Daughter refused transvaginal scan because of virginity

[Fej]

Our eldest daughter (19) has been experiencing a women's health issue that has required further investigation. She has been trying to get all of this done rather quickly, as she will moving abroad soon. When she went to have scans done, she was asked if she has ever had sex. After this question was asked, she was apparently told that they wouldn't be doing the transvaginal ultrasound, as they do not do them on women who are virgins. DD was very upset. She felt humiliated because the woman seemed surprised when she said no and even made a comment that she does not see that often with young women nowadays. DD has told me that she will just lie if asked in the future. It saddens me that she feels she has to lie to receive better treatment.

AIBU for feeling that this seems a very antiquated and outdated policy? Are they not aware that being a virgin does not necessarily mean that a woman has an intact hymen? Not to be vulgar but tampons and masturbation do exist. You would think that medical professionals would be aware of this. Someone shouldn't be denied superior medical care because of their sexual activity or lack thereof. Our daughters deserve better.

I’m 95% sure DD had one done aged 18 having not had sex previously. I remember thinking about it afterwards, especially as I’ve never had one but she was at uni so wasn’t something we talked about in any detail.

Which country are you in?

There is almost no scenario where this type of scan is the only available option (and nowhere did the OP say that ovarian cancer was being queried). There are always alternatives. Doctors are much more cognisant these days of the potential for traumatic eperiences during intimate examinations, and any type of penetration like this has to be justifiable; we don't - thank God - follow the US-type practice of 'routine' pelvic exams for young women, which are not evidence-based and which many find very uncomfortable, both physically and psychologically.

Many women, particularly very young women, have a partially intact hymen even after using tampons or masturbating - that's why many women bleed and experience pain the first time they have sex.

I agree that the way the question was asked was clumsy, and HCPs may need to reevaluate the language they use, but this really isn't the medical-misogyny-gotcha that many posters seem to think it is.

Well, it still can be, depending on how the question is asked, and the reason why explained, and next steps / alternatives given.

Sorry, off thread I know, but I am so relieved to find that I am not the only person who finds smear tests to be WAY beyond "unpleasant".

Indeed I refused them for many years until that eventually got me an appointment with a gynae consultant ... and I found out that speculums come in different sizes! (who knew!). AND in the hands of a skilled operator it CAN be painless.

Love your username! ha

I imagine it would be extremely painful for her OP and that is the reason.

My DS had to have one aged 17. He wasn't even asked about virginity or sex. I know the Medical Team were worried about cysts and having to remove either an ovary or the uterus so maybe the medical needs was greater. (The scan came back clear.)

This is dreadful. Your daughter should have been able to make an informed decision about her medical care - it's quite likely she would've been fine with a TVU, and they should've attempted if she was willing.

On the topic of hymens more generally - I remember, over 20 years ago when I was still a teenager, doing research and reading about how the Swedes had renamed the 'virginity membrane' (hymen) the 'vaginal corona', and learning that tearing/bleeding wasn't actually the norm, and that the (usually very elastic) vaginal corona is more often stretched and slowly worn down over time, although vaginal childbirth is understandably usually pretty destructive to whatever remains of the corona, I believe.

As this article points out:

One small study of 36 pregnant teenagers published in 2004, for example, found that medical staff were only able to make "definitive findings of penetration" in two cases. Another 2004 study found that 52% of sexually active adolescent girls interviewed had "no identifiable changes to the hymenal tissue".

And:

Some hymens may bleed when first stretched if the act is abrupt or if you aren't relaxed, but any blood is actually far more likely to come from lacerations to the vaginal wall due to forceful sex or a lack of lubrication.

And while this page uses ridiculous 'gender ideology' language, the facts about the vaginal corona are accurate:

No matter what their vaginal corona looks like, fewer than half of all people with one bleed when they have intercourse for the first time. Of those who do bleed, few do because the corona was tight; instead, there are usually other reasons.

And:

What’s actually there is the vaginal corona, consisting of elastic folds of mucous tissue, which can’t be ruptured or broken in one fell swoop by a penis or any other object inserted into the vagina. When the mucous tissue is stretched, minor ruptures sometimes develop and may smart a little. These soon heal, usually within 24 hours.

Abdominal ultrasounds can be less effective on obese people, so there will be plenty of occasions when a transvaginal would be the only option.

It's hideous. I agree. I've had them at least twice.

Perhaps it's regarded as being too invasive for someone who hasn't had sex. There's a lot of negativity here, and I'm certainly not saying that what happened here was right or wrong, but there could be a sense of sensitivity here.

Agree it can depend on the person doing it too! Aside from finding them painful I also find them unusually more exposing (not sure of the word I’m looking for really) than an internal scan. You’re far more covered for the scan and they’re looking at the screen vs between your legs. It’s somehow much less violating an experience.

Aside from that, I believe the NHS now check your smear for HPV first and if negative they don’t look at it any further. It makes me think that an HPV test done at home is probably a valid consideration for people that find smears so bad they don’t want to have them.

That's different though - OP's daughter is symptomatic.

The same happened to my DD through the NHS when she was 20, OP. They did the abdominal scan but would not do the TV scan because she had never been sexually active. She decided to go private, and the TV scan was then done. The TV scan showed uterine fibroids that were not visualised on the abdominal scan. As a previous poster mentioned, I believe that this policy of refusal infantilises adult women and is a hindrance to proper diagnosis. I would suggest that your DD should access private healthcare.

This happened to me - they were concerned I had ovarian cancer because of a large ovarian cyst and was in hospital. I was told they wouldn’t give me transvaginal scan (which would routinely be used to try to get a clearer picture of the cyst). I think it’s up to the person scanning you. I got quite upset and made it very clear I was consenting and how insulting it was (politely) and they found a female consultant gynaecologist who was okay with it. This was a London hospital so they did have a range of staff. After the scan, they were more comfortable that it was likely to be an endometrioma but obviously still treated the operation as urgent. I actually have continued to see her ever since, both privately and on the NHS. If you are in London, I can recommend her by DM if helpful.

Totally! Pre stenosis I struggled but suffered through painful smears being told to relax & bear it. The one size fits all is really unhelpful - most likely a huge reason smears are avoided & it’s a revelation when you find out (only in specialist services I think?) different sizes even exist. A hangover of medical misogyny IMO & the age old funding issue I imagine too.

Just to add another perspective- one of my daughters (who is older than your daughter and also hasn’t had sex with a man) was having investigative procedures for Endometriosis.
I was with her in the clinic when this discussion was taking place with the operative doing the scanning.

My daughter who was desperate for a diagnosis pushed for this procedure to go ahead and I backed her up.
She signed a disclaimer, and then (with reluctance on the part of staff) it was agreed that the procedure could go ahead.
Unfortunately, it was agony for her, causing her so much pain and distress that they had to stop quite soon after it started. So to be fair
for some people it’s not just the human rupturing but the internal stretching can be really painful even with loads of lubricant.

*Hyman rupturing - not human rupturing!

I am sorry to hear that. I had a laproscopy to diagnose endometriosis. I think that is the best way to diagnose it. They also remove the endo tissue while they are there. So its a win win situation!