Research on obstetric and gynecological violence has expanded considerably in recent years. Inspired by feminist mobilizations in South America, this phenomenon has gained international recognition as a form of gender-based violence, with documented prevalence and consequences underscoring its significance. This partnership-based study from Québec (Canada) applies a patient-centered analytic framework to explore how power inequities shape experiences of disrespectful sexual and reproductive health care reported within the last seven years.  We conducted ethically supervised, in-depth interviews with 35 participants who shared accounts of violent or disrespectful encounters. Through reflexive thematic analysis, we show how clinical encounters are situated within hierarchical structures of power and expertise. These hierarchies operate both in patient–provider interactions and within interprofessional relationships, producing contexts in which experiential knowledge is marginalized despite its perceived importance for high-quality care. Participants also described how partial or incomplete communication of information fostered doubt, eroded trust, and constrained their ability to engage meaningfully in decisions about their care. The analysis additionally highlights a persistent tension surrounding expectations of deference to medical authority and the normative role of the “good patient.” Participants navigated these expectations either to maintain harmonious interactions or to optimize perceived clinical outcomes. Taken together, these findings call into question the practical realization of patient-centered care, revealing systemic shortcomings that inhibit respectful and equitable care delivery.