random babble…

ETA: 18 Sept. 2010 After this post was linked at FWD/Forward in the RR, it was brought to my attention that this post possibly could be triggering to some people. This post should have a trigger warning for a graphic description of a medical procedure done on a young virgin girl. The procedure was upsetting to her, and the description could be potentially upsetting to readers who have had similar experiences or who have been sexually assaulted, or medically raped/assaulted. My most sincere apologies for not having the forethought to include this warning sooner, and to anyone whom this lack of thought may have hurt. ~OYD

Where did it come from?

A conversation starts about shaming in OB/GYN care, which is an important one.

Suddenly all of these people have flown out of the wood work to make sure that all of we lady folk know that getting our pap smears and pelvic exams is Just! So! Important! Medical and non-medical alike.

They need not even all be lady folk themselves, but experts who have lady relatives who have had their lives saved by paps, so they must impart to us the urgency to spread our thighs and allow ourselves to have invasive medical procedures that we do not want. Medical procedures that can be painful, traumatizing, and even, as has been show, unnecessary.

But there is a whole slew of thing that keep we peeps, and I say “peeps” because I am certain that there are people who do receive pelvic exams and paps who do not identify as women who may also feel bullied or forced into these medical procedures that they do not want as frequently as people feel the need to force us into them.

Why with all the pressure? Even when most of the information I found says every 2-3 years (I think it is worth noting that the Australia site is the only one that has information specifically for people with disabilities)? Even that information is varied. It seems that people, even medical providers pressure people to get paps every year. Especially if you want birth control. There seems to be this habit of holding birth control hostage if you are unwilling to submit to having a metal or plastic instrument shoved into your vagina and having bits of your cervix dug out.

Even on virgins. Oh, yes. In the U.S., for I can not speak to other nations, there is this fixation with making sure that doctors or other practitioners are the first ones to shove things into the genitals of virgins girls seeking birth control, whether or not she is seeking it for sex. Even though there are several good medical reasons why she could want birth control that don’t involve wanting to partake in heterosexual intercourse.

When I was fourteen, I was having period cramps from hell. I was bleeding like a stuck pig for three days straight out of ten. I would need to miss at least one day of school a month due to period cramps because I couldn’t get out of bed from the pain. Sometimes I would vomit from the pain.

Eventually, the cramping started coming when I wasn’t having my period. I was having cramping so bad that I was begging to miss school during this time as well. I remember my mother thinking I was a hypochondriac around this time of my life. She would sometimes groan, and often joke to her friends that I always thought something was wrong with me. I would often try to hide pain from her because I didn’t want her to laugh or make fun of me. She even had our doctor convinced that I was making things up. When I finally got in to see him, he chucked, and without really examining me, told me I had Mittelschmerz, and that what I needed was to stop coddling my body during my cramps and to get up and start being active during my cramps. This would not be the first doctor my mother convinced to laugh at my pain in my life.

So, I tried following his advice, and I would damn near pass out during gym class or band. The pain was so bad that I couldn’t eat and it would bring me to tears, dizziness, and I would dry heave. Finally my mother took me to the doctor again, who finally did an ultrasound and determined that I had large ovarian cysts that were causing me to have painful periods. I needed to see a gynecologist for a consult.

On top of being worried that anyone at church would think that I was having sex (because I knew so little about sex education at the time that I thought that the GYN was only for people having sex or babies), I was nervous. Incredibly nervous. I thought for sure that everyone thought that I had done something already and was lying about it. The gynecologist was the brother of my science teacher, and we were in a relatively small town. I was so worried that someone would KNOW WHERE I WAS. Also, that I was A LYING SEX HAVING SLUT!

Yes, I had cysts, and the doctor said that the best treatment was going to be to put me on the birth control pill (OH THE MORTIFICATION!) because it would help reduce them and ease my period. It was supposed to reduce my period and help them be shorter and lighter (let’s get this clear, for me this was a lie! I still have 8-9 day periods that are reminiscent of a butcher shop). He wanted to know if I was sexually active (OH MY GOD DID HE JUST SAY THAT WAS HE TALKING TO ME *FACE FLUSHING SCARLET*), and even though I said no, I had to have a pelvic exam and pap smear anyway, because that was routine procedure for prescribing birth control. (Wait. What?)

My mother had dropped me off and signed all the consent forms. How nice of her. I had no idea what was going on. What? OK. I guess so. What did that mean? You want to put WHAT? WHERE?

Suddenly this doctor, this man, whom I didn’t really know but looked an awful lot like my eighth grade science teacher, which made me really uncomfortable, was feeling my breasts, telling me that I needed to do the same thing in the shower (Uh-huh, OK, keep looking at the ceiling. That was nice of them to put a poster up there…). I had to put my feet in stirrups, which reminded me of riding horses as our friend’s farm, and certainly didn’t put me at ease. I was naked, and I had never been naked in front of any man who was not may Daddy trying to help me dress for bed, and that hadn’t been since I was about ten, and it wasn’t like this.

