As a 26-year-old woman living in Shanghai, one of China’s most progressive cities, I didn’t expect I’d have to lie about my marital status just to see a gynecologist.
Earlier this month, I called Meinian Onehealth — a major chain of private health clinics in China — to arrange an annual checkup. It was going fine until the receptionist on the other end of the line asked if I was married. “Why does it matter?” I asked. “If you’re married, you also qualify for a gynecological examination,” she replied.
“I’m not married, but I want to have this test,” I argued. But it was no use: the woman told me that our conversation was being recorded and she couldn’t give me the package for married people. Annoyed now, I bit back: “But that’s not fair!” The woman was silent for a few seconds. “OK, I’ll sign you up for the package, but don’t tell anyone,” she finally said.
What happened the following weekend left me wishing I’d heeded the receptionist’s advice. It started out fine: I shuttled from room to room at the health center, taking test after test with the help of smiling nurses. So far, so good — that is, until I walked into the gynecology room. A nurse accosted me at the door: “Excuse me, are you married?”
I hesitated a moment, then answered: “No, but I want to have the test.” The nurse said it was out of the question for unmarried women to be examined. “But I want to do it,” I pleaded. “Just because I’m single doesn’t mean I’m a virgin.”
I tried to explain that I have a long-term boyfriend, so the medical staff didn’t need to worry about breaking my hymen. In China, a lacerated hymen is traditionally seen as proof that a woman has had sex, even though it may be tear for reasons other than intercourse or be completely absent from birth. These days, few open-minded women in China’s big cities worry about social expectations to keep their hymens intact.
For health care providers, however, it is more concerning: In 2010, a woman from central China’s Henan province sued a local hospital after a doctor broke her hymen while performing a routine gynecological examination organized by the patient’s company. The woman had told the doctor she was unmarried, claiming in court that she worried about her “future reputation.” Eventually, she won 30,000 yuan ($4,500) in compensation.
In the end, the nurse at the door gave up and let me in. Later, as the doctor examined an ultrasound image of my womb and breasts, a young nurse in pink uniform piped up: “Things are better now, but previously, if we asked unmarried women whether they were virgins, they would take it as an insult.”
After talking about the incident with my female friends, I realized that many women like me frequently face systematic discrimination from Chinese private health care companies. A friend of mine who works for a Beijing-based internet firm had a similar experience when she visited a health clinic run by a company called Ciming. The staff refused to examine her after she admitted she was single. Too embarrassed to argue with the nurse in the reception hall with a dozen strangers, my friend forewent the test completely.
I was exhausted after my scans and was looking forward to leaving. But unfortunately, my Pap smear took place in yet another room. An older doctor stationed at the door launched into her “Are you married?” routine; this time, it was my turn to give up first. “Yes, yes, I’m married!” I lied, just wanting it to be over.
Private health care companies in China generally assume that unmarried women are virgins, an attitude that lags far behind the reality. According to data collected by Pan Suiming, one of China’s pioneering researchers in sexuality, more than 70 percent of Chinese people said they had engaged in premarital sex in 2012, compared to only 40 percent in 1994.
Even though a majority of China’s medical professionals acknowledge that sex before marriage is perfectly normal, some older doctors avoid speaking about it directly with patients. Tian Jishun, a 36-year-old obstetrician and gynecologist who is a medical director at Dingxiang Doctor, a digital platform that dispenses health advice, said in an interview that he remembered hearing older doctors asking unmarried women if they were “with their boyfriends” — a euphemism used for inquiring about their sex lives.
However, teaching methods have undergone drastic changes, Tian says. In his college classes, he was told not to speak about sex as if it were taboo. And younger doctors routinely ask patients about their sexual histories, habits, and orientations.
“Doctors won’t ask about your sex life at the very beginning [of an examination]. They ask for other information first, such as whether you have period problems, then they’ll maybe move on to talking about your sex life,” Tian says. “It’s unprofessional to care too much about upsetting your patients. [If you use a euphemism], what happens if they don’t understand your hints?”
“Many Chinese still feel reluctant to answer questions about their sex lives,” says He Bin, a contract researcher at the Center for Public Policy Research at the Chinese Academy of Social Sciences. “Performing a gynecological test might lead to complaints or even lawsuits, if the patient isn’t well-informed [about the procedure and its risks], so the majority of health organizations and doctors tend to be more conservative.”
The fact that Chinese work units and companies usually arrange private health checks for their staff doesn’t help the situation, either. “As most patients have a fixed-price package paid for by their companies, the fewer the tests, the better it is [for health centers],” He says. “Health centers don’t really care about individual patients’ experience, as long as the service is slightly better than public hospitals.”
Health care providers’ attitudes toward young, sexually active women comes partly from deep-seated social taboos. However, as someone who takes her sexual health seriously, I am glad that the next generation of doctors are more open-minded. After all, sexually transmitted diseases don’t discriminate against single people, so why should our medical systems?
Will I lie when I go for a checkup next year? Perhaps I would have done this year if I had known how much time I would waste arguing with the workers at the clinic. But now, I feel myself better informed and more determined to fight — both as a liberated woman and as a difficult customer.
Editor: Matthew Walsh.
(Header image: A woman receives a physical examination in Wuhan, May 1, 2008. Yang Hongbin/VCG)