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| Speculum. Image source. |
Background info for this post: I had vaginismus, but giving birth vaginally cured it. I wrote about it here:
How Pregnancy and Childbirth Changed My Asexuality (or, actually, A Post About Vaginismus)
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[content note: doctor-related trauma]
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So. I recently went to the gynecologist, for the first time in a few years. The previous time was my 6-week-postpartum check (ie, 6 weeks after I gave birth). I was really dreading this because I've basically always had a bad time with gynecologists.
Like, specifically, geez I can't believe I'm writing this on the internet, the part where the doctor has to stick things in one's vagina. Always hurt like hell, oh my god. And I assumed that was normal, that it was supposed to hurt like hell, because no doctor ever said to me "wow your reaction is different from normal, seems like it's much more painful for you than normal, let's care about this problem and try to find the reason why." And also, because I was "pure"- ie, I had followed the "sexual purity" rules and stayed a "virgin" for a long time, and then only had sex with one (1) partner, in total, my whole life- see, I had followed the rules, and that meant there couldn't possibly be anything wrong with my genitals. I was taught that having sex with multiple people over the course of one's life is what causes problems. That everyone starts out with their body perfect and if you keep it that way for your "future husband" only, then you will have no problems.
So one day I happen to be reading about pelvic exams on Planned Parenthood's website, and it says- get this- it says it's NOT SUPPOSED TO HURT. And OH MY GOD, I was just completely bowled over, completely... just shocked, just completely shocked. It's not supposed to hurt? No one had ever... never, nothing that any doctor had ever done had given me the impression that a pelvic exam is not supposed to hurt.
Just like, unbelievable.
So anyway, in recent years, starting around the time I got pregnant, I have adopted a different approach to gynecologist appointments. Basically, discuss with the doctor beforehand that sticking stuff in the vagina is painful for me, and so I need to be the one to put whatever it is in, and then after I myself have confirmed that it can go in there successfully, then the doctor can move it around or whatever. Like, I CANNOT BELIEVE that I really used to let doctors just go ahead and try to stick stuff in my vagina. I don't even let my husband do that. I have to be the one to put things in, I have to control the movement, and then once I've confirmed that everything is okay, then I can let someone else.
This strategy of handling gynecologist appointments has met with varying degrees of success. I'm always extremely nervous about talking to the doctor about it, and it always seems that they're not expecting that sort of discussion. (My experience is mainly with Chinese doctors at an international hospital in Shanghai- maybe other places have a different culture around this.) And one time, I tried and tried and just could not fit the doctor's tool into my vagina, so I let the doctor try a little little bit, and I made him stop because it was clear to me that he wasn't going to be able to get it without hurting me, so then we just didn't do a pap smear. ... Why do I feel bad about that? Why am I saying this is "varying degrees of success"? Ever since I adopted this strategy, no gynecologist has physically hurt me. Isn't that a success, then? If I can't have a pap smear without the whole "it hurts like hell", then the right thing to do is not have a pap smear.
That's a success, isn't it? Being in control and aware enough to know that it would hurt me, and then saying no and protecting myself.
But I still feel so nervous and scared and helpless.
Okay so anyway. I am writing this blog post about my most recent gynecologist appointment. After giving birth and then not having any gynecologist visits for a few years- not counting the 6-week-postpartum one, which I felt like didn't go well, which is par for the course for me.
So. So the doctor tells me to lay on the table or whatever, and I start telling her I am nervous about it because it has been very painful for me in the past. Okay, readers, I guess here I will give you my tips about how to have the "boundaries and consent" discussion with the gynecologist. Ideally, frame it as "I am nervous" and "let's work together and solve this problem"- rather than acting like the doctor is attacking me and I am fighting back- even though that was how I felt. And don't literally call it a "boundaries and consent discussion" because yeah that also sounds like "I am protecting myself from you."
