The Speculum for "people" with vaginas

Rose George is a very good journalist - she has written some amazing pieces on the importance of toilets in the developing world and a great long read on the menopause. I like her a lot.

R0wantrees

Yes.
My first smear was when I was 17. I was told I had vaginismus. By a male doctor with no chaperone.

31 years ago

Not all people with vaginas are women. Some are girls.

My first smear test was so unneccessarily distressing I nearly didn't ever go back.
I'd presumed I would wear a gown so was in T shirt and jeans (I've always worn skirts since)
Table in the middle of a large room
Very abrupt 'old school nurse' who told me my anxiety was 'silly'
Reference to the fact that 'no doubt the speculum was smaller than I was used to with my boyfriend' (I felt very uncomfortable to the link sex)
Told to lie on my side when my anxiety meant it was impossible lying on my back
Having her do this with my back to her was the point I just gave up, I remember feeling bullied and belittled but felt I had to comply. Few silent tears and a hope that this might be over quicker if I just gave up.
It was a long time ago but the memory is very vivid.

@Greymisty thanks for that. I should have said I understand the issues are complex and sometimes I assume funding-related and I absolutely don't feel particularly blamey toward individuals. I appreciate my cross-sounding post may not have been clear about that. In the end it is individuals who we have contact with, so that where our experiences take place.

I felt aggrieved re the gloves because it's science isn't it? Handwashing is just science/common sense, not me being picky or 'anxious' or whatever. She's not taking my blood pressure, whatever is on her hands is on my skin, and then potentially under it. And fine for her that gloves are for her protection, but what about mine? (I do vit b12 self-injections at home and am pretty blasé about it all but the one thing I do is wash my hands.) The other phlebotomist at the surgery doesn't wear gloves but the last thing she does before she touches you is wash her hands, I've seen her do it every single time.

And just to balance what I've said about today's appt, I know she's an excellent nurse (long story, I request her for other procedures) so I have no problem with her personally, I just wanted her hands to be clean (and ideally to not have to ask for that one small thing).

Following on from that, I want to point out that some of the emotions tied up in these matters (speaking as a feminist) is that we get tired of asking for basic stuff, and then tired of the stinkeye we get (eg judgements about 'anxiety') when we're forced to ask for reasonable things we should have got without asking. I mean, if an intimate examination can be made less physically and emotionally difficult, we shouldn't have to beg to have those adjustments made. Where is the dignity?

In addition I personally am fucking tired of gauging how to pitch it somewhere in between asking like an adult and being 'nice' so I won't be punished for not being nice enough. This last struggle alone is exhausting. Can I please stop apologising for being an adult now?

Sorry Op for piling my shit here, is is all tangentailly relevant.

I like her too. She sounds great.

"Please note that in my piece on the vaginal speculum, I only use the phrase “people with vaginas” b/c I referred to the design team in the US using it, with some sarcasm. That was cut. Me, I call people with vaginas “women.”

I like her.

@thefirstmrsdewinter feeling what you wrote. Anxiety implies its senseless or pointless worrying when actually in this context women have real thoughts, life experiences or requests such as yours. When we're not listened to of course we will be anxious but they'll be a reason for it and it's valid.

I used to work as a HCP and I did find its how you approach something with someone that made all the difference to someone's comfort. Maybe it can't be perfect for a patient but we can communicate, listen actively and do things with them not to them....and obviously change gloves if the patient asks! Also not just change gloves but wash hands too. But I was very particular and I had the fortunate experience of freedom to work to patient requirements. We're seeing that less as procedures become rigid and patients are treated like parts in a production line.

@Greymisty I'd go so far as to say that in a lot of cases this doesn't qualify as 'anxiety' which sort of implies there is some lack of reason or groundlessness to these feelings, whereas a lot of women have very sound reasons (which require sound solutions) for not liking or wanting or being satisfied with this procedure.

I've said here before that 25 years ago I was told by the person who did my smear to ask for a long speculum. I've asked for one every single time I get a smear - for 25 years - and every single time bar one I've been told they don't have one. I know it makes the procedure easier and less uncomfortable. I know that the people who do my smear are professionals who do it every day on every iteration of woman (tall, short, mothers, young, old etc) so should be expected to have the correct equipment. When I ask for the long speculum I feel like the answer is important, it shows if they see me, if they think I'm worth hearing. So if the answer is no (and to be fair depending on how they say it, whether or not they make an effort to find one etc) it does make me think twice about putting myself in that vulnerable position.

That article seems preoccupied with anxiety/fear, and I find the “careful explanation” theory a bit . Like we are timid and flighty and need someone to squat down to our level and 'explain' in simple language as opposed to being treated with respect, keeping our comfort and dignity in mind. This might be a consideration for first-timers but what about those of us who know what a smear is like and make our decisions based on our experiences?

