Saying “No” to a Pap Test

Every time I go to a walk in clinic the doctor asks me “When was your last pap test?” Even though my reasons for visiting have nothing to do with my reproductive organs — once I went because of a sprained ankle, another time because of a flu — it doesn’t seem to matter to the doctors. They are always more interested in finding out the date of my last pap test than in finding out about my actual problem.

And because I’ve never once had a doctor explain anything about pap tests to me, I never even knew what they were for until one day I did my own research, and only then did I learn they were used to screen for cervical cancer. I was shocked when I also learned that cervical cancer is RARE, that pap tests are rampantly inaccurate, and that doctors are supposed to be offering us a choice about whether or not to screen.

So, the last time I needed to see a doctor, I decided to turn down the inevitable offer of a pap test.  This post is for all you women who need to see a doctor but who, like me, have decided not to have a pap test or pelvic exam.

After years of compliance, this is how the experience of saying “no” played out:

I’m up for this and I arrive feeling in control – I can do this no problem . .

Trying to stay limber in the waiting room

And trying not to think about some doctor’s attitudes

Finally shown into the exam room and soon after the doctor walks in

Here’s hoping the doctor will focus on the reason for my visit, but one of the first questions the doctor asks is “when was your last pap test?”

And I’m like

But then I gather courage, and explain that I’m not there for a pap test because I’ve chosen to not participate in cervical cancer screening

And the doctor’s like

The doctor says things like “but it’s for your own good, pap tests save lives, it only takes a minute and since you’re here anyway . . .”. I’m tempted to give in

But no, I actually feel like doing this

And this

But I take the high road and instead do something like this

Explaining the reasons why I have decided to opt out of cervical cancer screening (for example, because cervical cancer is rare and pap tests are rampantly inaccurate, etc.) did not go over too well with the doctor. Doctors make extra money from pap tests, and some doctors also don’t like to have their opinions questioned. Bringing up the reasons why I’m opting out of screening (no matter how valid and well researched those reasons are) led to a long argument, and I end up in this type of situation:

After much verbal sparring, I end up getting my way. But another idea occurs to me in the process: in the future if I don’t want to go through a lot of arguing, I could always say I’m currently having a heavy period. Or, if I don’t want to lie, I could schedule my appointment for that time of the month.

Or, if the doctor’s a male, I could act surprised and then say I only allow women to perform pap tests, never men

Or, I can bring a really big guy with me into the exam room

But, how ever you decide to approach it, if you manage to get what you need without being coerced into an unwanted exam, then congratulations  – well done!

More on this topic:
Other ways to combat pap test coercion: https://forwomenseyesonly.com/2012/12/06/three-ways-to-combat-doctors-bullying-you-into-unwanted-pap-tests-and-pelvic-exams/
Female doctor who does not have pap tests: http://www.goodreads.com/author_blog_posts/2234123-why-i-don-t-have-smears
Informed consent missing: http://www.kevinmd.com/blog/2009/11/informed-consent-missing-pap-smears-cervical-cancer-screening.html
What some male doctors do when women say “no”: https://forwomenseyesonly.com/2012/10/17/what-some-male-doctors-do-when-women-say-no/

About forwomenseyesonly

Hi. My name is Sue and I am interested in promoting holistic and respectful health care.
Gallery | This entry was posted in comedy, health, humor, humour, informed consent, pap test, unnecessary pap test and tagged , , , , . Bookmark the permalink.

213 Responses to Saying “No” to a Pap Test

  1. Mint says:

    My new standard response at an appointment, is to state to the good doctor or nurse that I am not here to discuss or have a smear test. I give them a big smile and look them straight in the eye. It lets them know that I’m in charge of this consult and I’m here to talk about ME and MY concerns.

  2. Ro says:

    I haven’t had this experience yet, as I haven’t had to go to the doctor yet(thankfully) since reaching the magic age of 21. When/if I do have to go next though, on the form where it asks about the last pap I had, I’ll just write: informed patient: opting out, non-applicable. I didn’t think of the non-applicable thing until now, but I think it adds a sense of finality. Anyway, then once in the consult room, if it gets brought up I’ll firmly tell them no and tell them why I’m actually there. If they expect me to explain myself, I won’t. I’ll just keep giving firm no’s and changing the subject back to the reason for the visit. No means no, regardless of the situation. I don’t think it’s necessary to explain my reasoning to anyone, much less people who make money from me being in less-than-fantastic health. Perhaps I’m a bit cynical, or perhaps I’ve just spoken with a lot of women (and a few men as well) at this point and it’s allowed me to view things realistically.

    • Heather says:

      We are not obliged to explain our decisions to doctors. It just wastes thevconsult time and costs us more money. The doctors try either make money on paps, or on charging us for longer consultation most of which was spent on pap coercion.

      For me, the best approach is this:
      On the patient form for the ” Last Pap smear ” write “Opted out, no reminders or further discussion please”.
      In the doctor’s room:
      — When was your last pap?
      — Could we please not mention paps or any other screening, and dedicate MY today’s visit to MY today’s concern?
      — But pap tests are important / part of comprehensive health care / save lives / blah-blah-bull$hit…
      — I do not wish to discuss paps or any other screening, at all, ever. Please take my NO as a final answer. The reason for my visit is…

      Firm and polite. Stay in control, all the time. No arguments, no lengthy discussion, no justifications, no explanations. Just NO.
      In a free country, a grown-up, sane woman should have a full right to say NO to tools showed into her genitals without the need to defend her decision.

      • Heather, that’s good advice re staying in control and I admire women who can manage it. It’s such an emotionally charged topic for some women. So many women have been harmed from pap testing, and the various ways different doctors bring up the topic (e.g.failing to meet your eyes, brusqueness, authoritarianism, or worse – with anticipation) can really touch a nerve. I’m not on the pill, but I imagine it must be especially difficult for those women when they need a refill. Or for any woman who really needs something.

        The topic of birth control pills and pap test coercion has come up a few times on this blog, and its frustrating that the situation doesn’t seem to have gotten any better. I’m surprised there have been no law suits. It seems to be common knowledge by now that a pap/pelvic is NOT medically indicated for birth control pills, so why are doctors still insisting women ‘need’ to have one. Why are they still being permitted to get away with it? It might be more effective to go above the doctors, and start writing to MP’s.

      • Jola says:

        Heather, you wrote: ”In a free country, a grown-up, sane woman should have a full right to say NO to tools showed into her genitals without the need to defend her decision.” If you meant the US as a free country, I strongly oppose it this. The US is not a free country, unfortunately, especially from what I read here about treating women by the medical staff.

      • Alex says:

        Heather: Not for nothing & not to put words in your mouth, but her not being grown-up or sane shouldn’t have anything to do with it- especially seeing as medical personnel seem to like using the “they aren’t in their right mind” argument whenever someone argues with them. Another thing is that her being a minor doesn’t mean it’s okay to force these things on her. Supposing she had a relative that decided to “play doctor” on her while she’s below the age of majority?

        Jola: You’re totally right about America not really being a free country. An article I had been reading was saying how girls that are the victims of forced prostitution get locked-up! They get snatched up or whatever & PUT on the street, then are treated as a criminal (with all the attendant security & hygiene measures- and probably all kinds of medical impositions, as well).

        Not that these things are always proportionate if someone DID do something, of course, but they aim things like that at people WITHOUT any ascertainment of guilt. This is an concern on the level of justice & injustice, but it’s also something that most likely generates negative returns (maybe it’s a factor in someone lashing out or starting a drug habit, for instance). This is WITHOUT someone having a history of abuse, much less getting afforded things like this (and probably more, unofficially) FOR that abuse.

        You know what else is pretty off-the-wall here? If a 16-year-old & an 18-year-old screw around consensually, this is deemed a wrongdoing because the age disparity is seen to vitiate consent (and in this specific case, that’s a bit unrealistic). Yet, if someone is a minor & something unconsensual HAPPENS to them, not only are they persecuted despite being the victim, they’re deemed culpable for something like this take place with a minor! The same condition that makes the first situation a problem is disregarded so the victim can be persecuted FOR the second situation that was IMPOSED on them! This expresses a deep inclination to inflict the situations they afford these children & a general antagonistic quality.

  3. Moo says:

    If a male doctor does not refer you to a female colleague when you explain that you would be more comfortable with a female doctor doing those types of exams. … You have to know that the male doctor is not interested in your health. Just what is he interested in? Meeting his quotas for the bonus? Gratification in seeing and touching naked women?

    Of course I would rather not have a pelvic or breast exam at all from either gender of doctor….

  4. Elizabeth (Aust) says:

    I think it may be easier staying with the same doctor. I’ve been seeing the same female doctor for many years now. I interviewed several before settling on the Clinic and my doctor, her female colleagues are also, very good/respectful/professional. Pap tests are rarely mentioned, if it happens, it’s usually a new doctor or locum and I just refer them to the note on my file. No rudeness, end of story, sometimes they may be curious. It seems most women just agree to have a pap test or start with the excuses, doctors still seemed to be surprised by an informed, “No, thank you”. I’m in control and firmly stand my ground, but I’m always polite. When I was in my 20s I avoided doctors, rarely saw them, and I’ve never taken the Pill, I could see that would expose me to coercion and a battle at every consult so I opted for the Billings Method. (medical coercion was the norm in Australia in the 80s) In my mid 30s though I decided I wanted a regular doctor, why should I be denied healthcare because I don’t want an optional screening test?

    A good strategy is to show alarm, “I wouldn’t go near our program, might as well head straight over to day procedure!”…I try to wind up any pap test discussion as quickly as possible and get back on topic, but as I say, it’s rarely mentioned. I do wonder whether other women find this Clinic as casual or it’s just me, they know I’ve made an informed and firm decision. Doctors tend to tread carefully with informed and confident women. For me, that came with age.

    I couldn’t bear having to go over old ground every time I see the doctor, that’s MY 10 to 15 minutes.
    While I was looking for my GP, I tried a female GP close to my home, I wanted a referral to a dermatologist, at the end of the consult she asked me if I was up to date with pap tests.
    I said, “No, thank you, I’ve decided not to have pap tests”. She looked annoyed and muttered as I left, “you SHOULD be having pap tests”. I ignored her, thanked her for my referral and never went back, FAIL, I wouldn’t use a doctor who felt she had the right to order me into screening, someone offended I’d exercised my legal right and decided against a screening test.

    I wouldn’t explain myself to other doctors at this point, just say I’ve made an informed decision not to screen. We don’t have to explain ourselves or plead our case with doctors, but the reality is…my GP may have raised the matter now and then, but after our initial discussion it was clear (unlike most women) I’d make an informed decision. Strange making an informed refusal is important, but no one seems to care that women are not making informed decisions TO screen.
    If I lived in the States and it was an argument about pap testing, breast screening at every visit, I’d also, avoid doctors and order my meds over the internet, I couldn’t stand going over the same topic at every visit.

    • Victoria says:

      “You SHOULD be having pap tests.” By that logic, you should also be going in for every medical test that exists to screen you for all the cancers and other diseases that are more common (which would make a long list!). 😀 But I imagine a few days of screening, plus the lab staff ploughing through all the samples/images, would be a bit impractical for both yourself and the health service.

  5. Diane says:

    The GIFs you found are HILARIOUS! Of course, the subject matter and the fact that this happens to women every day really aren’t funny at all.

    I now respond to the pap question on forms by writing either “n/a” or “opt-out.” I’ve been lucky enough lately to find doctors who respect that; but of course I’ve come across this reaction, too. I remember dealing going to a low-income clinic (before the Obamacare insurance kicked in) for an orthopedic consult, and of course the resident asked me about damn pap tests. When I said I was there to talk about my knee, he got very angry and said “I’m a different kind of doctor, I want to check you out head to toe.” I looked him in the eye and reiterated that I was there to talk about my knee and he finally backed off. Like Hell you’re checking me out “head to toe,” buddy…read my chart and stay on topic, kthx.

    • Elizabeth (Aust) says:

      Diane, that’s another point of difference, it would be plain weird for an Australian dermatologist or orthopedic surgeon to ask you about pap tests, really weird, it would be a GP or gyn asking you that Q. Just amazing an orthopedic specialist is asking you about pap tests. I’ve certainly never been asked and have never heard of another Aussie woman being questioned about pap tests outside general practice or gynaecology.
      It makes women VERY vulnerable if any doctor can pressure you into pap tests, you’re not safe anywhere.

      • Diane says:

        Well, to be fair, it was a general clinic; the resident I saw was a GP who was supposed to be looking at my knee x-rays and referring me further (he didn’t; I had to go back AGAIN for that) because there were so many gatekeepers to get to the specialists. All the same, yeah, the form in my file explicitly said that I was there for an orthopedic consult on an existing issue, nothing else…so he had no right to ask about it. It’s definitely annoying and disturbing that it came up, and quite honestly if I’d been less resistant about it, I’m sure he would have tried the whole “well, we can do your pap now!” line.

        At this same clinic they also made every single adult patient go through a verbal questionnaire about drug use as part of their vitals. At one point I asked the nurse “if I really was a drug addict, do you think I’d answer ‘yes’ when you asked me ‘do you have a problem with drugs?'” LOL.I was insulted by that because it seemed to be that they were equating low income with drug or alcohol abuse, which is insulting at best and disingenuous at worst.

    • Kleigh US says:

      I herd that those kids of clinic for low income shove pap smears and gyn exams on woman bc its asumed those woman are all uneducated sleeping around. i was going to go once for head achs and after reading that they push gyn exams on woman like we dont know whats best for us. no thank you.

      • Diane says:

        In all honesty, in my experiences with low income clinics and Medicaid, that is exactly what I’ve found. They act as though being low income is synonymous with being an uneducated, diseased, promiscuous drug addict of low intelligence…and I also got the feeling that they didn’t want to “waste” specialists on poor people. Unless of course it was a gynecologist who could test me for all those STDs I probably had, right? In the clinic system I think I found a grand total of three doctors/PAs who were great; the rest had that negative attitude toward low-income/uninsured people. When I got my Obamacare Medi-Cal, the first thing I did was insist on getting a doctor in private practice. I’ll never go near a community clinic again if I can possibly help it.

      • Moo says:

        No it is assumed that low income women are prostituting themselves for money or drugs. Maybe even all women. Can one tell if a women is a prostitue by their clothing, mannerisms, reported income etc? So likely they are told to assume every women who walks into an ER or clinic is a prostitute.

        Actually I do not like the term prostitute. I would rather like to use sex worker. If a person so chooses to work as a sex worker the. They should receive respectfully and adequate healthcare even if their profession involves “risk”. Many other professions involve risk: police office, fire fighter, chemical worker. Most of the diagnostic alogoriths do not include considering a person past or present occupation.

        Pointless to ask if someone is an addict if the walk in clinic’s policy is that they do not prescribe or keep narcotics there. Usually it is posted up on the wall anyway. Many addicts purchase their drugs from people who get these pain killers prescribed to them legally. You can bet some doctors and pharmacists are in one some drug deals as well. I suspect some doctors also “prescribe” medications for patients that are filled and never make it to the patient. Some doctors are addicts.

        It is assumed that lower income women do not have time to take off work or pay for child are to get paps so that put the “all in one visit” but it also boosts up their quotas. Doctors should have to post up,what incentives they are receiving from the government for screening and from drug companies. Especially in Countries such as Canada where we have public health services. I have no idea what a doctor is billing and I am not sure if I can ask for the codes. I would report several doctors in the case they bill for services they never did or I did not consent to or feel I required.

      • Diane says:

        The other hilarious thing about assuming that low-income people are addicts/drug seekers is that addiction to prescription pain killers is something that happens across the board. Frankly someone who is affluent has the time and the money to doctor shop and find ways to get the drugs they want, and there ARE doctors out there who will essentially sell prescriptions. There have been plenty of cases of doctors “treating” celebrities who just got them whatever they wanted in terms of meds, and plenty of well publicized cases where celebrities have been apprehended in possession of copious amounts of oxycontin and such. They have no issues getting those drugs.

        What pisses me off there is that it makes it so much harder for people who do have chronic pain and really, really need the pain meds to get through the day. There are so many legit chronic illnesses where a person might need to be on maintenance doses of controlled substances, but doctors will underprescribe or accuse those folks of being drug seekers or addicts. You’re low income and you need those meds? Good luck there…

        It’s a good point about sex workers, Moo. I agree with you. I remember reading somewhere that since sex workers are legal in Holland, they receive pensions, etc. like any other workers, as well as regular medical care. And I believe that in the parts of Nevada where prostitution is legal, it’s the same situation; they’re entitled to health care, social security contributions, etc. As it should be. Whatever one’s profession, they deserve medical care without judgment. My one concern with sex work, particularly in the States, is how many people aren’t there voluntarily, but are pushed into it by human trafficking and are basically slaves who are being severely abused by their captors. That doesn’t mitigate their right to respectful healthcare, of course, but it’s deeply wrong and one wishes that there was a way to get them the hell out of their situation.

      • Elizabeth (Aust) says:

        Dutch prostitutes also, pay tax and they’ve always been offered the same pap testing program as other women, 7 pap tests, 5 yearly from 30 to 60.
        Now they’ll only be offered a 5 yearly pap test if they’re HPV+
        More pap testing is unhelpful and just means over-treatment, can you imagine how many pap tests would be recommended for an American or Australian prostitute? The woman would be considered very high risk and pap tested to death…the high risk/low risk woman is largely irrelevant now, informed consent, your age and HPV status should be the only considerations.
        I read an article several years ago about the Dutch sex trade and they said many of the prostitutes would have a lower risk of HPV than a sexually active woman who didn’t use condoms regularly. Most Dutch prostitutes insist on condoms, use dental dams and take other precautions like doing a visual check of the man’s genitals before anything happens and have access to medical care.
        If you always use a condom, the risk of HPV drops by 70%, that was the finding of a study of American college students. It may vary a bit with other groups, but it certainly offers decent protection.

      • Diane says:

        The Dutch have it right on this one, as they do with their pap program for those who are not sex workers. Check one’s HPV status with the Delphi screener; and then offer – OFFER, not require – the pap at rare intervals if they are HPV+.

        It makes me cringe to think about how that would go in the USA or Australia– they’d probably have those poor women getting paps every three months on the claim that they were “high risk.” And as you say, sex workers are probably far more careful than the average person having sex, they’re vigilant about condoms, etc. I remember seeing a Louis Theroux documentary about a brothel in Nevada, and he showed just what you mentioned- the women checked their clients’ genitals for disease before they got anywhere near a bedroom, didn’t normally kiss the clients, and insisted on condoms.

        Condoms really do a good job at protecting people from all sorts of diseases. In the USA with the abstinence-only movement there has been a push to discredit condoms and portray them as unreliable for birth control and STD protection. – – all of those programs are based on very religious, conservative teachings and not actual science or fact. Unfortunately the religious right has been able to get abstinence-only sex education (which of course is a misnomer; they basically tell the kids “don’t be dirty sluts and don’t have sex until you’re married” and don’t provide any factual information on STDs, birth control, etc. ) implemented in public schools in quite a few states. It’s managed to sway some young people away from condoms…it’s been noted that in states that use abstinence only sex education they have way higher rates of teen pregnancy and teen STD infection…the kids just don’t have the right information to take steps to protect themselves.

  6. Alex says:

    It think those GIFs are pretty funny, too. Personally, I think House’s face would have worked better for the doctor’s expression (it’s not like there’s a shortage of “you’re an asshole” looks coming from that character). Maybe it’s just because I like Tony Stark as a character a lot.

    One thing I wanted to say & I hope this doesn’t come off badly: If it was women that looked like that first one make points against these things, it’d probably be much more potent. I’m not saying these things should happen to fat women or women that have outright ugly looks (I guess saying she “is” ugly tends to imply more than just looks), but if someone were to be anywhere from pretty to extremely hot it would work well. It really shouldn’t be about marketing of course- but it DOES get “sold” & sometimes the “beautiful people” angle is used.

    It actually WAS something they tried with the models in Britain, right? I remember that being discussed a bit & how it might have been some model looking to get ahead or there might have been more subtle reasons (ex: getting males to think well of the whole situation so he’s less supportive if the woman he’s with brings up that she’s getting pestered about things).

