Though gynecologists are often thought of as being strictly limited to the treatment of women, the truth is that there are certain disorders that occur in both men and women that gynecologists are most qualified to treat. In particular, gynecologists are the experts best-trained to deal with anal cancer, a disease often caused by the human papilloma virus (HPV), the same virus that causes cervical cancer. Anal cancer rates have been on the rise in recent years (2.2% per year for the last decade). Because it is treated the same way as cervical cancer is, gynecologists are best qualified to treat anal cancer.
In the past, gynecologists were barred from treating men in most capacities. Thanks to new rules from the American Board of Obstetrics and Gynecology, however, ob-gyns can now treat men without risking their board certification.
The American Board of Obstetrics and Gynecology (ABOG) is responsible for certifying ob-gyns and thus providing them with the credentials they need to work. In 2013, the ABOG determined that ob-gyns could only treat men to perform circumcisions on newborns and if the individual was transgendered. If they treated men in any other circumstance, ob-gyns faced the loss of their certification.
In Austin, TX, New York City, San Francisco, Boston, and other major medical centers, the outcry against the new rules was swift. It also didn’t come just from ob-gyns. Much of the dissent came from physicians who referred patients to ob-gyns to treat anal cancer and other conditions. In particular, doctors who specialize in infectious disease called the change in rules “disruptive.” One even wrote a scathing rebuke in the New England Journal of Medicine.
The reaction from the ABOG was slow, but the board eventually revised its policy to say that ob-gyns can treat men as long as the majority of their practice was devoted to women’s health. This was a major reversal from the original position, which said that at least 75% of an ob-gyn’s practice had to include the direct treatment of women.
Why Does It Matter?
Training for the use of high-resolution anoscopy is limited, but the procedure is necessary for the diagnosis and treatment of anal cancer. In some locations, particularly more rural locations, disallowing ob-gyns to perform anoscopy on men means that there are no providers available to carry out the procedure. Waiting to get a diagnosis or waiting to start treatment for anal cancer can be the difference between curing the disease and serious long-term health consequences, including death.
There are disorders beyond anal cancer that ob-gyns are better qualified to treat than other physicians. Examples include chronic pelvic pain, infertility, low testosterone as it affects reproduction, and cosmetic procedures in the pelvic area. Simply put, there are a multitude of roles that ob-gyns can fulfill better than most other physicians when it comes to treating men.