Pap tests for people that are ace: are they needed?

[seventh_swan]

tw: some medical stuff that discuss a cervix/vagina and details of pap tests (though nothing overly explicit)

 

Years ago, I went to get a pap test because I'm a cis woman and it's generally considered to be one of those annoying medical things you need to do when you get to a certain age (I believe I was mid to late 20s at the time). The doctor began to administer the test but immediately stopped when she realised my hymen was still intact. She said that, because of this, I didn't need the test. I was kinda embarrassed by the whole ordeal and I've never gone back for another one. 

 

Of course, my hymen is still likely intact as I've never had penetrative sex or genital contact of any kind. I'm in my early 30s now and I've began wonder if I need to try again as I'm starting to question whether the doctor was right to dismiss the possibility (though, granted, she was a woman with a medical degree and likely knows more about the subject than I do) . Looking up this topic in google wasn't much help as sites generally said that HPV is "transmitted via skin to skin contact. If you are or have been intimate with someone who has been exposed to HPV, there is a chance you could contract HPV even without vaginal or anal penetration." but since I've never been intimate with anyone, or had any kind of sexual contact (unless kissing counts?) I'm not sure I fall into this category.

 

So... does anyone out there in a similar situation get pap tests? I could really use some advice because, to be frank, I'd have to psych myself up if I wanted to get one (and give myself a very thorough pep talk lol). 

 

EDIT (tw: more details of a pap test -and I get pretty explicit here)

 

Okay, so I went to the doctor today. 

 

For me, even telling him I was ace was a bit of a hurdle because I haven't told many people and I've only been seeing this particular doctor for a couple of years. But I breathed through my embarrassment and explained the above situation to him. I must say, he was very kind and understanding. He calmed me down (no small feat, to be honest) and explained that even nuns could get cervical cancer and that's what the test was looking for. Since cancer is caused by changing cells, the cells collected in the exam would be examined under a microscope for abnormalities. 

 

I then asked about false positives and what would happen if something was flagged. He said false positives in general were pretty rare but also explained that, should the cells be flagged, nothing would happen. Instead, I would be referred to a gyno who would run further tests to double check everything. They would (depending slightly on what these tests found) likely ask I undergo yearly pap tests to monitor the changing cells over a period of 5 years before relaxing back to a less frequent testing. Should the cells continue to show abnormalities, they would then discuss different courses of action (this again depended on how the cells were abnomal).

 

Then he asked me if I'd like to do the test today and 'get it over with'. I said yes because I know myself too well and would have managed to stress over it otherwise. I figured like a bandaid was better. He asked if I wanted him to talk during the exam. Um, yes please. Distract me as much as possible!! 

 

So I laid down on the table and he explained what he was be doing. He said he was parting the lips of my vagina and then inserting an instrument to the entrance of the womb. He explained everything as he acted and I pretty much lay there with (I kid you not) my hands over my face as I took deep breaths and shook profusely. Inserting the instruments didn't exactly hurt but it stung a little and when he collected the sample, it was also vastly uncomfortable. I have no words for how much I profoundly did not enjoy the whole experience but it also wasn't the worst thing I've ever done. The doctor did it as quickly as possible and gave me as much privacy as he could. He also told me how brave I was several times, which I found very reassuring. I think he could tell how hard this was for me. He even offered me a free balloon at the end which, I must admit, I very nearly took. 

 

He finished the exam by saying that I wouldn't need another one until 5 years had gone by as I was very low risk and would, therefore, not need periodic tests unless this one came back with a flag of some sort. 

 

Well, at least that's something. Only needing a test twice a decade is reassuring. 

 

Happy for anyone to ask any questions about the exam if they have any. What I will say is, though it was embarrassing, I found that communicating honestly with my doctor made it a lot less stressful since we could negotiate terms and perform the test in a way that was least anxiety inducing for me. So I think that would be my advice for anyone else in this situation: communicate and be honest. Even if you decide not to do the test, explaining your situation with your doctor may help you come up with alternatives or they may have some other advice for you. 

 

Thanks again to everyone that commented here. I must admit, I felt more confident knowing I wasn't alone in this.  

Edited September 23, 2021 by seventh_swan
detailing doctors visit

[everywhere and nowhere]

I anyway refuse to submit to any examination of my private parts even if it was explicitly recommended. I would honestly rather die than have anyone see or touch this area. I am extremely nudity-averse and unashamed of being nudity-averse.

