Title: Exploring Turkish Women's Gynecological Examination Perceptions Based on Their
Metaphors: A Qualitative Study
Version: 2 Date: 09 Dec 2024
Reviewer's report:
This article aims to understand the perceptions of women in Turkey about gynecological
examinations by collecting data through an online form and analyzing the metaphors the women
used in this form. The questions in the form ask what gynecological exam and the exam table
reminds them. As a result of their qualitative analysis of the metaphors, the authors concluded
that women often have negative associations regarding the gynecological examination in
Turkey. As it is, the data supports the conclusion reached. This study is significant in being
probably the first medical study asking women in Turkey about their experiences with the
gynecological exam table and the experience, and the number of women they reached is
considerable for a qualitative study. However, it needs some significant revisions in order to be
publishable, including analytical improvements, and more engagement with key literature.
One major area that can be improved is that the literature cited does not include some of the
seminal works regarding the way metaphors are used in medicine and women’s bodies, such as
Susan Sontag’s work on cancer and Emily Martin’s Woman in the Body. I believe the analysis
could benefit a lot from inclusion of these.
Another major issue is an analytical one: some of the metaphors listed under the “gynecological
examination that brings to mind the reason for the procedure” category are not really metaphors
but simply reasons for gynecological exams themselves. Metaphors are often used and analyzed
in how they bring in different meanings to a situation or concept that is outside of the expected
meaning (e.g. the metaphors of war or fighting in relation to the immune system). Then, this
additional meaning is evaluated in relation to the existing context. In this case, pregnancy or
health are not really bringing any new or different meaning to the gynecological exam.
Similarly, the analysis of the metaphors women could use more context. For example, what is
the typical experience of a woman going to a gynecologist? How long does the procedure last?
What is the relationship between doctors and women are like? Are there differences between
public or private settings, age of women, etc. It would be good to have some kind of information
on the medical setting in Turkey, and the cultural expectations and medical culture.
More minor points are improvement can be listed as below:
• There is some lack of clarity in the Methods section: is the data solely based on the forms
presented in the appendix, or are there additional interviews performed? On page 6 the procedure
is explained as data collection through forms, but on page 8, in Data Analysis there are references
to interviews.
• What was the purpose of the illustration in the online form? Data about that is not mentioned,
or elaborated on in the analysis.
• I don’t think the Figure 1 is contributing anything to the analysis. In my opinion it can be
skipped.
• Instead of “our country” it would be better to say Turkey.
• In line 131-132, page 6 there is a parenthetical reference, all others are endnotes. They should
be consistent.
• The manuscript could benefit from some English language revisions