OB/GYNS Stir Up Sexual Distinction Trouble

by Walter Brasch

        It took a lot of outrage by scientists, physicians, and the public, but a gynecologist in Boston will not lose her board certification.

      The American Board of Obstetrics and Gynecology had planned to remove Dr. Elizabeth Stier as board-certified.

      Now, you may think that Dr. Stier has a string of malpractice suits after her name. Or that she didn’t pass critical examinations for her specialty. Or that, maybe, she just didn’t take required courses to keep her certification.

      Actually, Dr. Stier is an extremely competent physician. She’s also an associate professor at the Boston University School of Medicine. Her problem is that in the course of some of her ground-breaking research about anal cancer, she treated men.
      That’s right. The American Board of Obstetrics and Gynecology had said that to get its stamp of approval, its members must treat only women. It magnanimously allowed a few rare exceptions—emergency care, family planning, fertility testing for man and woman couples, and the treatment of a sexually-transmitted disease, but only if the male was a partner of a female patient already being treated by the gynecologist.

      Every other medical specialty board in the U.S.— there are 24 of them—can treat men and women. That includes proctologists and urologists.

      Anal cancer is primarily a sexually-transmitted disease, usually transmitted by the human papillomavirus (HPV). Although anal cancer is rare, it is present in persons—men and women, straight and gay—who are infected by HIV.  The Board’s strong opposition also put at risk a $5.6 million grant from the National Cancer Institute. That grant would have been used by gynecologists to conduct clinical studies to determine the best way to detect and treat anal cancer—in woman and men.

      Dr. Stier had begun treating men as part of her practice as a gynecologist after she modified techniques used to treat women for cervical cancer in order to detect and possibly treat those with anal cancer. She is one of the nation’s leading specialists in this area.
      An officer of the American Board of Obstetrics and Gynecology told Dr. Stier more than two months ago she would lose her right to be a board-certified obstetrician and gynecologist if she continued to treat men. The Board’s decision was firm. In a separate letter, three other officers, including the executive director, explained the Board’s position. According to Medscape, the officers told Dr. Stiers: “There are currently too few doctors to provide care for pregnant women, too few to manage female cancer, and too few to provide necessary preventive women's healthcare.”

      After absolutely saying that Dr. Stier would lose board-certification, the Board this past week modified its woman-only rules to allow obstetricians and gynecologists to treat men with sexually-transmitted diseases.

       Three decades ago, almost all obstetricians and gynecologists were men—treating women. Today, about 80 percent of OBGYNs are women, according to the Board of Obstetrics and Gynecology.

      All five of the Board’s executive professional staff are men. Five of its six officers are men. Ten of the 15 members of the board of directors are men.

      Perhaps, if the Board of  Obstetrics and Gynecology is so determined that there be a gender-specific clause in its rules for certification, it might wish to examine its own officers and staff—and possibly require, with rare exceptions, that only women can be officers, members of the board of directors, and, especially, be employed as an executive staff professional.

      [The latest of Dr. Brasch’s 18 books is Fracking Pennsylvania, a look at the health, environmental, and economic consequences of hydraulic horizontal fracturing. The book also investigates the collusion between politicians and the oil/gas industry.]