  7. Allison says:

    Hi Sue. What a super blog. Thanks so much for enlightening women and allowing them to speak their minds. Not too sure whether you would be interested, or, whether you have perhaps written on self-collection HPV testing before, however, I thought it may be worthwhile dropping you a line regarding http://www.udotest.com. They are empowering women with a discreet, accurate and easy, alternative screening option, if they wish. Happy holidays and keep up the great work!

  8. Dachsodis says:

    I really loved this, especially the gifs that went along with it that made me smile. I was denied birth control because I have an extreme phobia of pelvic exams due to trauma I experienced as a child, but no doctor ever cares. I’ve had kind doctors that gently try to persuade me to submit, and I’ve had mean, insensitive doctors that look at me with disgust and try to intimidate me. My go-to excuse (slash lie) was, “Oh, I had a pap smear a few months ago,” but then something happened and I couldn’t lie anymore. I like the saying you’re on your period idea, though! I did want share something with you though, so you don’t get side swept by another argument the male doctor could try and shove on you when you say you only allow them to be performed by women…at my last doctor’s appointment with a male, after I told him I was afraid of them, he said he could get a female provider in the room right then and there to give me the exam. So they may try and come at you with that, so please be prepared!

    • kleigh us says:

      Its sad we shouldn’t have to give an excuse. If I’m not having problems I don’t want exams. I don’t know anyone who has been helped by them. Doctors are missing something they need to respect woman right to decline intamte exams.

      • Dachsodis says:

        I agree 100 percent. I’ve gone in for other issues, like lung problems and stomach pain, and still, the first question they always ask is, “When was your last pap smear?” Um, I can barely breath and you can hear my wheezing from across the room, but yes, I’m a virgin and you’re still more concerned with my cervical health than my obvious issues that brought me in. It drives me crazy! Luckily I have never been denied care because of me denying pap smears, I’m not sure what I would do if that ever happened to me. Heart disease is more common in women than cancers of the reproductive tract, but I don’t see doctors asking when’s the last time you saw a cardiologist.

  9. Elizabeth (Aust) says:

    No woman should ever be denied contraception because she chooses not to have an elective cancer screening test that has nothing to do with the Pill. Are men refused Viagra if they decline bowel cancer screening or an opportunistic exam of their testicles? Of course not, but it’s exactly the same thing.
    The pure insanity of denying contraception so you can force completely unnecessary exams that expose us to risk (routine pelvic and breast exams) or elective cancer screening that can never be required for anything. This exposes women to serious risk…an unplanned pregnancy,(no wonder about half of all pregnancies in the States are unplanned) it’s a disgrace when reliable contraception is around…but has been locked behind unnecessary medical barriers. It may also, mean miscarriages, abortions or ectopic pregnancies.
    When you consider the lifetime risk of cc is only 0.65%…(shaking my head…)

    Also, the evidence shows that women under age 30 do not benefit from pap testing…and now it’s even easier, HPV+ women aged 30+ are the only ones with a small chance of benefiting from a pap test. Regardless, it has nothing to do with the Pill and should be de-linked NOW.
    This “practice” must be broken down…it amazes me more has not been done to break down these barriers. The consequences of these barriers is so serious and must cost the healthcare system a small fortune. (not to mention society, the workforce etc.)

    The only clinical requirement for the Pill is your medical history and a blood pressure test.
    I’d urge any woman placed in this position to lodge a formal complaint and shop around for another doctor. (I know that’s harder in the States) Buying the Pill online may be an option as well.
    I think this practice will only die away when more women avoid doctors who treat them this way and lodge complaints….when it means fewer patients and less money…they’ll change.

    Once women couldn’t find a doctor who’d prescribe the Pill without the coercion, but that’s changed here and in the UK (although you may be pressured and harassed) and I get the feeling that more US doctors are also, doing away with this practice.
    Now that ACOG has said the Pill should come off script, hopefully, in the future women will be free to use the Pill….that’ll be a positive day for our health and lives.
    To call these practices good healthcare shows how warped the thinking in women’s “healthcare”.
    Welcome to the forum, Dachsodis
    One idea…write to a few clinics and ask them whether they still require these exams and test before prescribing the Pill, say you’re aware ACOG and others say these things are unnecessary for the Pill and you’ll only use a doctor who follows the evidence. Excess is harmful and cancer screening is elective, and legally and ethically requires informed consent. Put them on notice, if they say okay…then you can always point to their response if the pressure starts in the consult room.

    • Dachsodis says:

      Thank you for the welcome! I hate what us women have to go through to get birth control. My first doctor kindly prescribed it even knowing I didn’t have a pelvic exam, but only because I told her I was still a virgin because my husband was in AIT (advanced military training the soldiers go to after basic) and we were able to get married, but there wasn’t much privacy to…well…make love (and that was the truth, I didn’t start lying until after we moved a few months later because I didn’t want my prescription to be taken away). I would love to write clinics and try to find a doctor willing to give me birth control, but sadly because we’re military we are assigned our doctors and to see someone else requires us to pay out of pocket, which we simply can’t afford right now. I’m hoping to use Planned Parenthood’s HOPE program when it becomes available in our state. Until then, condoms it is.

      • Alex says:

        You do know that it’s actually illegal for them to withhold birth control from you because you won’t let them probe you. Right off the bat, properties don’t change by designation- just like if a doctor were to poison someone with a needle, it’s still murder. This is an interface wtih a sexual area (specifically, a penetrative one) as a product of someone else’s decision-making, which is an attack. I think the term would be “coercive iatrogenic assualt & reproductive endangerment.” Just mentioning these things would be fairly likely to get them to do what you want ( I know how that sounds, but there’s no way to say anything so someone else can’t lie or twist your words).

        I’ve heard of women getting these pills online & even from their shrink, but threatening to make a complaint or actually doing it might also work. Recording things can be ify as far as laws go, but you might be able to get somewhere by telling them that you want it in writing that they won’t give you these pills because you refused to get these exams.

    • Moo says:

      Ha! This exclusion form for NZ assumes that a woman has a “regular smear taker” that will be responsible for reminding when smears are do and getting follow-ups etc. it is does not acknowledge that some women do not want pap tests at all. Similar the Ontario (Canada) form I filled out for exclusion of cancer screenings letters assumes I have a “family doctor” who will be pressuring me for all those. I dropped the family doctor when he was inappropriately pushing me for pap screening when I told him I did not want them or breast exams.

      Notice how the enthicity of the women is asked on the form. Of course I know thegovernment where I live can get access to the census information. I really find it all a groos invasion of my privacy.

  10. Elizabeth (Aust) says:

    Hi Ada
    I think these forms are for the small number of informed women who choose not to screen (and other groups, those who’ve had a complete hysterectomy, terminally/seriously ill etc.)
    Of course, I doubt much will change at the Clinic level and I think the pressure to screen probably varies from Clinic to Clinic.
    It was a NZ woman who posted a nurse had called at her home to give her the test or arrange an appt. (she did not want)
    Some practices chase up unscreened women, harass them at every appointment etc.

    A NZ man posted over at BlogCritics, he was outraged by the way doctors and this program treated women, including his wife. He complained to the surgery when an inappropriate and offensive notice went up about unscreened women in the waiting room etc. Some doctors and nurses see themselves as the pap test police, chasing and pressuring women who “avoid” screening.
    I certainly got the impression from the posters and others that Informed consent is part of the program at an academic level, but is missing at the Clinic level. We have pap test police doctors here too, I was disgusted with a male doctor’s comments on the Australian Doctor site, and said so, I wouldn’t go near a doctor who viewed women in such an insulting way. He boasted about holding the pill until they have a pap test. Another male doctor felt this practice was fine IF the doctor made that clear to women before they made the appt, I doubt that, otherwise, what’s to stop doctors demanding a breast exam before prescribing antibiotics? It would be a predators paradise if doctors could make up their own requirements.
    I know the Medical Board look at clinical requirements when they’re examining a doctor’s conduct.

    • adawells says:

      Thought it might have been too good to be true, but I’m amazed it was available online, as I don’t think any opt out letters are available online in the UK. Most GP surgeries are denying their very existence.
      I found this interesting link from a book about personal medical information. This page describes how the cervical screening programme, in complete contravention of privacy laws and human rights, was pushed through parliament and inflicted on women. Their private medical information was distributed on outside databases without any knowledge or consent. Although I can’t agree with the author that the programme is a worthy cause, he does at least admit that the laws were indeed broken to push this programme through.
      https://books.google.co.uk/books?id=HAzUYtDLfm4C&pg=PA6&lpg=PA6&dq=personal+medical+information+kenneth+clarke+consent+screening&source=bl&ots=Dchjw-oRXT&sig=ch6uY-99NtV7AHpBB7KxkjYmY78&hl=en&sa=X&ei=gZS3VMaBOPHe7AbGhICYCg&ved=0CCMQ6AEwAA#v=onepage&q=personal%20medical%20information%20kenneth%20clarke%20consent%20screening&f=false

      Another document I’ve found is this one:
      http://www.cancerscreening.nhs.uk/cervical/publications/nhscsp-gpg1.pdf
      On page 1 it states:
      “The [UK] Data Protection Act 1998 will also require that women who have expressed a clear desire to be ceased from the programme should no longer receive invitations and that they should be ceased from the invitation schedule.”
      I’ve had a look at the Data Protection Act and it is a heavy volume, I’m unable to find the phrase about opting out of screening programmes at present. This Act was forced onto the UK government, by the European Union, as British human rights laws were falling well short of European standards. I had repeatedly told my GP during the 1990’s that I was totally against this screening programme, but had 2 paps forced on me against my will during and after pregnancy in 1997. It seems that this Act did finally set the wheels in motion for women getting more rights with regard to screening, but I think most are oblivious to this ,even now. In 2003, I succeeded in opting out permanently.

      It is interesting to note that also on this page it gives the following figures of women who have opted out during 2001 – 2:

      “The cervical screening programme’s Statistical Bulletin 2001–02 shows that the number of pre-menopausal women in England who were ceased from recall for reasons other than absence of cervix or age are:
      Age 20–29 3 900 women
      Age 30–39 13 000 women
      Age 40–49 22 900 women
      Age 50–59 42 600 women”

      It is encouraging to think that this is the number of women who are deciding to quit screening in any given year, and only 78% of those still on the programme are taking up their tests. Hopefully the numbers are even higher for this now.

  11. adawells says:

    Does anyone have access to the UK GP magazine Pulse? It appears there are new instructions of things a GP no longer has to do for women patients at appointments.
    http://www.pulsetoday.co.uk/clinical/womens-health/what-not-to-do-womens-health/20008273.article

  12. Hez says:

    The gifs gave me a good chuckle. That’s exactly what it’s like! I’ve got an appointment Monday with a new doctor because I suspect Hypothyroidism has finally decided to rear its ugly head (runs rampant in my family), but I’ve already got the “pap problem” covered. I don’t usually lie to my doctors, but I really don’t or feel like I should have to explain/argue with a new doctor over why I refuse the test and pelvic exams. I made up a fake date for my supposed last one so it doesn’t look like I’m due. That way, they have no reason to push one on me right now (head ’em off at the pass!). My other go-to line of BS is that I’m on my period. I usually use this one if I’m not at my usual doctor and theyWhen they ask when my LMP, I say, “You know what, it just started yesterday.” Can’t get an accurate pap when you’re on you’re period!

    Another tactic I’ve used with regular family docs is saying, “Thanks for reminding me. I’ll be sure book that with my OB/GYN” so it looks like you do get the tests done, just with another provider.

    I’ve only ever had one pap smear/pelvic and it was during my one and only pregnancy. I had a wonderful midwife who respected my feelings and was very understanding. She told me she would do it whenever I felt comfortable, just to let her know. I think I was maybe 5 months along when I had her do the exam…which was fully clothed (I wore a dress), on MY bed, with my husband present, and I was in control of the situation. I will never, ever submit to that test or that exam in any other setting. No humiliating gowns, no stirrups, and above all…no pressure. I highly suggest seeing a midwife for your girly care if you want to have the tests/exams done, but don’t want it to be done in a medical setting. Many midwives do well-woman care.

    That Udotest is a freaking godsend, as far as I’m concerned. Thanks again for this amazing site!

    • adawells says:

      Hez you were lucky to have got away with the one pap at five months pregnancy being normal.
      I was put under great pressure to have one during early pregnancy many years ago now, and doctor made me bleed. This contaminated the sample, and so was classed as inadequate. As well as causing me pain, the bleeding caused me a lot of concern for my baby. However, all went well, but I got a 2nd degree tear during vaginal delivery, which left me tender for weeks. At the post natal assessment, doctor just rammed the largest speculum into my healing vagina, which was agony. This moves me to tears many years later. That’s why I’m on this website.
      A lot of women think, OK I’ll just have the one pap, and have a better excuse next time, so that will get them off my back for ever more, but the ones done during pregnancy (often the first ones for many women) are often inadequate or abnormal. The doctor causes the damage, so has to do another, and another, and another, and you are locked into testing.
      I understand that in the UK now, pap tests are not done on pregnant women anymore, because of the high number of too many false results caused by the pregnancy. It’s a small consolation, but makes me so angry, that they can quietly let this practise slip, after harming so many women for years this way.

      • kleigh us says:

        Why on earth is a pap part of prenatal care hear in the us usually the first visit but no one dare pap a pregnant woman in other countries BC of false positives? The american system seems so messed up to me. I have heard it was a way to capture woman who usaly avoid gyn exams. This tells me they don’t care about woman.

      • Alex says:

        There’s a relatively new slur for Americans called “pindo.” It more or less means “a hapless creature that’s entirely dependant on all kinds of gadgets & gizmos.” I figure there’s a link, because there’s a massive general urge to “induce” in this part of the world- whether it’s “running” equipment or “running” people, there’s always this urge to “operate” something.

        Just to make another point & I’m not trying to come off overly religious or anything: That substitutive style compares best with a demon, not a parasite. Trying to hi-jack people & “crawl into their skin” is a fairly common trait here & people that want to crawl into other people’s skin tend to make somewhat literal attempts.

        I’m wondering if that has something to do with some of America’s tendancies. Especially with groups that feel that they are in a position to establish & implement policy, it’s a running theme. Medically, there’s a lot of things that don’t work as advertised & don’t functionally work- but there’s a noticeable tendancy to try to stick something in somebody, too.

      • Elizabeth098 says:

        I cried when I read your story. It fills me with rage to read how women are treated by this barbaric institution, and for no reason. It is all so pointless.

      • ethelgrimes says:

        adawells, I’m so sorry for the pain you suffered…that doctor should have had more sense! Let’s hope karma has its way with him the next time he has to get a prostate exam. (That wasn’t nice, was it?) Seriously, though…aren’t these people trained to be more careful than that?

  13. Moo says:

    I have checked several instruction inserts for pap kits that use the endocervical brush or “broom” type collection device. Both say do not use the endocervicla brush after the 8th week of pregnancy. There is a reason for that but most docotrs are ignorant of it, Truthfully a pregnancy is not really dated until an ultrasond is done to measure the crown rump distance. These paps are done when a women first misses her period and confirms with a home pregnancy test. She could be 5 weeks, or 7 weeks or 9 weeks. However is what the manufacturer considers safe at 7 1/2 weeks is not at 8 weeks and one day?

    I am constantly reading accounts of women saying they had miscarriages within 48 hours of the first prenatal pelivc exam and pap test. Others say they had bleeding which could mean threatened miscarriage. It really depends on the position of the placenta. Doctors excuse this all by saying one third of all pregnancies naturally miscarry in the first trimester. No excuse for destroying my precious baby. Sex might be ok but pressure from their exam and pushing in swabs and removes the mucus seal on the cervix.

    The reasons given for a pelvic exam in first trimester are not good enough for me. I would also avoid the transvaginal ultrasound. An outside ultrasound might be useful at a later stage.

    Just think about it.

    • Alex says:

      I remember hearing ultrasounds aren’t too bad, but might be an issue for the baby. Not sure if it causes hearing lose like with sonar for marine animals, but it seems to have a “nails on a chalkboard” effect.

      • adawells says:

        I seem to remember reading that lefthandedness is more common where ultrasound has been used. Don’t wish to offend any of you lefthanders out there! For this reason, they like to keep ultrasounds to a minimum in the UK, just in case there is a link. So glad they didn’t do vaginal ultrasounds in my day. Just had the one abdominal one at about 14 weeks, and this is a rite of passage really, as it is exciting to get the first baby picture. I’m shocked if the vaginal one is now the norm for pregnant ladies. That’s quite unnecessary if enough information can be got from an abdominal one.

      • Elizabeth (Aust) says:

        Honestly, it seems like women have to fight off unnecessary intimate exams and tests right through life. I know some gynecologists are dropping the routine pelvic and breast exam from the first pre-natal exam, but most still insist on a pap test. (we all know a pap test taken at this time is more likely to be “abnormal”)
        I’d also, be very cautious with vaginal ultrasounds. A friend was suspicious of a male technician who often claimed he’d need to do a vaginal ultrasound, he couldn’t get a decent image through the abdomen, when my friend insisted on a female technician…surprise, surprise, she was able to get a decent image through the abdomen.
        Let’s face it…it would be another easy way of taking advantage.

      • adawells says:

        In a UK brochure for healthcare practitioners in my area:

        Additional cervical samples
        Additional cervical samples are not justified in any of the following situations:

        on taking or starting to take an oral contraceptive

        on insertion of an IUCD

        on taking or starting to take hormone replacement therapy

        in association with pregnancy – neither antenatally nor postnatally, nor after termination

        in women with vaginal discharge

        in women with infection

        in women who have had multiple sexual partners

        in women who are heavy cigarette smokers

        This is for additional cervical samples. It doesn’t specify exactly what happens if the routine screening schedule isn’t up to date.

    • kleigh us says:

      I don’t like that they push the trans ultrasound on pregnant woman. My cousin cried out in pain when they did the trans at her prenatal apt. I don’t want any of that and I don’t believe a pregnancy is in danger with out all thses invasive procedures that seem so unnesery to me.

    • kleigh us says:

      Why are all these unnesary things pushed on pregnant woman when they don’t even have a good reason why they do them. Thin woman are told if they don’t have all the prenatal care there indangering there baby?

      • Alex says:

        Not to split hairs with you, but is it that you’re thinking why or that you’re thinking it’s bad? I think a lot of people ask “Why?” when they mean “No,” whether it’s when someone’s aiming something at them or just talking about a subject. At its root, it seems to be trying some kind of “verbal judo flip” as a method of recourse. Ever notice how often people say “Yeah” and then argue the opposite side? Same thing- it’s trying to take the whole argument & throw it down. I remember starting to do that when I was a kid, maybe 7 or 8 years old.

        I could see someone arguing with a doctor that wants to do something & saying “Yeah… no, actually not “yeah.” Would be a useful way to get yourself out of that “momentum” & also makes a very solid point that they are aligned against the situation. If someone seems hesitant or “unsolid” in some way, they tend to keep trying.

  14. Apocalyptic Queen says:

    Hi – I’ve only very recently come across this blog but I must say I love all the articles and the comments posted here. Some of the research (legal, scientific and political) and arguments are just phenomenal! It is so heartening to see a group of informed and intelligent like-minded women (and men) highlight what is so very wrong about this situation.

    I am from the UK and I made an informed decision not to participate in this screening ever since I found out about these tests. I opted out from the screening programme in 2005 and to date, haven’t heard anything from them since. I’m familiar with the work of Angela Raffle, Prof Michael Baum and Margaret McCartney. I’m luckier than most here for all my adult life, I have only been asked about screening once by my GP and when I explained that I’d made an informed decision to opt out, she was very supportive and the subject has not been raised again. I live in Wales so not sure if there’s a more relaxed attitude here than in England but I’ve also heard the requirements for opting out has now changed? If so, I wonder whether this contravenes Data Protection law and Art 8 of HRA because the interference is downright unacceptable and the harrassment faced by women is appalling.

    Back to the topic at hand, I personally think that if you’ve made a decision to opt out and you know that you’re never going to screen, be brave and be firm with relatively short answers. I’d advise something like “I’ve made an informed decision to opt out of screening.” If you offer explanations, they’ll just harp on and most likely, see your “justifications” as a weakness (typical to them of female stereotypes). I think they’ll also try to challenge you. I think you might still get pressure you either way, but you can be firm, mention their ethical duties, legality of informed consent and threaten to take the matter further. I think adopting a firm and resolute tone is especially important with a male doctor. I never expected my GPs’ relaxed approach when I disclosed to her but I had prepared myself for worse case scenario and in the event I ever have to switch doctors and am asked this, I will be firm. Maybe adopting assertive body language techniques could assist? As it has been documented by psychologists that body language can be very effective in various settings.

