Doctor Sues on Sex Discrimination : Dispute Over Gender’s Relevance in Child Abuse Exams

When an opening came up in the Child Sexual Abuse Protection Program of San Diego’s Children’s Hospital and Health Center, Dr. Charles Gilman figured that the skills acquired in his family practice would serve him well in the job.

But the medical director of the program, Dr. David Chadwick, denied Gilman’s application. Believing that victims are more comfortable with a female examiner (the job involves physical examination of children suspected of being abuse victims), Chadwick’s policy is to hire women physicians exclusively.

“I was really very hurt,” Gilman, 49, said, describing his reaction to the rejection in a recent interview in his Poway office, which is northeast of San Diego. “I was bitter. I took it back home with me--the implication that I’m not good enough.”

Gilman filed a sex discrimination suit against Children’s Hospital, and it is being heard this week in San Diego. At issue is whether gender of the doctor may be a legitimate occupational qualification for examining sexual abuse victims and whether hospitals have a right to enforce their opinion in that regard.

Most Victims Female

Attorney Debbie Peteler, representing Children’s Hospital, argues that because as many as 94% of child sexual abuse victims are female and “nearly all” the abusers are male, a child who was forced to be examined by a man could suffer “a repetition of the loss of control experienced when abused.”

Yet Gilman’s attorney, Gloria Barrios of the Department of Fair Employment and Housing, said the hospital is making hiring decisions according to a sexual stereotype--that women are more compassionate than men. “If we start letting people discriminate on the basis of sex, they’re mostly going to discriminate against women,” Barrios said.

No matter what the rationale of the employer, “it’s a terrible thing to be told you can’t do a job when you think you can,” she added.

Gilman got his introduction to working with sexually abused children 20 years ago. During his internship in Detroit, Gilman said, he sometimes saw abuse cases in the emergency room. He said he felt at the time that such children needed special care, and he believed he got along well enough with children to supply that concern.

Greater Competition

Gilman went on to build a successful private practice in Michigan, he said. When he moved with his wife and three children to San Diego seven years ago, he found it more difficult to support his family here because of greater competition in the medical field. Gilman said he took some jobs on the side--working in a smoking clinic and umpiring baseball games, for example--and kept looking for a permanent position to supplement his income.

In December of 1982, he saw an ad in San Diego Physician Magazine seeking women physicians for a sexual abuse program. Gilman concluded this might be the sort of part-time work he needed in addition to his practice, and the nature of the job appealed to him--since coming to Poway, he had continued to see an occasional child sex abuse case in his office.

“I thought that (the specification for female doctors) was either maybe a mistake, or peculiar,” Gilman said. When he called the number in the ad, the coordinator of the program told Gilman that she didn’t think they were considering men for the job, but that she would leave word with medical director Chadwick.

Got an Interview

When Chadwick didn’t return his call, Gilman said, he contacted the Department of Fair Employment and Housing. With the department’s intervention, Gilman managed to obtain an interview with Chadwick.

“Definitely, I would have been hired (if Chadwick were open to hiring men). But I never received another call after the interview,” Gilman said. “He (Chadwick) just left it at: ‘Thank you, but my program will only work with female doctors.’ ”

According to attorney Peteler, speaking for Chadwick, all children are asked when they come into the unit whether they would prefer a male or female physician. Most request a woman--a decision that is “a natural development” for a child who has been abused, Peteler said.

For boy victims, or those girls who may prefer being examined by a man, Chadwick himself performs the examination. All other physicians who see children on the unit are female, Peteler said.

“I’m not saying there aren’t some children who wouldn’t be frightened by (being examined by) a male,” Gilman added. “But I feel I’m a good enough doctor to establish rapport with the child.”

Issue Is Compassion

An associate professor of psychology at UCLA, Dr. Paul Abramson, who’s serving as an expert witness on behalf of Gilman, points out that the examination process in child abuse cases is by its very nature intrusive. Children would prefer not to have anyone do the exam, he said, “so it depends ultimately on who’s most compassionate. The physician’s confidence, knowledge of the subject and sensitivity are the critical factors. Gender is an incidental factor.”

(Abramson pointed out that, in rare cases, abused children may develop a true phobia of men and that those children should indeed be examined by a woman physician.)

Attorney Peteler called Gilman’s insistence on being hired “frivolous and unreasonable. We agree that at some point a sexually abused child should be able to develop a normal relationship with adult males, but this is not the place to start that process. He or she (the victim) is out of control at this point.”