Physician Gender Preferences Among Female Attendees of an Obstetrics and Gynaecology Clinic at Tafo Government Hospital, Kumasi, Ghana

Physician Gender Preferences Among Female Attendees of an Obstetrics and Gynaecology Clinic at Tafo Government Hospital, Kumasi, Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Physician Gender Preferences Among Female Attendees of an Obstetrics and Gynaecology Clinic at Tafo Government Hospital, Kumasi, Ghana Christa Osei-Mensah, Felix Amekpor, Daniel Fordjour, Stephen Amoasi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8661756/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Physician gender preference has been widely discussed in obstetric and gynaecologic care, particularly because of the intimate nature of these services. However, evidence from low- and middle-income settings, including Ghana, remains limited. This study explored the views of female patients regarding physician gender preference and the factors underlying these preferences at Tafo Government Hospital in Kumasi, Ghana. Methods A qualitative exploratory approach was used to capture women’s perspectives. Female patients attending the obstetrics and gynaecology clinic were engaged to discuss their understanding of the role of obstetricians and gynaecologists, their preferences regarding physician gender, and the reasons influencing these preferences. Data were analysed thematically to identify key patterns and explanatory factors. Results Most participants demonstrated a reasonable understanding of the role of obstetricians and gynaecologists, although a few had incomplete knowledge of the specialty. Views on physician gender preference were mixed. While some women expressed no preference and emphasized professional competence over gender, others preferred either female or male physicians, largely due to comfort during intimate examinations. Communication style, physician attitude, empathy, and perceived technical competence emerged as the most influential factors shaping preferences, often outweighing cultural or religious considerations. Past positive experiences with a particular physician gender reinforced preferences for some participants. Importantly, most women reported that physician gender did not delay or prevent them from seeking obstetric or gynaecologic care. Conclusion Female patients’ preferences for obstetric and gynaecologic physicians at Tafo Government Hospital are shaped more by interpersonal and professional qualities than by gender alone. Although cultural and religious values play a role for some women, effective communication, respect, empathy, and perceived competence are the primary drivers of patient comfort and trust. These findings highlight the importance of patient-centered care and provider communication skills in improving women’s experiences in obstetric and gynaecologic services. INTRODUCTION 1.1 Background to the Study Historically, obstetrics and gynaecology (OB/GYN) was a male-dominated specialty, but recent trends indicate a significant decline in male participation. Contemporary studies suggest that fewer than 5% of OB/GYN residents in the U.S. are now male (AAMC, 2023), reflecting a broader shift in medical career preferences. While the reasons for this decline remain understudied, potential factors include patient gender preferences, societal perceptions of the specialty, and workplace culture (Lancaster et al., 2022). At the same time, patient attitudes toward provider gender have evolved. Although most women still prefer female OB/GYNs, recent research highlights a growing openness to male providers, particularly when communication skills and clinical competence are emphasized (Spaich et al., 2018; Dahl et al., 2020). This shift may be driven by younger patient demographics and changing societal norms surrounding gender and healthcare. While some patients attribute equal competence in emotional, professional, and interpersonal aspects to both genders, there are some who demonstrate a preference towards female obstetricians/gynaecologists (Riaz et al., 2021). Globally, research indicates that physician gender can significantly influence patient comfort and satisfaction, particularly in sensitive medical fields such as obstetrics and gynaecology. Studies have shown that female patients often prefer female physicians due to perceived empathy, understanding, and better communication skills (Al-Ghafri et al., 2019). For instance, a study in Lebanon found that female patients preferred female obstetricians/gynaecologists, attributing this preference to compassion and proficiency in communication (El-Haddad et al., 2015). Similarly, a scoping review highlighted that implicit gender biases could affect clinical decision-making processes, impacting patient care and outcomes (Zahrdad et al., 2021). In many Sub-Saharan African communities, choosing a doctor isn't just about medical qualifications - it's deeply personal. Cultural traditions and social norms often lead women to specifically seek out female healthcare providers, especially for sensitive matters like pregnancy care and reproductive health. Research analysing maternal health services across the region shows something interesting: while women certainly care about having good equipment and well-run clinics, there's still a strong preference for female doctors and nurses (Oluoch-Aridi et al., 2020). Why? For many patients, it comes down to feeling understood. Female physicians are often seen as more approachable for intimate health concerns, creating a sense of comfort that's rooted in both cultural expectations and personal experiences. Across West Africa, patients' preferences for doctors of a specific gender are quietly shaping healthcare visits in meaningful ways (Okeke et al., 2021). Take Nigeria's medical schools as an example, researchers there have found that deep-rooted patriarchal traditions and hospital policies continue to influence whether patients feel comfortable with male or female providers (Adekunle et al., 2022). This explains why so many women in the region specifically ask for female doctors when dealing with sensitive health issues like reproductive care. Much of this comes down to cultural norms that have shaped community attitudes about healthcare for generations (Fatusi et al., 2023). In Ghana, a low socioeconomic country, factors such as cultural norms, patients' education level, and religion are the main contributors to discrimination against male gynaecologists (Amoakoh-Coleman et al., 2016; Mthembu et al., 2020). As in many other countries, these preferences are particularly pronounced in obstetric and gynaecological care due to the intimate nature of the services provided (Jackson et al., 2022; Fuseini et al., 2022). Preference affects physician-patient relationships which can manipulate various clinical outcomes including patient satisfaction, compliance to treatment and follow-up appointments, and in some cases, the general health of the patient. Some factors that contribute to patients preferring one gender over the other include ease of communication from the patient’s end when expressing their medical issues, empathy, rapport building, and religious barriers when it comes to gynaecological examination and procedures (Riaz et al., 2021). In current society, increased access to education and greater awareness of human rights have empowered individuals to exercise more autonomy in their decision-making. This empowerment has extended to healthcare choices, particularly in shaping preferences for physician gender during medical consultations. In most studies, around 60–70% of women preferred female OB/GYN care, citing comfort and shared experiences as key reasons (Dahl et al., 2018). During our clinical rotations at Tafo Hospital, we frequently observed female patients exhibiting signs of discomfort or reluctance when discussing sensitive health issues due to male physicians dominating OB/GYN department. Factors such as culture and religion, knowledge of women's health issues, previous experience and empathy contribute to these preferences. Physician gender preference can manipulate various clinical outcomes including patient satisfaction, compliance to treatment and follow-up appointments, and in some cases, the general health of the patient (Riaz et al., 2021). This study aims to explore views of females attending the Tafo Government Hospital’s Obstetrics & Gynaecology clinic regarding their gender preference for physicians. METHODOLOGY 3.1 Study Setting The study was conducted at Tafo Government Hospital, a public health facility located in the Old Tafo Municipal District of the Ashanti Region, Ghana. The hospital serves a diverse population providing a range of medical services including outpatient and inpatient care. The facility is equipped with various departments including, Obstetrics and Gynaecology clinic that emphases on Obstetrics and Gynaecology conditions and its complications. Tafo Government Hospital also serves a varied demographic, including urban and rural populations, and provides comprehensive medical services. The Hospital is assessable to residence of Old Tafo Municipality, and it is surrounding areas. Patients can assess the clinic through referrals from primary health care providers or self-referrals. The Obstetrics and Gynaecology Clinic at Tafo Government Hospital is precisely designed to provide medical services to persons with Obstetrics and Gynaecology conditions. The Clinic operates under the supervision of trained Health Care Professionals including Obstetricians and Gynaecologist, House Officers, Medical Officers, Midwives and Nurses. The clinic functions on specific days of the week that is; Monday, Tuesday, Wednesday and Friday appointments can be scheduled to see a doctor. 