Association Between General Practitioner's Sex and Documented Diagnoses of Female-Specific Disorders in German Primary Care: A Large Matched Cross-Sectional Study.

BACKGROUND/OBJECTIVES: In Germany, women have direct access to gynaecologists without GP referral, making the GP's role in female-specific conditions largely secondary. It has not previously been examined whether the sex of the GP is nonetheless associated with the documented prevalence of these conditions in primary care records. METHODS: This retrospective cross-sectional study used data from the IQVIA™ Disease Analyzer. All women aged ≥18 years with at least one visit to one of 1183 GPs in Germany in 2025 were included. Women attending female and male GPs were matched 1:1 by propensity score on age, statutory health insurance, practice size, consultation frequency in 2025, and the van Walraven comorbidity score (excluding malignancy), yielding 661,485 women per group. Associations between GP sex and the documented prevalence of eight female-specific conditions were examined using conditional logistic regression within the age strata clinically relevant to each condition (from 18-30 to >75 years), with the age × GP-sex interaction tested in a single model per condition and E-values calculated to assess robustness to unmeasured confounding. RESULTS: The association between GP sex and documented prevalence was strongly age-dependent, with a significant age × GP-sex interaction for seven of eight conditions (all p < 0.001). Female GP sex was associated with higher documented prevalence in mid-life, including menopausal and perimenopausal disorders (46-60 years: OR 1.37, 95% CI 1.28-1.46), endometriosis (31-45 years: OR 1.15, 1.03-1.28) and benign neoplasm of the female breast and genital organs (46-60 years: OR 1.16, 1.04-1.29); in the oldest women, the pattern attenuated or reversed (menopausal disorders > 75 years: OR 0.81, 0.72-0.90). No association was observed for breast cancer or female genital organ cancer at any age. CONCLUSIONS: In German primary care, the association between GP sex and the documented prevalence of female-specific disorders is age-dependent-most pronounced for conditions that require active clinical recognition and patient disclosure in mid-life, and absent for specialist-managed malignancies.