethics.
“Some doctors might have a conservative personal opinion that sex before marriage is wrong, but you don’t impose your values onto others in medicine, that’s not what being a doctor is,” she said. “A doctor violates the primary principle of ‘do no harm’ with prejudices and accusatory actions. Unfortunately, we have colleagues who judge and belittle patients.”
Bülbül said that many doctors in conservative areas were under a lot of pressure, working with a large number of patients but with few resources. Some were afraid of offending conservative female patients by asking directly about their sex life, and did not know how to pose questions during the examinations. She said doctors ought to listen politely and get to know the patients and their lifestyle.
It helped that women who were being bullied by their doctors were speaking out, she said. “Change will start as these incidents are exposed,” Bülbül said. “But women must be honest and make their voices heard.”