3.2 Study Design This study was an exploratory study which used a qualitative research approach to explore physician gender preference of females attending obstetrics and gynaecology clinic and the reasons behind their choice. 3.3 Study Population The study population was female patients aged 18–49 attending obstetrics and gynaecology clinics at Tafo Government Hospital. 3.4 Sampling and Sampling Techniques A purposive sampling technique was used to select participants who have relevant knowledge related to the research topic. 3.5 Techniques, Instruments for Data Collection and Analysis A semi-structured interview guide was the data collection tool. This contained open-ended questions designed to elicit detailed responses. Interview was one-on-one and conducted in a private and comfortable setting within the Tafo Government Hospital to ensure confidentiality and minimize disruptions. The private setting ensures that participants can speak freely without fear of being overheard, promoting honest and open communication Each interview lasted approximately 20–35 minutes and was audio-recorded with the participants' consent. Field notes were be taken to capture non-verbal cues and contextual information. The audio recordings were transcribed verbatim. Data was analysed using thematic analysis. 3.6 Validity and Reliability To ensure the validity and reliability of the data, the following strategies will be employed. Triangulation ensured that the data was comprehensive and provided a well-rounded understanding of the phenomena being studied. Member Checking : Providing participants with summaries of their interviews to verify accuracy and allow for any clarifications or additional insights. This ensured the data accurately reflects the participants' experiences and perspectives. Peer Debriefing provided an external check on the research process and helps to identify any potential biases or assumptions. Participant feedback was used to check credibility, transferability, dependability, and confirmability to ensure every finding was both authentic and actionable (Korstjens & Moser, 2018; Birt et al., 2022). The interview guide was reviewed by the supervisor involved in our research project. The interview guide was pre-tested with a small group of females who are not part of the main study to ensure clarity, relevance, and appropriateness of the questions. All necessary modifications were made to ensure that the interview guide effectively captures the intended data and facilitates a smooth data collection process. 3.7 Limitations of the Study The study's findings were based on a relatively small sample size, which may limit the generalizability of the results to the broader population of females. Using purposive sampling can introduce selection bias, as participants were elected based on specific criteria rather than randomly. The study relied on self-reported data from females. Participants might provide social desirability responses, which could affect the authenticity of the data collected. 3.8 Ethics Approval and Accordance This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki for research involving human participants. Ethical approval for the study was obtained from the Internal Review Board (Garden City University College, Kumasi, Ghana), for permission to conduct the research prior to commencement of data collection. Permission to conduct the study was also granted by the management of Tafo Government Hospital, Kumasi, Ghana . Participation in the study was entirely voluntary. Written informed consent was obtained from all participants after they were adequately informed about the purpose of the study, procedures involved, potential risks and benefits, and their right to withdraw at any stage without any consequences to their care. Confidentiality and anonymity of participants were strictly maintained, and no personally identifiable information was collected or disclosed. All data were handled securely and used solely for research purposes. RESULTS 4.1 Demographic Profile of Participants The respondents’ demographic data showed that 3 of the participants were within 20–29 years, 6 were within 30–39 years whereas 3 were aged 40–49 years. Concerning their educational level, 5 out of the 12 participants, the majority had had Tertiary education, 4 participants had had Junior High School education, while 3 being the minority had had Senior High School education. Also, 5 participants were Petty Traders and Food Sellers, 3 were Unemployed, 2 were Bank Tellers, whereas the other 2 was a Teacher and Hairstylist respectively. Additionally, most of the participants, 7 were Cohabiting, 4 were Married while 1 was a Widow. 4.2 Organizations of Themes Four main themes and five (5) sub-themes were constructed after the content analysis. The themes were derived from the specific objective. The sub-themes were, however, derived from the responses made by the participants when they were interviewed. 4.3 Knowledge of Physician Gender Preference 4.3.1 Definition of an Obstetrics/Gynaecology Physician Responses from participants during the in-depth interviews revealed that several of the participants have knowledge about Obstetrics/Gynaecology Physician, while few of the participants could not mention who an Obstetrics/Gynaecology Physician is. One participant said, ’An OB-GYN physician is someone who has been trained to treat diseases of female (woman) especially diseases of the female genitals’’ . (23-year-old, Participant 8) 4.4 Physician Gender Preference Responses from participants during the in-depth interviews revealed that several of the participants have no gender preference. Others preferred male physicians, and few preferred female physicians. A participant said, ‘’The gender of the physician is not my concern. The important thing is receiving effective care, regardless of whether the doctor is male or female’’. (38-year-old, Participant 2) Another participant verbalised, “To me the gender of the physician examining me is important when seeking care at the OB/GYN clinic”. (47-year-old, Participant 4) 4.5 Reasons for the Choice of Physician Gender Responses revealed Physician qualification status, good listening, empathy, sympathy, Physician competency, feeling comfortable to voice out their problem and not feeling shy are some of the factors that contributes to the importance of Physician gender when seeking care at the OB/GYN clinic. 4.5.1 Communication Style Responses from participants after the in-depth interview revealed that, several participants stated Communication Style is the reasons behind their choice of physician gender when attending OB/GYN Clinic. A participant intimated that, ’I prefer a male doctor because, in my experience, they communicate well with patients. They tend to be calm, listen attentively, and I’ve found that they don’t raise their voices like some female doctors might. This makes me feel more at ease during my appointments’’. (32-year-old, Participant 3) Another participant verbalized, ‘’The reason I don’t have a gender preference for my physician is that I believe both male and female physicians are equally capable of communicating effectively and making patients feel comfortable. I’ve never had any issues or difficulties discussing my health concerns with either, so I’m comfortable with whichever doctor provides my care’’ (30-year-old, Participant 9). 