#pelvic exam

I’ve refused pelvic exams for almost 20 years because of reasons I’m not getting into. For a couple years now my OBGYN said a self taken HPV test was on the horizon.

So I had my physical today and was able to do the test while I was changing into a gown. It’s just taking a Qtip and swabbing for 30 seconds then you mix it into a liquid and throw the Qtip away. It’s like a Covid test just up your vagina.

I'm asking this as someone who has and always has had severe bottom dysphoria to the point that I've never done anything with those parts and literally never even touched myself. I've just lived painfully aware that I have that stuff but simultaneously pretending as much as possible that I don't. So just the thought of "having to" get that done, being touched there by someone etc, makes me sick and gives me anxiety and I just full on do not want to do that. Ever. But apparently I have to if I'm ever gonna get a hysto, which I really really want.

So now I just feel like it's lose/lose. Either I have to let someone touch me in a way that just thinking about me makes me sick, or I can never get a part of transition that I've been wanting forever since I was kid and learned about my anatomy.

And I just.. mentally, emotionally, physically in every way just really don't know how to deal with that.

I guess it's not that big of a deal for people who don't have bottom dysphoria or not that much of it, and honestly sometimes I feel kinda alone (and almost guilty? Like it's wrong somehow?) in how extremely uncomfortable I am with bottom stuff compared to how I've seen other people be chill with it, but yeah.. idk what to do or how to cope with this.

Don't feel bad about feeling bad -- I may like my dick, but that hole gives me panic attacks and I'm not looking forward to my own exam coming up soon. I worry every time that I am going to kick someone in the face by accident. :/

A pelvic exam/pap is not required to begin HRT, but you will need one for most hystos. Plus, it's just good preventative care. Also, if you are young enough, get your HPV vaccine (a 2 shot series, iirc) to help prevent cervical cancer.

Things that have helped me during gyn exams:

Take the entire day off, if you can. Have a treat set up for after your appointment.

Go with a friend, if possible. They may not be able to be with you in the exam room, but they can at least drive you and wait for you.

Be firm that this is hard for you and anything they can do to make it easier will be helpful.

Put your shirt back on after the breast exam. I don't take "no" for an answer here. Having an extra bit of clothing on makes me feel better.

Ask for the "pediatric" speculum -- it's smaller and won't hurt as bad. Insist on it.

Have something you can grip to take your focus off below.

If they want to do a sonogram, refuse the transvaginal one. Do it the old fashioned way, which will require drinking a lot of water. They can deal.

Don't be embarrassed if your self-care afterwards requires crying, or similar. This is an exhausting thing to do, no matter how brave a face you put on in the exam room. I usually just crawl back into bed to sleep it off.

Above all, never take comments like "just man up" or whatever from the medical team. If that happens, be mean back, or simply get up, get dressed, and leave. Find someone else if you have to.

Scripts I have used. Workshop your own and practice them:

"This is my first time. I'm worried this will be a very uncomfortable exam physically and emotionally for me and I would appreciate anything you can do to make it easier. It helps me if you explain everything as we go."

"I do not have penetrative sex, so would like to try the smallest speculum lubed up best you can."

"I am going to put my shirt back on. It will help me be calmer for the rest of the exam."

If they are rude: "You are being unkind and I will walk out of here and find another provider if this attitude continues."

If they insist on a transvag sonogram: "I will only do an external sonogram. We can schedule it another day for me to prep, or give me time to drink the necessary water." (This is hard, btw -- it is enough water to make you vomit.)

Do whatever mental larping you need to do to get through it all. It's important to psych yourself up so you can control as much as possible. Remember, you can stop things whenever you want. If they are mean, all bets are off.

If you're like me, it will suck, but please try not to put it off. But getting through it means you can tackle anything else related to transition, should you go that route. Seriously, if you can do this, you are fucking golden. Take care. <3

I already lost a significant amount of respect for this woman when my abnormal cycles (18-20 days, extremely heavy bleeding and horrible cramping & nausea) were immediately dismissed and I was instead instantly informed about contraceptive methods (BC), when I made it abundantly clear that I was searching for something that would get rid of my period, not work as birth control.

Considering my age at the time (15), I was told that pills were hard to remember to take, and I outright REFUSED an IUD, so I was set up with the Nexplanon implant in my arm.

I arrive for my appointment, and my OBGYN is sick. Coughing and sniffling sick. Apperently, my local clinic is also on some Grey's Anatomy bullshit, so she had an intern come in to do the insertion, an intern who looked absolutely confused and nervous about what my OBGYN was explaining for her to do.

Nonetheless, I get the implant (extremely painful insertion, btw), and of course, my periods immediately get worse. Going from 18-20 day cycles of pain to 22-26 day cycles. I was told to give it some time after it took about 3 weeks to get a damn phone call back from her.

