Challenging gender norms, one specialty at a time

Gender imbalances are not new in numerous professional domains, and medicine is no exception. But two medical specialities long dominated by one gender – men in Orthopaedics and women in Obstetrics and Gynaecology (OB-GYN) – in Tamil Nadu are slowly seeing the gender lines blur.

The numbers may be small but a handful of doctors have been breaking the prevailing gender stereotypes, with more women making inroads into orthopaedics and more men stepping into OB-GYN in the government sector over the past few years in the State. Though certain challenges and disparities remain, some of them consider this a step in the right direction.

For S. Abirami, a final year post graduate at the Institute of Orthopaedics and Traumatology, Madras Medical College (MMC), it was love for the subject that made her pick it. “It is challenging, but I asked myself why not? Many of my friends also liked orthopaedics as a subject but did not pursue it as it has not had many women takers. But things are looking better than before. We have a WhatsApp group of nearly 40 women orthopaedicians in TN and it is definitely picking up,” she says.

In a male-dominated field, it is important to be bold enough to communicate and voice out, she believes. “Not a single day have I felt being treated differently in my department. I have equal space and opportunities here,” she adds.

Another woman orthopaedician, who requested anonymity, adds, “It is not an easy road. We need to be strong about the choice we make. Of course, there are gender biases and we have a long way to go because as of now, women doctors are a minority in orthopaedics. At the national level, there are at least 200 women orthopaedic surgeons and 30 to 40 in TN. The numbers are slowly increasing.”

There have been people who have said different things, she says, adding: “Some have told me to discontinue the course, and things like ‘we never had women doctors around’, ‘we do not know how to handle women’. Everything is in one’s mind; people are not used to having women doctors in orthopaedics and there is a certain macho attitude.”

“Yes, there is social stigma,” Dr. Abirami, says, adding: “Some people used to ask me if I have the strength to handle orthopaedic instruments. Some questions had me wondering in the past if I should have chosen another speciality but I have zero regrets. Orthopaedics is a little more physically demanding but it can be difficult for both men and women. We need to reduce fractures and bring the bones to its alignment. We need to handle and carry heavy instruments and implants. It demands strength to position the patients during surgery. All this requires physical strength but I am learning on the go.”

One concern for women in orthopaedics is exposure to radiation. “It is worrying. We do wear lead aprons but we need to be careful. We need to plan our marriage and pregnancy as there are potential radiation hazards during pregnancy and harmful effects on the foetus,” she adds.

Stereotypes are yet to be broken in TN, Arvindh Santhosh, assistant professor, Institute of Obstetrics and Gynaecology, MMC, points out. “My mom is a gynaecologist. This was definitely a factor that influenced me. She used to talk to me every day and that raised the curiosity in me. Yet, I knew that it was a stressful speciality,” he said.

During internship, he found that there is more to OB-GYN that remains unexplored. “It was mostly limited to deliveries, caesarean sections and hysterectomy. When I finally took the decision to pursue OB-GYN, there were different reactions. Some encouraged me but a few questioned my decision. In the last five years, a lot of men are opting for OB-GYN in TN,” he says. Cities such as Pune, Mumbai and Ahmedabad have a high number of male doctors unlike Chennai, he adds. Do patients prefer a woman OB-GYN? Dr. Santhosh says, “In my experience, very few women patients have requested a woman doctor. Many of them are comfortable with male doctors. I ensure that I keenly listen to them and understand them.”

One of the issues faced by male OB-GYNs is that private hospitals prefer women doctors, and so, the initial phase of practice gets delayed, Dr. Santhosh points out.

A stint with OB-GYN during internship was an instant pull for Ajay Mukherjee, a final year PG. “I opted for the speciality without giving it a second thought,” he adds. Being the only male PG in a class of 20, he faces no issues with his team but ensures that he is extremely careful when it comes to his patients. “The patient load is huge. I take care of how I communicate with my patients. I ensure that a female doctor or nurse is by the side when examining a woman patient. In my experience so far, no woman patient has objected to being treated by me,” he says.

Sooraj, who completed OB-GYN this year, points out, “One of the questions that I have faced is ‘how will you understand the speciality when you do not have the organ’? Sadly, gender biases and discrimination and discrimination are from within hospitals and colleagues, and never from the outside.”

He believes that every branch of medicine will function well when there is an equal number of men and women. “Men dominate in a number of branches, while OB-GYN is majorly an all-women team. It is slowly changing due to men’s changing perception of equality, genuine liking for the specialties, and looking at childbirth and parenting as equal responsibility,” he adds.

All of them are looking to further specialise in OB-GYN. As Dr. Santhosh puts it, “An area such as endometrial surgery is not as advanced as we want to be in Chennai and there are very few doctors in this area. More expertise in gynae-oncology and endometrial surgery should be brought to government hospitals.”