4.5.2 Relationship with Patients Responses from participants after the in-depth interview, several participants revealed that Relationship with Patient is the reasons behind their choice of physician gender when attending OB/GYN Clinic. One participant said, ’I prefer male doctors because they tend to be patient, empathetic, and have a welcoming attitude. They often make patients feel at ease and encourage them to express their health concerns openly without hesitation’’. (30-year-old, Participant 5) Another participant also said, “Compared to some female doctors, male physicians tend to maintain a calm and respectful tone, avoiding confrontational behaviour such as shouting in the consulting room’’ (40-year-old, Participant 1). 4.5.3 Technical Competence Responses from participants after the in-depth interview revealed that, most participant mentioned physicians’ technical competence is the reason behind their choice of physician gender when attending OB/GYN Clinic. One participant said, ‘’I believe both males and females Doctors are knowledgeable, skilled and very good at what they do’’ (37-year-old, Participant 10). Another participant said, ‘’Although some female physicians are good, but naturally male physicians are very skilful and knowledgeable compared to female physicians’’ (36-year-old, Participant 6). 4.5.4 Cultural and Religious Belief Responses from participants after the in-depth interview revealed, few participants stated that Cultural and Religious beliefs are the reasons behind their choice of physician gender when attending OB/GYN Clinic. A participant said, ‘’ As a Muslim woman, my faith and traditions discourage being exposed to a man who is not my husband. Because of this, I feel more comfortable having a female doctor care for me during my visits to the OB-GYN clinic’’. (47-year-old, Participant 4) 4.6 Past Experiences with Physicians Responses after the in-depth interview revealed that, several of participants experiences had influenced their decision to choose a particular gender. A participant said, “ During my first pregnancy, I visited the Tafo Government Hospital for both my antenatal care and delivery. The midwife there communicated warmly, often smiling, and took the time to explain what to expect during labour” (24-year-old, Participant 12). Another also verbalised that, “The healthcare team was patient, attentive, and provided thorough counselling throughout the pregnancy. This positive experience played a role in shaping my perspective on physician gender preference ” (28-year-old, Participant 11). 4.6.1 Delaying in Seeking Obstetric/Gynaecological Care Responses after the in-depth interview revealed that several participants had not delayed or avoided seeking OB/GYN care due to the concerns about the physician’s gender. Few of the participant revealed they had delayed or avoided seeking OB/GYN care due to concerns about the gender of the physician and claimed she was young, naïve, shy and was her first seeking consult at the OB/GYN clinic. One participant verbalised, ‘’During a past visit to the OB/GYN clinic, I was asked by a male physician to lie down and open my legs for a physical examination. As it was my first time at such a clinic, I felt shy and inexperienced, which led me to refuse the examination. Consequently, I was asked to leave the consulting room since I was unwilling to proceed with the examination’’. (47-year-old, Participant 5) DISCUSSION, CONCLUSION AND RECOMMENDATIONS 5.1 Discussion of Findings The objective of the study was to explore views of females regarding physician gender preference at Tafo Government Hospital. The study sought to answer the following research questions. What are the views of female patients regarding physician gender preferences? What are the reasons behind the gender preferences? Results from the study shows that participants generally demonstrated a reasonable understanding of who an OB/GYN physician is, with many correctly identifying the role as related to the care of female reproductive health. However, a few participants showed limited incomplete knowledge about the specialization. This finding aligns with studies s by (Chuang a et al., 2022) and (Dehlendorf et al., 2023), who noted that patient awareness of specialized medical roles varies and can affect healthcare engagement and preferences. Similarly, the finding aligns with a study by (Adekunle et al., 2022) which reported that broader health communication challenges in low-resource settings. Understanding who an OB/GYN is facilitates informed decision-making by patients regarding their care, especially in sensitive fields such as obstetrics and gynaecology (Spaich et al., 2018). Regarding the OB/GYN physician gender preferences, the study revealed mixed views regarding physician gender preference. Some participants stated having no gender preference, emphasizing competence over gender, while others strongly preferred female or male physicians, mainly due to comfort with the intimate nature of care. These findings corroborate prior research showing that although many women prefer female OB/GYNs for intimate exams (Spaich et al., 2018; Ogu et al., 2020), a significant portion remain neutral or prefer providers based on qualities beyond gender, such as communication and empathy (Dahl et al., 2020; Fiscella et al., 2019). This complexity suggests that patient gender preference is multifactorial and cannot be reduced solely to biological or cultural factors. On the reason behind their choices of the gender OB/GYN physician, the study revealed that communication style and physician attitude were the most frequently cited reasons for gender preference, outweighing even cultural and religious factors for most participants. This supports existing literature that emphasizes the importance of empathy, respect, and effective communication in patient satisfaction (Ha and Longnecker, 2020; Shahid et al., 2020). Perceived physician technical competence was one of the factors that influenced physician gender preference in this study. This finding aligns with a study by (Street et al. 2021), who demonstrated that patients who rated their physicians as highly competent has a greater adherence to treatment recommendations and reported higher trust levels. Cultural and religious beliefs played a role, particularly among participants who preferred female providers due to modesty and religious norms. These findings align with studies from Saudi Arabia and other conservative cultural contexts by (AlMousa et al., 2021; Zigdon et al., 2020), who emphasized the influence of Islamic modesty on gender preference. Moreover, with regards to whether past experiences significantly shaped preferences, the study revealed that participants who had positive interactions with a particular gender were more inclined to stick with that preference, echoing findings from Wallace et al. (2022) and (Shahid et al., 2020). Furthermore, concerning whether a patient has delayed/avoided seeking at the OB/GYN clinic because of the gender of a physician, findings from the study revealed that most participants had not delayed or avoided seeking OB/GYN care because of the provider's gender. Only one participant reported a delay, which she attributed to personal inexperience, shyness, and the sensitive nature of her first OB/GYN consultation. This finding is consistent with literature emphasizing that, although gender can be a barrier for some, most women will prioritize receiving necessary care if trust and professionalism are established (Dahl et al., 2020). Overall, communication style, perceived technical competence, respect, empathy, relationship with patient and cultural and religious beliefs alignment emerged as key drivers of preference, often outweighing gender itself. 5.2 Conclusions This study explored views of females regarding physician gender preference at Tafo Government Hospital. Most of the participants had no preference regarding the gender of Obstetrician and Gynecologist. Although Ghana is a country greatly influenced by cultural and religious values, these factors don’t seem to greatly affect patients' choice of preference for their OB-GYN physician. However, most of the respondent’s choice of preference for their OB/GYN physician was influence by factors such as communication style, relationship with patients and competence level of the physician. 