    • adawells says:

      Welcome, Apocalyptic Queen. As you may have read in previous of my posts I had more trouble than you opting out of the cervical screening test in England, but it was during the 1990’s when the situation was an absolute meat-market in the UK. GP’s were getting over 83% screening rates and hammering every woman who walked in through the surgery door, much to my cost. The Data Protection Act came in in 1998 and then the Human Rights Act in 2000. Both attacked the screening programme and forced through some changes especially with regard to consenting to the procedure, but a little too late for me as I had 2 smears forced on me in 1997, by a woman GP who clearly had no time at all for women’s rights. I opted out (permanently) in 2003 after I was telephoned at home, completely out of the blue. Like most women in the UK, the knowledge you CAN opt out and HOW is kept from women, so most just chuck the reminders in the bin, and have to go armed with excuses at every appointment.

      I have read that as so many women have managed to opt out permanently, they have changed the “rules” again, so that when you request to opt out you are only opted out of that screening round, and will be spared the 2nd and 3rd final reminder notices. It will all start over again for you in 3 or 5 years time, when you have to express your desire to opt out all over again. At least that is what I have read.

      So glad to hear from other women in the UK who are challenging the system.

  15. Apocalyptic Queen says:

    Hi Ada – if that is true, how can that be legally justified? That’s not an opt. I thought the spirit of the DPA supported the premise that a woman must be released from the programme if she has expressed a clear desire to do so? If this were happening to me, I wouldn’t hesitate to seek or threaten legal action.

    It feels empowering to be one of the select informed few but the attitude of other women never ceases to amaze me. I’ve written a few scathing opinions on this topic on some forums and it’s clear I have support, but other women are downright rude, intrusive and insulting to some who express an opinion that goes against the grain shall we say. They are also adamant that women should be screened from the age of puberty or the start of sexual activity, regardless of what the evidence or some of the more educated commentators tell them – they don’t understand and there is no remonstrating with them (I bet you can guess which website forums I am referring to). These women and culture that go with it are essentially the gate-keepers of this programme. If most women felt like we do, the screening programme would be on its knees and that is what I think, is keeping the screening lifeline going.

    Recently, it emerged that screening take-up in the UK is at an all time low. A third of under 35s elect not to be screened. They say this is because women are too “busy” or due to other “excuses” but I’ve read a few pieces to suggest that more women are making informed decisions. At the same time, they say cc rates have “soared” in the last ten years but using data on the efficacy of the tests, a few very informed readers deduced that the rise in carcinogenic cc was far more likely due to sexual practices, which brings me onto my next criticism of the screening programme. Are girls in schools taught about HPV and it’s link to cervical cancer? Is it emphasised to girls AND boys alike (seeing as HPV is also linked to penile cancer) that wearing condoms is important

    • adawells says:

      AQ I’ve been trying to research this about whether an opt-out is permanent or just until the next screening round and I found this from the Audley Mills GP practice in Essex, UK. Check out section CS4 points 7 and 8:
      http://www.audleymills.co.uk/…/Cervical%20Screening%20Policie… 
      It may be a little out of date as is 2006.
      Hope the link works,.as am having some problems attaching links from my tablet.

      I have seen some very interesting developments:
      This NHS document just published in 2015 actually “advertises” the fact that women do not need to participate and can actually opt out:
      http://Www.screening.org.uk/fair-data-processing.html

      As if I couldn’t believe my eyes, I also discovered some GP practices are also “promoting” the fact that cervical screening is an option, and if women do not wish to participate, they can fill out one of the opt-out forms. But the slimy gits won’t give up so easily: although a woman may have opted out, they will send you a reminder letter to “remind you of your opt out status” at least every 5 years. Sounds like they have simply replaced one nagging letter with another…
      These surgeries (none near me) offer opting out:
      Farnhamgps.com
      Waterfieldpractice.co.uk
      Asplandsmedicalcentre.co.uk

      But I’m sure there must be more.

      • adawells says:

        Sorry the link doesn’t seem to work, but if you search:
        Audley Mills Surgery cervical screening policies
        it comes up as a Word Doc you can read.

      • Karen says:

        Great find! I was thinking the NHS should have a list of surgeries with this option. Or alternatively, there should be a blog listing them.

      • adawells says:

        I’ll keep checking as I’m sure there must be more surgeries offering the opt-out letter. This one is another – the West Green Surgery in London. http://Www.westgreensurgery.co.uk “finalists for the prestigious General Practice awards for 2014”.
        Their website says that for women not wanting to participate in screening they can just download the opt out form, which is provided by clicking a link. No mention of having to discuss it with the quack.

    • Alex says:

      I would imagine that a lot of women either don’t say or don’t know the term of it being antagonistic to their alignment. That or whatever else would be a good word for it “going agaisnt the grain” in that way. “Sexually affrontive” perhaps? Maybe “sexually contraventional”?

      Anyway, it’s astounding that someone would say that it’s an issue & then someone else would say “No it’s not.” As if something ceases to exist in spite of its existANCE.

  16. Apocalyptic Queen says:

    and provides 70+% protection against contracting HPV? I don’t think they are even told that smoking and promiscuity increases their risks – this information is essential in allowing individuals to make informed decisions and monitor their lifestyle choices to minimise risk accordingly. All we were told in school was – you “must”/”should” have cervical smears as soon as you are sexually active. Nothing more, nothing less. Heard one woman say on a forum that had she known all this in her younger years, she’d have taken more care of her sexual health. This is downright irresponsible and the information is not promoted so as to keep the focus on the precious screening programme.

    As for not knowing they can opt out, this is astounding. How do they think that a fully grown adult can be compelled to do anything? What do they think is the worst the “authorities” can do if they challenge them? I admit as someone who studied law, I’m at an advantage because by virtue of the doctrine of “informed consent”, I knew that the statement “you must have smears” was bull**** and so I was always prepared to back myself up with that. The fact that many women are frightened into compliance or are gullible enough to fall for the spin is so frustrating. Aaargh! Sorry for long post. Rant over! :O

  17. oddvar says:

    why cannot you women just say to a male ob-gyn who wants to examine Your vagina and you dont like it.tell him like this,” go to hell”.why are you so women to weak and cannot say like this?.for me and my wife a doctor is only a man in a white coat and no more and nothing special With him.he is only a man and nothing else.a doctor is same important as taxi driver,an engineer or a man who is removing Garbage..why do you think that there is something special With a doctor???he is only important in his own eyes and you should learn how to say NO to him.

    • Alex says:

      I’ve been wondering this myself & it seems to vary with the woman. I thin there’s a lot of mental bullshit that occurs. Let’s say that someone presents something as mandatory. So? What happens is what occurs & if this situation doesn’t happen, it doesn’t occur. Fairly simple point, but in confrontational situations (of various kinds) it seems to go unrealized. This can be true with men, as well (all kinds of creepy shit that runs a parallel with what gets aimed at women gets launched at men in an encarceration scenario). Again, actions have to be engaged in order to occur.

      Not for nothing, but I think feeling trapped probably has a lot to do with it. That & presuming a lack of support for their efforts- not really groundless, since women seem to get yelled at whenever she brings up having a problem with something a doctor does.

    • Apocalyptic Queen says:

      I can’t presume to speak for all women but from my own experience, I knew of many women who submitted to the exam because contraception was effectively being held hostage unless they agreed. The failure to acquire BC can put many relationships under strain unless the couple can agree an alternative and many young people (especially 16-24) are simply unaware of their rights and do not always think this is just a policy or a try-on. I knew a lot of young women who either submitted (believing they’d have to find an alternative doctor) or told the GP to stuff it and forego contraception. When BC isn’t an issue, it’s easier to say no because generally speaking, the powers that be don’t have that monopoly.
      However, the author states that this issue is also being brought up in more general health matters in some US practices as well and if someone requires treatment for a painful knee and the GP refuses to treat that individual unless they submit to an exam, I guess many go into panic mode. It can be hard for young people to question or complain to those they perceive to be in positions of authority, who they think can reasonably withhold medical treatment. It’s about intimidating people by limiting their options.

      Brainwashing is also a factor. Girls are indoctrinated in schools that they “must” have this when they are older and it always baffled me how many of my counterparts seemed to think “well that’s that then” without question. I remember thinking how ridiculous it was that they thought they could tell me that I’d “have” to have anything when I reach the age of consent and am a competent adult. I was fully aware of the concept of consent and would have challenged the doctor with that if it had ever occurred.

  18. Apocalyptic Queen says:

    Hi everyone! First of all, let me apologise – I wanted to create one post yesterday but because I was commenting from my (very awkward) phone, I had to dissect the post into two separate comments. I thought both the second would follow on from the other but didn’t happen that way. My point was why are girls kept ignorant of the association between HPV and carcinogenic cc – it’s fairly obvious they are being indoctrinated to see smear tests as the only way to prevent cervical cancer.

    Ada – thanks so much for that. The 5 year opt-out scheme is a shambles. It’d drive me crazy! It contravenes the HRA and DPA in my opinion.
    Good to see the (better late than never) shift to INFORMED CONSENT taking place. Not sure how you feel Ada but I feel there has been quite a big shift here in the UK in recent years to debunking the myth that is the so called miraculous power of smear tests, even in some media outlets. Some of the more conservative, right wing outlets continue to cling to the tired old mantra that is “smears save lives”, “all women must have them” etc but other outlets are more sceptical in their reporting. Recently read a piece in another outlet which had an interview with a Cancer MacMillan spokesperson and the message very much was: “all women need to make an informed decision on what is best for them”. I certainly feel there has been a sea change in the last few years. Thought a recent parliament document where Angela Raffle (or was it Dr McCartney?- cannot remember) gave evidence in chief was very interesting & provided some really revealing insights. The impression I got was that they were pretty annoyed with the value of current screening programmes, knew they were c*** and unethical (bordering the illegal) but had to plough along for now anyway as the public (probably militant women) and vested interests love them – and we (the government) have invested so much money into this tripe.

  19. Elizabeth (Aust) says:

    Hi AQ
    We’re still a long way behind the UK in terms of “real” awareness, most/many Australian women still consider pap testing a must, we have virtually no critical discussion here. We have no Dr McCartney or Michael Baum, these programs, especially cervical screening, are free to adopt any and all unethical (and possibly, illegal) measures to increase coverage. We’re finally hearing something about over-diagnosis and uncertainty of benefit in breast screening, but it’s coming from 2 or 3 people, many women will dismiss them as radicals.
    It also, sounds like we’ll follow your lead and introduce a call and recall system under our new cervical screening program. Horrible abuse occurred in the UK when that system was first introduced, women were routinely bullied into screening, some were sacked by doctors if they didn’t agree to “elective” screening, many women were harassed by letter, phone, receptionists, nurses…and at every visit to the Clinic.
    It’s concerning, I can almost hear the jackboots approaching…

    Of course, as an informed woman, I’m safe from all of this, but I fear for the women here who haven’t looked behind the official discourse. Our waiting rooms, specialists and day procedure centers will continue to be very busy, which is what vested interests want…and will continue to get into the future. It seems we’ll do HPV primary testing from age 25. (the invasive version, no HPV self testing unless you refuse the invasive HPV test for 6 years or source and pay for it yourself)
    Basic research is all you need to do to see why you should not do HPV testing on women under 30, we’ll start at 25, this means 40% of women aged under 30 will be HPV+…transient and harmless infections that will clear in a year or two, by age 30 only about 5% are HPV+.
    This move will mean our young women will continue to suffer under the new program, you can’t tell me our doctors are so dumb they’re unaware of the research, but it confirms in my mind that vested interests basically run these programs.
    The current review of our program IMO, only happened because more women were choosing not to screen every 2 years, and there are more informed women around they can’t silence as effectively…danger…so change is on the way. IMO, the exercise has been largely a juggling exercise to find something that keeps most vested interests happy, if they still get their share of healthy cervix to test, biopsy and “treat”, then they’ll play along with the change.
    IMO, the system is rotten to the core, they know vested interests can spook the herd, losing control is a huge concern, so vested interests come first. Initially, one “survivors” group were dead against testing from 25 instead of 18, (or even younger) but they’ve gone quiet and now seem to support the change…I wonder what sweetener was thrown their way.
    It may sound cynical, but I’ve been around long enough to know how women’s cancer screening operates in this country. These cancers are a concern (cervical cancer has always been fairly rare though) but these programs pose a far greater threat to our legal rights, health, peace of mind/quality of life…and can even take our life.
    Thanks for your posts, music to my ears, love to read comments from informed women. (or women looking for real information) For many years it was like talking to a pack of lemmings or to crazed fans who had no clue what they were talking about or to “survivors”. (almost all were simply the over-treated) It was not their fault though, but the inevitable result of a carefully executed propaganda campaign by a highly unethical and powerful system – and that’s putting it politely!)

    Few women questioned the “must” and “should” message, but like you, that means my heels go into the ground and I’m alerted to the fact this is probably not in my interests. Beware!
    When anyone needs to push, really push, there is usually a good reason why, otherwise they’d simply present the evidence and respect our right to choose, wouldn’t they? Hard sell usually means…don’t touch it with a barge pole.

    • adawells says:

      AQ and Elizabeth it’s good news that the NHS is starting to “filter in” the fact that women have a choice about screening, but you really have to look for it, and I doubt very much that many doctors actually tell women they can opt out. Nearly all women I’ve EVER spoken to about it believe that it is mandatory, (my close relations included), so it is very much “business as usual”. I would be very interested to know whether the wording in the recall letters has changed. I doubt it very much. They will probably make a subtle difference in the wording of the accompanying leaflet, which is sent out at the same time. As the woman would have received the last leaflet 3 or 5 years previously, I don’t think the woman would know if it had been changed.

      The Data Protection Act and the Human Rights Act came about due to pressure from the European Union, which forced the UK to implement these rights. The UK was falling well short on human rights until then, and I’m pro-European because of this. There were big implications for the UK in the field of healthcare. I have read that these Acts forced the UK cancer screening programmes to make significant changes, giving citizens more rights in these programmes, hence the UK has been forced to change by the EU, which could explain why Australia has not, but I have been unable to get any deeper than this in my research at the moment. So wish I had studied law!

      As EU citizens we can get healthcare in any other EU member country, with our ID healthcards, but as cervical screening is regarded as a specialist service and linked to the electoral roll, a British woman could not put herself on the Dutch programme and claim a free HPV self-test kit from the Netherlands when these come in next year.

      I’ve just heard that Australia is taking part in the next Eurovision Song Contest! How has this come about?

  20. Elizabeth (Aust) says:

    Not sure how that happened, Ada. Eurovision?
    Can UK women order the Delphi Screener online directly from the manufacturer in The Netherlands?
    Aussie women could order it online from Delphi Bioscience in Singapore, but the program has managed to stick their beak into our business once again, of course, they HAVE to control all women.
    I understand if you want to order the Screener now, DB (Singapore) will refer you to the local distributor and you have to nominate a GP, who gets a copy of your results. (or you can ask your GP for the test and pay for it) I’m not sure whether you have to get your results from your GP or whether they mail you a copy as well.
    I’m sure Papscreen monitor comments on this subject and when the Screener was mentioned, scrambled into action. At every turn, it’s block women from acting independently and making their own decisions….find a way to feed them into the program.
    I guess “capturing” these women will boost their stats as well…a certain % of women screened this year. Of course, this is just to trap the few informed women using the DS, they certainly won’t be promoting it, most women are unaware they can get the Screener through their GP.

    Here’s a UK woman who’s declined pap tests and has written about it in the Huffington Post, fabulous, we need to hear from more of these women. For too long we’ve been silenced by censorship or were afraid to challenge this program and to talk about our negative experiences, concerns and feelings. (or to admit we don’t screen, without apologizing or putting ourselves down, “I know I’m being silly but…etc.) It was always easy to attack/dismiss the lone “I’m so silly” dissenter, a lot harder to attack an informed audience. (and even a lone informed woman)

    http://www.huffingtonpost.co.uk/jade-lane/cervical-screening_b_4959164.html

    • Alex says:

      It’s interesting, but I have to wonder if some of these (and other) abnormalities might disappear. So someone has an abnormality that’s a “sign” of cancer on the horizon- that doesn’t mean that it won’t go away. It’s a little like someone being diagnosed with a terminal disease & living anyway.

      Example: My uncle had bad asthma when he was young. They said he’d die if he ran around the schoolfield by his house twice- he ran a marathon after basically outrunning his asthma. Huo Yuanjia seems to have done something similar by training in wushu when everyone thought he was too frail- it built him up.

      They say all kinds of things & plenty of them are to help themselves out. I don’t know if they said “we know what abnormalities will turn into cancer,” that anything would change- if somoene got cancer, they’d still treat them the same way (which tends to be unsuccessful, however popular the treatment is). They’d still potentially lie & say someone had it. They’d still potentially do things to cause problems & may or may not blame it on something else (like saying it’s a pre-existing condition or something that “just happens” instead of being what they did).

    • Apocalyptic Queen says:

      I agree that the default position continues to be “you must” etc. I just get the impression from the last few years that the legal requirement of informed consent is becoming harder to dismiss. UK screening rates are apparently at an all time low so it’s clear women are challenging the system. I feel media campaigns have gone into overdrive, turning the focus from “you must” to emotional blackmail. Pretty desperate in an attempt to reverse falling screening rates.

      It was interesting to read about the wording in recall letters. When I received my first (and last) in 2005, I recall it stating: “Your records show you are due for a cervical smear test”. As you can imagine, my response was a strongly worded letter to the effect that I certainly was not!

      The wording quoted by another poster here stating words to the effect, “We are inviting you” is slightly more respectful than the high tone I received back in the day, so an interesting but subtle change at best. The programme coordinators are behaving like spoilt children who are being threatened with having their toy taken away.

      I haven’t read the Jade Lane article yet but I agree, we need to hear more from these women. Women assume we are all complying and those who don’t, seem to need impaling! Interestingly, all the women in my family are pro-choice. Four females (including myself) have never had them and two had them done back in the 80s & 90s because they felt pressurised and haven’t had any since.

      However, I try to avoid the topic with friends as they are rather militant about this issue but if asked directly, I wouldn’t lie or deny the fact that I have opted out. Informed consent is important and the consequences of false positives (such as LEEP) are not insignificant.

      As well as HRA and information emerging on the dubious methodology of screening, I wonder if more women entering the medical profession (thus perhaps, lessening the impact of “paternalistic” culture) may help influence change in the future.

      • Apocalyptic Queen says:

        Alex – The vast majority of those diagnosed with CIN I, II or III as a result of testing will not develop cancer. CIN levels I, II or III are treated as potential pre-cursors of cancer, with CIN level III being regarded as the most serious. But studies show that even high grade changes – designated CIN III – will revert to normal in 70 – 88% of cases yet all those receiving this diagnosis are at high risk of receiving damaging procedures which can damage their health and fertility. Biopsies and LEEP treatments are brutal and women receiving these suffer crippling pain for days afterwards. I’ve also heard of hospitals banning husbands from attending with partners due to fears they will question the treatment.

        Ada & Elizabeth – I think your research skills on this thread are fantastic. You’ve managed to unearth a lot of information. Even before HRA, I’d say they were in violation of consent and possibly other civil violations under torts such as battery and assault.
        But the HRA strengthened the position – notably Article 8 and maybe even 14 – on prohibition of discrimination. Maybe they’re ultra defensive of this programme because they also fear possible legal repercussions in the future? Women who have been coerced to accept this could argue they have been assaulted. Giving bad information is bad enough but telling your patient to submit because you will withhold treatment is coercion and can surely fall within the sexual offences category. A judge would have to apply HRA and even if judge ruled no laws had been broken, people could apply for appeal and more could come forward with claims. This would be a big legal minefield to navigate. No wonder the programme is being protected to the hilt!

        I haven’t tried to access the Delphi screener as of yet but someone here posted a link to obtain another self-screener. Are you able to access that in Australia? If not, could you file a complaint, re Delphi?

