Yikes. I didn’t expect the threads myself and other amazing muslim women in medicine started on an NBME question referencing a muslim patient to blow up. For those confused about why that question upset us, I’ll explain here: a thread. 1/

To be a Muslim Woman AND a Hijabi (someone who wears the traditional islamic head covering) in America is a unique experience. For many, we are a rare breed - the only exposure they have to people who look like us are the images portrayed in the media. 2/

Unfortunately, these images often depict muslim women as oppressed and subservient - without a voice and subject to the whims of the male in charge of them (Husband, brother, father, etc.). I am not denying this is not a reality for many Muslim women. It is an unfortunate 3/

product of culture and not religion. One of the foundations of western healthcare is the principle of patient autonomy. It is hammered into us over and over that a patient should always have the right to dictate their care regardless of their background 4/

with the only exception being if they pose a threat to the health of others…but even then there’s a gray area (anti-vacccers anyone?). To see a questioned framed at teaching “cultural competency” at the expense of “patient autonomy” is harmful because it reinforces the tired 5/

trope that all conservative muslim women (which, what does that even mean?) are voiceless and powerless. For many training physicians in America, this question is the only exposure to Islam they will have. What happens when they encounter a muslim woman as their patient? 6/

Will they give her the same privilege of choice in her care as they would any other woman? Or will they default to her husband/father’s preference? Speculum exams are very sensitive, and make many women uncomfortable, regardless of faith background. 7/

The harms of this question extend beyond Muslim women as it implies that /only/ Muslim women are uncomfortable with a male performing their exam. This is simply not true. The only way to get to the bottom of things for any patient is to just ask what their preferences are. 8/