5.3 Recommendations Based on the findings of the study, the following recommendations were made. The hospital should reassure patients that both female and male Obstetrician-Gynaecologists are given the same training in healthcare delivery hence they are equally knowledgeable, has good communication skills and good relationship with their client with respect to women’s health. The hospital should provide gender-sensitive communication training for all OB/GYN staff to foster trust and patient comfort. Further research should be conducted to explore male patients' perceptions of physician gender in intimate care to broaden the understanding of gender dynamics in healthcare. Declarations Data Availability declaration The authors confirm that all data generated or analysed during this study are included in this published article. Author Contribution declaration Conceptualization C.O.M.; and D.F.; methodology, F.A.; D.F. and C.O.M; validation, C.O.M.; formal analysis, F.A. and S.A.; investigation, S.A. and Z.A.G; resources, D.F.; C.O.M.; S.A. data curation, Z.A.G. and F.A.; writing—original draft preparation, Z.A.G.; S.A. and F.A.; writing—review and editing, C.O.M and F.A.; visualization, D.F.; C.O.M and F.A.; supervision, C.O.M.; project administration, C.O.M. All authors have read and agreed to the published version of the manuscript. Competing Interest declaration I declare that the authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper. Research Funding Declaration This research did not receive funding. References Adekunle, A., Fatusi, A., & Yakubu, I. (2022). Gender preferences in healthcare: A study of patriarchal influences in Nigerian medical schools. Journal of Medical Sociology, 15(2), 45–60. 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(2021). Patient-physician communication and health outcomes: A meta-analytic review. Patient Education and Counseling, 104(2), 224–233. Wallace, R., Nwaozuru, U., & Omenka, O. (2022). How gender biases affect reproductive care: Cross-cultural insights from Ghana and Nigeria. African Health Sciences, 22(3), 321–331. Zahrdad, M., Alshamsan, R., & AlFaris, E. (2021). Implicit gender biases in clinical decision-making: A scoping review. BMJ Open, 11(5), e045516. Zigdon, A., Sheiner, E., & Walfisch, A. (2020). Religious influence on gender preference in gynaecological care: A study among Ethiopian women. Archives of Gynaecology and Obstetrics, 301 (4), 987–993. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8661756","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":591642103,"identity":"e35a8c4e-a005-4222-81da-2b0ad5948f63","order_by":0,"name":"Christa Osei-Mensah","email":"","orcid":"","institution":"Department of Physician Assistantship Studies, Garden City University College","correspondingAuthor":false,"prefix":"","firstName":"Christa","middleName":"","lastName":"Osei-Mensah","suffix":""},{"id":591642104,"identity":"9d931c0a-f181-49b7-9f0c-bf6ddab9ce26","order_by":1,"name":"Felix Amekpor","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYBAC9gYGBsYGCNuA4QOQZGMnoIXnAJIWxhkgLcykaGHmAVEEtbCfTnw4c4dNPgN78zZpm1/b5PmYGRg/fMzBo4Und7PhxjNplg08x8qkc/tuG7YxMzBLztyGW4s9Q+42yYdthw0YJHLMpHN7bjMCtbAx8+LRwsP/dvtPsBb5N2bSlj237QlrkcjdxrgRbAuPmTTDj9uJRGh5u1ly5pk0AzaetGLL3obbyW3MjM14/cLDn7vxY+8OGwN+9sMbb/z4c9t2fnvzwQ8f8WgBA1DEsIEZbTAuIYBQ84ew4lEwCkbBKBh5AADqq00gTn9bYgAAAABJRU5ErkJggg==","orcid":"","institution":"Department of Clinical Pathology, Noguchi Memorial Institute of Medical Research, University of Ghana","correspondingAuthor":true,"prefix":"","firstName":"Felix","middleName":"","lastName":"Amekpor","suffix":""},{"id":591642105,"identity":"42761c07-76e6-4525-85dc-cd588aa9303d","order_by":2,"name":"Daniel Fordjour","email":"","orcid":"","institution":"Department of Physician Assistantship Studies, Garden City University College","correspondingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Fordjour","suffix":""},{"id":591642106,"identity":"d98b0c9f-7b25-4726-aa9e-9f5a63279084","order_by":3,"name":"Stephen Amoasi","email":"","orcid":"","institution":"Department of Physician Assistantship Studies, Garden City University College","correspondingAuthor":false,"prefix":"","firstName":"Stephen","middleName":"","lastName":"Amoasi","suffix":""},{"id":591642107,"identity":"ec32dbec-690e-46e3-9316-163aaa7fd0aa","order_by":4,"name":"Zuweira Abdul Ganiw","email":"","orcid":"","institution":"Department of Physician Assistantship Studies, Garden City University College","correspondingAuthor":false,"prefix":"","firstName":"Zuweira","middleName":"Abdul","lastName":"Ganiw","suffix":""}],"badges":[],"createdAt":"2026-01-21 15:54:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8661756/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8661756/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106393084,"identity":"c603f352-8c60-4142-ac38-29a7efaff515","added_by":"auto","created_at":"2026-04-08 07:30:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":966204,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8661756/v1/0f605b0b-9002-4467-a1ba-2a27b32f0cb4.pdf"},{"id":102931033,"identity":"7a823633-eff8-4493-89d6-bd1567132244","added_by":"auto","created_at":"2026-02-18 14:58:03","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":71213,"visible":true,"origin":"","legend":"","description":"","filename":"APPENDIX.docx","url":"https://assets-eu.researchsquare.com/files/rs-8661756/v1/a7f14ff0a26f3bb054a7adb8.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Physician Gender Preferences Among Female Attendees of an Obstetrics and Gynaecology Clinic at Tafo Government Hospital, Kumasi, Ghana","fulltext":[{"header":"INTRODUCTION","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Background to the Study\u003c/h2\u003e \u003cp\u003eHistorically, obstetrics and gynaecology (OB/GYN) was a male-dominated specialty, but recent trends indicate a significant decline in male participation. Contemporary studies suggest that fewer than 5% of OB/GYN residents in the U.S. are now male (AAMC, 2023), reflecting a broader shift in medical career preferences. While the reasons for this decline remain understudied, potential factors include patient gender preferences, societal perceptions of the specialty, and workplace culture (Lancaster et al., 2022).\u003c/p\u003e \u003cp\u003eAt the same time, patient attitudes toward provider gender have evolved. Although most women still prefer female OB/GYNs, recent research highlights a growing openness to male providers, particularly when communication skills and clinical competence are emphasized (Spaich et al., 2018; Dahl et al., 2020). This shift may be driven by younger patient demographics and changing societal norms surrounding gender and healthcare. While some patients attribute equal competence in emotional, professional, and interpersonal aspects to both genders, there are some who demonstrate a preference towards female obstetricians/gynaecologists (Riaz et al., 2021).\u003c/p\u003e \u003cp\u003eGlobally, research indicates that physician gender can significantly influence patient comfort and satisfaction, particularly in sensitive medical fields such as obstetrics and gynaecology. Studies have shown that female patients often prefer female physicians due to perceived empathy, understanding, and better communication skills (Al-Ghafri et al., 2019). For instance, a study in Lebanon found that female patients preferred female obstetricians/gynaecologists, attributing this preference to compassion and proficiency in communication (El-Haddad et al., 2015). Similarly, a scoping review highlighted that implicit gender biases could affect clinical decision-making processes, impacting patient care and outcomes (Zahrdad et al., 2021).\u003c/p\u003e \u003cp\u003eIn many Sub-Saharan African communities, choosing a doctor isn't just about medical qualifications - it's deeply personal. Cultural traditions and social norms often lead women to specifically seek out female healthcare providers, especially for sensitive matters like pregnancy care and reproductive health. Research analysing maternal health services across the region shows something interesting: while women certainly care about having good equipment and well-run clinics, there's still a strong preference for female doctors and nurses (Oluoch-Aridi et al., 2020). Why? For many patients, it comes down to feeling understood. Female physicians are often seen as more approachable for intimate health concerns, creating a sense of comfort that's rooted in both cultural expectations and personal experiences.\u003c/p\u003e \u003cp\u003eAcross West Africa, patients' preferences for doctors of a specific gender are quietly shaping healthcare visits in meaningful ways (Okeke et al., 2021). Take Nigeria's medical schools as an example, researchers there have found that deep-rooted patriarchal traditions and hospital policies continue to influence whether patients feel comfortable with male or female providers (Adekunle et al., 2022). This explains why so many women in the region specifically ask for female doctors when dealing with sensitive health issues like reproductive care. Much of this comes down to cultural norms that have shaped community attitudes about healthcare for generations (Fatusi et al., 2023).