At a loss for words: A qualitative exploration of female genital knowledge among obstetrics and gynecology patients

Patient health literacy, including basic anatomy knowledge, leads to improved communication and better health outcomes. Limited empirical data suggests that external genital anatomy may represent a particular knowledge gap. To inform future health literacy improvement efforts, we explored patient perspectives about how gynecologic anatomical literacy is generated and applied. Twenty semi-structured interviews with obstetrics and gynecology patients at a tertiary care centre were conducted to explore their knowledge of female genital anatomy and the origins of that knowledge. Thematic analysis was performed comparatively and iteratively, informed by principles of constructivist grounded theory. Participants highlighted an overwhelming lack of health education and high levels of internalized shame, leaving them ill-equipped to engage in conversations about their genitalia with healthcare providers. To combat this, participants attempted to construct knowledge for themselves; however, many grappled to identify reliable sources of information and felt uncertainty when communicating about their bodies. These findings contribute to an ongoing conversation about how an avoidance of naming may perpetuate the passivity and embarrassment that women experience regarding their reproductive health. Healthcare providers are well-situated to improve patient self-perception by using purposeful language and working to address both patient knowledge and activation.