Xanthine writes:
I had my first pelvic exam in 2001, at the university health centre. The doctor was fast and brusque and no-nonsense, and though it hurt and I did a lot of flailing around, I came out thinking it wasn’t that bad. Today I just went for my second pelvic exam (please don’t yell at me! I move a lot) with the doctor who delivered me; he’s prestigious and hard to book appointments with. My mom actually pulled some strings to get me a booking with him in less than six months.
He seemed like a pleasant enough older fellow, European, polite and calm; he reassured me that his prestigious fingers wouldn’t do any walking till I told him I was comfortable. I gave him permission, he got in there, and we proceeded to have a conversation about… my weight. He’s touching my ovaries and talking about my gut. “Does diabetes run in your family? Ah, I thought so. You know, that’s mostly weight related, eh? You must cut out refined starches, all refined starches. And potatoes. Ha ha! It seems you have eaten many potatoes over Thanksgiving.”
I was a bit breathless from the pain and being tensed up at this point, and he’s got one arm apparently up to the elbow in my hoo-ha, and he’s using the other to palpate my abdominal area, all the while going on about how yes, ha ha! There is a little too much of you, my dear, a little too much, too much belly here. What could I say? It’s hard to come up with a sensible, body-positive, or even logical response with that going on. He winds up, and as he’s washing his hands he says, again, unnecessarily, “So you will do as I say, eh? Cut out the refined starches. Lose some of that gut, yes, at least twenty pounds you could stand to lose. Ha ha! Goodbye!”
Finally I said very meekly, “So, my periods. Uh. And them being heavy. What do you think about that?” He blinked at me as if he’d forgotten why the appointment had been booked in the first place, then grudgingly discussed my birth control pill for a while, did my medical history, mentioned the possibility of micro-fibroids, and he gave me a prescription for a different brand of pill as well as blood tests. I left feeling pretty violated in a couple of different ways, and sore in a couple of different ways. First, my gut should not in the least affect my pelvic exam. (Does it? Someone please back me up here!) Secondly, is the sliding scale of fat discrimination still sliding? What’s it greased with, Olestra?
I weigh a hundred and thirty-five pounds.
And I had to coax this man to talk about my pelvic exam.
I have never encountered a doctor whose fat stigma started at so low a cutoff weight. I hope to never encounter one again. Next time I go in for a pelvic, I’m going to see if I can book with one of the other doctors. I think the worst part is that I agreed to do everything he said and even thanked him on the way out.
First, Do No Harm 
jaed
/ July 9, 2009my gut should not in the least affect my pelvic exam. (Does it? Someone please back me up here!)
They palpate the uterus through the belly, so it might make a difference if you had a great deal of fatty tissue there. (This doesn’t mean they can’t do the exam properly – they just might have to modify it slightly to accommodate the patient’s body type.) But at a hundred thirty-five pounds??? It is not physically possible for it to have caused any problem whatsoever. You’re completely correct – Doctor Whatsis was not just out of line and unprofessional, but also potentially delusional. (Also dangerous, if you’d taken him seriously about needing to lose fifteen percent of your body weight. Yeesh.)
I’m not going to suggest you report him, because it’s unfortunately unlikely to result in any good outcome – the licensing authorities don’t seem to care about unprofessional behavior, rudeness, ignoring the actual medical complaint, or driving people right out of the willingness to see a doctor at all, as long as the doctor didn’t actually kill anyone. However, if you book another appointment at that practice, I’d urge you to ask for another doctor and specifically tell them that you don’t want Doctor Whatsis because he behaved unprofessionally at your last appointment.
lilacsigil
/ July 10, 2009At my weight, the doctor needs to move my belly around a bit to palpate my uterus, but I weigh a bit over 300 pounds/137kg and most of that is in my belly. Even so, they can do a perfectly good exam without exhorting me to lose weight! Don’t blame yourself for not being able to respond snappily – the important thing is that you recognised the unprofessional conduct (rather than blaming yourself) and have access to alternate healthcare.
eli
/ July 10, 2009I think you should report him. It is just so damn inappropriate to be talking about a woman’s body and weight while you’ve got your a hand in her vagina.
Jesus! Even without it going on during the actual examination, it would be bad enough.