\u003c/p\u003e \u003cp\u003eIn Ghana, a low socioeconomic country, factors such as cultural norms, patients' education level, and religion are the main contributors to discrimination against male gynaecologists (Amoakoh-Coleman et al., 2016; Mthembu et al., 2020). As in many other countries, these preferences are particularly pronounced in obstetric and gynaecological care due to the intimate nature of the services provided (Jackson et al., 2022; Fuseini et al., 2022). Preference affects physician-patient relationships which can manipulate various clinical outcomes including patient satisfaction, compliance to treatment and follow-up appointments, and in some cases, the general health of the patient. Some factors that contribute to patients preferring one gender over the other include ease of communication from the patient\u0026rsquo;s end when expressing their medical issues, empathy, rapport building, and religious barriers when it comes to gynaecological examination and procedures (Riaz et al., 2021).\u003c/p\u003e \u003cp\u003eIn current society, increased access to education and greater awareness of human rights have empowered individuals to exercise more autonomy in their decision-making. This empowerment has extended to healthcare choices, particularly in shaping preferences for physician gender during medical consultations. In most studies, around 60\u0026ndash;70% of women preferred female OB/GYN care, citing comfort and shared experiences as key reasons (Dahl et al., 2018). During our clinical rotations at Tafo Hospital, we frequently observed female patients exhibiting signs of discomfort or reluctance when discussing sensitive health issues due to male physicians dominating OB/GYN department. Factors such as culture and religion, knowledge of women's health issues, previous experience and empathy contribute to these preferences. Physician gender preference can manipulate various clinical outcomes including patient satisfaction, compliance to treatment and follow-up appointments, and in some cases, the general health of the patient (Riaz et al., 2021). This study aims to explore views of females attending the Tafo Government Hospital\u0026rsquo;s Obstetrics \u0026amp; Gynaecology clinic regarding their gender preference for physicians.\u003c/p\u003e \u003c/div\u003e"},{"header":"METHODOLOGY","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Study Setting\u003c/h2\u003e \u003cp\u003eThe study was conducted at Tafo Government Hospital, a public health facility located in the Old Tafo Municipal District of the Ashanti Region, Ghana. The hospital serves a diverse population providing a range of medical services including outpatient and inpatient care. The facility is equipped with various departments including, Obstetrics and Gynaecology clinic that emphases on Obstetrics and Gynaecology conditions and its complications. Tafo Government Hospital also serves a varied demographic, including urban and rural populations, and provides comprehensive medical services. The Hospital is assessable to residence of Old Tafo Municipality, and it is surrounding areas. Patients can assess the clinic through referrals from primary health care providers or self-referrals.\u003c/p\u003e \u003cp\u003eThe Obstetrics and Gynaecology Clinic at Tafo Government Hospital is precisely designed to provide medical services to persons with Obstetrics and Gynaecology conditions. The Clinic operates under the supervision of trained Health Care Professionals including Obstetricians and Gynaecologist, House Officers, Medical Officers, Midwives and Nurses. The clinic functions on specific days of the week that is; Monday, Tuesday, Wednesday and Friday appointments can be scheduled to see a doctor.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Study Design\u003c/h2\u003e \u003cp\u003eThis study was an exploratory study which used a qualitative research approach to explore physician gender preference of females attending obstetrics and gynaecology clinic and the reasons behind their choice.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Study Population\u003c/h2\u003e \u003cp\u003eThe study population was female patients aged 18\u0026ndash;49 attending obstetrics and gynaecology clinics at Tafo Government Hospital.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Sampling and Sampling Techniques\u003c/h2\u003e \u003cp\u003eA purposive sampling technique was used to select participants who have relevant knowledge related to the research topic.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Techniques, Instruments for Data Collection and Analysis\u003c/h2\u003e \u003cp\u003eA semi-structured interview guide was the data collection tool. This contained open-ended questions designed to elicit detailed responses. Interview was one-on-one and conducted in a private and comfortable setting within the Tafo Government Hospital to ensure confidentiality and minimize disruptions. The private setting ensures that participants can speak freely without fear of being overheard, promoting honest and open communication Each interview lasted approximately 20\u0026ndash;35 minutes and was audio-recorded with the participants' consent. Field notes were be taken to capture non-verbal cues and contextual information. The audio recordings were transcribed verbatim. Data was analysed using thematic analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Validity and Reliability\u003c/h2\u003e \u003cp\u003eTo ensure the validity and reliability of the data, the following strategies will be employed. \u003cb\u003eTriangulation\u003c/b\u003e ensured that the data was comprehensive and provided a well-rounded understanding of the phenomena being studied. \u003cb\u003eMember Checking\u003c/b\u003e: Providing participants with summaries of their interviews to verify accuracy and allow for any clarifications or additional insights. This ensured the data accurately reflects the participants' experiences and perspectives. \u003cb\u003ePeer Debriefing\u003c/b\u003e provided an external check on the research process and helps to identify any potential biases or assumptions. Participant feedback was used to check credibility, transferability, dependability, and confirmability to ensure every finding was both authentic and actionable (Korstjens \u0026amp; Moser, 2018; Birt et al., 2022). The interview guide was reviewed by the supervisor involved in our research project. The interview guide was pre-tested with a small group of females who are not part of the main study to ensure clarity, relevance, and appropriateness of the questions. All necessary modifications were made to ensure that the interview guide effectively captures the intended data and facilitates a smooth data collection process.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.7 Limitations of the Study\u003c/h2\u003e \u003cp\u003eThe study's findings were based on a relatively small sample size, which may limit the generalizability of the results to the broader population of females. Using purposive sampling can introduce selection bias, as participants were elected based on specific criteria rather than randomly. The study relied on self-reported data from females. Participants might provide social desirability responses, which could affect the authenticity of the data collected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.8 Ethics Approval and Accordance\u003c/h2\u003e \u003cp\u003eThis study was conducted in accordance with the ethical principles outlined in the \u003cb\u003eDeclaration of Helsinki\u003c/b\u003e for research involving human participants. Ethical approval for the study was obtained from the Internal Review Board (Garden City University College, Kumasi, Ghana), for permission to conduct the research prior to commencement of data collection. Permission to conduct the study was also granted by the management of \u003cb\u003eTafo Government Hospital, Kumasi, Ghana\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eParticipation in the study was entirely voluntary. Written informed consent was obtained from all participants after they were adequately informed about the purpose of the study, procedures involved, potential risks and benefits, and their right to withdraw at any stage without any consequences to their care. Confidentiality and anonymity of participants were strictly maintained, and no personally identifiable information was collected or disclosed. All data were handled securely and used solely for research purposes.