We are in 2025. India is a global leader: the world’s fastest-growing major economy pioneering split-second digital payments and the first to land near the moon's south pole! With bullet trains and cutting-edge technology transforming the country, it seems we’re making progress in every sphere. Yet, for unmarried women in India, not much has changed. Despite these advancements, they still face systemic barriers to basic healthcare, with access to gynaecological services like Pap smears denied based on marital status. Ugh, only! Let me remind here that cervical cancer is the second most common cancer among women in India and boosting screening services like pap smear test IS the ONLY way to reduce the disease burden.
Denied once
I was 32, working as a UNICEF consultant to the Ministry supporting national policy writing and roll-out, held a Masters and carried over a decade’s experience in the Indian development sector. Basically, my support work was to benefit 16 Cr rural households! And providing guidance to bureaucrats, engineers and other implementers on ground (not mentioning this to sound cocky, but to establish that I was/ am considered to be a well-educated, influential person, of sorts!)
So, when an ultrasound scan as part of my annual regular health check-up in 2022 (cuz I have PCOS, Tx to stress from the same work!) alerted for an immediate pap smear test to rule out cervical cancer (the word cancer is enough to send jitters especially when both your grandma and uncle passed away with it!), I went to a big hospital in Hyderabad by myself because a pap smear test is just like any other diagnostic test, right? (and we’ve already established that I can do important things by myself!)
Wrong!!
I laid half-naked in the ultrasound room (ya, there was a cover on top!) waiting for the radiologist, smiling nervously at the helper and making small-talk (all the while praying the gods i don't believe in for a negative test result!). The doctor walked in, put on her gloves and picked a vaginal speculum (used to hold the vaginal walls apart and see the cervix), and a small spatula to collect samples of cervix cells. Almost done, I’ll know soon that I don’t have cancer. Hopefully.
Just before inserting it, she asked, "Are you married?". “No”, and in a split second, she retracted the instrument and yelled at the helper, “Don't you know to check these questions before calling me!?” and hurried out leaving me helpless. No regard whatsoever for the fact that cervical cancer doesn’t check for wedding rings. On this note, remember to blacklist Sudha Diagnostic Centre in Kompally, Hyderabad (even if you are not from Hyderabad! Solidarity sakes!) I was furious. And naturally, I did the first thing that any sane woman would do in that instant. Cry. But I din’t want to give any of them the satisfaction of their power, so I held it in until I got out, sat on their steps, and let it all out. I was crying because of the humiliation, the no-explanation-deserved kinda treatment by fellow women, that too supposedly highly-educated women, their blatant disregard for the law that protects women’s rights; coupled with the fact that I was about to get married in three months which will change these experiences, not because of my rights but because of my marital identity! Argh! I gathered myself. Went back upstairs and demanded answers. Noted their patriarchal responses, contacted a journalist to get it printed. Nimisha did a great job and here’s the link that I referred to again while writing this one.
To access a test that should have been as routine as any other simple diagnostic, I instead had to educate them, pull out my saved notes, demand to speak to superiors, question their medical oath and rulebook, help them understand the difference between a legal and moral obligation, explain the concept of consent forms, and refuse to let it go. (all the while with my two worrying parents and father-in-law sitting on the side considering it best for them to leave me to do my thing! Better than being stuck in the crossfire! Although my poor mum tried to remind me of more important scans to understand why I fainted!). Of course I got it done. I could’ve said I was married, but that’s not the point!
Cut to 2025 Another friend, Priyanka, was refused a pap smear at MedPlus AS Rao Nagar. She was told point-blank that the test was only for married women. It took arguing and escalation to finally get it done. We understand that not everyone is privileged with information and social capital to assert themselves, but this is the only way we know to deal with such injustice. And our way of hopefully making it better for the next person walking into their buildings.
The doctor reportedly told her that she was taught in her medical school to never conduct such tests on unmarried women because of the importance given to virginity. Virginity - a patriarchal curation that literally is a social construct and has NO medical or biological definition. Read this fun and brilliant article for more data on dispelling the hymen or virginity myth. Let me quote one, “a small study of 36 pregnant teenagers published in 2004, found that medical staff were only able to make "definitive findings of penetration" in two cases”. (lol!)
Anyway, the doctor went on to inform Priyanka that to her knowledge no one would do this test despite a gynaec prescription because of unmarried status, that it’s her personal choice (apparently has nothing to do with medical ethics and oaths they take!) because they’re the ones to face repercussions, if anything happens. Face-palm!
Asking for it and still not getting it!
None of us had gone in asking for something experimental or ethically ambiguous. These are standard procedures, backed by national and global medical guidelines.
The World Health Organization recommends regular cervical cancer screening for all women starting at 30 yrs. In the UK, where I currently reside, the NHS proactively invites women every three years to get their Pap smears done, regardless of whether they are sexually active, married, or not. In India, the National Programme for Prevention and Control of Cancer also encourages such screenings. Yet, in practice, our healthcare system often treats unmarried women seeking gynecological care with suspicion.
There is a cruel irony here: India is the most populous country in the world, and yet our public discourse and medical practice often operate as though sex only happens within the sanctity of marriage and that marriage is monogamous. Lol!. The fallout is severe. Women delay or avoid screenings. They suffer unnecessary anxiety. Worse, some may miss early diagnoses altogether.
What lies beneath these refusals is not just ignorance — it is a potent mix of moral policing, patriarchal values, and institutionalised stigma. It's a healthcare culture that presumes control over women's bodies unless validated by marriage. It assumes that medical ethics must align with cultural conservatism, even at the cost of health. Thanks ChatGPT for this para.
As someone who straddles both research and grassroots advocacy, I know this issue isn’t anecdotal. It’s systemic. The denial of gynecological care based on marital status violates ethical standards, medical protocols, and basic human rights. Yet, it continues because no one is holding diagnostic centres accountable.
Why I joined SEYA Collective?
To channel my frustration with these double standards, I have joined SEYA Collective. SEYA (Sexual Education for Young Adults), is a youth-led, women-led, rights-first bilingual initiative empowering young adults aged 18–30 to understand and claim their sexual and reproductive health rights (SRHR).
We are seeing more and more of these cases, mostly whispered in private, sometimes shared in grief. The silence around it only makes the issue more pervasive.
That is why I am speaking out. We all at SEYA are speaking out to do something about it. So, come join us, speak to us, get courage and ideas on how to own your voice.
We need India’s professional medical bodies to take a public stand, especially from
FOGSI (Federation of Obstetric and Gynaecological Societies of India),
Indian Radiological and Imaging Association (IRIA),
National Medical Commission (NMC),
Indian Medical Association (IMA).
State Medical Councils,
Medical Ethics Committee within hospitals.
We need clear guidelines sent to hospitals and diagnostic centres stating that no woman can be denied SRHR services based on her marital status. We need medical education to reinforce informed consent, not moral judgment.
We also need the public to be angry. Angry that young women in 2025 still have to fight for basic preventive care. Angry that the systems meant to care for us are, in fact, hurting us.
As a society, we must ask: Do we want to save lives, or do we want to shame them?
"Because right now, the message to young women is clear: get married or get denied."
About Author: Spurthi Kolipaka is a trained social worker from TISS, India and currently a PhD scholar in the UK. She is a core committee member of SEYA Collective, which works on sexual and reproductive health rights for young adults in Telangana.
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