Megan
/ July 10, 2009Ridiculous. You’d have to be 4’7″ before his comments made any sense. Fat can definitely affect your period via your hormones, but you have to be pretty darn overweight before it happens. And really? Unless you asked, it’s none of his fucking business.
I disagree with the previous poster. Report him. If enough women do it, someone might eventually pay attention.
LadyGrey
/ July 10, 2009Echoing what the commenters above said, part of the pelvic exam is “bimanual” as in one hand is inside and one is outside and the clinician uses both to feel the uterus and the ovaries. At 135 pounds? Even if you carry all your weight in your belly (as, uh, lots of us women do), that shouldn’t interfere with his ability to palpate properly at all. And if it did, the proper response should be “I can’t evaluate you adequately this way, so what else can I do to thoroughly investigate your problem?”
Jenny Rose
/ July 10, 2009Women want to be on a waiting list for this dolt? A pelvic exam can be a uncomfortable but it shouldn’t be extremely painful if done correctly. It is a different story for abuse survivors.
Can you get another doctor? There are body positive docs out there who will treat you as an actual human being. Have you asked your mom what she sees in this person?
Please know that you deserve much, much better treatment.
Katia
/ July 10, 2009I’ve had the same thing happen — my gyn is a woman of few words. She has a low, hoarse voice. At my last exam, as she was feeling around inside me, she barked “You’ve got to drop the extra weight!” Now its a year later, and I’ve gained weight, not lost it, and I’m dreading seeing her again. I’ve been agonizing for a year about how to face another appointment with her because I dread the pelvic exam so much. But it’s doubly important that I get examined because so many of my relatives have female cancers. My primary care physician is also callous and abrupt about my weight. I can’t describe how horrible I feel after I’ve just been to either doctor. (Once I get back to the car, I usually break down in tears.)
I now weigh about 200 lbs at 5 ft 4 inches, and I had my last period a few years ago. (I’m 56.) So far, I’ve been healthy as anything — it’s my family history that has me concerned.
My mother and her two sisters all had cancer. Two of the sisters were quite slender and died of cancer at the ages of 55 and 67. The other sister (my aunt) is quite a bit larger than me, and first had breast cancer, I don’t know, 30 years ago, is about 80 years old now and still going strong, living on her own and doing fine.
But I’m scared of the doctors, and I’m afraid that if I just tell them to shut up about my weight then they won’t take seriously any medical issues that might develop.
Karin
/ July 10, 2009You weigh 135 lbs and he’s complaining about your gut? He’s causing you pain in your exam because of your “tremendous” gut? Geez… I weigh 250 lbs and my GYN has *never* had any problem with the exam…she also has never caused me any pain. I have slight discomfort, but it only lasts as long as it takes for me to put my clothes back on.
This guy sounds like a jerk. He may be all in demand, but he’s still a jerk. Get another doctor. Report him as others have suggested.
I bet he wasn’t buff either. 🙂
Barbara
/ July 11, 2009Sounds SOOOO much like PCOS or something related.
returnofconky
/ July 13, 2009This reminds me of last year, when my GP sent me to a urologist. I had had blood in my urine for 2 years straight at my annual exams (something I had to point out to my GP, but that’s another story), and my doc wanted to rule out bladder cancer. The urologist (late to my appointment because she just got back from the gym) proceeded to go through a pelvic with me, and told me that the weight from my belly was potentially irritating my bladder. I’ve been heavy my whole life, and that was a whole new wrinkle in the equation. I left wondering if that could be true or if it was just poorly disguised disgust with my body.
ricki
/ July 14, 2009“I weigh a hundred and thirty-five pounds.”
Ho. Ly. Crap. And he said you were too fat? (While I think it’s always a bad thing for a doctor to bring that up in an unrelated exam – and to bring it up if the patient hasn’t expressed concern first, this is really egregious).
I’m a bit north of 200, I have a poochy little pot belly, and my GYN has never expressed concern about being able to feel what she needs to feel…she usually says something like, “Yup, there are your ovaries, and they feel just like they should” (I think that’s to reassure me; I’m a nervous patient.). She also doesn’t hassle me about my weight, which is why I still go to her even though it involves traveling some distance for my annual exams.