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On Censorship. . . Yes, censorship is alive and well in the United States as big brother, er, Good Morning America tries to protect us from "too negative" of a statement about hysterectomy. Oddly enough, I can sincerely identify with Ms. Plourde's position in this case regarding the title of her book, The Ultimate Rape. I've encountered the very same censorship regarding the title of this website. Several people have told me they would love to link to this site....if only it wasn't called sex, lies, and uterine fibroids. It is, apparently, viewed as distasteful because it uses the word "sex," angry because it implies that doctors lie and/or cheesy and simply not a serious title that lends the website any credibility. My publisher agreed with all 3 of those items and indicated, at one time, they would not publish my book with that title. The same treatment Ms. Plourde received when she sought publication of her book. I have no intention whatsoever of changing the title of this website. Thanks to market analysis along with statistical input from this website, a compromise was reached with my editor. New title of my book: Sex, Lies & The Truth About Uterine Fibroids. UPDATE: Elizabeth Plourde recently updated her book and retitled it in the process. New name: Hysterectomy & Ovary Removal: What ALL Women Need to Know.

During the GMA segment, both Beth Tiner and Elizabeth Plourde were interviewed and shown as representative of women who experience sexual dysfunction after undergoing a hysterectomy. Although I personally believe that both of these women showed tremendous amounts of courage to appear on national TV to discuss this extremely personal topic and that both did an outstanding job, in subsequent conversations with both Beth and Elizabeth I found that each of them expressed disappointment in the outcome of their individual interviews. For example, in Elizabeth's case, she was interviewed at length about her book (The Ultimate Rape) and yet, in the end, the segment that was broadcast failed to mention that this terrific resource even exists. It is my understanding that the title of her book was deemed "inappropriate" for the Good Morning America viewing audience.

In the short amount of time that was used for Dr. Yvonne Thornton's commentary during the Good Morning America interview, she made several critical statements that positioned her as an adversary to many, many women who were viewing this television segment. First of all, she indicated that she believed the vast majority of women who undergo hysterectomy do not experience sexual dysfunction. Secondly, she went on to indicate that sexual functioning and "...the big O..." are not taught in medical school. The question that arose, of course, is how in the world would this doctor know much of anything about female sexual dysfunction -- much less what occurs post hysterectomy -- if she and other gynecologists are never even taught about this aspect of a woman's body in medical school? Her jovial demeanor during the interview on what is a rather serious topic to an incredibly high number (perhaps well over a million) of women currently experiencing female sexual dysfunction in this country was, in addition, somewhat offensive.

But was this the real Dr. Yvonne Thornton? Were those 15 seconds really the "essence" of her 1 1/2 hour interview with Nancy Snyderman? Was this really what she wanted to say to women about the topic of hysterectomy and female sexual dysfunction?

On Friday, January 7, I had the opportunity to speak with Dr. Yvonne Thornton at length on the subject of hysterectomy, female sexual dysfunction, ACOG, and her interview on Good Morning America. The answer to all 3 of the above questions is simply "No."

First, some background information about Dr. Thornton. As a high-risk, neonatal obstetrician, Dr. Thornton is currently the Director of the Perinatal Diagnostic Testing Center at Morristown (NJ) Memorial Hospital. She is a Fellow member of ACOG and is board certified in Maternal & Fetal Medicine and Obstetrics & Gynecology.

She is also the author of The Ditchdigger's Daughters which was named one of the 1996 Best Books for Young Adults by the American Library Association. This book is a biographical account of how her uneducated father and her mother raised their six daughters to become successful professionals, including two doctors, a dentist, and a lawyer. Her story was also made into a cable television movie for the Family Channel. More recently, Dr. Thornton is the author of Woman to Woman: A Leading Gynecologist Tells You All You Need to Know About Your Body and Your Health. While searching for background information on Dr. Thornton, I discovered that there are literally hundreds of webpages about this physician accessible on the internet.

Dr. Thornton was NOT the gynecologist scheduled to be interviewed by Nancy Snyderman for the GMA segment on female sexual dysfunction after hysterectomy. A male gynecologist was originally scheduled but he apparently backed out at the last minute. Since Dr. Thornton is a physician who has appeared on GMA six times previously, she was asked to step in at the last minute and replace the gynecologist who bowed out. She indicated to me that she did so of her own volition and was not, in her perspective, representing ACOG in this regard. The subtitles and voiceovers that appeared on the segment that indicated she was, in fact, representing ACOG were in error. In addition, she was completely unaware that they were also interviewing gynecologists on the west coast that would "appear" to have an opposite perspective from her own.

The interview that Dr. Thornton gave to Nancy Snyderman covered a wide range of topics related to hysterectomy. According to Dr. Thornton, she had a casual, peer to peer conversation (Nancy Snyderman is a M.D.) that was, at times, lighthearted. In addition, she indicated to me that her emphasis to Nancy Snyderman regarding sexual functioning and hysterectomy was ensconced in a discussion about cancer. Apparently, sexual functioning is of such tremendous concern to some women that even when cancer has been fully diagnosed they will refuse a hysterectomy. Dr. Thornton expressed strong feelings about women who make the decision to preserve their uterus for the sake of sexual functioning when their entire life is at stake due to cancer. She verbalized to me that she wished she could get it across to these women that "living is more important than sex."

