Asexual Women Musings

[Shadow007]

Just now, LVG said:

And no Donald Trump.

So true... 

Not as sure about all the hype with hockey, but at least there's better access to the Northern Lights over there (it's definitely on my bucket list).

[Tintinfan]

Random question... When is the right age to start having pelvic exams?

[dragon_nerd]

@Tintinfan I think it depends. Either when you have a problem or when you have a pap smear (25 yrs old in the UK) 

[borkfork]

20 hours ago, Tintinfan said:

Random question... When is the right age to start having pelvic exams?

The Mayo Clinic says 21 though there's a lot of articles about teenagers getting to know their OBGYN and external exams before then. My mom made me start going when I was 16.

 

A pelvic exam is more than the pap smear. They do palpating and pressing on your organs to check those. Something everyone needs because of things like cysts. The well woman exam includes a breast exam, too. Again, anyone can get breast cancer. 

 

https://www.mayoclinic.org/tests-procedures/pap-smear/expert-answers/pap-smear/faq-20057782

 

Quote

 

In most cases, cervical cancer is caused by a sexually transmitted infection called human papillomavirus (HPV). If you've never had any type of sexual intercourse, you're unlikely to have HPV. However, there are other risk factors for developing cervical cancer, such as family history and smoking, so talk to your doctor if you have concerns.

 

For effective cervical cancer screening, many organizations recommend an initial Pap smear at age 21. Discuss when to begin cervical cancer screening with your doctor. Together you can decide what's best for your particular situation.

 

 

 

 

[Gloomy]

I'd rather just get a full body CT scan if I was concerned about cancer honestly.

[Tintinfan]

@borkfork and @dragon_nerd

 

Thanks that was very useful. 

[SaturnOOO]

17 hours ago, borkfork said:

Sounds like a cost cutting measure to me. STIs aren't the sole cause of cancer and other problems with reproductive organs. Getting a well woman exam is just part of being an adult and taking care of yourself. 

 

(Getting those with vaginas to get exams has been discussed at asexual summit type meetings, but I've yet to see any effort getting information out.)

There's budgetary cost slashing and then there's well-studied cost benefit analysis on a public health level. Working on the front lines for years, I've seen both, and this is the latter. Many people underestimate the harm (and not just financial harm) of over-screening and over treatment. Note I'm talking about routine population level screening, not diagnostics or assessment for those who are experiencing symptoms. Only one province in Canada has only an age cut-off for screening without a sexual activity component. The never sexually active population is extremely low risk for cervical cancer and stand to lose the most in the case of unnecessary colposcopies, for instance, in the event of an abnormal finding (as in, with their low pre-test probability they are most likely to encounter an abnormal result that is false-positive, leading to unnecessary cost, anxiety, and very possibly invasive procedures that do not promote the health of this patient. 

 

2 hours ago, Tintinfan said:

Random question... When is the right age to start having pelvic exams?

Completely depends on your region. In Canada most provinces have the guideline along the lines of age 21 or 3 years after first sexual activity (of any sort,) whichever comes later.

 

2 hours ago, Gloomy said:

I'd rather just get a full body CT scan if I was concerned about cancer honestly.

This is not a good idea for a lot of the same reasons I mentioned above.

[LVG]

I first went to the OBGYN when I was 21. Again, I really think it depends on the person. 

[Snao Cone]

I've never seen a gynecologist, as my family doctor does the routine things. That is why the appointment I scheduled for my pap also included a tetanus shot and an order for blood work.

[SaturnOOO]

3 minutes ago, Snao Cone said:

I've never seen a gynecologist, as my family doctor does the routine things.

Yeah it seems in the US it's more common for specialists do a lot of the stuff that family practitioners do here! In Ontario as well it's standard for family practice to do the routine stuff. You wouldn't necessarily see a gyne unless referred for something specific. Anyway, I went when I was probably 21 as well, but I had been sexually active.

[borkfork]

I've had a false positive before, and all I had to do was get another pap. 🤷 ¯\_(ツ)_/¯ Healthcare companies here are determined not to pay for anything extra. 

 

The sad fact is we see a lot of people looking for any excuse to avoid getting any sensitive area examined. They really want believe not having sex grants a magical immunity to all reproductive organ issues. Which means no breast cancer screening, and if a lot of the people on here aren't comfortable with their own vaginas I doubt they consistently do breast exams on their own. 

 

I have no idea why I know so many women around my age with things like PCOS, endometriosis, ovarian cancer. I haven't researched and if these things are more common now or what. I can tell you the person with ovarian cancer has never had sex, and was dragged in screaming and crying by her roommate and myself because we were concerned about one symptom she continually ignored. I've seen it ignored in period thread, too. She really believed in a magic immunity never having sex granted her and it would have killed her.

 

Maybe those with no HPV risk should get a pap every 5 years instead of the every 3 I do. That's something to discuss with their doctor. The point is, avoiding it isn't doing yourself any favors.