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Demographic Profile of Participants\u003c/h2\u003e \u003cp\u003eThe respondents\u0026rsquo; demographic data showed that 3 of the participants were within 20\u0026ndash;29 years, 6 were within 30\u0026ndash;39 years whereas 3 were aged 40\u0026ndash;49 years. Concerning their educational level, 5 out of the 12 participants, the majority had had Tertiary education, 4 participants had had Junior High School education, while 3 being the minority had had Senior High School education. Also, 5 participants were Petty Traders and Food Sellers, 3 were Unemployed, 2 were Bank Tellers, whereas the other 2 was a Teacher and Hairstylist respectively. Additionally, most of the participants, 7 were Cohabiting, 4 were Married while 1 was a Widow.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Organizations of Themes\u003c/h2\u003e \u003cp\u003eFour main themes and five (5) sub-themes were constructed after the content analysis. The themes were derived from the specific objective. The sub-themes were, however, derived from the responses made by the participants when they were interviewed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Knowledge of Physician Gender Preference\u003c/h2\u003e \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e \u003ch2\u003e4.3.1 Definition of an Obstetrics/Gynaecology Physician\u003c/h2\u003e \u003cp\u003eResponses from participants during the in-depth interviews revealed that several of the participants have knowledge about Obstetrics/Gynaecology Physician, while few of the participants could not mention who an Obstetrics/Gynaecology Physician is. One participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026rsquo;An OB-GYN physician is someone who has been trained to treat diseases of female (woman) especially diseases of the female genitals\u0026rsquo;\u0026rsquo;\u003c/em\u003e. \u003cb\u003e(23-year-old, Participant 8)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Physician Gender Preference\u003c/h2\u003e \u003cp\u003eResponses from participants during the in-depth interviews revealed that several of the participants have no gender preference. Others preferred male physicians, and few preferred female physicians. A participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo;The gender of the physician is not my concern. The important thing is receiving effective care, regardless of whether the doctor is male or female\u0026rsquo;\u0026rsquo;.\u003c/em\u003e \u003cb\u003e(38-year-old, Participant 2)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAnother participant verbalised,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;To me the gender of the physician examining me is important when seeking care at the OB/GYN clinic\u0026rdquo;.\u003c/em\u003e \u003cb\u003e(47-year-old, Participant 4)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Reasons for the Choice of Physician Gender\u003c/h2\u003e \u003cp\u003eResponses revealed Physician qualification status, good listening, empathy, sympathy, Physician competency, feeling comfortable to voice out their problem and not feeling shy are some of the factors that contributes to the importance of Physician gender when seeking care at the OB/GYN clinic.\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section3\"\u003e \u003ch2\u003e4.5.1 Communication Style\u003c/h2\u003e \u003cp\u003e Responses from participants after the in-depth interview revealed that, several participants stated Communication Style is the reasons behind their choice of physician gender when attending OB/GYN Clinic. A participant intimated that,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026rsquo;I prefer a male doctor because, in my experience, they communicate well with patients. They tend to be calm, listen attentively, and I\u0026rsquo;ve found that they don\u0026rsquo;t raise their voices like some female doctors might. This makes me feel more at ease during my appointments\u0026rsquo;\u0026rsquo;.\u003c/em\u003e \u003cb\u003e(32-year-old, Participant 3)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAnother participant verbalized,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo;The reason I don\u0026rsquo;t have a gender preference for my physician is that I believe both male and female physicians are equally capable of communicating effectively and making patients feel comfortable. I\u0026rsquo;ve never had any issues or difficulties discussing my health concerns with either, so I\u0026rsquo;m comfortable with whichever doctor provides my care\u0026rsquo;\u0026rsquo;\u003c/em\u003e \u003cb\u003e(30-year-old, Participant 9).\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section3\"\u003e \u003ch2\u003e4.5.2 Relationship with Patients\u003c/h2\u003e \u003cp\u003eResponses from participants after the in-depth interview, several participants revealed that Relationship with Patient is the reasons behind their choice of physician gender when attending OB/GYN Clinic. One participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026rsquo;I prefer male doctors because they tend to be patient, empathetic, and have a welcoming attitude. They often make patients feel at ease and encourage them to express their health concerns openly without hesitation\u0026rsquo;\u0026rsquo;.\u003c/em\u003e \u003cb\u003e(30-year-old, Participant 5)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAnother participant also said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Compared to some female doctors, male physicians tend to maintain a calm and respectful tone, avoiding confrontational behaviour such as shouting in the consulting room\u0026rsquo;\u0026rsquo;\u003c/em\u003e \u003cb\u003e(40-year-old, Participant 1).\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section3\"\u003e \u003ch2\u003e4.5.3 Technical Competence\u003c/h2\u003e \u003cp\u003eResponses from participants after the in-depth interview revealed that, most participant mentioned physicians\u0026rsquo; technical competence is the reason behind their choice of physician gender when attending OB/GYN Clinic. One participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo;I believe both males and females Doctors are knowledgeable, skilled and very good at what they do\u0026rsquo;\u0026rsquo;\u003c/em\u003e \u003cb\u003e(37-year-old, Participant 10).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAnother participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo;Although some female physicians are good, but naturally male physicians are very skilful and knowledgeable compared to female physicians\u0026rsquo;\u0026rsquo;\u003c/em\u003e \u003cb\u003e(36-year-old, Participant 6).\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section3\"\u003e \u003ch2\u003e4.5.4 Cultural and Religious Belief\u003c/h2\u003e \u003cp\u003eResponses from participants after the in-depth interview revealed, few participants stated that Cultural and Religious beliefs are the reasons behind their choice of physician gender when attending OB/GYN Clinic. A participant said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo; As a Muslim woman, my faith and traditions discourage being exposed to a man who is not my husband. Because of this, I feel more comfortable having a female doctor care for me during my visits to the OB-GYN clinic\u0026rsquo;\u0026rsquo;.\u003c/em\u003e \u003cb\u003e(47-year-old, Participant 4)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Past Experiences with Physicians\u003c/h2\u003e \u003cp\u003eResponses after the in-depth interview revealed that, several of participants experiences had influenced their decision to choose a particular gender. A participant said,\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eDuring my first pregnancy, I visited the Tafo Government Hospital for both my antenatal care and delivery. The midwife there communicated warmly, often smiling, and took the time to explain what to expect during labour\u0026rdquo;\u003c/em\u003e \u003cb\u003e(24-year-old, Participant 12).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eAnother also verbalised that,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The healthcare team was patient, attentive, and provided thorough counselling throughout the pregnancy. This positive experience played a role in shaping my perspective on physician gender preference\u003c/em\u003e\u0026rdquo; \u003cb\u003e(28-year-old, Participant 11).\u003c/b\u003e\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section3\"\u003e \u003ch2\u003e4.6.1 Delaying in Seeking Obstetric/Gynaecological Care\u003c/h2\u003e \u003cp\u003eResponses after the in-depth interview revealed that several participants had not delayed or avoided seeking OB/GYN care due to the concerns about the physician\u0026rsquo;s gender. Few of the participant revealed they had delayed or avoided seeking OB/GYN care due to concerns about the gender of the physician and claimed she was young, na\u0026iuml;ve, shy and was her first seeking consult at the OB/GYN clinic. One participant verbalised,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026lsquo;\u0026rsquo;During a past visit to the OB/GYN clinic, I was asked by a male physician to lie down and open my legs for a physical examination. As it was my first time at such a clinic, I felt shy and inexperienced, which led me to refuse the examination. Consequently, I was asked to leave the consulting room since I was unwilling to proceed with the examination\u0026rsquo;\u0026rsquo;.