        Welcome to Eurovision btw! 🙂

      • Alex says:

        That banning of the husbands seems to be exactly for a “disarming” purpose. Men tend to be much more comfortable with confrontation & ANY support would potentially block a move they try to make. Women that this particular woman might bring along for defense purposes might very well be suceptible to the same things as the woman whatever thing is being directed at. Kind of like how a woman that got beat by her husband might not be the most supportive person when another women is looking for help to get out of that situation.

        The same could apply to medical abusiveness. If she’s been sold on the “this is a part of a woman’s life” (maybe adding in: “because the people doing it direct this at her”), she might falter when it involves someone else.

        There’s an old saying that goes “A man that won’t protect himself won’t protect anyone else.” This is generally true. Sure, it might be that he flips out if someone went after a kid or something, but usually they won’t do something period. This can easily apply to women, too. If a woman won’t at least TRY to defend herself, she might not do anything to protect her kids or anybody else.

        Granted, she MIGHT get some “Mother Bear” going & she MIGHT see things a little more clearly third-person, but it’s a bit more unlikely.

    • adawells says:

      I’ve just been checking about the Delphi Screener, but I can’t find any outlets for it in the UK, but we already have a number of other HPV self test kits on the market. They are private companies who will not involve your GP.
      http://www.test.me
      http://www.better2know.co.uk/?gclid=COKm9-DM6cMCFevpwgodZUYAPQ
      http://www.udotest.com
      and I think tampap are still operating too. These companies offer all STD checks without any involvement from your GP, but they come at a price, from about £50 to £250.
      I know of someone who ordered hers on the Monday, it arrived next day and she had the result by the Friday. As HPV negative did not need to bother with a pap test.

      Dr McCartney complained about Tampap’s ad to the Advertising Standards Authority who upheld her complaint. One of the reasons was that the ad implied you could forego pap testing if you used this test. I have to say I don’t agree with the result: surely if you are HPV- there is every logical reason to forego pap testing…?

      From where I live we can travel to the Netherlands for a day trip, and if they are for sale, we could purchase a Delphi Screener in the Netherlands, but I don’t see there would be any need as we have these other tests available in the UK. I’d be very surprised if many women had heard of them though, and as ChasUK says, the GP’s certainly wouldn’t tell you about them, and are still pestering women. Although many doctors like Dr McCartney think the public is being ripped off by these companies, if you have a very persistent GP, are unsure about your HPV status and don’t want the pap test, they would provide a woman with the “ammunition” she needs to fight off a bullying GP and show she is informed enough to take matters into her own hands.

      I don’t see a reason why these companies couldn’t send these test kits abroad.

      • Apocalyptic Queen says:

        I’m surprised at Dr Margaret McCartney if I’m honest. Fantastic that these kits are available to UK residents. I agree, if there’s business to be made, I don’t see why they can’t post them overseas. Prices are steep but £50 – £75 wouldn’t be too bad. They might be pricey but I prefer that to the alternative and how much money have the powers that be made at the expense of inflicting painful and damaging treatment on women?

  21. ChasUK says:

    The UK facts leaflet does state the word choice, but you try exercising that right of choice to forgoe the screening, still difficult! Your GP wants to discuss it with you ie. counsel you and convince you into choosing to screen. Choice what a joke, they see the only choice is to screen. I recently asked my GP to remove me from the programme…………not done as yet – I still get letters every 3-4 months. Thank you everyone for all your fabulous input, this site is a godsend x

    • Apocalyptic Queen says:

      Hi Chas 🙂 The tide is turning, they are being told that they must recognise that it is a choice so instead of bullying, they are changing tactics by resorting to emotional blackmail, trying to make you believe it is in your best interests and that they are interested in your welfare etc. Either way, it’s still harrassment. They shouldn’t be sending you letters if you want to opt out. Easier said then done I know. Have you tried asking your GP for an opt-out letter or asking the screening “authority” for it?

      You can state that you have made an informed decision to opt out and that you feel your decision is not being respected. Say it’s causing you stress, that you feel pressurised. Refer them to NHS guidelines which now acknowledges that it is a joke. Counselling is a joke, you are a competent adult and can make your own decisions. The law says they MUST respect your decision.

      If you like, I could have a go at drafting a letter for you to send to either your GP practice or your local Health Board. No guarantees it’ll work but I could give it a try if you like.

      • adawells says:

        http://www.acornsurgery.com/website/D81633/files/Cervical_Screening_Opt_Out_Form.doc
        There is an opt out letter here from this surgery. Other surgeries have sometimes links to opt out letters. They are all the same with the wording.

      • Elizabeth (Aust) says:

        I contacted the UK screening authority last year after someone else mentioned this “counseling” requirement (as if it could be) and was told the counseling session sounded like the idea of an over-zealous GP.
        I’d send the doctor a letter stating their attitude is counter to the program’s policy of informed consent, is causing you stress and if things don’t change, you’ll be forced to write to the program and the Medical Council.
        I resent having to opt out of something I didn’t join in the first place, but can see that’s probably less hassle and more effective in the end.
        So don’t buy the “counseling” nonsense, you can’t be forced to have a smear or a counseling session. Of course, there is nothing to stop them hassling you in the consult room, but if you send them a letter setting out your concerns, I’m sure they’ll stop.
        I’ve found doctors back off quickly when they’re confronted with an informed woman.
        I’m always firm and polite and have found that works a treat.

      • ChasUK says:

        Thank you AQ – I did actually email our screening office for the correct address to send a letter to opt out and they gave it to me no problem, but no mention of this form/disclaimer. They did however point me to my GP who they said can remove me and when I did this in November in a consult visit my GP said “I’m not sure I can do that” – of course I argued that and said “oh yes you can and you know it”, he smiled and said he will see what he can do. Then asked me what I was reading and could I provide some of it, I did say yes but have not yet as I told him I am not providing this to you as my excuse to be removed, my wishes should be honoured end of. Also I/all did not sign into screening so should not really be made to sign off of screening. My decision must be accepted as final. The last letter was December 2014, usually 3 to 4 months another one will land on my doorstep, this will be around March or April – I will hang on to see if he has done what he said he would, sorry I should have said that in the last comment. I know maybe I could sign a disclaimer but it bothers me so much that I am expected to do this, it really bothers me! My GP is also well aware at how much all of this screening crap bothers me too! My father in Spain has been in hospital since 02/08/14 for a 2cm tumour in colon, 6 operations later, sepsis, kidney failure and the rest including memory loss, colostmy bag and catheter – all for 2cm of a tumour that probably would not have bothered him before he dies of something else. Now he has serious problems from all this so called great treatment – very sad for him and his wife, 7 months of hell for both and all of the family. Thank you again for your comment and suggestions very much appreciated.

  22. oddvar says:

    My wife an I are happy because we live in Norway.There are screening programs and mammografi also in my country,but everything are in the hands of the women.After a certain age of a woman,she gets an invitation letter to be screened for cervical cancer or a mammografi.I dont remember the ages.If she does not answer that letter,she will get a reminding letter after 1 year.But there are nobody who will make a phone Call to you to remind you.And absolutely nobody will remind you about pap smear if you go there for another reason.Your system there in USA,UK,Australia or whereever,is rude and shows no respect for women.Also in Norway you can choose your own doctor.Some women want,of different reasons,only a female doctor,and that will be granted in my country.Gender choise is very important for some women,like my wife.Some women are comfortable with a male gynecologist and its their choice and shall be respected.Some women only wants a female gynecologist and its their Choice and shall be respected.My wife who is soon 50 years old,have never seen any male doctor for any reason.She Works in a hospital as a nurse.And when i ask her why she is so mad on male doctors,she says that she has seen enough of how rude some male doctors are against female patients and how little respect they have for female patients.A little bit to think about for you who absolutely wants a male gynecologist???

    • Alice (Australia) says:

      O, Norway!
      I spent some time there because of work… Best time of my life. Beautiful, clean, tidy, safe country, with so much respect for indifidual choice, freedom and autonomy. A country where it’s clear that people’s tax money are funding the common good, not someone’s vested interests.

      I wish I could stay there! Even though I haven’t seen any doctors during my time there, I can easily believe that the respect for women and for individual choice stretches to the medical system as well.

      • Alex says:

        Alice: I was wondering if birth control was available over-the-counter in Norway. I asked this to oddvar, but it doesn’t look like he’s a regular poster & I might not be able to get an answer. If he does, great- I would like to know more detail about Norway (or any other countries, really). Since I’m planning on taking off in a year or two any information could come in handy. Scandinavia seems pretty interesting, although I’m still somewhat partial to the Mediterranean & increasingly the Czech Republic.

      • Alice (Australia) says:

        Alex, unfortunately I can’t help you with the answer. I don’t use pills for birth control because here in Australia the pills are not over the counter. I knew I would be forced to see a doctor for each prescription refill, go through a privacy-invading and humiliating process of discussing my sex life with a stranger who will inevitably be pressuring me in all sorts of unwanted intimate exams and tests. So when I went to Norway, I didn’t get any experience in this area. Also, most of my colleagues who spoke English were men, so the information on how the contraceptive pills are obtained in Norway has never popped up in the conversation.

        But one thing I can tell you is that Czech Republic may be another good choice. I spent some time there too, but it was over 10 years ago (there were a few shorter visits later, but that doesn’t count), so I’m not sure how much the country has changed since then. I have a special affinity to history and architecture, so I throughly enjoyed myself in the heart of Europe. However, I was young and in a very good health then, so I had no interactions with any aspect of the medical system while I was there, and therefore I can’t advise you on how good it was or is. If you do decide to move there, you may want to watch out for gypsy-populated areas when choosing a place to live. I don’t know whether it is still an issue, but back then those areas were pretty scary to walk through, let alone live there. Other than that – a beautiful, compact, relaxed and affordable country, with lots to see, and very convenient for traveling to other European countries because it is right in the middle.

    • Alex says:

      Got a question on Norway: Is birth control over-the-counter there? I’m looking into different countries to live & Norway has some appeal (particularly due to the whole bushcraft thing- seems to be big there). I’ve mentioned before that I kind of use the situation with birth control as a little bit of a “litmus test” for how things go there- at least on a medical level (how dictatorial they are, how likely they might be to pull something behind closed doors or when someone’s unconscious, etc…).

      I know it’s not a perfect system (ex: birth control is over-the-counter in Mexico & they can be REAL abusive toward women across the board). I just figure when there’s little “disqualifications” like that, you might run into more of them.

      • oddvar says:

        Good evening Alex.I just recognised Your question to me now and i will answer your question the best I can.Birth control pills are not over-the Counter in Norway.You need a prescription from Your doctor or a midwife.If you are under the age of 20,you can go to a health sister and get Your prescription.There are no examination of a womans private parts,they only check the blood pressure of the woman.And if you are under the age of 20,the birth conrol pills are free.If you are more than 20 years old,you can also go to a midwife and get Your prescription.In Norway we dont use ob-gyns during pregnancy,the midwives take care of everything.All municipalites have midwives and they are well educated and all are females.They are the ones who take care of Your monthly check-up during pregnancy,they do the ultrasound and even small surgery like sewing,if necessary, during a womans delivery.And the Third Place where you can get Your birth Control pills,are from Your own doctor whom you have choosed.So getting birth Control pills in Norway are really easy.There are no examination of a womans private parts and everything are handled by females if thats what you want.I also want to add that Medical care are free in Norway and there are no Insurance Companies who tells you which doctor you shall use.You are the one who are choosing Your doctor and thats real freedom.So i Wonder why USA,who Calls themselves the country of freedom,dont give the women any freedom in Health care???Norway is a sosialist country and we really have freedom in all matters.Alex,take a look at UN developement list of which countries in the world are the best to live in.So as i said before in an earlier post,both my wife and I are happy to live in Norway.

      • Alex says:

        Thanks, oddvar. It’s good that they don’t back women into things, but I was hoping it was over-the-counter (since there’s less potential for that overall at that point). Actually, I’m a guy- but I’m looking to get the whole wife & kids thing started up and I want a good environment to do that in. I figure I’ve got to worry about the “climate” in that way, just on the level of what my daughter is going to be growing up in. The environment for my wife is a point, too- but she’s grown & probably better able to handle herself if someone tries to start some shit. That’s a big point in America, too. It’s not just talking about freedom & independant decision-making, but not functionally being that way. They also act like they approve of the kind of woman that isn’t easily pushed around, but in reality they seem to tend VERY heavily toward being disdainful of that kind of trait. There was even a case in Nebraska where a woman wasn’t allowed to use any term that denoted attack when she woke up with some guy on top of her. I’ve found that theft is theft & murder is murder by any vehicle or variation here, but when things get strange to any extent things are more or less given the “green light.”

        I have a little bit of a not-so-PC question: What’s going on over there with muslims & such? I remember hearing that there was a rape wave not too long ago & that they’ve basically invaded through immigration in some areas. I also heard that they were recently trying to get a piece of Norway, saying they’d pull something like a 9/11 if they didn’t get it & saying that they didn’t want to live with you “filthy beasts.” I definitely remember hearing about some teenagers inventing something of a reverse-chastity belt for things like that.

        I know it comes off racist or something, but people FROM these places would say that this is how things go there & it just seems that some cultures act like it’s oppression OF them to not be oppressed BY them & try to use the angle of “if you don’t act like us, you’re insulting us.” It just seems that there’s a lot of “you are our shield & our victim” going on over there.

        I guess if it was rampant, you & your wife wouldn’t really be happy there- but I can’t find direct information on that very easily because of PC culture.

  23. Apocalyptic Queen says:

    Chas – These buzz words would probably do the trick: “you are required by law to accept my decision”. Cc’ing other orgs into letters (ie. screening “authority”/ Local Health Board) can also help.

    You sound like you’ve been quite firm with your GP, so I’m guessing that he might (reluctantly) opt you out – but any problems, give me a shout. I understand what you mean about having to opt out. I was angry too but I must have written a strongly worded letter because I received the opt-out form a few days later and only one GP in the surgery has questioned me since (very politely, I might add).

    Elizabeth is right – being firm, polite (if you can!) and not explaining or justifying yourself is the best approach and no, he can’t force you to do anything (doing so could constitute a sexual offence).

    Is getting a GP to “sign off” required for opting-out in addition to filling out an opt-out form? I’ll have a look at the letters this weekend (can’t download them from my phone) because if this is the case, it needs challenging.

    I read the Jade Lane article yesterday. What an intelligent, balanced and refreshing piece that was informative without having to resort to nasty, ill-informed remarks to get her point across (not referring to any members of a particular movement of course). Yes most definitely, more of the same is needed. The message is getting out. This article would not have been published ten or twenty years ago.

    Alex – I think you are right. Another woman might be more likely to believe that the treatment is “necessary”. While not being derogatory to my own gender, my experience is that women who are susceptible to the brainwashing seem to be quite naive and maybe also, hypochondriacal on some level. A man or informed woman might look at things objectively, ie. question the risks/ benefits of treatment, so probably better for health professionals (from their perspective) not to risk being challenged at all by ensuring that patients turn up alone for treatment.

    • adawells says:

      “he can’t force you to do anything (doing so could constitute a sexual offence)”.

      Hi AQ, I looked into this some time ago, as I had a smear test forced on me against my will, when I had gone to my GP for a postnatal assessment. What I found out was that in the UK, the law specifies that rape is always with a penis. If it is with another instrument it is “sexual assault by penetration”. This can carry the same penalty, but as a “sexual” assault it must require that the perpetrator got sexual gratification from the act, and there needs to be proof that the doctor got this from forcing a pap test. Impossible to prove! That leaves “assault by penetration” which is nigh on impossible to prove. I saw a poster once say on Patient.co.uk that she went to the police about one that was forced on her, but they told her they’d heard it all before – if you attended the appointment and were lying there with no underwear on, it is tantamount to consent, and there is no case to deal with, they said. It is very difficult to show that you attended about another matter, and the pap was suggested to you “on-the-spot” and you agreed. They have got this stitched up all ways – they are a doctor and this instrument is designed to be shoved up you if the doctor thinks it necessary. It makes me very sad and angry, but I have never been able to get redress for what happened to me, because agencies I have complained to cannot see anything wrong in what happened. As Healthwatch have said, it was a “normal” medical procedure, and some medical procedures hurt, and some don’t, and it was carried out because it was overdue. I don’t think they saw anything wrong in it.

      Doctors are supposed to work by the doctrine of “First, do no harm”, but this seems to have been changed to “Do as you please to the patient” if a test has the remotest of odds of saving a life.

      • Apocalyptic Queen says:

        Did you report it to the GMC? It’s appalling that no redress (or even apology can be gained in that instance). I’m guessing with it being pre-Human Rights (and pre-civilisation by all accounts), they feel they had no case to answer as they were acting in “good faith” and in accordance with laws at the time. But it was still a violation of your right to INFORMED CONSENT and still amounted to coercion, with a doctor abusing her position of trust! – Appalling.

        You’re right, having undergone a screening test and alleging it was sexual assault would be very difficult to prove.

        The premise is that if you have attended the appointment and gone through with the test, consent is said to have been “implied”.

        If you have a doctor threatening force with a medical device in his hand and you continually refuse, but physical force is used to restrain you, then that would at least amount to assault.

        With regard to proving the sexual component of the offence of sexual assault, there was a case in Australia where a male doctor insisted on performing a pelvic examination on a patient. She later complained to the Police and he was charged.

        It was held that as no legitimate or genuine reason for the exam on health grounds could be found, it was inferred that the exam was done for sexual gratification and he was convicted.

        So this is an example where it is possible to infer sexual gratification.

        Looking at that argument, I guess a case could be made that continually badgering a patient into submission to the detriment of her health, threatening to withhold medication and refusing to allow access to a female doctor could also be inferred as sexual gratification – nothing to say that this could not happen in the future. Laws continually evolve and are ripe for manipulation.

        It makes refusal and a patient’s exercise of informed consent all the more important – because as explained in a previous post, a patient cannot be forced by her doctor to undergo a screening test. If a patient resolutely refuses to have a screening test, the only recourse available to that doctor is the use of physical force and that would constitute at the very least, an assault.

        Interesting that the Police told the patient, “We’ve heard it all before” which suggests to me that these kind of complaints are commonplace?

        That tells you something about the practice, and how patients don’t always view them as entirely medical.

      • Alex says:

        Gratification is only an accentuating factor. If a woman runs another woman over with her car, it’s still an attack whether she gets any gratification at all- including the sexual kind.

        So if someone is reluctant to cut someone else’s head off, there’s no murder taking place? What if the hold their breath while they go on a drive-by shooting? None of those people die?

        Maybe if they feel guilty afterwards the situation is retroactively altered? You know, I wonder if all this applies to prisoners & broomsticks?

  24. Apocalyptic Queen says:

    Pardon my ignorance – thought the opt out letter was in pdf format. Just had a look at it – so it seems you don’t require counselling or your GP’s permission – all that is required is completion of the form and return to the GP (though it’d probably be wise to keep a copy and send it to the screening programme and keep a copy for yourself so that you can remind the GP that you have opted out – in case he/ she denies they have received it).

    As for the opt-out letter – what a load of waffle, loaded with misleading statements. Hard to fathom that the word “no” is so incomprehensible to the NHS.

    • Moo says:

      Where i live (ontario, canada) it does not matter to a doctor if I have sent in the form to not get reminder letters for pap tests or other cancer screening. It only stops the letters from being mailed to me or any phone calls, It does not remove my name or personal information from their database. The doctor will still get my name on their reports that I was untested and a barrier to them getting their bonus reward for percentage of registered patients tested. The letter does not give them an exemption code from their quota. The only way to remedy that is for the doctor to put me off their register. The letter also does nothing to prevent the doctor from harrassing me about getting tested every time I visit for any reason.

  25. Well now this is disheartening. Dr. Bernstein has just made the following comment on his Bioethics discussion blog: “With regard to your question about what students are instructed regarding any relationship between prescribing oral contraceptives and associated pelvic examinations, I don’t know since this may be taught in the clerkship period. Certainly, a physical examination including a pelvic exam would be appropriate prior to prescribing the first dose of a contraceptive. Beyond that, I would think repeated routine pelvic exams, without symptoms, is unnecessary.” http://bioethicsdiscussion.blogspot.ca/2015/01/patient-modesty-volume-71.html#c1317483009827349752
    Scroll down to Thursday, Feb. 19th comments to see it in context. Hard to believe this was admitted, on a supposedly patient-centered discussion forum, in such a public way.