 

 

3 hours ago, Snao Cone said:

I've never seen a gynecologist, as my family doctor does the routine things. 

Mine offers, but I like to keep those things separate.

[Hermit Advocate]

I was 20 when I first saw a gyno. My sister was 18, but she was sleeping with her ex at the time so it made sense for her to start going sooner than me. I understand the importance of making sure I'm healthy, but I really hate going. It makes me feel disgusting for the following days. 

[SaturnOOO]

7 hours ago, borkfork said:

I have no idea why I know so many women around my age with things like PCOS, endometriosis, ovarian cancer. I haven't researched and if these things are more common now or what. I can tell you the person with ovarian cancer has never had sex, and was dragged in screaming and crying by her roommate and myself because we were concerned about one symptom she continually ignored. I've seen it ignored in period thread, too. She really believed in a magic immunity never having sex granted her and it would have killed her.

But those things aren't screened for in a pap. And seeking care for symptoms isn't the same thing as routine screening, which is what I'm talking about.

 

7 hours ago, borkfork said:

The sad fact is we see a lot of people looking for any excuse to avoid getting any sensitive area examined. They really want believe not having sex grants a magical immunity to all reproductive organ issues. Which means no breast cancer screening, and if a lot of the people on here aren't comfortable with their own vaginas I doubt they consistently do breast exams on their own. 

I'm not arguing that virgins get a free pass from all health care; I'm saying it's reasonable to skip the routine pelvic. That does't take away the onus of the health care provider to ensure that the patient actually knows what no sexual activity means, and that no, it doesn't mean just no PiV.

 

[borkfork]

1 hour ago, SaturnOOO said:

I'm not arguing that virgins get a free pass from all health care; I'm saying it's reasonable to skip the routine pelvic. That does't take away the onus of the health care provider to ensure that the patient actually knows what no sexual activity means, and that no, it doesn't mean just no PiV.

 

I wouldn't think you would argue that. 

 

A pap smear isn't the only thing done during a routine pelvic exam. I just used the example of a breast exam because it's something we can probably all agree is important. 

 

I'm simply stating a fact that HPV is not the only cause of cervical cancer therefore no one is immune. Less likely doesn't equal immunity. The other risk factors are something to discuss with a doctor. Getting them in the door is the important part. 

 

(See my earlier post citing the Mayo Clinic)

[Gloomy]

I’m 26 and have never been to one. My doctor had me sign a waiver saying she recommended it to me but that I made a choice not to do it, and that was that. Like I said if I was concerned about cancer(which I’m currently not to be honest), I’d rather just kill 20 birds with one stone and check my whole body with one scan lol.

[borkfork]

1 minute ago, Gloomy said:

I’m 26 and have never been to one. My doctor had me sign a waiver saying she recommended it to me but that I made a choice not to do it, and that was that. Like I said if I was concerned about cancer(which I’m currently not to be honest), I’d rather just kill 20 birds with one stone and check my whole body with one scan lol.

Be thorough, cancer sniffing dog.  

 

Not sarcasm for once. 

[SaturnOOO]

A bimanual exam is extremely insensitive and non-specific for pcos and ovarian cancer, (and cysts without other symptoms /signs won't get you a dx of pcos anyway, so it's not something we screen for,) and it's not going to tell you anything about endometriosis. But I do think it's awesome that you're involved in encouraging people to be proactive about their health and educating those with vaginas the importance of preventive health care. I know fear and dysphoria can be barriers to that, and it's certainly something worth talking frankly about. I also think it's great that you're willing to talk to people about what to expect in these types of exams and share your experiences to make it less intimidating  

[Snao Cone]

I've seen posters in certain spaces that encourage transmen to get paps. I've also heard a jingle to the tune of "If You're Happy and You Know It" that goes like "If you have a cervix you should get a pap" but I would never want to plant that earworm in you all.

[borkfork]

35 minutes ago, SaturnOOO said:

A bimanual exam is extremely insensitive and non-specific for pcos and ovarian cancer, (and cysts without other symptoms /signs won't get you a dx of pcos anyway, so it's not something we screen for,) and it's not going to tell you anything about endometriosis. But I do think it's awesome that you're involved in encouraging people to be proactive about their health and educating those with vaginas the importance of preventive health care. I know fear and dysphoria can be barriers to that, and it's certainly something worth talking frankly about. I also think it's great that you're willing to talk to people about what to expect in these types of exams and share your experiences to make it less intimidating  

One of the reasons I'm hesitant to mention the manual exam much is because I've read that though I wasn't sure how accurate it was. Still, I think it's an individual doctor-patient thing, not something for a government or insurance company to decide whether a person should do it. Second hand smoke, for example, is a risk factor.

 

I'll see if I can dig up the video later, I think it might have been one of the early Unconferences (during SF pride week). The assumed immunity is a problem that's been discussed. 

 

There's a documentary about a transgender man who died of ovarian cancer called Southern Comfort. Not because he didn't try, but because no doctor would treat him. 