I just ended up sucking it the fuck up for two years which is when the Nexplanon expires. I come back at 17, I get it removed, and immediately go on Norethindrone - a pill that FINALLY stops my periods. A pill that I could have been taking two years prior if I wasn't watered down to a hormonal and forgetful 15 year old.

I haven't seen her since then, it's been three years. We haven't had to go in for an appointment, we haven't gotten a phone call, nothing.

APPERENTLY - This woman was supposed to be calling me in for a checkup once a year to renew my prescription, and finally remembered to do it this year, the year when I fall chronically ill, DURING THE TIME OF YEAR WHEN IT IS ALMOST IMPOSSIBLE FOR ME TO LEAVE THE HOUSE.

Fibroid tumors also run in my family, which is something that should have been taken into account FIVE years ago when I was 15 and first came to her about my cycle problems, but I guess not. Either way, my birth mother just discovered her first set of tumors, so I figured I'd get a pelvic exam out of the way this year. I decided that since I need to go in to see her anyway, I'll do the pelvic exam during the same appointment as the Norethindrone renewal.

I COME TO FIND OUT - My last refill was provided about 7 days ago, and each refill is 30 pills each. I have 23 pills left, and she was conveniently only able to squeeze me in for an appointment 35 days from now.

Literally EVERYTHING sets off my POTS & GERD symptoms since they're intertwined. I already deal with extreme nausea and cramping on the daily from both GERD and POTS, and this bitch is forcing me to go through 8+ days of a brutal period, the first period I've had in 3 years so it's going to be MASSIVE, because SHE REFUSES TO DO A PHONE CALL.

YOU CAN'T ABUSE NORETHINDRONE. WHY DO I NEED TO COME IN AND TELL YOU THAT I'M DEFINITELY STILL THE SAME PERSON I WAS THREE YEARS AGO AND THAT I'M IN FACT NOT ABUSING IT. YOU REFUSE TO RENEW MY PRESCRIPTION OVER SOMETHING THAT COULD BE DONE IN A TWO MINUTE PHONE CALL. THERE'S NOTHING TO DISCUSS. I DON'T HAVE A PERIOD ANYMORE, THE PILL IS WORKING, I TAKE IT EVERY DAY, I'M STILL ME. CONGRATULATIONS, YOU DID YOUR JOB. YOU HAVEN'T CALLED ME IN FOR THREE YEARS. WHY SUDDENLY NOW, AND WHY PREVENT ME FROM A MEDICATION THAT'S CRICIAL TO MY MOBILITY, WELL-BEING, AND QUALITY OF LIFE SIMPLY BECAUSE YOU CAN'T DO A 2 MINUTE PHONE CALL.

I'm still going in for the damn pelvic exam. I'm not excited for this lady to be digging in my ushy gushy but possible tumors are more important than my comfort and the flare that could happen from this woman fondling the vagus nerve in my punani. There is absolutely no reason why she can't let me call in this refill and then still see me on the 28th.

Say: This may be uncomfortable but it shouldn’t hurt. Please tell me if it hurts and I will stop.

Don’t say: this won’t hurt

Say: This is my hand touching your leg

Don’t say: these are my fingers down here

Say: now I’m going to insert the speculum

Don’t say: I’m putting it in/ sticking it in now

Say: you will hear a click as I open the speculum

Don’t say: that noise is me opening you up

Say: you may feel some cramping as I collect some cells from your cervix with this brush

Don’t say: now I’m gonna take a scraping of your cervix

Say: how are you doing? Are you okay?

Don’t say: everything feel good?

Say: Everything looks normal

Don’t say: everything looks great down here

Say: Now I’m going to remove the speculum

Don’t say: I’m backing out/pulling out now

*yes, the don’ts are things I’ve heard in exam rooms

A ban on pelvic, prostate and similar exams on unconscious patients who haven’t given permission needs only the signature of Gov. Josh Shapiro to become law.

Note: Saw Saw X, it deserves XXX.

Imagine being Diego’s girlfriend and being kept out of the loop on the Pederson Project. Until you accidentally catch him in scrubs.

“Gynecologist... roleplay. I want to try gynecology roleplaying. With you.” He paused. “For my medical kink.”

“Huh.”

You two had done it in his cab. But mostly because it was convenient. Carnally, Diego was pretty basic. Came quicker than you, too. (Though he always made sure you finished.)

Harriet Williamson (April 29, 2023). "Trans-inclusive cervical cancer campaign defies anti-LGBTQ+ hate: ‘We deserve to be screened.’" PinkNews. https://www.thepinknews.com/2023/04/29/cervical-cancer-screening-smear-test-lgbtq-inclusive-remove-the-doubt/