And also, very important: Don't take your pants off until the "boundaries and consent" discussion has come to an acceptable conclusion. In my experience, the doctor is not expecting a "boundaries and consent" discussion, so they are trying to rush you along to the next thing you're supposed to be doing, and something about social cues and politeness just makes me like... allow myself to be pushed along bit by bit by bit- and if you've already taken off your pants and underwear, you might end up in a position where the doctor can already hurt you, when you haven't even concluded the "boundaries and consent" discussion. So draw a line for yourself there, don't take your pants off until you're satisfied with the "boundaries and consent" discussion. And if you don't get a good enough answer, then I guess you don't have a pelvic exam, and... I know I would feel like a failure, but I'd like to tell you not to feel that way. You protected yourself. You did the right thing. Saying no makes you stronger.
Ugh, thanks non-existent Christian sex-ed, now you got me writing about vaginas on the internet. Do you think I want to be writing about vaginas on the internet? But I have to, because there could be someone who needs to hear this.
Okay. So. I tell the doctor I'm nervous because it was always really painful in the past. And she says, well now it will be different because you've had a baby. I felt like she wasn't really taking me seriously, and didn't believe me that it was painful in the past.
Also I asked her, "if it hurts and I tell you to stop, will you stop?"
Uh I don't remember the details of how she responded, but she agreed to have a nurse come in (which made me feel better, not being alone with the doctor) and to use the smallest speculum, and I can put it in my own vagina first. So I was okay with that outcome of the "boundaries and consent discussion."
Oh another thing. I don't use the stirrups. Nope, not gonna put my feet in those dumb stirrups, no one can make me. Because what if you got your legs open and your feet hovering in the air, no support for your legs, and you want to withdraw consent, oh god you're like a turtle on your back. You're not able to move your body physically to attempt to withdraw consent, the only option is verbally. And oh god, just the sheer obstacles that you have to overcome, from that position, in order to successfully get the doctor to stop, using only words. You have to first realize that you would like to withdraw consent. Sometimes your body might know it but your mind doesn't- so that's the first obstacle. And then you have to say words, have to think of words you can say, to an authority figure, who is totally not expecting it... one factor is your own courage and the second factor is the doctor being able to realize what you mean, that you really want them to stop immediately.
Imagine laying there like a turtle on its back... it's just, it's just unimaginable to me that in that situation I could possibly come up with words so that a doctor would really understand that they need to stop immediately.
At least without the stirrups, you can physically back away, which should help indicate to everyone that something is wrong.
So I don't use the stirrups. Not gonna happen, nope, nope.
Ugh remember when I was so young and naive and "pure" and just did whatever the doctor said? Now I am here on the internet warning my readers about those cursed stirrups.
And okay, maybe I'm going too far, maybe I'm scaring teenage girls unnecessarily. All of this happened because I had vaginismus, and now I'm making all the people who don't have vaginismus scared of gynecologists for no reason. Some girl is terrified that all these problems I had are going to happen to her. Okay, here's my advice then: Try to put 2 fingers- your own fingers- into your vagina. I 100% recommend putting lube on your fingers for this, but maybe some high school girl reading this doesn't have access to lube- I certainly did not, when I was that age. Really should use lube for this though. Okay, if you can put 2 fingers in no problem, then you should be fine I would say. You won't have the problems I had. You don't have to worry that all this will happen to you.
And if you can't get 2 fingers in, and also you don't have access to lube, and you're about to go to your first gynecologist appointment and I've made you super-nervous about it, well... sorry I guess? Sorry we live in a world where girls who don't even have access to lube are expected to just let other people stick things in their vagina. Like you don't even own your body, but someone else does.
Really try to get some lube though. "Personal lubricant." Look for it in the "family planning" aisle.
Or, using tampons when you have your period can also be a good way to vaguely get a sense of whether you have vaginismus or related problems. Tampons are small compared to like, a doctor's tool or a penis, though, so it doesn't give you that much information. But if you can't even get a tampon in, you know you ABSOLUTELY need to figure out what is going on before you let anyone else try to put anything in your vagina.