    • ADM says:

      I’m not surprised. It’s good that he has facilitated the modesty discussions over the years but have noticed that he views medical modesty as proper draping and same gender care. He doesn’t understand or will not admit that coercion for intimate examinations exists in health care and is still surprised that people will avoid health care because of intimate examinations. He still recommends the yearly routine physical which was found back in the 1970’s to be of low clinical value and does not save lives. I wonder if he understands that his requirement of an intimate exam for BC amounts to sexual assault.

  26. Elizabeth (Aust) says:

    It’s a tactic they’ve used for a long time now, but an examination is not required for the Pill, initially or at any stage. (apart from a blood pressure test)
    I don’t know how many organizations have to say that before doctors take it on board. (perhaps, some don’t want to take it on board)
    I think women will have to do the educating, and challenge and report any doctor holding the Pill hostage…forcing them into harmful excess.
    I think some doctors also, are so used to the “casual” reach when it comes to the female body, it’s no big deal to tack on invasive extras. It’s time to enforce boundaries, if it’s not a clinical requirement…don’t do the exam/test. Do American doctors mandate an inspection of the male genitalia when they’re asked to prescribe Viagra? I doubt it…(although nothing would surprise me!)
    Personally, it makes me VERY uncomfortable that a woman may be put through a breast and pelvic exam, possibly a recto-vaginal exam, and a pap test, simply because she wants the Pill.
    When these things are not clinical requirements, IMO, the exam becomes an assault. (it smacks of a doctor taking advantage either with a perverse motive, on a power trip or to pump up the bill)
    How on earth could any reasonable doctor think this is right and proper?

    Very disappointing to see Dr Bernstein is not aware of the clinical requirements for the Pill or has ignored the clear statements made by so many health groups and organizations. Why? He created a forum that focuses on breaches of privacy in medical settings, tacking on excess is a serious breach of privacy. (to put it lightly)

  27. Alex says:

    Well, that’s how they are. Yeah, I said it- ha ha (kind of).

    The concept of “required” really doesn’t matter. If they put it on the list, who cares? It’s still the same thing as a product of someone else’s decision-making. It wouldn’t make a difference if it was safer or more accurate at that point.

    Ultimately, I think that medical personnel tend to figure that their diktats (actually the correct spelling- weird, huh?) are what constitutes a medical condition. Like declaring someone dead is the same as killing them. Maybe they just figure that their stamping their foot about something is all-important? I know they have a tendancy to think that what they say goes with someone else’s self.

  28. Apocalyptic Queen says:

    Disappointing indeed – not to mention unethical, inappropriate and bordering the illegal. This needs to be challenged.

    The legal debate with Ada and Chas encouraged me to dig out my old textbooks last night! They’re pretty old (2004/05) but some of the laws are pre-HRA.

    I don’t have any medical law books but mine do cover torts violations in medical settings.

    I’m not aware of any case where someone has alleged that a coerced smear amounted to an assault or battery in torts; but it seems there is nothing in the case law which would necessarily preclude a case from being brought forward to allege that it amounted to a tort violation.

    Civil violations are easier to prove because the burden of proof is on a “balance of probabilities”.

    An assault is defined as an ‘act which causes another person to apprehend the infliction of immediate, unlawful force on his person’.

    A battery is defined as the ‘actual infliction of unlawful force on another person’.

    The two generally go hand in hand but battery can occur in isolation.
    For instance, a woman who had undergone a pelvic exam without prior consent while unconscious in hospital, could allege that this amounted to battery.

    If a claimant argued that a coerced smear amounted to an assault and battery in torts, the defendant (doctor) would use the defence that the patient gave consent.

    The case would then turn on whether the patient/ claimant did provide consent and this would turn on the facts of the case.

    A doctor’s failure to warn of the risks of the procedure thus disabling a patient from making an informed decision does not vitiate consent if the patient is aware of the nature of the procedure in a broad sense.

    However, consent must be ‘freely’ given (no duress).

    In an 1830 case, an employer forced his female employee to undergo a medical examination despite the fact that she sobbed and protested throughout. She thought that she had to comply, but the judges ruled in a majority decision that this did not vitiate consent.
    It was a very controversial – decision even for its time.

  29. Apocalyptic Queen says:

    The case (similar to the modern day coerced pap stories) would not result in the same outcome today – and duress (if it can be proved) does vitiate consent.

    For instance, in one case, a person subjected to a medical condition and undue influence was said to not have been fit to make a decision as to whether or not to consent to a medical procedure.

    It surely could be argued that a doctor could be exercising undue influence when pressuring a patient to submit. Furthermore, if the patient is suffering from depression, is anxious to secure medication or are otherwise vulnerable (after having a baby for example), surely a case can be made that consent has not freely been given, using the same logic as the case referred to above?

    Of course, supporting circumstantial evidence could help – did friends and family notice a patient was unduly upset after the procedure?

    Also, consent is limited to the act for which permission is given.
    Going to see the doctor for an unrelated issue and coming out having undergone a smear could come under this construction.

    As for proof, a GP would have a patient’s medical records which a claimant’s solicitor would specifically request as part of any legal proceedings.

    Could family, friends corroborate the claimant’s story? Could the claimant produce a script to help support the case that she originally went to see her GP for an unrelated problem?

    Not saying this would be successful but clearly, there is nothing in the case law to specifically rule out such a potential future action in torts – it basically turns on whether you can sufficiently prove that ‘consent’ was obtained under duress and so wasn’t really consent at all.

    Sorry to have derailed this thread a bit – I will revert back to topic. Might be good to have a discussion on this in the future? Any additional arguments women can use to arm themselves must be a good thing.

    I’ll research whether there have been any relevant significant legal changes in this area.

    • ADM says:

      You didn’t derail the thread at all. I would think that withholding medication such as BC for a pelvic exam and pap would amount to duress or coercion considering that those exams are not medically required for the safe use of BC. He is definitely acting unethically.

  30. Apocalyptic Queen says:

    Yes, I definitely agree with you. Most people would agree that amounts to coercion. Problem is, I don’t think it has ever been tested in a court of law.

    But the bottom line is, there is nothing in Torts (civil law) or even the criminal law (assault by penetration) which specifically preclude that a coerced smear does not amount to a violation. It fits the legal principles.

    If there is duress and undue influence, one surely has to question the value of “consent” given. It’s just a matter of proving it in a court of law and having it upheld.

    Another factor I think is, policy. If there was just one successful case, authorities would fear opening the “floodgates” for a flurry of cases ending in prosecution or compensation, as well as the programme itself being left in tatters.

    The following might be handy for those who are having difficulties reminding those pesky docs of their ethical and legal responsibilities:

    http://legal-dictionary.thefreedictionary.com/coercion

    http://medical-dictionary.thefreedictionary.com/consent

    http://legal-dictionary.thefreedictionary.com/assault

    http://legal-dictionary.thefreedictionary.com/battery

  31. Elizabeth (Aust) says:

    http://www.spiked-online.com/newsite/article/the-tyranny-of-health-down-under/16705#.VOkrC7OUd0w
    Thought this was an interesting article, Spiked is a UK internet publication covering health, politics, religion etc. The tyranny of health down under, exactly!

    • Alice (Australia) says:

      Good article! Thank you Elizabeth.
      It pinpoints it perfectly: Australian authorities think that that we can’t be trusted to act responsibly – that we need protection from ourselves.

      Though, I do agree that plain packaging for tobacco products and strict alcohol licensing laws are a good idea. Smocking is just about the worst thing one can do to their health legally (besides seeing a doctor 🙂 )

      However, they are right about the bike helmets: there are studies showing that those who wear helmets actually have a slightly higher risk of serious injury than those who go as they please. Plus, the legal demands to wear helmets deter people from cycling, and therefore from getting extra healthy exercises, and increases the amount of cars on the road, and therefore pollution, — both bad for health.

      And they are definitely right about some kind of public-health dictatorship down here! Once we accept that the government can nullify our basic rights in the name of making us healthier, we set ourselves a very dangerous precedent.

      • Moo says:

        The problem is that some people equate public health care as an avenue for the government to force people into certain things such as vaccines, exams and making other laws. I have heard people aruge that consuming raw milk should be illegal because IF people get sick from it they will use more healthcare. Or that everyone should be forced to get vaccines. Everyone should be forced to wear a helmet or a seatbelt because IF they are in accident then they use too much healthcare. IF should be not used as such a big word.

        This argument my doctor used to try and coerce me into cancer screening tests (pap, colon, breast) because IF I did develop cancer symptoms the it would cost the health system more. He did not have time or facts to prove it. Actually I feel all those cancer screenings are a waste of taxpayers money as so are bonus incentives he receives for getting his targets plus he is getting a consult fee for arguing with me about it as “patient education”.

        If I ever get pregnant at my advanced age I am going to the church to get recommended to a pro-life doctor. I heard too much about older women being coerced into abortions. People with disabilities are deemed “worthless” and a “drain” on the health system. Sorry I am not a capitalist at all.

        I beleive in public healthcare. If it is done properly it is wonderful. I wonder how Cuba handles as this female care. What are their birth rates are and ages of maternity. What are their rates of LEEP, cancer and hysterectomy?

      • Apocalyptic Queen says:

        Even that doesn’t make any sense. As well as not knowing anything (seemingly) about patient rights and doctors’ legal and ethical duties, they seem to not know an awful lot about finances either.

        I can’t think that testing every member of the female adult population for cervical cancer (costs of each tests are $70 – $85 apparently), and providing those with high grade “abnormal” changes (a high number considering around 65 – 99% have a lifetime average risk of referral for coloposcopies, potentially leading to LEEP treatments etc). The cost of LEEP treatments cannot be cheap and what about the costs incurred when women whose damaged cervixes have caused pre-term births, miscarriages and menstrual problems, seek associated medical assistance?

        Compare these costs to the average cost of providing treatment to the relatively few women diagnosed with cervical cancer. By his own logic, the doctor’s argument is flawed.

  32. Alex says:

    You know this is going to sound extreme but I wanted to say it: How is someone supposed to force the doctor to give them these birth control pills without any imposed probing? Do they have to shove their fingers up the doctor’s ass?

    Really, if somoene tried to back my daughter into a corner like that & she told me that’s what she did, I wouldn’t care. Well, I’d be worried that it could trace back to her or someone else- but that’s it.

    This is an instance of compulsion at the end of the day. She didn’t put this on the schedule, someone else did.

  33. Elizabeth (Aust) says:

    http://butternutrition.com/why-i-wont-get-a-mammogram/#comment-231271
    This looks like a US site, she’s also, written an article on pap testing, basically presenting the evidence against annual pap testing. (haven’t read that yet)
    It’s great to see some informed comments on a US website. (I’d like to see more here too)

    I was staggered to see some comments on one US website about getting rid of the annual pelvic exam, one comment has stayed with me. A nurse posted, she had a complete hysterectomy when she was young because of a “benign ovarian cyst”…why?
    She then goes on to talk about the annual pelvic exam, she thinks they should stop, she’s been having them annually for 20 years post surgery. Now remember this woman is a nursing sister.

    What exactly is her doctor checking? Her uterus, ovaries and cervix have been removed…
    How on earth could someone with a nursing qualification allow the medical profession to treat her in this way? I know some quacks justify pap testing after a hysterectomy by saying they’re checking for vaginal cancer. Honestly, these “doctors” scare the life out of me.
    If the routine pelvic exam is a useless exercise when we haven’t had a hysterectomy, how on earth could you justify its use after a complete hysterectomy?

    • Elizabeth (Aust) says:

      “The initial visit for screening and the provision of reproductive preventive health care services and guidance should take place between the ages of 13 years and 15 years. The initial reproductive health visit provides an excellent opportunity for the OB/GYN to start a patient–physician relationship, build trust, and counsel patients and parents regarding healthy behavior while dispelling myths and fears. …A general exam, a visual breast exam, and external pelvic examination may be indicated. However, an internal pelvic examination generally is unnecessary during the initial reproductive health visit, but may be appropriate if issues or problems are discovered in the medical history”

      I cannot imagine how traumatizing it must be to face a gynecologist when you’re an asymptomatic 13 or 15 year old…and endure a doctor looking at your breasts and doing an external pelvic exam.
      It makes me feel ill, if an Australian doctor suggested such a thing, I’d probably knock over furniture in my haste to get to the Police, forget about the Medical Board.
      (“No more breasts and pelvic exams?” School of Medicine, University of Utah – it’s a download)

      • Alex says:

        Who was the one saying all that? I also don’t figure it’s an “excellent opportunity” for anything, since there’s a number of problems with this branch of medicine anyway. They’re not saying “Hey, this is a high-risk, low-utility way to detect something massive rare to begin with & there’s at the very least the ability for you to do all this stuff yourself- oh, and it’s illegal for someone to back you into any probing to get birth control pills, just so you know.” So it might build false trust, but that’s it.

      • Apocalyptic Queen says:

        An excellent opportunity for grooming more like.
        People may think me extreme but taking a young adolescent girl against her wishes to a gynaecologist is abuse. 13 and 15 year olds?! I think it is totally abhorrent. These children are vulnerable in every sense – they feel intimidated by authority figures and without life experience, they do not know how to stand up for themselves. As I’ve said before, I do hate saying this but it reminds me of female genital mutilation – a practice enforced on young girls by their female relatives, only difference is, it is implemented in a Western culture.

        Ritual pelvic exams don’t happen in Europe (bar Germany) and even here in the UK, there is more open debate on the efficacy of pap tests and informed consent but in the right wing, highly conservative newspapers, I am still astounded by the number of women who believe young girls should be “examined” and “pap tested” as soon as they start their periods and they won’t filter in any counter arguments or evidence that the perhaps more educated commentators tell them, so if it wasn’t for our policies which dictate that these practices are medically unneccessary and so are not routinely carried out, these women would also be dragging their daughters to the GPs also. In fact, they don’t seem to be able to understand why this is not medically neccessary.

        I know a lot of these mothers have been fed decades of misinformation, but they also seem to inadvertently be part of the culture which continues to promote this.

        I hope the number of female Ob Gyns outnumbering their male counterparts may help rectify this misinformation to young women – as I’m sure some of the reasons for the stubborn persistance in these practices lie in paternalism within the Ob Gyn culture, stubborn adherence to old practices and control over some of these young women.

      • Anna says:

        I did undergo a breast exam and external pelvic exam at 13. This was done by a pediatrician during a school physical (I’m in the U.S.). I had even asked the nurse before she left the room if I would have to remove my undergarments during the exam and she said ‘oh no, of course not.’ So apparently this wasn’t a standard part of the physical. I had never felt so embarrassed, humiliated, and degraded in my life. I felt physically ill afterwards and I locked myself in my room when I got home and burst into tears.

        When I told the (female) doctor that the nurse said I would not have to remove extra clothing, the doctor replied ‘well you have to get used to it.’ I will never forget those words and I see red ever time I hear them, no matter the context. I am so grateful for finding this site as I don’t think I could ever bear going through another intimate exam.

  34. Elizabeth (Aust) says:

    Hope you’re right AQ, but I’m not hopeful. I told myself decades ago that things would change as more women graduated from medical school. Not much has changed, most have adopted the same offensive model…mandating cancer screening for women, embracing opportunistic testing etc. I suspect these attitudes are formed and encouraged in medical school, and of course, these attitudes and practices are never or rarely challenged.
    Change will start with us, with individual women pushing back and refusing to be treated this way. The mantra should be…my body belongs to me, consent and informed consent matters.

    The profession has made no effort to change over the decades. Many can’t SEE how women are treated by the medical profession, by these programs and others. We’ve been trained over decades to view this as important medical care that’s in our interests, but when that violates legal and ethical boundaries, it’s not care, but abuse.
    I watched Q & A last night, the topic was domestic violence. One young women said she didn’t feel safe in Austalia, that men felt they had a right to her body etc.
    Yet no one would think to include healthcare and screening in that issue, but I think it’s a serious issue when the Pill is still locked behind a script, when women often face coercion and pressure to screen and have unnecessary exams when they ask for the Pill, when a screening story is fine for women, but men get real information and a choice. Informed consent and sometimes, even consent itself, is not respected for women in this country. Outrageous public comments made by male spokesmen for the AMA pass without comment or any sort of challenge. I know there would be an outcry if they spoke about men in this way. It means many women feel abused and violated in the exam room, by a system that encourages and rewards doctors for treating women in this way. Being scared, pressured, coerced or misled into a penetrative vaginal exam amounts to the abuse of women, I’d call it assault.
    Abuse comes from many quarters, including the way girls and women are treated in healthcare.

  35. lou says:

    Since last year I received a another letter stating I haven’t had a pap test. I will continue to ignore these letters from the medical clinic.

  36. Alex says:

    I wonder if patients started mailing letters to doctors & their offices that THEY have not received the screening that they feel they should have? “It doesn’t matter what the utility of it would be, I think you should come over to my house & let me probe you.”

  37. Alex says:

    Anna: That’s horrible! I’ll bet that this was presented as something other than an affront when you told your parents about this- it’s like there’s a blindspot for unconventional attack.

    This is a big part of why I want to leave this country- I don’t figure my kids would be reasonably safe from things like this. Just out of curiousity, what year was this? I’m just trying to get a sense of if it was one of those “it’s the 50s so you’re wrong” kind of things or the modern “you’re wrong for stopping us from doing something to you” that’s pretty common now.

    There was actually a case in 1995 or 1996 about them ambushing 59 girls (who were somewhere around 11 years old) with pelvic exams. It seems that it got penetrative with at least some of them. This was in Stroudsburg, Pennsylvania- if you’re trying to look it up.

    I’d teach my daughter that if she couldn’t win & she couldn’t get away, to give them a memory that doesn’t wash off! That’s iatrogenic child molestation! It’s a bizarre thing that an instance of a girl that age doing some kind of role-playing thing with a guy her age or a little older would probably be seen as an assualtive situation, regardless of consent.

  38. Anna says:

    Alex: This was about 10 years ago. I didn’t know enough to refuse the exam or even tell the nurse what had happened. I’m not sure the doctor would have been disciplined anyway.

    It’s hard for kids that age to stand up for themselves because we’re all taught that doctors are ‘safe’ and trustworthy. Obviously not true.

    I looked up the Pennsylvania case and was shocked that school authorities seemed to think there was nothing wrong with what happened. I don’t know what they put in the water in this country.

    • Kleigh ( US) says:

      They said the same to me when I was 17 ” you have to get used to it bc next year you have to start having pap smears. well that never happened , im 30 now and never went for gyn checkups I never belived I needed. im healthy and alive. no one has to to get used to any thing or “has to have any exam. I hate the way doctors talk to woman like they own are bodies.

    • Alex says:

      So you’re a bit younger than me (I’m 27). This could have easily happened to one of my cousins. Sure, there’s no exchange of situation by imagination, but if there are broad actions or ambient conditions it still applies as a concept. This is like putting poison in Halloween candy- even if no one eats it, that’s still “pulling the trigger.”

      A major point that I’ve noticed is that they (both medical personnel & the school employees) seem to think that they basically have a blank check to work their will. That “life wants to live” & since life isn’t just biological activation (it’s also the activities & conditions that make up one’s situation) they act like it’s self-protection to maintain an attack. There’s a general condition of unwillingness to push people around that gets used to facilitate attacks & the thing is that self-defense IS contradicting someone. It’s outright going against their wishes, but is a different context- just like shooting someone that broke into your house as opposed to shooting someone that you invited to your house. There’s no way to say something so that someone else can’t lie or twist your words, so making your case with matters of right & wrong can be tough to do. At the end of the day, someone can always say “I know it’s a problem, but I like problems” or just do something & say nothing.

      On that note: the accusation of being a hypocrite is a pretty common tactic- someone acting like the person is doing exactly what they are against by going against them. It’s merely an attempt to win more room to operate & a more favorable environment to do things like this. I think that people try to convince someone that the ones they are addressing are just like them to try to capitalize on their self-preservation urge. Same with acting like whatever happened was their fault- it destruction of life in the activities sense of the word. Sneaky tactics that I doubt someone that does them could actually put into words, but then one doesn’t necessarily need to be able to articulate something verbally to have a grasp of the situation.

