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The Question

About a month ago, I went to my gynecologist. There were big poster ads for labiaplasty in the waiting area. I was still surprised, though, that once the doctor was examining me, he suggested he could do this procedure for me. I curtly told him 'no thanks' but he didn't stop. In the middle of the exam that was not related at all to cosmetics, he showed me on his monitor where he could trim my labia. I still said no, but felt ashamed and wondered if I should do it. Only later did I realize how violating this was. Is this type of behaviour illegal or is there any recourse for admonishing this doctor? I'd like to save other women from having to go through this.

The Answer

The behaviour of your gynecologist is alarming and you are right to want to protect other women. The medically unnecessary procedure he was peddling is a lucrative one: It fetches $3,500 to $6,000 for the surgical reduction of the labia. Some cosmetic surgeons, in their promotional material, suggest the operation greatly enhances self-esteem, creates an attractive look and comfortable feel. To me, it seems like one more thing to make women feel lousy about their bodies.

I would have no issue if, after your examination was over, and you are fully clothed in the office, you asked about the procedure after seeing the poster on the wall. But when you are getting a sensitive examination, it was highly inappropriate for him to raise it. He's supposed to be working in your best interests, not for his own financial gain.

"She went to her gynecologist obviously because she needed a specific examination and was not going for a cosmetic reason at all," said Samantha Kelleher, deputy registrar of the College of Physicians and Surgeons of British Columbia. "The comments are really completely out of context for what she went to the physician for and the way they were presented to her during the physical examination is really inappropriate."

In sensitive examinations, doctors know they must be especially careful with what they say and do, with often the only appropriate talk being a description of the exam itself.

Often, issues between patients and doctors can be resolved with communication, but not this one.

I recommend you explore reporting him to his regulatory body, the College of Physicians and Surgeons in your province. Ask about the complaints process; some take anonymous complaints but I think you will find for a successful resolution, you will have to identify yourself to college investigators. Your identity will not be made public should there be any proceedings.

"This is something that the college in her province would certainly be interested in hearing about," said Dr. Kelleher, who is responsible for complaints regarding serious boundary violations. "Just based on the small amount of information, there are significant concerns about the conduct."



The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com .

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