And because I just returned from a blood draw and am cross I'll add that the nurse put gloves on before she used her keyboard and printer and then was going to take my blood with the dirty gloves on. When I asked her to change them she said they were for her protection not mine which is beside the point. Clean hands are for my protection. So this is what we're often dealing with, people who treat us like children.

...and LittleLebowski told us all this hours ago.
Sorry for the repost!

The author has tweeted twitter.com/rosegeorge3/status/988470355160453121

"Please note that in my piece on the vaginal speculum, I only use the phrase “people with vaginas” b/c I referred to the design team in the US using it, with some sarcasm. That was cut. Me, I call people with vaginas “women.”

Its more the case that it is like the only advice dished out to women. Great if it helps some feel more comfortable but if that doesn't cut the mustard for you then there's what?

Patient: I'm nervous and uncomfortable
HCP: No one likes smear tests and my tip is to wear a skirt
Patient: still uncomfortable here
HCP: wear a really long skirt
Patient: I'm anxious now
HCP: wear a skirt which drifts behind you everywhere, collects mud and trips you up on the stairs
Patient: thank you for taking my concerns seriously HCP I feel listened to and respected

The advice about the skirt is one piece of practical advice which clearly helps some women yet some of you are falling over yourselves to rubbish and seemingly would prefer if it wasn't given at all.

But you’re allowed to wear trousers, it’s just saying that you might prefer to wear a skirt, it’s not forcing you.

According to the research that the jo’s Trust did around attendance of cervical smears it found that embarrassment to be a barrier. That’s not to say that it’s the only barrier or that women should just get over themselves, or we shouldn’t look into making the entire thing less traumatic but I don’t see why women shouldn’t also be given practical tips.
We do need to overhaul how women are treat in medical situations, the whole thing is a misogynistic mess, but I don’t think we should throw the baby or with the bath water.

On the skirt issue, I guess everyone is different. I mean I think the piece of paper towel they give you to put across yourself for dignity is totally pointless, given they are about to have a proper root around in your vagina. Same with a skirt really. But some people might feel comforted by having it there, or by wearing a skirt.

Thats great Lass, did anyone tell you to get over yourself for not wanting to wear trousers?

And I don’t think you can speak for all abuse surviviors crow some people find the being naked from the waist down aspect very upsetting

I am not an abuse survivor but the only time I had this type of examination when I wore trousers and was half naked was horrible. It is standard advice on Scottish NHS leaflets that wearing a skirt avoids this.

Agree with Upstartcrow 100%

Also I personally find the advice -stupid- unhelpful...I'm quite picky over what and who goes in my vagina and that's the anxiety for me about smears. Its not whether or not my legs are covered i find the advice condescending women aren't frightened little birds who need their eyes covered so they can't see what the vet is doing to them.

It's the "tip" that gets passed around whenever a woman is anxious about it or questioning the procedure. Shut up and stop complaining "tip" they should call it.

The speculum is called Yona..... Have they been consulting with Brian from Hull?

I am wondering if the use of 'people with vaginas' in this context means they have used it on animal studies but not human? Woman/women appears frequently otherwise. They have given it a female name, yona, at least. Mind you TRAs would probably claim that for themselves.

And I don’t think you can speak for all abuse surviviors crow some people find the being naked from the waist down aspect very upsetting.

crow

I’m sure wearing a skirt isn’t going to make you magically better if you have ptsd but it’s not just people with ptsd who find smear tests upsetting, and actually wearing a skirt (or taking one in your bag) is a good piece of advise that maybe someone who has never had a smear test would not have thought of.

For some women it may make the difference of whether they repeat the experience or not.

Yes, they use that sentence once, but throughout the article they use the term 'women'? It's also posted in the 'women' section of the website. I really don't think this is an attempt to erase female experiences. Maybe they should have just said 'it hasn't been tested on vaginas yet'. But maybe it has been tested on e.g. animals with vaginas- who knows?

Surely if this was a militant pro self-ID article it wouldn't refer to women at all throughout the article?

Wearing a skirt does not make the procedure less daunting if you are an abuse survivor.
Its being on your back with your legs spread while a piece of metal is inserted into your vagina that is the most problematic part.

Wearing a skirt can make you feel more vulnerable walking to and from the test. I know women who stopped wearing skirts after an assault. There are reasons for that kind of behaviour, and its nothing to do with being precious and needing to get over yourself.

People who don't have to manage PTSD could perhaps take more of a back seat on issues like this instead of ranting their exasperation at other peoples feelings.

I was also a bit unimpressed by the Jo's trust

This is where I have been for some time. No further text needed.