The directive prohibited treating male patients, except in certain circumstances like circumcising newborns, treating transgender people or helping couples with infertility or genetic problems. The board also said members had to devote at least 75 percent of their practice to obstetrics and gynecology.

Doctors take such requirements seriously. Although board certification is voluntary and not required by law, doctors need it to work because most hospitals and insurers insist on it, as do many patients.

In an interview in November, Dr. Gilstrap said the board’s action in September was meant to protect patients and the integrity of the specialty because some gynecologists were practicing other types of medicine, like treating men for low testosterone or performing liposuction and other cosmetic procedures on women and men. And some, he said, ran ads offering those services and describing themselves as board certified, without specifying that their certification was in obstetrics and gynecology, an omission that could mislead patients into thinking they were certified in plastic surgery or some other specialty.

The first reaction against the September directive came from gynecologists who were screening men at high risk for anal cancer, using techniques similar to those used to detect cervical cancer in women. Few doctors had expertise in screening men for anal cancer, those gynecologists said, and they feared the ban would interrupt patient care and interfere with a major government-funded study aimed at finding out whether screening for precancerous growths can prevent the cancer.

The board initially refused to change its position, but in November, it relented on that point and gave members permission to continue screening men for the cancer.