Dr. Thornton indicated that she does not regularly perform hysterectomy nor does she believe it to be a necessary procedure for benign disease of the uterus. She does believe that female sexual functioning is not taught or inadequately taught in medical schools even today and indicated that most physicians learn about this aspect of gynecology from their patients. (Note: I personally found this to be a rather sad thought actually, considering a recent study indicated that 75% of women don't even talk to their physicians about sex for fear of embarrassing them.)

All in all, throughout my interview of Dr. Thornton, she seemed dismayed and somewhat appalled by how this segment was put together to represent adversarial viewpoints on the issue of hysterectomy and sexual functioning. She indicated that she has no doubts whatsoever that hysterectomy can indeed cause sexual dysfunction in some women. In addition, the surgical skills of the gynecologist performing the hysterectomy as well as the type of hysterectomy may play some role in a subsequent outcome of sexual dysfunction. She also stated that women experiencing sexual dysfunction should proactively seek out the care of a sex therapist.

In closing, Dr. Thornton expressed "good healthcare requires individuality in health management" and that she believes first and foremost in the credo "above all, do no harm."

It is so unfortunate that the media finds a need to manipulate sound bites from interviews in a way that is not representative of the individual interviewed. I'm quite certain that there are plenty of gynecologists out there who seriously pooh-pooh the concept of sexual dysfunction post hysterectomy and, if they had truly tried, they could have found a more appropriate individual to interview regarding this perspective. I find myself asking, over and over again, "Why DID they choose Dr. Thornton?" I have some thoughts on the subject -- but no real answer.

Furthermore, I do want to make it clear that I am not writing this story as a specific indictment against ABC's Good Morning America. I am quite certain that they are not alone in how they put their stories together for their viewing audience. As I learn more about how the media plays a role in what and how we all think and react to what is presented, I can't help but wonder how often my perspective was manipulated and how often it was wrong. The lesson learned here is that caution regarding information (about health matters and health officials) is always warranted when the source of information is capsulized into 10 second sound bites by the news media, press, or commercial television. Regardless of who is presenting it. Question everything that strikes concern in your mind and don't be afraid to have open discussions with your doctor about what you see and hear via the media on health topics that are important to you.

If you are a woman experiencing sexual dysfunction and would like to seek out the care of a sex therapist, sex therapist Laura Berman of the Women's Sexual Health Clinic in Boston (Boston University Medical Center) suggests you send a self-addressed stamped envelope along with your request for a list of certified sex counselors and therapists practicing in your area to:

AASECT
P.O. Box 238
Mount Vernon, IA 52314-0238

In addition, the AASECT (American Association of Sex Educators, Counselors and Therapists) website has additional information and many valuable links. A list of members is also available on their site.

After reading this post, if you feel inclined to send email to Dr. Yvonne Thornton, please do so via the following email address:

resources@ACOG.org

Please put Dr. Yvonne Thornton's name in the Subject line of your email.

Best wishes to all of you as we each continue to seek out "the truth" from the medical professionals we turn to for support and guidance in our ongoing healthcare needs.

Carla Dionne
cdionne@earthlink.net

Resource Links

The Ultimate Rape: What Every Woman Should Know about Hysterectomies and Ovarian Removal
New Voice Publications
Elizabeth Plourde
http://www.newvoice.net/

Sans Uteri
Beth Tiner
http://www.findings.net/sans-uteri.html

Woman to Woman : A Leading Gynecologist Tells You All You Need to Know About Your Body and Your Health
Dr. Yvonne Thornton and Jo Coudert
http://www.amazon.com/exec/obidos/ASIN/0452279860/o/qid=948562789/sr=8-1/102

The Ditchdigger's Daughters
Dr. Yvonne Thornton
http://www.amazon.com/exec/obidos/ASIN/0452276195/o/qid=948562789/sr=8-2/102 -2623667-2710421

Transcript of GMA interview
http://www.uterinefibroids.com/rhi_sex_GMA11-23-99.htm

American Association of Sex Educators, Counselors and Therapists
http://www.aasect.org/

Hysterectomy and Sexual Functioning
Julia C. Rhodes, MS; Kristen H. Kjerulff, PhD; Patricia W. Langenberg, PhD; Gay M. Guzinski, MD, JAMA; Vol. 282 No. 20, November 24, 1999 (The following link only provides an abstract which is NOT the complete picture of this study--it is important to read the ENTIRE study to get a true picture of what this research attempted to accomplish and how desperately it failed.)
http://jama.ama-assn.org/issues/v282n20/abs/joc81686.html

FAQs on female sexual dysfunction
Jennifer Berman, urologist and Laura Berman, sex therapist
http://www.msnbc.com/news/229163.asp

Hysterectomy Can Have an Impact on Sexuality
http://onhealth.com/ch1/columnist/item,15017.asp

Fear Of Talking Sex With Docs, Sex Over 40, July 1999
(This issue is no longer available online but may be available via request to the editor.)
http://www.sexualhealth.com/content/topic.cfm?topicID=53&thetopic=Sex%20Over%2040

American College of Obstetricians & Gynecologists
http://www.acog.com/