First of all, there’s the paper gown with the gap in front. It’s hard to call that couture. But then insult is added to injury when the paper sheet comes out so that you can cover yourself from the waste down. Hey – if someone is going to be all up in my vagina, I want to see what they’re doing.
Second, I hate scooting to the end of the table. “Just a little closer. You’re not quite there yet.” It always feels like I’m ready to fall off of the table, but the doctor is always telling me, “just a bit more.” There has to be a less awkward way of doing the pap smear, one that doesn’t require me to confront my fear of falling.
Then there’s the stirrups. My doctor politely covers the stirrups with oven mitts so that patients don’t have to touch cold metal. But there’s still something a little off-putting where oven mitts and my vagina are concerned. I’m not a cake coming out of an oven. Do we have to use the stirrups?
Last, but not least, is the dreaded speculum – those metal pliers that look like duck lips. They spread your labia apart so that the doctor can get a real good luck up inside your vagina. But is a speculum really necessary?
It turns out that none of this is necessary. My partner has gynecological issues. And when he started seeing a new vagina doctor, the doctor told him that she didn’t need a speculum to insert the swab to do a pap smear. She used her fingers to spread the labia (as so many of us do when we are participating in other vagina-related activities). This is what is called a “blind swab.” In fact, clinical studies in Europe have shown that pap smear tests from blind swabs are just as reliable as swabs that are taken using a speculum. (see source citation below) Why, then, are doctors still using a speculum?
I also found out that stirrups aren’t necessary. In cases where the patient has had sexual trauma, or is developmentally delayed, doctors can perform a pap smear without requiring the patient to get all uncomfortable up in the stirrups. Why isn’t that the norm? I’ve been sexually assaulted, but I shouldn’t have to tell my doctor that to get a pap smear without the stirrups.
Why aren’t women and transmen demanding that doctors eliminate the awkward, and usually uncomfortable, use of the speculum and the stirrups during a pap smear? Largely because most of us don’t know about it. I know I was surprised to find out that a speculum was unnecessary – I just thought that it was a unfortunate, but necessary, part of having a vagina. You get your naughty bits examined once a year, and that’s just the reality of life. But once I started researching, I found out that there was a lot (like the stirrups factor) that I didn’t know about a pap smear.
Moreover, the general opinion in this country is that vaginas are made for penetration. We just assume that stuff goes up in there. As feminists, we tell folks that they are the owners of their bodies, and that no means no. But how many of us have the ovaries to disagree with a doctor when they tell us that something is necessary, even if it makes us uncomfortable? If you have a history of “normal” paps, then a doctor doesn’t need to go spelunking up inside your vagina. I can see where a speculum might be necessary if there was a concern about lesions or an inflamed cervix. But for you average, run of the mill pap smear, all of this insertion and leg spreading seems totally uncalled for.
So let’s start advocating. Vaginas of the world unite. Down with the speculum! No more stirrups! Will you join me?
Source Citation: D. John Morgan, et al. “Comparison of Gram-stained smears prepared from blind vaginal swabs with those obtained at speculum examination for the assessment of vaginal flora,” BJOG: An International Journal of Obstetrics & Gynecology, Volume 103, Issue 11, November 1996, Pages: 1105-1108.