But the fact is that pap smears are not officially recommended for people who have never had sex. If some doctors and medical boards don't acknowledge it, it's because of not believing that adults who don't have sex really exist.

99% of cervical cancer cases are HPV-related. I have not heard of it being transmitted by kissing and ordinary, non-sexual physical contact. Because of this, having never had sex indeed does equal very low risk of the disease. So it is not officially recommended because iatrogenic damage can cause problems too, so avoiding unneeded examination in low-risk cases seems prudent. And besides... high accuracy of testing plus relatively low prevalence of disease means... a high chance that a positive result is a false positive. Here is an explanation how it works in mathematical terms. The basic most important thing to remember is that a test for an illness being N% accurate means that if you are sick, you have N% probability of a positive test result, and not that if you test positive, there is N% chance that you are sick. So in practical terms: mass testing of low-risk groups for cervical cancer would also mean many false positives and a lot of needless distress.

So if you don't have sex and don't intend to, you don't need to do pap smears, perhaps except if you have family history of non-HPV cervical cancer.

Also another practical thing, and please note that writing about g. examination gives me extreme distress, I'm so repulsed that I can't even think about it. An intact vaginal corona (hymen), particularly if it's large and/or thick (as in my case - self-tested, of course), can make a pap smear very painful or even impossible to perform.

 

I anyway refuse to consider pelvic exams just "an annoying medical thing you have to do". No. I prefer to think of it as a matter of cost and benefit - and it's not true that the "cost" is the same to everyone. That it's merely "unpleasant", "uncomfortable" and "embarassing" to everyone. No, for me it's mortally terrifying and it doesn't mean that I'm wrong and you are right. Nor does it mean that I am right and you are wrong. No, I'm doing what is right for me (and you are doing what is right for you) and I demand respect for my choices, and not constantly being threatened with horrifying results of my implacability.

[Phalena]

Yes, I get a pap test once every year despite me never having sex. It's not only to check for STDs but for other things that could be off as well. Though I have to admit that I'm not too knowledgable about all the things that an AFAB could contract since I'm super squeamish and afraid of doctors in general. Ignorance is bliss, sometimes. It's the same with all regular doctor visits: Better be safe than sorry.

[Guest]

Are they necessary? Well, that's open for interpretation. I believe pap tests are to AFABs about like PSAs are to AMABs, namely a way to detect specific issues that will probably kill you one day if never addressed. I highly recommend that people take preventative screenings for whatever they are at risk for, but I'm not particularly averse to medical procedures or hospitals so that's easy for me to say.

 

I think pap tests are more about STD/STI detection, but I believe they also address risk factors for a few forms of cancer. I don't know about you, but that seems like a good enough reason to consider it to me. 

 

Obligatory disclaimer, I'm AMAB. Trust me, we don't like going to the doctor either. You have no idea how many men die from easily detectable or treatable things like prostate cancer.

[nanogretchen4]

Not all cervical cancer is caused by HPV. It's a significant risk factor, but most people with HPV don't get cervical cancer and people without HPV can still get cervical cancer. It's possible the doctor canceled the pap smear because she felt your risk was lower than average, plus the average risk of already having cancer in your 20's is pretty low regardless, plus an intact hymen might have made the exam more difficult. But often a hymen gradually diminishes over time. If you can use tampons, for example, the pap smear should go fine.

 

Not so fun fact about the aging process: Your risk for most cancers increases with age. Age related risk is usually not very high in the early 30's, but in another twenty years the pap smear will be only one of several recommended cancer screening procedures you should have periodically. 

[Forest Spirit]

You can get cervical cancer without having sex, so yes it is needed if you want to check for that (I'm only aware of that use, maybe it's different elsewhere). At least in my experience, not ever having had sex didn't make the screening difficult or more uncomfortable.

As to the hymen, I recommend checking out myths about it. Here's a video/TEDtalk f.e. Such myths have been floating around since forever and can actually be harmful to people

[nanogretchen4]

Hymens vary a lot, and people with no penetrative experience are more likely to tense up from fear, which can cause more discomfort than the actual hymen. When I was about 18, a doctor canceled a routine pap smear since I was very nervous and also at quite low risk at that age. But all my scheduled pap smears after that one went smoothly.

[seventh_swan]

29 minutes ago, nanogretchen4 said:

When I was about 18, a doctor canceled a routine pap smear since I was very nervous and also at quite low risk at that age. But all my scheduled pap smears after that one went smoothly.

This makes sense. I must admit I was a bit of a nervous wreck that first time (okay. so. more than a bit) so that may have been a contributing factor. 

