Thursday, 19 March 2020

Medical Fatphobia – The Ob/Gyn Should Not Be A BYOS (Bring Your Own Speculum) Party

I don't want to hear another word about how fat people have poorer health outcomes until fat people have equal access competent, stigma-free careI talk a lot about medical fatphobia (because medical fatphobia literally kills fat people,) and I’ve now heard from several super fat people who went for their annual visit to the gynecologist only to be told that the gynecologist doesn’t have the proper size speculum. In most cases, the person was just told outright that they couldn’t be helped (prompting them to e-mail me to see if I knew of any options.) But in one case the patient was told that specula that would work existed, and that if the patient wanted to buy one (the doctor suggested Amazon.com) they could bring it in for an exam. Then the doctor refused to refund their co-pay, since they “shouldn’t have expected” that they could be accommodated. With a speculum. At the gynecologist. For a pre-scheduled pap smear.

This is such blatant and disgusting fatphobia that I can hardly put my rage into words. It’s not just specula – thought that feels like a particularly awful aberration since going to the gynecologist is such a stressful situation to begin with, and putting off the visit can mean missing/postponing a cancer diagnosis. But it’s also blood pressure cuffs, knee braces, higher weight capacity beds and chairs, longer needles for vaccinations and other procedures, and on and on and on.

In some cases the needed medical equipment doesn’t exist – larger size knee braces, for example, may need to be custom made. And that’ s completely unacceptable since it is a known fact that fat people do both exist, and have knees.

But in many cases, the items absolutely exist but the healthcare facility has simply chosen not to bother to provide competent care to fat patients. This is, obviously, inconsistent with any belief in “doing no harm” or anything resembling a community health practice.

Plenty of fat patients have been forced to participate in humiliating weigh-ins under the guise of it being “medically necessary” (spoiler alert: It’s almost never medically necessary) only to find that their healthcare practitioner cant’ even take a correct blood pressure because they haven’t bothered to spring for the properly sized cuff (which I found for $30 online from a medical supply company, and $12 on ebay.)

Size discrimination by medical facilities should not be allowed. Patients of all sizes should be able to sit and lie down as necessary for the care. They should be able to get an accurate blood pressure reading – something that is as basic as basic gets when it comes to medical care. Not bothering to have appropriately sized needles shouldn’t be a barrier to vaccination. A visit to the gynecologist should not be a BYOS party.

I don’t want to hear another damn word about how fat people have poorer health outcomes until fat people have equal access to competent, stigma-free care (and of course this is compounded for those who are subject to other oppression and bigotry in healthcare including racism, transphobia, homophobia, and misogyny.)

Fat patients deserve the same care that thinner patients get, there is absolutely no justification for anything less.

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