  39. Kleigh ( US) says:

    that was also way over the top for a school physical. breast exam and pelvic on a 13 year old . I will never tolerate that if I have a daughter.

  40. Apocalyptic Queen says:

    Just seen this link in relation to child immunisation in Australia: http://www.bbc.co.uk/news/world-australia-32274107
    Seems that Public health over there appears to be very militant indeed.

    • adawells says:

      The Australian PM says that unvaccinated children are a risk to the rest of the population in this article. How can they be a risk to those who have been vaccinated since these children are now immune? Doesn’t make any sense to me.
      In the UK GP’s receive incentive targets (heard that before somewhere?) to vaccinate 90% so 10% have a choice. We don’t immunise against chicken pox here. I had it very severely as a child,
      And this is the childhood illness I was most concerned about for my own children. One still hasn’t had it.

  41. Elizabeth (Aust) says:

    Yes, militant is the word, I don’t agree with coercion. The heavy hand coming down, “do as you’re told or we’ll punish you!”. I think education is the way forward, let’s have a public debate about vaccination, let’s be calmer and more open about it. I think this measure will just make some parents more suspicious and fearful.
    A high profile anti-vaccination person was headed to this country earlier in the year, protestors made sure that venues cancelled, and from memory, the tour didn’t go ahead. Some called for the woman to be refused entry into the country.
    Wrong move…if this woman is talking absolute rubbish, why are we so fearful? We always seem to go back to…silence the dissenters! (doesn’t this sound familiar?) Let’s hear what she has to say, let us judge. I also, strongly disagree with this idea that we shouldn’t hear anything that might put us “off” something…if something stacks up, the evidence is there, let it speak for itself.
    We missed a perfect opportunity, to invite her to debate the subject with one of our vaccination experts.
    What next? Mandate Gardasil, pap tests, mammograms OR else….you pay more tax.
    We’re also, thinking of introducing a call and recall system for cervical screening, similar to the UK, it gives them greater control over women. (informed consent…what’s that?)
    Ehealth records…some say that means more information for them, more control, less privacy. (I must have a closer look at this subject)

    • Moo says:

      Used to be that some countries threw people in prison and oppressed them for their POLITICAL views. So now it is for medical viewpoint? Is the new political viewpoint, a medical viewpoint?

      There is a current fuss in my city about a juice bar in a large health food store where an employee was found to hepatitis A. So now the public health is asking all the regular customers to get hep A vaccines. Hep A is spread by the fecal oral route. People should be more concerned about the juice jockey’s handwashing technique and often these workers also wear gloves when handling produce. These workers are required to have government sanitation training and pay a fee to sit an exam. It is just propaganda.

      • Apocalyptic Queen (UK) says:

        I have long thought about this. Our western countries (well UK & the US) spout about tyrannical countries for their political oppression and want to invade said countries at the drop of a hat, yet our so called “democratic” countries either support (or turn a blind eye to) silencing those who want an open debate on the efficacy if mass child immunisation and screening programmes (only for women of course) and encourage the harrassment of parents and women who choose to exercise INFORMED CONSENT against low utility, or dangerous and invasive procedures. In the case of screening, many women are bring denied control over their own bodies and what happens to them! While neither is desirable, I am thinking that I’d rather be politically oppressed by a government than medically oppressed. Our governments are totally hypocritical in some instances and public healthcare is becoming a powerful and corrupt lobby group, far too big for its boots.

    • Apocalyptic Queen says:

      Will there be a consultation on the proposed call and recall system? Shame there is no lobby against it because it needs to be prevented from happening. You are right – the recall system enabled doctors to harrass women systematically and allows far too much control and information recording, it is state sponsored harrassment. I’m sure you mentioned that Australia will be upping the screening age to 25 as well. Is this correct? If so, it could be a saving grace. I feel the upping of the age in England and Wales has forced discussions regarding the reliability of the test because policy makers have been forced to concede to the militants why screening is not really needed on the under 25s hence those awkward discussions in some media outlets concerning “false positives”, false negatives and harm. There are various campaigners, doctors and militant women who continue to campaign to lower back the screening age as well as spout about.them being “necessary” for all women, but by and large, the upping of the age did help contribute to a more open debate on the reliability of screening in general and this might also be the case if the screening age is upped in Australia because policy makers will have to admit why the change is taking place after insisting it was necessary to screen young women for so long, ie. that the test was never as accurate as they had all been insisting for so long.

  42. Elizabeth (Aust) says:

    The visit by Peter Gotzsche was similar, I’m surprised they let him in, but then they managed to keep his talks about breast screening under wraps, I heard about them later, and the media coverage was benign, “A Danish Professor with some controversial views on breast screening”…hardly. Once again, I’m sure they’d argue, we’re saving lives, don’t want a dissenter putting women “off” this lifesaving test. (and we’re still chasing that target, don’t want him scaring the herd) There was coverage about the over-use of psychotropic drugs and over-diagnosis in psychiatry though.

  43. Kleigh US says:

    Just got back from the grocery store, those womans mags make me want to thro up. telling womqn whqt they should be doing with there bodies, like geting pap smears and not to question there doctors. no wonder so many are brain washed. i used to love to look at all the clothes and fashon in the mags now i cant stand them. womans health has taken them over for the most part. did it ever acuer to these pple that woman may chose not to have paps or gyn cheeck ups every year? dont get me started on the teen mags. “when should i start going to a gyno.” Barf.

  44. Bridget says:

    I am going in to the doctor to discuss my anti-depressents and not for reproductive reasons myself. She’s a new doctor and I hope she doesn’t give me hell or something about it! This is my body and my choice. Didn’t women fight for the right to vote, have abortions, and any other thing we deserve to have? I am not pregnant and don’t plan to have children ever. I do like kids, but it costs time, money, and energy to have kids. I have regular periods and will discuss hormone treatments with her when the time is right!

  45. Chaste4ever says:

    I greatly fear that one day in America, women will be required to undergo these tests. I’ve noticed that every time that I tell someone that I am refusing the examination, they automatically provide some reason that I should have it or get into an uproar. I’ve noticed that the Planned Parenthood issue has been in the news a lot lately. It makes me nervous because, while I am not necessarily a supporter of abortion (except in certain cases), I don’t agree with making it completely unavailable or making healthcare for women that want it completely not affordable (I don’t use these types of examinations, but I think women should have rights to decide what happens to their bodies).

    I have even heard of some pharmacists trying to talk someone out of taking the ‘morning after’ pill, in hopes of stalling enough that the baby starts to develop and the pill is ineffective. Where will it end? I also know that some military programs required female examinations. Why? There are no male examinations of this type.

    Nonetheless, women that have had children are automatically subjected to extremely large post-partum speculums. This doesn’t make sense! The one that they use on ‘normal’ women are already far too large for the opening. After a woman has a baby, her muscles become tight again. Why rip her back open with this type of speculum? Also, pregnant women in labor are subjected unknowingly to episiotomies (a cutting of the vagina to make the child come out easier) unless they specifically state that they do NOT want one. This is not discussed with women, so they do not know that they are getting one until they later realize that they cannot have s_x with their husband due to scarring.

    America truly has some sort of sick problem with trying to control the s_x lives of women. If she has not lost her virginity by 15, she needs to be ripped apart with a speculum. If she’s a virgin at 30, she’s lying and needs to be ripped apart with a speculum. If she survives all of that and enters a successful marriage, then she needs an episiotomy and a LARGE speculum to rip whatever is left of her vagina to ensure that she cannot have fulfilling s_x after a birth. It’s like they have already decided that a woman’s s_x life begins at 15 and ends at 25 and will do anything that they can to make it the truth.

    I am engaged and in my thirties and I have never had s_x and have avoided pelvic exams like the plague. I intend to have a fulfilling s_x life with my future husband and I will turn down all unnecessary exams even while pregnant (if that happens). I will also request a C-section so that doctors will not have any reason to even touch my vagina and I will make sure that my husband is present and can talk if they try to touch anything.

  46. Alex says:

    I wouldn’t suggest thinking about “necessary” or not- since at the very least they can always string together all kinds of specious reasoning (connecting false dots is the way I think of it).

    Also, an action has to be engaged in order to occur, so technically there would be a “need” in order to accomplish the action. There’s a question of POTENTIAL UTILITY, but then there’s always the use of doing that particular action.

    What happens when a need goes unfulfilled? It doesn’t happen, of course. I think a lot of people instantly equate that with dying, though. Even if it did, there’s a question of sutability.

    Another thing is that doctors act like people are trying to recruit them or like they are being solicited for an opinion for the other person to adopt. That’s not the case, of course- but it’s kind of like a Jedi Mind Trick. It’s just implied, because that’s what would have to be the case for what they are presenting to be true- instead of just plainly stating something & someone thinks it’s true as a knee-jerk reaction.

  47. EMarie says:

    Thank you so much for writing this! Those funny pics really made my day. My doctor is trying to get me to get a PAP smear and I told her before I don’t want it. I’m in my 50s and never had a relationship (thanks for not laughing), and the last time a doctor tried to PAP me it hurt so bad that I had to make her stop. Even though my current doctor is said to be very good at these tests, I’m still afraid and would rather not have this done. If they’d only give you a local anesthetic at least, then I’d give my consent.

    • Elizabeth (Aust) says:

      Hi EMarie, welcome to the forum.
      Forget about local, if you’ve never been sexually active, have had no sexual contact, you’re not at risk of cc and cannot benefit from a pap test. HPV is an STI, in rare cases high-risk strains cause changes in the cervix that over time become cancerous. Most women simply clear HPV within a year or so. Cervical cancer is fairly rare in the developed world, lifetime risk is 0.65%
      Given you’ve never been sexually active, you don’t have to worry about HPV or cervical cancer.

      A pap test would be an unpleasant and painful waste of time, it could even risk your health, older women are more likely to get a false positive because of normal changes during/after menopause so you might then be looking at re-testing, an unnecessary colposcopy and excess biopsy.
      You shouldn’t feel the need to tell your doctor that you’re a virgin, it’s your business, just confirm you don’t want pap tests and would prefer not to discuss the matter at every visit or even send a letter asking for a note to be made on your file.
      I went doctor shopping until I found someone who’d respect my decision not to have pap tests, I’ve used her for many years now and my consults are about the reason for my visit, not going over old ground.

    • ADM says:

      Legally and ethically a Dr has to respect your wishes to not have a medical test or treatment. If you have made your wishes known and your Dr continues to bring it up in an attempt to get you to screen they are acting unethically and illegally. It is coercion to continually bring it up in an attempt to get you to screen. A Dr is also required to provide you with the information about the benefits and risks and screening to allow you make an informed decision.

      • EMarie says:

        Many thanks! They had sent me a letter wanting me to make such an appointment…I’ll be sure to let them know I’m saying nay-nay. 😉

    • Alice (Australia) says:

      Marie, for a person who has never had a sexual contact (nothing to laugh about — it’s a personal choice and no-one’s business), a chance of getting cervical cancer is less than winning a million dollar lottery with one ticket. Which means, you cannot possibly benefit from an antiquated, unreliable, humiliating and painful PAP testing. At the same time, a chance of being sent to even more painful further investigations and follow-ups is about 77% for women who submit to PAP smears.

      In many countries, doctors get insensitive payments (government-sanctioned medical bureaucratic bribes) if they pressure a certain percentage of their female patients into cervical cancer screening and surveillance of their reproductive organs. That’s probably why you are being told to do this test even though all scientific evidence suggests that you can only be harmed by this tests with no possible benefits.

      • ethelgrimes says:

        Alice, I wouldn’t be at all surprised…especially with those of us who have insurance (I’m on Medi-Cal) , it seems once we start hitting that 40+ or 50+ and up mark the docs want to do a bunch of stuff to us. I have no issues with mammograms—I get one every year and am treated very well during the exam—but gynos are a whole different ball game. I had to go through one when I was 14 (I was having trouble with my periods) and it was a frightening and painful experience. So now that I’m grown, I think I have the right to decide who gets near my “junk” .

      • Alice says:

        You may like to do some online research about mammograms and the risks of breast screening. So far, there is no hard evidence that screening actually prevents cancer deaths. There is evidence however, that radiation and pressure from regular mammograms can cause the very cancer they are meant to “catch early”.

        While breast screenig is less painful, invasive and humiliating than cervical screening, it is no less dangerous.

      • Elizabeth (Aust) says:

        Ethel
        Yes, I agree with Alice.
        I’ve declined both cervical and breast screening, informed decisions.
        A mammogram every year is a lot of radiation and of course, it accumulates in your body.
        I know Professor Michael Baum, UK breast cancer surgeon, has expressed concern that early and frequent breast screening may actually cause breast cancer.
        For me…it comes down to over-diagnosis, I think the risks of screening exceeds any benefit.
        I’d urge you to read the Nordic Cochrane Institute summary, they’re an independent, not for profit medical research group. Don’t trust anything coming from these programs or from medical association, they all have a vested interest in screening. I’ve also found politicians and women’s groups tend to spout the screening “story”, rather than the evidence.
        http://www.cochrane.org/CD001877/BREASTCA_screening-for-breast-cancer-with-mammography

  48. kleigh us says:

    I went to a clinic with my grandmother and low and behold they had a whole part of the patent history question sheet marked “for woman only . obstetrics and gynecology.”. The questions were when was your last pap smear? And check it it was abnormal and also mamo gram and was that abnormal. Do you use condoms? And what BC do you use and do you want to be screened for STDs. This was only for female patients not males. I found it very annoying esp that only woman were asked if they wanted std screening. Errrr

    • Alice (Australia) says:

      Looks like that clinic thinks that only women get STDs.
      I’d return that sheet empty, or crossed over with one word “IRRELEVANT”. And if the clinic still insists on filling it, leave the quackery den for good. A place like that cannot provide a decent medical service anyway.

      The medical system and the government believe that female reproductive organs are the property of the state, and therefore need constant motoring, testing and surveillance as the authorities see fit. Whatever the reason for seeing the doctor is, every doctor must find a pretext to check out the woman’s vagina. Otherwise it is not a “high quality, comprehensive health care”.

      • kleigh us says:

        I agree . the pa only addressed my grandmothers tooth infection but when he was gonna give her a shot to numb the tooth she got upset and said she was scared BC the gums were so swollen and tender she was scared of the injection. The pa made a comment that he didn’t know why woman were so scared of him that he was a nice guy. I’m assuming they do physicals there and the table had pull out stirrups.

      • kleigh us says:

        Something else swabing a mans penis does not bring in the revenue like a pelvic exam does on a woman for STDs and that is the way most still screen . most woman aren’t told they can test urin. Very telling if you ask me.

    • Elizabeth (Aust) says:

      I agree with Alice, one look at that form and I’d leave and send them a letter of complaint. I would never answer such personal questions, if I want their advice or a screening test, I’ll ask for it. I’d be tempted to write, “None of your business!”.

  49. kleigh us says:

    I’d like to add it was for my grandmother to be seen for a tooth.

  50. kleigh us says:

    Oh and do you have sex with males or females.

  51. kleigh us says:

    Sad part is hear in the Us its like that where ever you go . weather it be a doctor or walk in and even some dentist want gym information. Its never have you had this or that, its always ask for a date of the exam. Makes me sick

  52. kleigh us says:

    Gyn info I mean.

  53. kleigh us says:

    And asks if the results were abnormal.

  54. Emily says:

    Apparently, way way back there was something called ABC that they were supposed to go by to help them determine if it was necessary. A was for abstinence B was for both faithful or been fathiful and C was for condoms. Whatever happened to that?? Probly the greedy SOBs werent making enough money so they just decided “hey let’s just make all women get them and not tell them they don’t need it”…isn’t our medical system just great? <—–sarcasm

  55. ethelgrimes says:

    Alice and Elizabeth, thank you for letting me know about mammograms. I hadn’t considered about that radiation, and that’s pretty scary to think about. Do they use radiation in colonoscopies? My doctor’s insisting that I get one of them too, and I wouldn’t mind getting out of that one! (It’s not so much the process I’m dreading as the prep-work. )

    • Elizabeth (Aust) says:

      Hi Ethel
      There’s a lot of real information on mammograms on the net these days so do some reading and then see how your feel.
      I’ve thought long and hard about bowel screening and decided not to have a colonoscopy, it’s such an invasive procedure and on the evidence it doesn’t reduce overall mortality.
      People who have a polyp removed assume it would have become cancerous, in fact, only 3% would progress to cancer.

      Dr Gilbert Welch and his team at Dartmouth are doing a randomized controlled trial comparing the FOBT with the colonoscopy, he’s concerned the colonoscopy is favoured in the States because it makes a fortune for vested interests.
      If the FOBT produces the same or better results, it might be a better option for those who choose to screen. If they find a trace of blood in your sample, you might re-test but the next step is usually a colonoscopy. So people need to be prepared for that when they agree to the FOBT. (blood can also mean an ulcer, haemorrhoids, a small tear etc.)

      Some people take the view…well, if they find some blood, I want to know where it’s coming from so I’d agree to a colonoscopy under these circumstances.
      I’m saying…approach all screening cautiously and from an informed position: these tests can harm us and even take our lives, it’s worth our time to look at the other side of these medical recommendations.

      • EMarie says:

        Whoops! I usually post as EMarie and I goofed it up somehow. Oh well…let the world talk.

        Thank you for your information, Elizabeth. In fact, I did have an FOBT some months ago, apparently with no problems. I did in fact have bleeding issues years ago, but they had to do with hemorrhoids, I believe, and I’ve had no such problems since, thank God.
        If a colonoscopy isn’t all that necessary, I’d just as soon not go that route. I don’t know why people want to keep sticking instruments up my wazoo…probably because I refused to listen to people who told me to do that to myself, lol.

        All kidding aside, surely in this day and age there are safer and far less invasive ways to find out what’s going on with our bodies. And it shouldn’t matter what kind of insurance you have…or not.

      • Moo says:

        Where i live there is colon cancer screening programme where like the pap registry all those of a eligible age are sent the scare letters. They use the FOBT test and anyone getting a positive is pushed for colonoscopy. I looked up the FOBT test and it is not accurate at all. It can be effected by what a person eats, bleeding gums (flossing) and hemorrhoids. A better test is the FIT which only detects human hemoglobin but still it is not accurate if a person has certain conditions such as hemorrhoids.

        There could probably be a test out there that actually detects proteins that colon cancer cells give put but too many people are profiting from the colonoscopy clinics. I doubt these colonoscopies are 100% safe. There are risks involved. The equipment has to be cleaned and sterilized properly.

        So I suggest anyone read up and know the risks.

  56. linda says:

    Hi EMarie. There are safer and less invasive ways of doing almost everything. We live in an age where we have full body scanners, the human genome has been mapped, blood and saliva tests can reveal everything about you. But hey! Welcome to earth. Why do all of those things when you can stick things in someones wazoo, or waff, or have a good grope of some waps.

  57. rah says:

    I know I’m awakening an old post… But I just wanted to point out:

    Why don’t people get regularly checked for EVERY OTHER RARE cancer too while their at it?

    no thanks

  58. Jenny says:

    I totaly know what you mean about pap tests. It seems there is so much pressure on women, to get their annual exams. I figured out that this whole thing is a scam, when I found out that nesrly 95% of women have HPV.
    That sounds like an epidemic. And how does the medical industry deal with it? By victimizing women, and puting guilt on them for not always having their annual exams.

    Another way in whicj I am feeling victimized, is making a doctor belive I am not Pregnant.
    Sure, I am a woman, and I might have the ability to get pregnant, but I am sure I would know if I am pregnant.
    Instead, one doctor insisted I have a pregnancy test…which I already knew I didn’t need, because I have not had intercourse in over a year!
    Maybe “victimized” is not the word, but mayne “stigmatized” is. Either way, i dont think its right for a doctor to force a test on me…especially if the doctor will make a profit from it.

  59. Mandi says:

    Thank you SO much for this! I went today for a “wellness” visit for my insurance premiums and the 9,000 year old doctor treated me like I was shooting meth up in front of him when I told him I hadn’t had one in 3 years.

  60. Kleigh says:

    I havent had a pelvic exam since ibwas 17 and im 31 now. I think its over the top and its been taught to them by there schholing/. Profestion that woman desperately need thses exams. Its bull.