 

2 hours ago, Phalena said:

Better be safe than sorry.

Yeah, I kinda live by this motto because I've known people (unfortunately) who have died very unexpectedly.

 

I have since made a doctors appointment in a couple of days and will try to screw up my courage so I can ask my doctor about this and, you know, not have a panic attack. And then try to live through the test itself if thats what he suggests. Deep breaths, deep breaths!

 

Will also add let you know what my doctor has to say about this, by adding an edit to my post, for anyone else who is in a similar position. 

 

Thank you for all the comments. ❤️ 

[bare_trees]

26 minutes ago, seventh_swan said:

 

Will also add let you know what my doctor has to say about this, by adding an edit to my post, for anyone else who is in a similar position. 

Please do, and thanks!  I've mentioned this in various threads so I apologize if everyone's sick of reading about it, but I had a horrible pap smear experience a few years ago and I'm still dealing with trauma from it.  I'm in therapy right now to work through it, and my therapist has recommended a new GP.  When I go to see this new GP, one of the topics we'll be discussing is whether I need to attempt to have another pap smear done at this point, as I'm not sexually active but of course there's the cancer risk.  I keep hoping that by the time I'm ready to do this again, they will have developed a less invasive way to do the test.  Not sure if I should count on that.  I'd be interested to hear about what you find out.  Wishing you the best of luck, as I understand your anxiety. 💙

[ElloryJaye]

Something no one has mentioned yet is false positives.  While you can get HPV from sources other than intercourse, it's quite possible that the probability is so low that a test result saying there's something wrong, in someone who is still a virgin, is more likely to be an out-and-out mistake than a cause for concern.  In that case, it's better for you not to have the test.

 

Talking to your doctor is the right decision, as they're more likely to have accurate information on things like this than random people on the Internet.

 

[everywhere and nowhere]

4 minutes ago, bare_trees said:

I keep hoping that by the time I'm ready to do this again, they will have developed a less invasive way to do the test.  Not sure if I should count on that.

Oh, by the way: I haven't mentioned that, but I've read somewhere that indeed this horrible procedure may become a thing of the past, that in the future a blood test may be enough.

I seriously hope so for the sake of all the others. I anyway have never been a champion of caring for my health and I don't think I'll suddenly become one. I'm not saying that it's a good attitude, but obviously people who don't care about their health enough also don't deserve being constantly reproached. Anyway, I'm saying a firm "no" to letting anyone see my intimate parts. It's a mortally serious "no".

7 minutes ago, ElloryJaye said:

While you can get HPV from sources other than intercourse, it's quite possible that the probability is so low that a test result saying there's something wrong, in someone who is still a virgin, is more likely to be an out-and-out mistake than a cause for concern.  In that case, it's better for you not to have the test.

Well, I'm not sure how it is in case of servical cancer - but at least as far as I know, when for example HIV is detected, the blood sample is checked just in case using another method, so it's probably not like doctors deliver bad news without even considering that false positives are possible.

Regardless of that, I simply believe that anyone has a right to refuse a pap smear or other examinations. It's a matter of the right to bodily integrity.

[DarkStormyKnight]

I haven't had sex either, but have gotten a pap smear just to check to make sure everything's alright over there. My understanding is if you aren't sexually active then you don't have to get it checked as frequently, but it's still a good idea. Better safe than sorry. You can always talk to your doctor about it though! Which might be a good idea if you've had doctors in the past act weird about you not having sex.

[Sister Mercurial]

In the information leaflet I was given in my early 20s, it said such tests were not necessary for those who had never been sexually active.  Therefore, I do not go for them.  My stance on medical examination of areas one would rather not show to others is that it is only needed when there is something visibly wrong which the doctor's job is to cure, after which her memory will no longer be an accurate reflection of the area in question (so if I get some abnormality on a breast, for instance, I go and get it checked to make sure it's not cancer).  

 

When some idiot at my GP practice threatened to remove me from the practice lists a couple of years ago for exercising my right to refuse a smear test, I made an official complaint.  It is not official policy to remove women from practice lists for that reason, so the practice apologised.  They also shared an address to which to write to have one's name taken off the national smear test database permanently.  I wrote to that address asking them to remove my name.  However, this year, the GP practice has started harassing me over the telephone again about the test, and continued despite my reporting them to the Information Commissioner's Office for breaching GDPR, so I think I'll have to make another official complaint.  