\u003c/em\u003e \u003cb\u003e(47-year-old, Participant 5)\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"DISCUSSION, CONCLUSION AND RECOMMENDATIONS","content":"\u003cp\u003e \u003cb\u003e5.1 Discussion of Findings\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe objective of the study was to explore views of females regarding physician gender preference at Tafo Government Hospital. The study sought to answer the following research questions. What are the views of female patients regarding physician gender preferences? What are the reasons behind the gender preferences?\u003c/p\u003e \u003cp\u003eResults from the study shows that participants generally demonstrated a reasonable understanding of who an OB/GYN physician is, with many correctly identifying the role as related to the care of female reproductive health. However, a few participants showed limited incomplete knowledge about the specialization. This finding aligns with studies s by (Chuang a et al., 2022) and (Dehlendorf et al., 2023), who noted that patient awareness of specialized medical roles varies and can affect healthcare engagement and preferences. Similarly, the finding aligns with a study by (Adekunle et al., 2022) which reported that broader health communication challenges in low-resource settings. Understanding who an OB/GYN is facilitates informed decision-making by patients regarding their care, especially in sensitive fields such as obstetrics and gynaecology (Spaich et al., 2018).\u003c/p\u003e \u003cp\u003eRegarding the OB/GYN physician gender preferences, the study revealed mixed views regarding physician gender preference. Some participants stated having no gender preference, emphasizing competence over gender, while others strongly preferred female or male physicians, mainly due to comfort with the intimate nature of care. These findings corroborate prior research showing that although many women prefer female OB/GYNs for intimate exams (Spaich et al., 2018; Ogu et al., 2020), a significant portion remain neutral or prefer providers based on qualities beyond gender, such as communication and empathy (Dahl et al., 2020; Fiscella et al., 2019). This complexity suggests that patient gender preference is multifactorial and cannot be reduced solely to biological or cultural factors.\u003c/p\u003e \u003cp\u003eOn the reason behind their choices of the gender OB/GYN physician, the study revealed that communication style and physician attitude were the most frequently cited reasons for gender preference, outweighing even cultural and religious factors for most participants. This supports existing literature that emphasizes the importance of empathy, respect, and effective communication in patient satisfaction (Ha and Longnecker, 2020; Shahid et al., 2020). Perceived physician technical competence was one of the factors that influenced physician gender preference in this study. This finding aligns with a study by (Street et al. 2021), who demonstrated that patients who rated their physicians as highly competent has a greater adherence to treatment recommendations and reported higher trust levels. Cultural and religious beliefs played a role, particularly among participants who preferred female providers due to modesty and religious norms. These findings align with studies from Saudi Arabia and other conservative cultural contexts by (AlMousa et al., 2021; Zigdon et al., 2020), who emphasized the influence of Islamic modesty on gender preference.\u003c/p\u003e \u003cp\u003eMoreover, with regards to whether past experiences significantly shaped preferences, the study revealed that participants who had positive interactions with a particular gender were more inclined to stick with that preference, echoing findings from Wallace et al. (2022) and (Shahid et al., 2020). Furthermore, concerning whether a patient has delayed/avoided seeking at the OB/GYN clinic because of the gender of a physician, findings from the study revealed that most participants had not delayed or avoided seeking OB/GYN care because of the provider's gender. Only one participant reported a delay, which she attributed to personal inexperience, shyness, and the sensitive nature of her first OB/GYN consultation. This finding is consistent with literature emphasizing that, although gender can be a barrier for some, most women will prioritize receiving necessary care if trust and professionalism are established (Dahl et al., 2020). Overall, communication style, perceived technical competence, respect, empathy, relationship with patient and cultural and religious beliefs alignment emerged as key drivers of preference, often outweighing gender itself.\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Conclusions\u003c/h2\u003e \u003cp\u003eThis study explored views of females regarding physician gender preference at Tafo Government Hospital. Most of the participants had no preference regarding the gender of Obstetrician and Gynecologist. Although Ghana is a country greatly influenced by cultural and religious values, these factors don\u0026rsquo;t seem to greatly affect patients' choice of preference for their OB-GYN physician. However, most of the respondent\u0026rsquo;s choice of preference for their OB/GYN physician was influence by factors such as communication style, relationship with patients and competence level of the physician.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003e5.3 Recommendations\u003c/h2\u003e \u003cp\u003eBased on the findings of the study, the following recommendations were made.\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe hospital should reassure patients that both female and male Obstetrician-Gynaecologists are given the same training in healthcare delivery hence they are equally knowledgeable, has good communication skills and good relationship with their client with respect to women\u0026rsquo;s health.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe hospital should provide gender-sensitive communication training for all OB/GYN staff to foster trust and patient comfort.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eFurther research should be conducted to explore male patients' perceptions of physician gender in intimate care to broaden the understanding of gender dynamics in healthcare.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData Availability declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors confirm that all data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization C.O.M.; and D.F.; methodology, F.A.; D.F. and C.O.M; validation, C.O.M.; formal analysis, F.A. and S.A.; investigation, S.A. and Z.A.G; resources, D.F.; C.O.M.; S.A. data curation, Z.A.G. and F.A.; writing\u0026mdash;original draft preparation, Z.A.G.; S.A. and F.A.; writing\u0026mdash;review and editing, C.O.M and F.A.; visualization, D.F.; C.O.M and F.A.; supervision, C.O.M.; project administration, C.O.M. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI declare that the authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Funding Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive funding.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAdekunle, A., Fatusi, A., \u0026amp; Yakubu, I. (2022). Gender preferences in healthcare: A study of patriarchal influences in Nigerian medical schools. Journal of Medical Sociology, 15(2), 45\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Ghafri, G., Al-Balushi, A., \u0026amp; Al-Farsi, Y. (2019). Patient preferences for physician gender in Oman: Implications for healthcare delivery. Oman Medical Journal, 34(3), 204\u0026ndash;211.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlMousa, M., AlHarbi, N., \u0026amp; Alshamsan, R. (2021). Religious and cultural influences on OB/GYN provider preferences among Saudi women. International Journal of Women's Health, 13, 567\u0026ndash;578.