I was asked to slide down until I was squatting. There was cold jelly, and a metal thing, and even though he was talking to me through most of it, I remember the poster of the wooded lake on the ceiling, with the bridge over it, with one of those quasi-religious inspirational sayings on it. Suddenly I was being penetrated by metal objects and fingers…and it felt wrong and awful and I just was always told that this shouldn’t happen… not like this. Hot tears ran down my face. He asked if I was OK as he felt around inside me while pressing down on the outside of me at the same time. I could only nod, afraid of what my voice would sound like if I gave in to it. I don’t even know why they bother with gowns. They are laid open, and my whole being, my essence felt exposed on the cold crunchy paper. I didn’t know what to do with my hands. I shoved them into my hair, and pulled tight.

I didn’t know that doctors ever did this.

(The poster has a lake…are those birch trees?)

And it hurt. And he felt my ovaries to check for the cysts. And he took his sample…and it felt like a sample of my soul left me.

For all the talk of how having sex outside of marriage or whatever message had been pounded on me for however long, and how it would leave me hollow and leave me feeling worthless and damaged, and for all the ways I had been told that casual sex would leave me reeling and feeling depressed and with a hole of missing self-esteem, nothing I did in my consensual sex life has ever compared to the way that pelvic exam and pap smear felt to me, a fourteen year old girl. A person rising on the crest of womanhood, not yet there but ready to fly, and having had myself violated before I took my first steps.

I left that doctor’s office with a script in my hand and a hole in the depths of my soul and a hollow in my heart. I walked to my friend’s house, because I remember that my mother was on second shift. A long and lonely walk toting my French horn, the plastic molding of the case banging against my shin. They were the kind of friends that had become a second family to me, who kind of took me in as the kid who needed looking after sometimes and loved me intensely. I remember the mother, telling her where I had been and what had happened. And while I have never experienced what I consider sexual assault outright, I can imagine that this must be an ember of that fire. I cried, feeling dirty and awful and ashamed, as she held me.

My friend’s mother looked me in the face and leaned against the carved post dividing the kitchen, holding my face in her hands, as I looked into her angular face, with her short wavy hair, and her kind, almost smirkish smile that always had a way of washing comfort over me.

“Being a woman is Hell”, she said, which surprised me a bit, this being back in my church days. “Going to the gynecologist can feel as embarrassing as Hell, but it won’t always be so awful”. She hugged me against her shoulder, and brought me some Texas Sheet Cake, because it seems that chocolate could always help me calm down sometimes. Or maybe is was a combination thing.

I wonder if maybe it is a combination thing. If maybe I had been informed a little more and had an iota of a clue about women’s health care, and what a pelvic exam and pap smear is all about.

Or, maybe if things like pap smears aren’t forced upon young people who are not sexually active, or upon people who don’t want them. If we don’t hold birth control hostage. If we don’t do things like force people to the outside of their own health care, we might be more prepared. We need to set clear guidelines (OH WAIT! ACOG!) to make sure that folks know what doctors are expecting and what is actually needed, so they can be aware of what is suggested to keep them healthy. This “maybe every year, but it is really only needed every so-and-so years, but, hrmmm…we feel like doing it every two years stuff” isn’t cutting it. We have a right to know the guidelines, and to insist that we only have invasive medical procedures as often as needed. Not as often as someone else who is not us feels like it. Even Scarleteen, a site I love, is vague on the expectations of the requirements for paps and pelvics. We need our medical professionals to stick to what ACOG has laid out (or, in my case, I would like them to just be aware of what ACOG has put out before I am), so we can get a standard measure of care. ACOG has said the risk of being treated for a false positive is not worth testing every year.

Really.

When I see articles like this, I realize it is more about making sure we control women, who just can’t be left to their own medical decisions! They are all so silly! This isn’t about shaming women for being nervous or embarrassed (for very good reason). This is about understanding that people have a right to autonomy over their own bodies. Yes, even teenagers! (I know, I am so silly, thinking they might be people who have thoughts about their medical care!) And health care is a part of that autonomy. An important part.

Education, consistency, and plain ol’ listening to patients might help. Listening to women and people in general who have to have these procedures might be a step. Re-evaluating the reasons for insisting on them for simple things like birth control, especially for non-sexual reasons in virgin teenagers might be a step. Being more compassionate to people experiencing GYN care for the first time — or even in general — might be a step. Including women in conversations about their reproductive care might be a step.

But demanding, shaming, controlling, hostage taking of parts of care? That is not helping.

It could kill, and I venture to say it will do the opposite of what all of your concern-trolling of reproductive health is intending to do.

Kid had it right, learned it in Pre-school even: My face, my space. My body, my business.