 

What really gets my goat, though, is that none of this is needed because self-testing kits exist.  Instead of getting talking heads on BBC News 24 to pretend that it's not really that invasive for a woman to be violated by a stranger, if the health service was really serious about detecting cervical cancer early, they would generalise self-testing and send women self-testing kits as needed.  Like women's complaints of ailments often not being taken as seriously by doctors, this is just another instance of health service misogyny.  

[nanogretchen4]

I do not believe a pap smear is simply a test for HPV. If it were, once someone was confirmed to have HPV there would be no point to any future pap smears. I think what's really happening is that they are sampling a few cervical cells and testing them for cancer or precancerous mutations. So any type of positive is going to be followed up by further tests to get a clearer picture of the extent of the problem and decide on a course of treatment. 

[kelico]

I literally just had my gyno appointment last week and had a pap test. I've never had sex, but my doctor still recommended it. As others have said, it tests for many different things, not just what can be transferred from penetrative intercourse etc. It can be uncomfortable, yes, but it doesn't last long. It takes maybe 15 seconds of uncomfortableness. Then you're done! So yeah, I think it's a good idea to do, even if you don't have sex or have never had it. Wishing you the best!

[Geekykitty]

I've never had a pap test mainly because I'm just way way way too anxious 🤯 I suffer with anxiety. Even just normal every day things can set off my anxiety. Anything involving nudity or anyone touching me would  send me into a panic attack. I hope I never have to go to hospital for anything, I'd have to be sedated!

Anyways, I think as far as the pap test goes you have a right to request to have it. Your risk level for cervical cancer would be very low, but I have read its still possible to get it even if you haven't had sex. Maybe find another Dr? Ultimately I think we all have a right to body autonomy and should be allowed to request or refuse any medical test.

[Vivera]

I'm 29 and I have never had a pap test. My doctor has always told me it wasn't necessary if I was not sexually active, and I have heard the same messaging from other medical professionals as well. 

[Sea Lemon]

You're probably at a much lower risk, especially if you've also had your HPV vaccinations, but HPV isn't the only potential cause of cervical cancers, so I think it's probably dangerous advice for doctors to say it's completely unnecessary - smear tests detect pre-cancerous changes in cells, not the presence of HPV itself. 

[seventh_swan]

On 9/22/2021 at 1:04 PM, Vivera said:

I'm 29 and I have never had a pap test. My doctor has always told me it wasn't necessary if I was not sexually active, and I have heard the same messaging from other medical professionals as well. 

When I said something similar to my doctor today, he said pap tests have changed in recent years and the protocol on who should get them/how often has been adjusted. I'm not sure if this would change from country to country -maybe that would explain the discrepancy? I'm in Aus if that helps at all.

[Sally]

@seventh_swan, thank you for making this post, because it may calm some people down about having a test.  For some it's very frightening because of how they as individuals feel, but everyone's different, and you give a good picture of it being uncomfortable and unpleasant, but not terribly painful.  The doctor you had do it sounds wonderfully understanding of your nervousness; the ones I've had over the many years have been also.  For anyone else who is putting it off, don't read descriptions of how horrible it is -- everyone's perceptions are different.  

 

[Guest]

On 9/21/2021 at 1:34 AM, seventh_swan said:

Inserting the instruments didn't exactly hurt but it stung a little and when he collected the sample, it was also vastly uncomfortable. I have no words for how much I profoundly did not enjoy the whole experience but it also wasn't the worst thing I've ever done.

For some people the pain is also close to unbearable. And that's without the massive psychological pain it can cause too.

 

It's right up there with one of the most agonizing experiences for me, and I'm someone who has been through full labor twice. Those instruments (for me) are like torture devices.

 

I think it's important people know what they could potentially be getting in for so they can prepare themselves for the possible brutal pain, but all the leaflets and pamphlets etc they have imply it's really not that bad and this applies to everyone. 

 

If you know there may be a lot of pain, you can better prepare for it, and express those concerns to the doctor. If everyone tells you it's honestly not that bad then it can cause a sudden fight or flight reaction because you weren't expecting quite that much agony :c 

[Sally]

If you tell people that they are going to have horrible pain because that's what you experienced, they will possibly not have it done, which could be dangerous for them, or tighten up so much during the process that they will indeed experience pain.  And also, people reading about your horrible-pain experience will assume they will have such pain also, so you'll be frightening a whole bunch of people.