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmerican Association of Medical Colleges. (2023). Physician specialty data report. (AAMC)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmoakoh-Coleman, M., Yakubu, I., \u0026amp; Fatusi, A. (2016). Barriers to male gynaecologists in Ghana: A qualitative study. Reproductive Health, 13(1), 45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBirt, L., Scott, S., Cavers, D., Campbell, C., \u0026amp; Walter, F. (2022). Member checking: A tool to enhance trustworthiness or merely a nod to validation? Qualitative Health Research, 26(13), 1802\u0026ndash;1811. https://doi.org/10.1177/1049732316654870\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChuang, A. W., Ha, J. F., \u0026amp; Longnecker, N. (2022). Patient anxiety during OB/GYN procedures: A global perspective. Journal of Women's Health, 31(4), 512\u0026ndash;520.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDahl, E., Fiscella, K., \u0026amp; Wallace, L. S. (2020). Patient-provider gender concordance and satisfaction in OB/GYN care. Patient Education and Counselling, 103(5), 987\u0026ndash;994.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDehlendorf, C., AlFaris, E., \u0026amp; Zahrdad, M. (2023). Trust and adherence in OB/GYN care: The role of provider gender. Journal of Clinical Ethics, 34(1), 45\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEl-Haddad, J., Al-Ghafri, G., \u0026amp; Al-Balushi, A. (2015). Patient comfort and provider gender in Lebanon: A qualitative study. Eastern Mediterranean Health Journal, 21(6), 422\u0026ndash;429.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFatusi, A., Okeke, B., \u0026amp; Oluoch-Aridi, J. (2023). Cultural norms and healthcare provider preferences in West Africa. African Journal of Reproductive Health, 27(1), 34\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFiscella, K., Wallace, L. S., \u0026amp; Bennett, C. L. (2019). Patient perceptions of OB/GYN provider gender: A U.S. national survey. Journal of Women's Health, 28(7), 923\u0026ndash;930.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFuseini, K., Hall, J. A., \u0026amp; Yakubu, I. (2022). Intimate care and provider gender preferences in Ghana. BMC Women's Health, 22(1), 78.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHa, J. F., \u0026amp; Longnecker, N. (2020). Doctor-patient communication: A review. Ochsner Journal, 20(1), 38\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJackson, L. R., Bennett, C. L., \u0026amp; Shahid, U. (2022). Ethnic disparities in healthcare provider preferences. Journal of Racial and Ethnic Health Disparities, 9(3), 456\u0026ndash;465.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKorstjens, I., \u0026amp; Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice, 24(1), 120\u0026ndash;124. https://doi.org/10.1080/13814788.2017.1375092\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLancaster, T., Shahid, U., \u0026amp; Wallace, L. S. (2022). Declining male participation in OB/GYN: A global review. Medical Education, 56(4), 345\u0026ndash;355.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMthembu, S., Zigdon, A., \u0026amp; Okeke, B. (2020). Women's preferences for obstetric care providers in South Africa. African Journal of Primary Health Care \u0026amp; Family Medicine, 12(1), a2201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOgu, R. N., Okeke, B. C., \u0026amp; Fatusi, A. O. (2020). Gender preferences in obstetrics and gynaecology care: A Nigerian study. Nigerian Medical Journal, 61(2), 64\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOluoch-Aridi, J., Hall, J. A., \u0026amp; Fuseini, K. (2020). Provider gender and maternal health in Sub-Saharan Africa: A systematic review. PLOS ONE, 15(6), e0234587.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkeke, B., Oluoch-Aridi, J., \u0026amp; Fatusi, A. (2021). Cultural norms and healthcare provider preferences in West Africa. African Journal of Reproductive Health, 25(3), 34\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRiaz, B., Sherwani, N. Z. F., Inam, S. H. A., Rafiq, M. Y., Tanveer, S., Arif, A., ... \u0026amp; Jamil, H. (2021). Physician gender preference amongst females attending obstetrics/gynecology clinics. \u003cem\u003eCureus, 13\u003c/em\u003e(5).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShahid, U., Bennett, C. L., \u0026amp; Jackson, L. R. (2020). Interpersonal qualities in healthcare: A meta-analysis. \u003cem\u003ePatient Preference and Adherence, 14\u003c/em\u003e, 1423\u0026ndash;1435.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSpaich, S., Dahl, E., \u0026amp; Fiscella, K. (2018). Patient preferences for OB/GYN provider gender: A European perspective. European Journal of Obstetrics \u0026amp; Gynaecology and Reproductive Biology, 225, 222\u0026ndash;228.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStreet, R. L., Makoul, G., Arora, N. K., \u0026amp; Epstein, R. M. (2021). Patient-physician communication and health outcomes: A meta-analytic review. Patient Education and Counseling, 104(2), 224\u0026ndash;233.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWallace, R., Nwaozuru, U., \u0026amp; Omenka, O. (2022). How gender biases affect reproductive care: Cross-cultural insights from Ghana and Nigeria. African Health Sciences, 22(3), 321\u0026ndash;331.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZahrdad, M., Alshamsan, R., \u0026amp; AlFaris, E. (2021). Implicit gender biases in clinical decision-making: A scoping review. BMJ Open, 11(5), e045516.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZigdon, A., Sheiner, E., \u0026amp; Walfisch, A. (2020). Religious influence on gender preference in gynaecological care: A study among Ethiopian women. \u003cem\u003eArchives of Gynaecology and Obstetrics, 301\u003c/em\u003e(4), 987\u0026ndash;993.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8661756/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8661756/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePhysician gender preference has been widely discussed in obstetric and gynaecologic care, particularly because of the intimate nature of these services. However, evidence from low- and middle-income settings, including Ghana, remains limited. This study explored the views of female patients regarding physician gender preference and the factors underlying these preferences at Tafo Government Hospital in Kumasi, Ghana.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA qualitative exploratory approach was used to capture women\u0026rsquo;s perspectives. Female patients attending the obstetrics and gynaecology clinic were engaged to discuss their understanding of the role of obstetricians and gynaecologists, their preferences regarding physician gender, and the reasons influencing these preferences. Data were analysed thematically to identify key patterns and explanatory factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMost participants demonstrated a reasonable understanding of the role of obstetricians and gynaecologists, although a few had incomplete knowledge of the specialty. Views on physician gender preference were mixed. While some women expressed no preference and emphasized professional competence over gender, others preferred either female or male physicians, largely due to comfort during intimate examinations. Communication style, physician attitude, empathy, and perceived technical competence emerged as the most influential factors shaping preferences, often outweighing cultural or religious considerations. Past positive experiences with a particular physician gender reinforced preferences for some participants. Importantly, most women reported that physician gender did not delay or prevent them from seeking obstetric or gynaecologic care.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eFemale patients\u0026rsquo; preferences for obstetric and gynaecologic physicians at Tafo Government Hospital are shaped more by interpersonal and professional qualities than by gender alone. Although cultural and religious values play a role for some women, effective communication, respect, empathy, and perceived competence are the primary drivers of patient comfort and trust. These findings highlight the importance of patient-centered care and provider communication skills in improving women\u0026rsquo;s experiences in obstetric and gynaecologic services.\u003c/p\u003e","manuscriptTitle":"Physician Gender Preferences Among Female Attendees of an Obstetrics and Gynaecology Clinic at Tafo Government Hospital, Kumasi, Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-18 14:57:58","doi":"10.21203/rs.3.rs-8661756/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b94f0cb1-9542-4b7d-85fd-76eaa295cef6","owner":[],"postedDate":"February 18th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T07:28:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-18 14:57:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8661756","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8661756","identity":"rs-8661756","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}