  61. katrehman says:

    And I’ve not had a smear test in 16 years!!

  62. ethelgrimes says:

    Just got a letter from my doc today insisting (yet again) that I make an appointment for one. That didn’t exactly make my day. They’ve told me she’s really “good” at it, but that’s not enough to get my feet up in the stirrups. I still can’t forget how it hurt with that other doctor trying it; not to mention, I’m very self-conscious about that part of my body, even with a female doc.

    I know I’ve discussed this topic in the past, but I’m pretty agitated that they don’t want to let this thing go, even if they might feel it’s necessary.

  63. Dr.Sunshine says:

    Dear Women,
    Being a female medical student, I felt the need to write the following:
    First of all, it’s true, doctors SHOULD NOT IN ANYWAY force things on patients. But still, they’re obligated to explain. from what I’ve read, it doesn’t seem like you’ve given a chance for the poor doctor to explain the procedure nor why it’s done so you’d decide. Sadly, you just searched on the internet why pap smears are bad. I don’t know what medical databases you have access to, nor do I think that you have access to any!
    Dears, we medical students are being taught almost everyday how to make everything as much cost effective as possible for the patients!
    And taking pap smears as an example, few years ago, pap smears used to be recommended to be done once the female becomes sexually active no matter how old she is. and it used to be recommended to be done every year! however today, it’s recommended to have a pap smear test every three years for women of age 21 years old to 65 years old! or to have it every 5 years if done with the DNA test for HPV virus. can you see the difference now?
    how did doctors reach the conclusion that they should change the guidlines? because of the contineious research and case reports that are published to make everything as most effective as possible (taking into consideration their financial and psychological well-being).
    Do you want to know why doctors recommend this procedure? because it can be curable and prevented easily! there’re many cancer screening tests that have been discontineued because they showed that they’re not effective (they waste people’s money and increase the anxiety level). but as far as i can tell you for the latest guidelines (because we have the right reliable medical resources, while you don’t! and you can’t compare years of studying and specializing to a lame google search that you casually can do when you’re bored), pap smears are recommended and are still being used for an easily treatable and preventable cancer.
    The sad thing is that we spend our lives and sacrifice our youth to learn how to save lives, I feel unappreciated when i read or hear things like that. and when I see how far people can go with blaming doctors for everything, forgetting that they are human beings who are just trying to help!
    yes there’re bad doctors, but the majority just want to help!

    • Mint says:

      Dear Medical Student,

      I sincerely hope that you improve your spelling and grammar before you launch yourself into the medical world.

      You have no idea what sort of access the contributors to this blog have. Luckily for you, even though you do not seem to have grasped the above skills, you will get an “A” in how to belittle your potential patients.

    • Mary says:

      Dear Dr Sunshine,
      I am a medical science student and I have access to peer reviewed journals. I also share my information with the smart women here. As you know, medical students are taught by being given vast amounts of information at a very fast rate. There is too much information to learn anything in depth and with nuance. So, for example, my histopathology textbook states that pap smears are the most successful screening program ever done. For a start, there were no randomised controlled trials so we can never be sure if screening was responsible for the drop in cervical cancer or it was because of something else, such as increased condom use due to the AIDS scare. And if you google Angela Raffles, she will show convincing evidence that pap smears were not as successful in reducing cervical cancer as medical students and doctors think. Thus while you may learn everything by rote from your medical textbooks, (which can have errors), the women here are critical thinkers. Therefore, we dig deeper for information from credible sources rather than memorize facts that are not supported by empirical evidence.
      The women on this blog are more informed than many doctors I have met. For example Elizabeth has been saying for years that 5 yearly pap or HPV testing is far superior to twice yearly or yearly testing. Well guess what? Only now the authorities are doing what Elizabeth has been saying all along. She is years ahead of the screening authorities.

      Finally, I am quite dumbstruck by your rude, patronising post. But I presume being taught the god complex is part of the medical schools’ curriculum.

    • moo says:

      1. Doctors do try to force procedures, tests and prescriptions on patients.
      2. When they spend the average time of 5 minutes or patient consult they do not have time to explain anything.
      3. Where I live the HPV test is an add-on to the pap test that the patient pays for out of pocket. Why is a self HPV test not available at a pharmacy that I can use in privacy? Preganacy tests and other diagnostics tests are available at pharmacies. I can make my own decisions about those tests results but if I get a pap test the results are automatically put into a government registry and I will get harrassing letters to continue testings or get treatments I would refuse.
      4. Never have I met a doctor who was worried about cost or anxiety to the patient. More of them are worried about making more money for themselves, how much they can charge insurance companies and getting their quotas for cancer screening bonuses.
      5. Sure it cost a fortune to train as a medical doctor so the tuition fees should be free or greatly reduced to those students who qualify. Some countries such as Ireland have free tutition for doctors. It should be free in my country since it would greatly reduce the overbilling.
      6. Somehow I never have my car mechanic or hair stylist or lawyer complain about how much they spend on their education, training and overhead nor do they refuse me as a client for not wanting to take their advice and pay for services that I do not want.
      7. Sure doctors are only human but they do get blamed for everything that is why they have to have malpractice insurance as do many other professionals: engineers, lawyers, car mechanics, construction contractors.
      8. I am not stupid because I google. I have googled many studies published in peer reviewed journals.
      9. Did you know that green tea extract destroys the HPV virus? Why is there no medication developed for CIN from greeen tes extract although it is available for external warts?
      10. You really want to help people then volunteer at a clinic in a poor area or go for a few months to pratice in an improvished country. That would be appreciated.

      • adawells says:

        https://evekit.com/ Moo, I saw this on the internet the other day. It’s for an HPV self test kit costing $85. I think they’re based in Toronto.

      • moo says:

        Thanks for the info about the eve kit.
        https://www.ratemds.com/blog/women-in-canada-and-the-uk-can-now-test-for-hpv-and-stis-at-home-with-this-kit/
        The kit tests for two STI and HPV. I could not find information if the HPV results state whether the HPV strains are high risk. It must be a positive or negative result. The test kit does not require a doctor’s prescription and the results can be viewed by the woman herself by her computer. So far this sounds good to me. Some information was not given. I would just like to know if the results are reported to a doctor or to the provincial health board or cervical screening registries. But $80 seems somewhat expensive to me.

      • Elizabeth (Aust) says:

        Any HPV self-test kit freely available to women is becoming a rarity, the programs and medical profession have worked out it’s a way around the program and their services.
        Here self-testing will be blocked until women decline the invasive HPV test for 6 years and it will probably be offered to women who’ve never screened or not for a long time. The idea here is to get women into the program, “hard to reach” women. (is often the expression used)
        So now the Delphi Screener can only be ordered online if you include the name of your GP. I assume you have to see your GP to get your results, and probably handed on to the program. Unfortunately, getting the word out to women about the Delphi Screener also (I fear) alerted the program and vested interests, so once again, we see block-and-control-the-herd measures applied. There’s no doubt in my mind that they’re watching forums like this one.

      • adawells says:

        I have found about 4 or 5 HPV self-test test kits available online in the UK, costing between £50-£200 each. The companies supplying them don’t say they need only be used every 5 years, they suggest using them for frequently than that, so they get more money. All of them say in the small print at the end that women “must continue with pap smears as they are vital”. I think this was in response to a complaint from a GP that HPV self-test suppliers were selling these kits as an alternative to the speculum test, and saying women needn’t have smears if they had a negative HPV self-test result. That GP’s name: Margaret McCartney. The UK Advertising Standards Authority ruled in her favour and I think the company closed down. Too much a threat to the programme. The Daily Fail recently published an article on HPV self-test kits, also saying they can replace the speculum test, but on the NHS Behind the Headlines webpage, they have criticised this as being untrue.

    • adawells says:

      Sunshine, you seem to be very limited in your knowledge about what is going on in the rest of the world. The Netherlands and Finland have only 7 pap tests starting at age 30 and then only every 5 years during a woman’s lifetime. They’ve been doing this for years and years. They have some of the lowest rates of cervical cancer in the world, all achieved with just 7 tests compared to America’s 50 tests during a woman’s lifetime, many of these unnecessary tests resulting in a multitude of stenosis/biopsy damage, childbirth complications if not total hysterectomies. The rest of the world is often astonished at the unnecessary medical interventions American women endure. It is all done because medicine is a business, and poking around in women’s vaginas is a billion $ industry making people like yourself huge profits. Have you never wondered why your hysterectomy rates are the highest in the world and double or 3x those of other industrialized nations? But why should you, you are a trainee doctor and your job is to sell invasive medical procedures, not spare the public from having them.

      • Dr.Sunshine says:

        well, we’re being taught to test women every 3 years by the pap smear test, until she becomes 30 years when she’d start doing the pap smear alongside the DNA test every 5 years. So that’s kinda similar to what you’re saying.
        and i assure you that where I’m getting my medical education, they tell us everyday not to do unnecessary tests and procedures and to make everything as much cost effective as possible.
        I think it goes down to the individual doctor. that’s why you should never generalize, which is exactly what 90% of people who commented here did!
        I assure you that what got me into medicine is to help people and to do what I’m passioonate about! not for the money! And I’m sure that a lot of doctors got into medicine for that!
        And after what I learned, I could see myself advising women to do the pap smear test, because in my own opinion, it’s important. and as you are educated women and you know what this is about, many are not, and they need medical advice to decide for themselves.
        so maybe your doctors are actually doing this because they’re concerned about you, and because they want to get the cervical cancer incidence even lower, to save the world from one problem when they can.

  64. Penelope says:

    Aye Me, Oy Ve, and WTH, Dr. Sunshine:

    First, I’m starting to wonder if you’re really female. This is because it’s incredible that another female – ob/gyn student or not, would be so glib about such a personal women’s issue. Perhaps you really are a male medical student posing as a female, who thinks we will “listen” to such a condescending speech if it’s coming from another “female” Secondly, I wonder just how much real world experience you’ve had with your profession to be so conclusive and dismissive of the THOUSANDS of comments on this site who have shared personal, firsthand, horrifying, traumatic experiences at the hands of ob/gyn’s; who share link after link of professional articles and medical information; testimonies……how can you?

    I was thinking, – “Yes!” to Moo, Adawells, Mary, Mint – everyone who is trying to “teach” you what your professors apparently have not. Us “googlers” can teach you as much as – if not more than your professors. These ladies on this site can say “move over professors” and teach their own classes on ethics and pathology in the obstetrics and gynecology field; providing documented information and journal articles exposing the countless, needless traumatic exams that have done nothing other than provide power and pleasure to your professors (ex and current ob/gyns) and colleagues that have gone before you. You’ve forgotten one thing, Dr. Sunshine – the human element. Now Dr. Sunshine, let’s go by what you’ve presented and go along with your being a female student. You may just be the clay that we need to mold into a caring, compassionate ob/gyn who will actually care about her patients and not insist on pelvics; who will provide INFORMED CONSENT to ALL of your patients. You want to be the innovators, the next generation, then embrace the future: INFORMED CONSENT, HPV tests, and SELF-EXAMS. Instead of getting compensated for an $80 nasty pelvic, how about $50 to $80 on a self-test kit. Would that be good enough for you? Now, we know you’re in a precarious situation, seeing that you still have to graduate and go through residency. But, once you have your own office and set of patients, then you can really make the change. You can draw back the legions of females who are opting out of what really is medical rape and instead provide private self-testing and NO coersion into stirrups. It is legal medical rape, because the women are coerced into letting – male gyn’s – and questionable female gyn’s penetrate their vaginas all day; what is the weapon – fear of cervical cancer. The other weapon is withholding information that would lead to INFORMED CONSENT. Did they teach you that yet? You know how rare cervical cancer is. About 27,000 – maybe 50,000 women at best on the entire planet? You know pelvics don’t diagnose. Have you ever, EVER, in your life had a pelvic exam? By a male doctor? A female doctor? is it required for you and your colleagues to do pelvics on the female students? Has a train line of your own peers penetrated and violated you yet? I can’t imagine that and you still have this attitude. Unless you did and you’ve blocked it out – then you need another kind of help because you are in denial of your own trauma.

    Did you hear of the female students at Valencia College in Florida who were subjected to just that and are suing the college and their professors (female professors – can you believe it?) The thought was – if you’re going to do it to others, then you shouldn’t care if your peers do it to you – in front of an audience of them. Oh, I nearly forgot to ask – have you done a pelvic on an unconscious woman yet? And you’re still glib?

    This is your homework, Dr. Sunshine. Spend up to 2 hours reading as much of the thousands of testimonies on this site as you can. And if that doesn’t stir your heart, then spend another 2 hours reading some more or until you have tears in your eyes. In particular, read “The Other Side of the Speculumn” – submitted by a male colleague who must have angels wings for giving the naked truth about how dirty minded male gyn’s really are. There is also a testimony from a female colposcopy student who admits it’s all a sham. Colposcopys harm; they don’t help. They are linked to so many women not being able to carry their babies to term, because of the damage to their cervix. Then, see if you can still hold such a glib, uncaring opinion. You have the power and potential to bring change to this – currently preposterous profession. You also know that over in the other class, that a different set of rules are being taught to urology students who see males. They surely aren’t being taught to force genital exams on their potential clients with fear speech and shaming, so you must ask, why are women being coerced. It should be personally insulting to you. It’s good that about 80% of gyn students are female, now. You are the generation that can bring blessed change. In the end, it’s better to have a female gyn who actually cares; who provides informed consent, than a lecherous male gyn posing as a caring man who just wants to do a bimanual that diagnoses nothing – except how wet his female client gets. I can feel my own uterus to tell the size and shape; no need to get molested. However, if you’re going to act just as your male colleagues and take on their attitudes, then you aren’t bringing any change and you are no better than them. You will deserve their fate.

    I hope you know that you are blessed. Now go be a blessing to others.

    • Dr.Sunshine says:

      Dear Penolope,
      I understand where you’re coming from. I assure you that I’m female, and no, I’m not planning to specialize in OB/GYN. If at all, it’s all the way at the end of the list of possibilities. because as much as you’re concerned about having a doctor examine your genital tract, I’m grossed out by sticking my fingers inside another woman’s vagina to be honest (not trying to be rude, but that’s the truth).
      If your concern was male OB/GYN specialists, why don’t you easily choose a female doctor? or you just can’t do so where you live?
      And let me tell you that I’m as much sensitive to this issue as any other females, but would you prefer having this sensitive test once each 3-5 years or get cancer?
      and yes, I would definitely choose a female OB/GYN specialist instead of a male doctor because I won’t be comfortable just like you.
      I’m not trying to be against you all people, but until we get an official medically recommended self examining kit, I think we have to stick to what we have now (I’m now talking as another women who’s should also do this test).
      This all is coming from a medical student who see many patints and doctors doing wrong things and is actually concerned! I really wanna try to do a change, I just think I have a problem delivering my message 😦
      I will try to write down the major thing that i meant to deliver:
      Don’t convince other people, when you’re not a medical specialist, of your negative thoughts about an important procedure and try to convince people that it’s useless when it can help thousands discover an important disease (which once had a very much higher incidence before this test was used!) at its initial stage that actually can be treated efficiently when found early.
      if you’re sure you’d never get cervical cancer, or you don’t care neither about the disease, nor dying because a preventable one, other people care and might benefit and get their treatment.
      Again, having a problem with male doctors? find a female doctor instead! it’s as simple as that! I think that’s a better solution than dying.

      • Dr.Sunshine says:

        Dear women,
        I would also like to apologize if I sounded rude, I didn’t mean to do so. I wasn’t trying to belittle anyone, I was just trying to point out an important thing.
        The case is that many people (more than what you’d even think) have beliefs and get wrong knowledge from unofficial sources. I nearly hear weird things from my relatives and friends who’re not in medicine that are correlated to health issues, and it really makes me feel bad. because they then judge the doctors based on what they know.
        I see many people, including people who’re close to me, blaming doctors of what is happening to them while half of the time it’s because hey didn’t manage to follow the doctor’s instructions!
        they prescribe weird things to each other, like “oh don’t worry, it’s just ……, I know this case my grandmother used to have it, she used to mix lemon juice with salt and pepper to relief this, try it it’s really good!” the poor patients might actually listen while they might have a serious problem that lemon and God knows what want do anything! or worse, if they used a hermal remedy that might actually make things worse!
        Also people who’d prescribe antibiotics for the common flu, it amazes me really (yes, where i live you can easily get antibiotics without a prescription which is totally wrong), and guess what? people actually get the antibiotic and take it!
        and well, this post happened to be another thing that makes me feel angry from
        I see stupid health information being shared on social media and people believing it.
        many myths and stupid things.
        Also, I see doctors who don’t give a damn about their patinets. Doctor’s who don’t explain the patients’ cases nor make sure if the patient knows how to take their meds. I see doctors who don’t do wrong things.
        one last thing, here’s something that i got from searching on a reliable medical database: “Cervical cancer screening has decreased the incidence of and mortality from cervical cancer” I copied this from UpToDate, which is a database that reviews all significant researched and articles to combine them in one place, and from it’s name it’s up to date.
        once a cancer screening test shows that it actually decreases the mortality rate, it’s considered efficient. So that was my proof of how important this test is.
        I’m really sorry for being rude again if i sounded like it. Also, for people complaining about my English, it’s not my first language, so I’m sorry if i offended or annoyed you with my grammar mistakes.
        Have a nice day/night wherever you are.

      • ChasUK says:

        Dr Sunshine, no-one here is trying to convince any one person to screen or not to screen, all we want is the truth and complete honesty from doctors and the screening programmes, this will allow each woman to make that “informed decision” to screen or not, by their own choice! I am in the UK and each year out of 4.5 million women screened (yes the test is only a few mins….at this stage for now) nearly 200,000 women will be referred to colposcopy entering a system of uncertainty, biopsies, treatment with no guarantee of not getting cc, possible complications and all the anxiety that goes with it. 200,000 women…..really how many of these would actually get cc, how many are treated for no benefit, we know it is rare and so do you. The figures quoted on how many lives are saved is a guess as no-one can tell which abnormal cell will change and which will not. Also the figures reported before screening programmes implemented for healthy women included endometrial/uterine/cervical cancer, so yes it seems to most that it has worked but the figures now only report cervical minus the others above, so where’s the proof. No Randomised Controlled Trials on cervical screening either.
        Your other comment about following doctor’s instructions, forget it, I follow no-one instructions! My body my rules my choice my decision……please remember that when treating your patients, men & women.

      • Penelope says:

        Hi again, Dr. Sunshine:

        Since I’ve posted, you’ve posted about 7-8 times before I could post again. And none of them seem to show that you’re taking anything that all of us are saying to heart. I get the sense that you’re feeling defensive, then. From what I’ve gleaned, you insist on the “evidence” that you have been taught – or may have even read yourself online, that pelvics save lives. So, because of what you’re taught, then all that we are trying to say – also by proven fact, is all bogus and hogwash to you. We’re just dumb, Googling, women of all ages – thousands of us, who don’t know what we are talking about. We don’t buy what the gyno says and we don’t follow their directions, according to you. We all should be willing to just get it done- no matter how invasive, humiliating, uncomfortable, sexual (yes, sex organs are at stake here….), degrading it is because your textbooks and class literature says so. No questions asked. No matter that men are treaty – vastly different in the urologists office – if they go. For the record, Dr. Sunshine, my GP is male. I’ve never been to a male gyno. Thanks to Sue and this site, I never will. God forbid if I’m in an ER and one tries to do something gynecological to me. I have been to a female gyno, but it wasn’t promising. I’d rather go to a female if I really deem it necessary (the same choice men have to see a urologist…and/or have their genitals touched) than go to a male gyno and become part of the harem.

        Evidently Dr. Sunshine, you’re open to opposing opinion – or why post on a site where everyone is against – routine – pelvics and paps (no matter how many years apart); who insist on non-invasive tests; who demand informed consent – something you still don’t acknowledge. You haven’t answered my questions about if you’ve had a pelvic (I’m doubting you did) or if you’ve done one on an unconscious woman (I pray you didn’t).