 

 

[PenultimateSandwich]

10 minutes ago, Sally said:

If you tell people that they are going to have horrible pain because that's what you experienced, they will possibly not have it done, which could be dangerous for them, or tighten up so much during the process that they will indeed experience pain.  And also, people reading about your horrible-pain experience will assume they will have such pain also, so you'll be frightening a whole bunch of people.

 

 

With all due respect, I'm the same as @PanFicto. in that I can't stick ANYTHING up there, not even a tampon. If you're sex averse, yes it can definitely be a negative experience and traumatic at that. It's important to be open and honest with these things. Doctors can get real pap smear happy for people who don't necessarily need them.

[Sally]

58 minutes ago, PenultimateSandwich said:

 It's important to be open and honest with these things. 

It's very important to emphasize that that is your experience and may not be everyone's.  

[Guest]

3 hours ago, Sally said:

If you tell people that they are going to have horrible pain because that's what you experienced, they will possibly not have it done, which could be dangerous for them, or tighten up so much during the process that they will indeed experience pain.  And also, people reading about your horrible-pain experience will assume they will have such pain also, so you'll be frightening a whole bunch of people.

 

 

It's better to be prepared than not ready and have a doctor literally forcing it into you while you're crying because "it doesn't hurt it's just uncomfortable" (according to the docs). Almost every person I know with a pain disorder has had their pain disregarded by doctors because "it doesn't really hurt, it's uncomfortable for everyone so just relax".

 

If more people (and doctors) knew that extreme pain was potentially something that can happen, they could be a lot more prepared for that possibility instead of going about it the way you do with a person who doesn't experience penetrative pain.

 

The issue is they keep ramming it and pushing harder assuming it should just work the way it always does - however someone with pain completely tenses up so needs a much smaller speculum and a lot more lube to try to reduce pain as much as possible (and lidocaine, lidocaine would be so beneficial in these situations).

 

But all to often those who suffer penetrative pain are ignored and not believed. If people could accept this is a thing, and doctors were helped to prepare for it, ways could easily be found to try to reduce pain as much as possible.

 

So I think it's so important people are aware of it. I wish I'd known about it - that would have made me feel less like an alien and would have greatly reduced my anxiety knowing that actually, pain is relatively common for some people and nothing to panic over once it starts happening.

[Vivera]

On 9/23/2021 at 2:49 AM, seventh_swan said:

When I said something similar to my doctor today, he said pap tests have changed in recent years and the protocol on who should get them/how often has been adjusted. I'm not sure if this would change from country to country -maybe that would explain the discrepancy? I'm in Aus if that helps at all.

It must vary by country. I am in Canada, so I looked up the Canadian guidelines, and there is a qualifying statement that states, "Women who are not sexually active by the age of initiation should delay cervical cancer screening until sexually active." I'm not a fan of the assumption that everyone will eventually become sexually active, but I guess now I understand why I received different messaging than you did.

[quaintrelle]

On 9/24/2021 at 1:56 AM, PanFicto. said:

It's better to be prepared than not ready and have a doctor literally forcing it into you while you're crying because "it doesn't hurt it's just uncomfortable" (according to the docs). Almost every person I know with a pain disorder has had their pain disregarded by doctors because "it doesn't really hurt, it's uncomfortable for everyone so just relax".

 

If more people (and doctors) knew that extreme pain was potentially something that can happen, they could be a lot more prepared for that possibility instead of going about it the way you do with a person who doesn't experience penetrative pain.

 

The issue is they keep ramming it and pushing harder assuming it should just work the way it always does - however someone with pain completely tenses up so needs a much smaller speculum and a lot more lube to try to reduce pain as much as possible (and lidocaine, lidocaine would be so beneficial in these situations).

 

But all to often those who suffer penetrative pain are ignored and not believed. If people could accept this is a thing, and doctors were helped to prepare for it, ways could easily be found to try to reduce pain as much as possible.

 

So I think it's so important people are aware of it. I wish I'd known about it - that would have made me feel less like an alien and would have greatly reduced my anxiety knowing that actually, pain is relatively common for some people and nothing to panic over once it starts happening.

I had this experience with a doc about 8 years back. She got mad at me because only couldn't complete the exam. Then she told me I need to get it over with so I could have a normal relationship with a man or a woman. I didn't know what to say so I left the office and cried on my way home. I wish I stood up for myself at that time. I'm still in the process of working on getting my first pelvic exam. Gyn practitioners really need to be taught about this stuff. 