 

23 minutes ago, Snao Cone said:

I've seen posters in certain spaces that encourage transmen to get paps. I've also heard a jingle to the tune of "If You're Happy and You Know It" that goes like "If you have a cervix you should get a pap" but I would never want to plant that earworm in you all.

That sounds so cute.

 

Meanwhile, in my country, the Centers for Disease Control isn't allowed to use the words "transgender" or "diversity" in their budget this next year. Sigh.

[SaturnOOO]

Yeah I was gonna bring that up as a campaign that I think is much he more valuable than trying to get young sexually inactive aces!

[SaturnOOO]

1 minute ago, borkfork said:

That sounds so cute. Meanwhile, in my country, the Centers for Disease Control isn't allowed to use the words "transgender" or "diversity" in their budget this year. Sigh.

Yeah, THIS is disgusting. And utterly bizarre about the transman not being able to access treatment for ovarian CA? The point I disagree on is that population level screening recommendations ARE in fact a public health issue, and guidelines should be developed with systematic research and cost-benefit analysis, not just individual preference.

[butterflydreams]

I can’t really speak to the other topics, but it’s important for trans people to make sure they’re getting appropriate care for whatever parts they have. I know sometimes it can cause too much dysphoria, and in that case, something might need to be done to eliminate risks. Usually the removal of something.

 

I actually have a physical this week and I’m really really hoping it doesn’t involve a genital exam. The doctor did it once when I first saw her, but we haven’t had to do it again. Talk about dysphoria. I’m pretty sure it’ll include a basic breast exam though. That doesn’t bother me at all. It’s just to see the progress I’ve made, mostly. 36B! I’m excited, but a little disappointed. I shouldn’t be though, considering my genetics and the late start I had.

[Snao Cone]

Nice tits, Hads  (okay, feel free to slap me if that's creepy)

[SaturnOOO]

As a health care provider I'm definitely interested in gaining as much information as I can about how to ensure trans people get the right health care while causing a minimum of dysphoria. Especially for younger people, who may be at risk of avoiding necessary assessments and procedures later on if early experiences are traumatic. I doubt anyone has the perfect answer, but I find it useful to hear as many perspectives as possible, and I think luckily this is starting to be a more regularly researched topic.

[butterflydreams]

3 minutes ago, Snao Cone said:

Nice tits, Hads  (okay, feel free to slap me if that's creepy)

Hahaha  I honestly love having boobs. It’s the best thing ever and it goes so far to making me feel right about myself. I waffle on getting them enlarged to something a bit more proportional. I like that they’re all natural right now.

 

2 minutes ago, SaturnOOO said:

As a health care provider I'm definitely interested in gaining as much information as I can about how to ensure trans people get the right health care while causing a minimum of dysphoria. Especially for younger people, who may be at risk of avoiding necessary assessments and procedures later on if early experiences are traumatic. I doubt anyone has the perfect answer, but I find it useful to hear as many perspectives as possible, and I think luckily this is starting to be a more regularly researched topic.

My doctor treats trans patients all the time, so she was very good about doing an exam of me without making things awful. I don’t see why other doctors couldn’t be trained similarly. It doesn’t take much to make things better for me at least. I had to have a testicular exam in college and it made me want to cry.

[Snao Cone]

Saturn and bork, you've given me ideas to create an asexual health guide as part of my new Project Team role, and I may come tap your brains at some point in the future.

[SaturnOOO]

2 minutes ago, butterflydreams said:

I don’t see why other doctors couldn’t be trained similarly.

I think medical training is quote behind on this. That said, I remember during nursing school we got almost zero information on trans health, and now in my graduate program we talk about it quite frequently. I don't know if that's program specific or a sign that times are changing and programs are improving. Hopefully the latter.

[SaturnOOO]

4 minutes ago, Snao Cone said:

Saturn and bork, you've given me ideas to create an asexual health guide as part of my new Project Team role, and I may come tap your brains at some point in the future.

Oh I'd be happy to help out with that!

[butterflydreams]

6 minutes ago, Snao Cone said:

Saturn and bork, you've given me ideas to create an asexual health guide as part of my new Project Team role, and I may come tap your brains at some point in the future.

I think asexuality and discomfort around sex also plays a large role in feeling uncomfortable about certain medical things. In addition to being trans and experiencing dysphoria. So I think that would be a good resource to have. 

 

Incredulousness about someone who’s not sexually active is annoying.

[SaturnOOO]

2 hours ago, butterflydreams said:

Incredulousness about someone who’s not sexually active is annoying.

I'm so back and forth on this. On the one hand, my tendency is to treat people as adults and as long as I talk openly and honestly about the risks and benefits of what I'm offering and the reasons why I'm asking the questions I am, then trust that they are going to make the right decisions for themselves. On the other hand, after just 3 months in emerg I've seen tons of situations where, for instance, someone swears up and down that they've never had sex and ends up having an STI or being pregnant. And then it's like oh well just that one time. I hate that it creates this culture where health care providers simply assume not being sexually active doesn't exist (which to be fair it is rare.)