By "figure out what is going on" I don't mean you need to solve the problem or understand the reasons for it- but at least you need to be able to describe the problem. (I thought doctors would understand what the problem was and I wouldn't have to do any of that, but NOPE. It's all on you.) Use your fingers (and maybe a mirror) and feel around and figure out exactly where you are trying to insert something, at what angle, and so on. Know your body, own your body, be confident. It's your right. Your body belongs to you. Don't timidly kind of touch a little bit and then stop (like I did back then) because it's too weird or embarrassing or you think that a "good girl" wouldn't do that or because someone in a Christian magazine said you might become "addicted to masturbation". And if you can't even put anything in your own vagina, definitely do not let anyone else- doctor or sexual partner or whoever- try to put something in.
Wow, how am *I* giving advice about this? Maybe this is all wrong, not applicable to anyone else, only little-pure-Perfect-Number. I am not the right person to be giving advice on this. But here we are, somehow.
(Again, I am not trying to scare you- I encourage you to try to put 2 fingers in your vagina and if they go in no problem, then you don't have vaginismus and you can ignore all my scary warnings.)
Okay, so, where were we. At my recent gynecologist appointment. The doctor and nurse assured me several times that since I'd already had a baby, this would totally not be painful. I felt like the doctor didn't really believe me about the pain. But anyway. The doctor gave me the tool- the smallest size of speculum- and put lube on it, and let me try to put it in by myself. And wow I was able to put it in so easy.
Like holy crap so easy. Wow.
So then I told the doctor she could go ahead and control the movement of the tool or whatever she had to do for the pap smear. And, oh my god, get this- wait, wait, you better sit down because this is a REVELATION. If little pure Perfect Number from an alternate universe is reading this, sit down because you're going to be so stunned you'll probably faint.
Ready?
Okay.
You won't even believe this, but: About the pap smear. It was uncomfortable, but not painful.
WHATTTTTTTTTTTTTTT
OH MY GOD, ALL THESE YEARS, ALL THOSE DOCTORS WHO TOLD ME "it's not painful, just a little bit uncomfortable"- THIS WAS WHAT THEY WERE TALKING ABOUT? THIS WAS WHAT THAT WAS ABOUT ALL ALONG?
I, I, I JUST, I SWEAR TO YOU, I SWEAR, FOR REAL, I SWEAR ON ANYTHING YOU WANT ME TO SWEAR ON, THIS IS THE HONEST-TO-GOD TRUTH, it was uncomfortable but not painful.
Kinda felt like the doctor was scraping around in there with some kind of little bristly brush.
I JUST. DAMN. I am having a hard time putting this into words, maybe this is one of those times I regret my evangelical upbringing did not teach me how to swear effectively.
Just like, can you believe. All these years, every time I have a pelvic exam and it hurt like hell, holy shit it hurt so bad and I knew so little about my own body that I had no idea what exactly was hurting or why, and the doctors always said "it's not painful, just a little uncomfortable." And I thought it was normal that it hurt like hell, because when I screamed and all that, they didn't seem to react like anything unusual was going on, just told me "it's not painful, just a little uncomfortable." And then I always went home and added them to the gynecologist blacklist I keep in my head.
I thought it was like when I was in middle school and went to swimming lessons over the summer, when you get there, the swimming coach is always like "the water's not that cold today" but really the water is cold and they are just trying to put a positive spin on it to make you feel better. I thought, yeah sure the doctor says "it's not painful, just a little uncomfortable" but that's like, misleadingly optimistic, the reality is that it's painful, that's just the way it is.
BUT HOLY CRAP YOU GUYS. This time, it actually, literally, was not painful, but was uncomfortable. Like literally. Like if you were trying to objectively describe it, those are the words you would use. Like if you're trying to describe it with no "let's encourage the patient" bias or whatever, like if you were just trying to give a brutally honest accurate description of what it felt like to have a pap smear, I literally swear to you, I mean I know this is unbelievable, so unbelievable, I write one description after another after another in this blog post here but I still don't know if anyone will believe me because it's so so unimaginable, that a pap smear literally was not painful but uncomfortable.
It was. Legit. I, I, okay I have done all I can to describe it, I leave it up to you to decide if you can really believe such a thing is possible or not.
Before, the main thing I felt was the extreme pain of forcing the vagina to open. But this time, I didn't feel that at all. Just the little scraping brush.