[Guest]

2 hours ago, quaintrelle said:

I had this experience with a doc about 8 years back. She got mad at me because only couldn't complete the exam. Then she told me I need to get it over with so I could have a normal relationship with a man or a woman. I didn't know what to say so I left the office and cried on my way home. I wish I stood up for myself at that time. I'm still in the process of working on getting my first pelvic exam. Gyn practitioners really need to be taught about this stuff. 

Ugh that sucks! Whereas there's a chance if you knew it could potentially be very uncomfortable (and that's just something some people experience) and if the gyno was aware too so could be prepared for that with all patients, the experience could have been a lot easier. Something they can do to help is use a mini speculum for very young girls and a LOT of lube. They still couldn't get that bastard up me (it's still bigger than an average tampon) but for people at the less severe end of the pain spectrum it could help make the process a LOT easier. But for any female over like, 15, they usually go straight for the adult sized one which is like O_O and yep anyone with a pain disorder or even who is quite tight will have a hell of a time with it. If there was just more awareness around this potential issue I think it could lead to a lot less trauma in the long run. Also I'm sorry you had that experience, I know how bad they can be Y_Y One almost called the police when I was pregnant because I was crying during the exam and she was like "it's a sign of abuse we need to get the police involved" 1) yes I was being abused by my partner but police would only make it worse 2) I'm an adult but she was acting like I was a child being abused?? And 3) the pain I was in was just from my pain disorder, not from my abuse. It just hurts like hell having anything inside me.. wtf would I be meant to say if I was an average non-abused person who had the cops called on me over that???? 😧 Luckily my midwife was there with me and she went berserk at the woman, started yelling about invasion of privacy and stuff. Y_Y if doctors KNEW that severe pain was a potential, it could also prevent situations like that where an adult is almost getting the cops called on them because they're crying while things are shoved inside them Y_Y

[quaintrelle]

9 hours ago, PanFicto. said:

Ugh that sucks! Whereas there's a chance if you knew it could potentially be very uncomfortable (and that's just something some people experience) and if the gyno was aware too so could be prepared for that with all patients, the experience could have been a lot easier. Something they can do to help is use a mini speculum for very young girls and a LOT of lube. They still couldn't get that bastard up me (it's still bigger than an average tampon) but for people at the less severe end of the pain spectrum it could help make the process a LOT easier. But for any female over like, 15, they usually go straight for the adult sized one which is like O_O and yep anyone with a pain disorder or even who is quite tight will have a hell of a time with it. If there was just more awareness around this potential issue I think it could lead to a lot less trauma in the long run. Also I'm sorry you had that experience, I know how bad they can be Y_Y One almost called the police when I was pregnant because I was crying during the exam and she was like "it's a sign of abuse we need to get the police involved" 1) yes I was being abused by my partner but police would only make it worse 2) I'm an adult but she was acting like I was a child being abused?? And 3) the pain I was in was just from my pain disorder, not from my abuse. It just hurts like hell having anything inside me.. wtf would I be meant to say if I was an average non-abused person who had the cops called on me over that???? 😧 Luckily my midwife was there with me and she went berserk at the woman, started yelling about invasion of privacy and stuff. Y_Y if doctors KNEW that severe pain was a potential, it could also prevent situations like that where an adult is almost getting the cops called on them because they're crying while things are shoved inside them Y_Y

I'm sorry you had to go through that! It sounds like a nightmare. My mom used to accompany me but I was alone at that time. It took me a while to advocate for myself. In your situation my first instinct would be to kick the doctor away. My current doc (who is really nice) showed me the smallest plastic speculum and it didn't seem intimidating. Hopefully I'll get the exam by next year when I'm fully ready for it. 

[Nern]

These stories are terrible. One thing I will say is that I think I underestimated the emotional intensity/risk of the exam before having it done. I had told myself that this was a doctor, and even if it was uncomfortable or painful, it would be over quickly and I would be fine. I assumed I would be able to manage my emotions. What I found though is that I was so nervous, I think I possibly dissociated a bit? I was able to keep my body relaxed and converse with the doctor and everything, but I felt emotionally numb and distant throughout. I found the sensation of my cervix being swabbed to be particularly awful, and to remain relaxed and open to that required me to make myself vulnerable in a way that I hadn't experienced before, and it was just really emotionally intense. I truly don't blame anyone for listening to themselves and refusing the exam even if there's not any pain. I can't imagine how much harder it would be for someone with a history of trauma or pain issues.

 

Edit: I actually really admire people who listen to themselves over their doctors in situations like these. That takes bravery and courage of a different kind.