(As I've said in other posts, childbirth cured my vaginismus.)
And just, all these years, when doctors expected me to recategorize my feelings so that they could be described as "not painful, just a little uncomfortable"- I now suspect they weren't referring to the force-the-vagina-open pain at all. I'm starting to think, that's not supposed to happen. That's vaginismus. This huge giant pain that overwhelmed me, so that it was 100% what I believed a pelvic exam was... Apparently that's not what they meant at all, when they said "it's not painful, just a little uncomfortable." Apparently just the little brush getting a sample of cells from the cervix is "not painful, just a little uncomfortable"- but damn, of course back then I didn't even feel that or distinguish it as being a separate thing from the huge extreme pain.
It's like if the first time you go on a rollercoaster, there's an angry turtle sitting next to you, biting you constantly. And it hurts and you hate it, of course. You get off the rollercoaster, and somebody asks what you thought about it, and you say "it hurt." And they say, "well, some people don't like the feeling, but it doesn't really hurt."
(I do apologize for having multiple turtle metaphors in this post. That's just how it worked out.)
And you know so little about your own vagina, um, ahem, I mean rollercoasters, that you don't realize that you're talking about the angry turtle, and for the person you're talking to, there is no angry turtle at all. You think you're describing the same experience... and how can you even realize that you're not, when everyone is too timid to talk about sex and genitals explicitly, and all you can say is "it hurt"?
Of course you barely notice the ups and downs of the roller coaster, because an angry turtle is biting you constantly. Your view of rollercoasters is 100% about the angry turtle, but you don't realize it, because how could you even know that it's not normal to have an angry turtle with you? How could you even know that when people talk about enjoying sex, um, enjoying rollercoasters, they are talking about something that doesn't involve angry turtles at all. How could you know? Of course you couldn't. Every single time you rode a rollercoaster, the angry turtle was there.
And in my case, it's a failure of sex ed- purity ideology making me believe that the ideal situation is knowing nothing about my own genitals and then everything will just work perfectly- and a failure of doctors, a whole bunch of doctors, that when I told them "sex is painful" they seemed too awkward to talk explicitly about sex, so I now see that they never got anywhere close to understanding what the actual problem was.
It's astonishing, that I gave birth vaginally, and now the situation is so completely different; now I see from both sides, you could say. No problems opening my vagina anymore. No problems at all, and I'm still amazed at that. I'm still amazed that there is no angry turtle on my rollercoaster now.
Me, personally, going through this experience, that's what it took for me to discover that it wasn't normal to have so much pain. So I have to write about it- maybe someone else can discover that sooner.
And another thing- at my recent gynecologist appointment, the doctor assured me that because I've had a baby, the pelvic exam won't be painful. Apparently this is a known thing, that after giving birth vaginally, the vagina opens easier? My situation is much more extreme than normal, I would say, but apparently this is a known phenomenon? Why have I never heard about it?
I've only heard the misogynistic jokes about if a woman has sex with a lot of different men, it supposedly stretches out her vagina and her male partner won't enjoy the sex as much because of that- and then the feminists replying that no, the vagina does NOT permanently change just because of a penis; it stretches but then goes back to its normal size. But in my case- and apparently it's very common- giving birth through the vagina really did change it permanently. Why have I never heard about this before? I mean obviously men are full of it if they think something small like a penis can change someone's vagina, but a big baby head, now that's different.
I'm a little bit angry that this was never mentioned at all in childbirth class when they discussed the differences between a vaginal birth and a C-section. Imagine if I'd had a C-section- then I'd still have all the vaginismus problems. Would have been really nice to know that one potential benefit of a vaginal birth is it can make a big difference or even totally cure vaginismus.
So here I am, somehow, me, little pure and naive Perfect Number, somehow I'm giving sex ed advice on the internet. But I have to. I have to say these things, because I needed to hear them back then, and there was no one to tell me.
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Related:
How Pregnancy and Childbirth Changed My Asexuality (or, actually, A Post About Vaginismus)
They said it was about "valuing our bodies." That was a lie.
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