        Since you’re still so seemingly open to our opinions, then, I still hope that, once you are practicing – as a resident – as a private professional, that allllll of what we’ve said will flood your mind and heart. By then, you will be regularly facing live females with real feelings and reactions. I hope you become the compassionate gynecologist that you have the potential to be – offering informed consent and declining the pelvic to non-symptomatic patients. Even determining if the symptomatic ones really should be treated like that based on their verbal synopsis of their symptoms compared to all that you’ve been taught (self-tests – say it a thousand times…..). You will know just between your reading and hearing their symptoms that a pelvic is really necessary. This is because – YOU KNOW – that diagnoses aren’t made with those. It’s the MRI, CT-Scan, Blood draw and even x-ray. Pelvics and paps can be skipped. OR investigate and offer the self-test. Be honest with yourself. Somewhere you have or will learn that pelvics and paps don’t bring in that much per exam. So, you “learn” to try to get as many women as possible to get them. This is where you must examine your conscience, Dr. Sunshine and decide which is what you stand for; what you want for your practice to be – ALL about profits, or – since you – in one of those 7-8 posts said, you aren’t a bad person – will it really be about your patients’ best interests.

        If you choose all profits like your male, and shameful female colleagues, then it’s as I said, you deserve the same fate – a lackluster, failing practice because all of us smart women aren’t taking pelvics and paps – lying down – anymore.

        Be blessed.

  65. ChasUK says:

    Dr Sunshine, with regards to medical knowledge…….please look at the pages here on References and Education.

    • Dr.Sunshine says:

      well, i did look at some links, they weren’t exactly that reliable and links that i would consider for my future practice (we take info from databases such as UpToDate or cochrane library which is used in evidence based medicine practice, they basically include systematic reviews of all significant researches).
      and the test is meant to find the high risk PREcancerous lesions that have a high chance of developing into cancer to treat them before they do develop. that’s why the incidence for cervical cancer itself has reached a very low incidence compared with the times before the use of pap smear testing.
      and for your other point, I will remember that. I was just talking about the people who don’t follow instructions, yet, they blame the doctor who gave them the instuctions that they didn’t follow!!!

      • Dr.Sunshine says:

        And were links that I wouldn’t consider for my future practice**
        ^^ for the people who care about grammar.

      • adawells says:

        I am glad to see your respect for the Cochrane Systematic Reviews, but are you aware that Archie Cochrane himself came out against the pap test being universally applied as a screening tool for cervical cancer on the grounds that he was doubtful that it would reduce deaths from cervical cancer? In the UK deaths from cervical cancer were declining naturally by 2% each year without any screening. In 1989 the UK government set up a pap smear programme where over 80% of UK women were practically forced to have a pap test every 3 years. After spending hundreds of millions of tax payers money, the programme is now boasting that over the last 30 years it has reduced deaths from cervical cancer by 30%. But hang on a minute, if my maths serves me correctly, that’s the same 2% per year that was happening from 1950-1988, isn’t it?

        Many doctors have come out against screening as Michael Fitzpatrick here:

        http://www.spiked-online.com/newsite/article/9669#.WFLsaL2nzqA

      • Dr.Sunshine says:

        Have you tried searching on the actual Cochrane review site? because it appears like they think it’s so useful that they’re searching for the best ways to get people to do it:
        http://www.cochrane.org/CD002834/GYNAECA_invitations-and-probably-educational-interventions-increase-the-uptake-of-pap-smears

      • Dr.Sunshine says:

        And to be honest, I believe that the best medical practice includes reviewing the latest best evidence available (from systematic reviews and researches) alongside my own clinical experience (my own judgement as a physician) and whether the procedure or investigation is applicable or not, as well as the patient’s preference. After that, I might look into other doctor’s opinions if they were significant.
        So, what other doctors think don’t really matter to me in the first place, because it’s only their opinion, if they proved it through a clinically significant research then it would be important to me because that’d produce important evidence then.

      • Hi Dr. Sunshine,
        You might want to review this article: http://www.bmj.com/content/352/bmj.h6080 It was published Jan. 2016, very current.

  66. Dr.Sunshine says:

    Ok people, I know that I wrote many things on here. But after thinking more deeply about this issue, I think the main problem here is not the pap smear, instead, it’s actually the poor doctor-patient communication. This is a major problem that could cause many other problems, including patients not getting clear ideas about what’s going on with them or why they have to do things or what they should do,.. etc. Also it might cause gaps in recording the history of the patient which leads into missing important things that could lead the doctor to the diagnosis.
    Anyway, I wasn’t trying to be against anyone, i was trying to help people and will forever try to do that when possible.
    I’m not a bad person, nor a bad future doctor, because I’m very aware of the wrong things that the doctors do. I also happen to be a patient sometimes and would like to get the treatment that everyone should get and will definitely make sure that I give my future patients this treatment.
    I wish you all the best 🙂

    • Kate (UK) says:

      Dr. Sunshine,
      The Pap test was designed way back in the 1930’s to detect the early stage of cancer, not so-called ‘precancer’. Dr. Pap firmly believed in those days that abnormal cell changes indicated cancer. It wasn’t until mass testing began many decades later that the medical fraternity realised, with such an astonishingly high rate of abnormal results being produced, that these cell changes could not possibly all indicate the presence of cancer. Thus the nonsense term ‘precancer’ was invented to hide the fact that no-one knows what an ‘abnormal’ pap really means.
      Take away all the medical jargon and what do we really have here? You’re scraping a layer of skin away from one the most changeable parts of a woman’s body and examining the skin cells for signs of change. The skin can change for any number of reasons – infection, inflammation, chemical reaction, even hormonal fluctuations which are perfectly natural in young women, pregnancy, menopause etc. So… out of the thousands upon thousands of ‘abnormal’ test results, only a tiny minority of them indicate cancerous changes, but there is no way to distinguish between the majority of changes which are perfectly harmless and the tiny minority which do indicate genuine disease. Thus, thousands of perfectly healthy women are subjected to traumatic and physically damaging ‘procedures’ in order to help a very small number. The people who are harmed by screening (I include myself in their number) are swept aside as collateral damage.
      It’s all about ‘preventing disease’ or ‘saving lives’, and no-one seems to give a damn about all the people who suffer in the process. That is simply unacceptable. We deserve better than this. And I firmly believe that the only reason that women’s healthcare remains stuck in the 1950’s is because of the revenue that these unreliable tests and procedures generate.

      • adawells says:

        Fantastic post Kate. I’ve read frequently that if this test had been invented recently there is no way that it would be introduced as a widespread screening tool across entire populations. Such a test has never been sustainable in developing nations where cervical cancer is more prevalent. These countries are now making self-testing with screening swabs or urine the first test. No need to come forward for a pap unless you are positive. They are saving millions of $$$$ as well as many lives, but it’s unlikely to keep our wealthy western gynos in business, so western women remain stuck with Dr Pap’s dodgy test to keep the $$$ rolling in.

  67. ChasUK says:

    Evidence Based Medicine has been under the spotlight too! so perhaps you need to look a bit further! And there it goes again “interventions to increase uptake” – give the honest facts and leave us to decide for goodness sake! This attitude would never be used against Men….would it…..why?…….You’d get a smack in the face is why! As to patient doctor relationship and communication, well it would be a lot better if I was not hassled at non-related visit for screening I DO NOT WANT and have politely declined! I do not need counselling about that decision either, not by anyone! Please don’t forget that all cancer screening has plenty of it’s own risks too, for me less riskier to decline any cancer screening! Which…….shock…………….horror, is my decision to make! Gee perhaps I should look at arranging my own funeral soon, as being a woman quite obviously I am a walking disease and ticking time bomb about to explode!

  68. adawells says:

    https://www.theyworkforyou.com/wrans/?id=2016-12-08.56799.h&s=Cervical+screening#g56799.

    Good grief! It looks as though there is going to be no HPV primary screening until 2019 in the UK. Will anyone still be turning up by then?

  69. Penelope says:

    Overitall:

    I hope you’re still there.There’s been alot of posts – mostly from Dr. Sunshine – since I was able to get back to the site – and have time to post to you. Please be mindful of her. I don’t know if she pounced on you as her post to you her post isn’t visible on the main page after all the other posts. She responded to me, and I’ll get to that – but first I want to post to you. The site though has a way of moving the posting times around because we’re on different continents and time zones, but whatever my time posts, I want you to know I answered you with priority and alot of concern.

    My utmost, heartfelt sympathy goes out to you at this time. I’ve had people I love die of cancer. I lived it too. When the doctors tell you there’s nothing more you can do – for me, I went a little numb. Then, I decided that for whatever time was left, I would do my best to be there. That helped so much. They knew i loved them. We had no loose ends. When time got close, they were too weak for me to hug, so I gave a gentle kiss and squeezed their hands; touched their faces. When they passed, I had peace knowing I did what I could. I hope you find that same peace.

    I hope, Overitall, that you don’t allow your fears to make you do irrational things. I’m glad that you’re not getting a mastectomy as breast cancer isn’t related to ovarian cancer or cervical cancer. Please, please, be careful what you do regarding the steps you take for your own health. Please don’t allow yourself to become a guinea pig to gynocologists who will see your fear. These gynocologists are really, really something. I’ve learned from my own research and from this site, that they are really are – sigh – not sincere in the slightest. To confirm that, all I needed do was compare the treatment that males get with urologists – it is grossly different and worlds more respectful to men than any 1,000 gynecologists put together. They don’t coerce anything with men. Gynos are all about the pap smear and pelvic, because these bring in about $80 a pop. Their interest is to find as many vulnerable women as possible – and convince them that they have to go between their legs with the most sincerest of faces. If they get 100 women, why that’s about $8,000. The conflict of interest is clear – and sincerity then, is false. They order tests that are not only not useful but harmful – physically, psychologically, emotionally, mentally. YOU, Overitall, will be subject to needless tests if you allow it. If you allow, male and female students will watch you get these tests that you now say that you don’t care about because of what your aunt is going through. Don’t allow the pelvics or paps. They will insist you need one every six months. If you choose a female doctor in a mixed practice, you can bet that she will mysteriously “take the day off” or “be busy with another patient” and a male will step in. By the way, they won’t tell you if he’s a student.

    No, Overitall, any diagnosis must be made with an MRI, CT-scan, and blood draw.. Bimanuals and rectovaginals it appears come from sex tricks that have found their way into the gyn’s office – male gyns – no surprise – and will not diagnose or tell the wonderful doctor if you are at risk or even have any cancer of your uterus and ovaries. But if you allow a male to do these, then you’re allowing yourself to be prostituted for power and pleasure. If you let a female do it and you think she’s questionable – well – at least she can’t get an erection fantasizing about you after you leave. But, it can also be disturbing if she is obviously abusive. You say you don’t care, but according to the women on this site – you will. In your quietest time, you will. All I ask, Overitall, is that you carefully consider your path. I know you’re feeling like – just get it done. But no gyn – that actually is – oh my – respectable – and it’s I can’t believe I’m saying it – more likely to be a female will 1.- subject you to endless stirrups if you are not symptomatic, nor 2. -will they order endless invasive tests if you’re not symptomatic.They won’t give you a hysterectomy either. I just don’t want to see you make a new problem for yourself – allowing needless, invasive tests that, according to the women on this site – takes a world to overcome. Since you’re really concerned- get tests – but only the non-invasive ones that actually diagnose – insist on it. MRI, CT-Scan, blood drawn. And for God’s sake – No transvaginals!

    Please keep us posted. You and your aunt and your family are in my prayers.

    Be blessed.

  70. Penelope says:

    A little clarification, Dr. Sunshine:

    Lest I be misunderstood and appear in support of the pelvic to you – I must correct myself: you will know just between your reading and hearing their symptoms that a pelvic is NOT really necessary. This is because – YOU KNOW – that diagnoses aren’t made with those. It’s the MRI, CT-Scan, Blood draw and even x-ray. So, if your patient is an 18year old – who may or may not be a virgin; or a woman comes in crying and says she hates pelvics and was traumatized by them; or if your patient comes in sounding like us – you have to decide how you will respond – profits (pelvic – but no colposcopy? – you said you were taught to be cost effective to your patients…..) or will it really be about your patients’ best interests and you offer alternatives to these invasive tests – MRI, CT-Scan, blood draw, X-ray. NO TRANSVAGINALS. If you insist on giving them, then – practice what you preach – get it done, yourself and see how you like it. Don’t be a sadist – get it done – not by a male, rather at least by a female gyno. Then tell yourself – yes this is best for my patients. I doubt that you will be able to without denial. Somewhere between the practices and hospitals having to pay for that machine and denial that they are sex toys with condoms and gel, they are still being used. What an absolute sham and disgrace.

    Please listen to us, Dr. Sunshine – you may safe yourself a world of trouble, as well.

    Be blessed.

  71. Evaro (US) says:

    okay all you smart ladies- I need help!
    I finally had the guts (and knowledge) to try to schedule an appointment with my GP for birth control. I also made clear to the receptionist that I will not be volunteering for a pap. Cancer screening is not a prerequisite for birth control, and the two are linked. She insisted that no doctor would prescribe the pill without a pap. I asked her to refer me to someone more accommodating or to just ask the doctor for me. I told her I pay a lot for my mandated insurance every month and I should be able to prevent an unwanted pregnancy without under going cancer screening. I also mentioned I was hpv- last time I had a pap 5 years ago when I was pregnant with my first child. I told her I don’t want to pay a co pay or waste time at an appointment that will not meet my needs as a patient.
    she called back the next day and said the doctor thinks I really should have a pap because im overdue. she said I can schedule an appointment for one and the we can discuss birth control options from there. I explained that I just had my second child six months ago and was diagnosed ITP. I have very low blood platelets because my body is constantly attacking and destroying them faster then I can replace them. my pregnancy was extremely over managed and involved a lot of fear mongering and coercion to initiate steroids. I told her having another child right now is not in my best interest, and potentially dangerous. she apologized and said that the doctor is just following “the standard of care” regarding the pill. she would relay the other information and see what she could find out.
    They know im right. but that last little bit she threw in there about standard of care was the real kicker. its what most doctors would require, so it is in her right to follow suit. like she thinks its medical negligence (malpractice) not to do one. im sure ill get a call back tomorrow and if she still insists, how do I refute her statement about standard of care. I really don’t want to go doctor shopping, and all the doctors at the hospital I use are connected and in contact anyways. I’ve meet the doctor once in the past and she seems descent and not too confrontational, but I have to jump through hoops and play the telephone game with these damn receptionists and nurses.
    to anyone out there, help me think of something to get the pill and not the pap. look up standard of care as well. this is so stupid. the perfect little phrase to support and implement all their little lies.

    • A S says:

      Planned Parenthood. Last time I went to get birth control I was “overdue” for a pap, but they didn’t seem to care and didn’t push the issue. I was prepared for a fight, but it never even came to that. They gave me a 3-month supply and sent me on my way.

      In the past, they always pushed the pap-test-before-birth-control issue, but perhaps the new recommendations changed all that. Regardless, I got what I needed without having to take off my clothes. You have good reasons for avoiding a pap (even though you shouldn’t even need a reason…no means no!) so I don’t know how they can still push the issue. It’s ELECTIVE, for god’s sake, and the state of your cervix would never give them any valid reason to deny birth control. (In fact, they won’t even wait for the results of the pap to give you birth control, which just enforces the idea that results don’t even matter.)

  72. Evaro (US) says:

    typo! “..and the two are not* linked..”

  73. Dr.Sunshine says:

    Dear people,
    I have clearly stated what I meant until now on this site. We, medical students, are being taught about all of these procedures and how important they are and why. and it all makes sense to me and every other medical students because we learn detailed information about them all.
    yes, the genital tract is a very sensitive area. yes, some male or even female doctors can do wrong things. But that deosn’t mean that these tests are not important, or that they’re not useful when needed to be done.
    We, as doctors and future doctors, can’t take decisions based on what we FEEL is right or wrong! or based on the patients orders and self diagnosis! (as if they’re ordering pizza or something. “Oh please I think I have ……., can you do me an MRI with a bit of blood sampling topped with a lumbur puncture? and no, I don’t want your help because I know what my tummy wants”).
    A doctor is supposed to look at the available, reliable, official, researched information that’s been reviewed by different doctors, scientists, and health specialists, then correlate it with the presenting case, then the doctors can look at their own experience and explain to the patient the possibilities if there were any. the patients also has the right to do non of the options if they wanted to!
    we are going to be asked to do no harm, how can we do that if we didn’t use the info and the skills that we learned when we should because the patient doesn’t want to talk about it? because patients know their own bodies more than we do? I’m learning about my own body, and guess what? I still don’t even know half the things that go on or could go on within it!
    I don’t think anyone likes injections, taking pills, surgical procedures, colonoscopies (that both males and females do!), chemotherapy, or any other medical procedure. They all have their advantages and disadvantages.
    we as females, are built to have this very specialized genital tract! it goes through a lot. it goes through a hormonal cycle (which includes many effects on the organs from the ongoing proliferating endometrium to menstruation, to ovulation,.. etc), it might or might not go through 9 months of pregnancy, maybe once or even more! We have this huge amount of stressors and changes going on in our genital tract that males go though non of them!
    Stop comparing your bodies, organs, tests, examinations, treatment with males! we are different!
    we have estrogen dominating while they have testosterone, they do not go through this proliferative and destructive (in case of menses) cycle every month! they do not go through pregnancy and will never know about how huge this thing is! they do not have a vagina! They don’t have ovaries! They don’t have a uterus or a cervix! they have different things and each of the genders need their own and special treatment!
    My message to you is to not treat your doctors as your enemies, because they’re there to help you! you may not like us, because we do painful, sensitive, invasive things. we ask you to follow strict health programs, we ask you to do hard things, but it’s because WE ARE TRYING TO HELP YOU! yes there are bad doctors, but they are not all the same!
    Finally, I’ve been accused on this site to be close minded by planning to follow the safe recommended, research prooved procedures while I’ve still said before in another long comment that yes, you do have a point, it is invasive and uncomfortable. Also, I’ve said that I believe that we shouldn’t settle for this (this anyway goes through research every once in a while and is updated from time to time as with the USPSTF), and that I will try to be the change as much as I can. That I’ll try to spread more awareness about how tough and sensitive it is so doctors can do their best to make it more comfortable. I told you that I would also try to get involved in research about better procedures or to check if it was really not important anymore as you’re claiming, I told you all that I’ll try to do my best, but you never seemed to care about it! you just ended up saying that I’m closed minded!
    I was also accused of having “God complex” just because I stated my opinion that I thought was very important to be shared! you don’t want to listen to other people’s opinions and you start judging the people these opinions belong to, but still, you expect yours to be heard and respected?
    I would end this by saying that, after having OB/GYN at the very end of my possible specializing options, it’s now no longer on the list at all, because I really don’t want to deal with such things. having to repeat myself and defend myself, not being listened to, not respected. I also don’t want to be considered as an enemy to people that I’ll be working day and night just to help them and make sure that they’re healthy. It would’ve been nice to go into OB/GYN and start a change, but I don’t want to go into that if my efforts aren’t going to be appreciated!
    but as promised, I’ll still try to draw more attention to the case and maybe get involved in research in the following 2 years before I either go into cardiology or neurology, where there’re still going to be unappreciative, disrespectful people that think doctors are their enemies, but they won’t be as much!

    • moo says:

      Please use your talents and intellect for a greater cause such as neurology or cardiology where you are treating very sick patients. The worst you will do is revoke some patients’ driver licence so they lost their independence and will to live.

      You will find the norm in most medical fields is following a logarithm for diagnosing and ordering tests.

      You will find your way.

    • ChasUK says:

      First do no harm – so in the UK 200,000 women are carted off to the colposcopy unit, do you really think this is fair? That is a big figure! Have you really any idea what it feels like emotionally for a woman to have to go through this….the constant fear of something so rare! This kind of behaviour has worked against me as now I trust no-one especially within the Medical field, I question absolutely everything in relation! I have been put off even visiting my GP for problems more important than a dam smear test! How has this helped! Change needs to start somewhere and yes it would be nice if you/others made those changes instead of many turning the other cheek. No-one should be convinced, coerced, tricked or pushed into Optional/Elective screening, whether you think it is a good idea or not! I wish you good luck in your chosen field.

  74. Samantha says:

    This just came up for me today. I made an appointment two months ago for a routine wellness checkup, while on the phone the receptionist asked if I would like a pap smear I declined. That was it appointment made.
    So I go into the doctor today and the first thing the nurse asks is “When was your last pap smear?” I informed her that I opted not to get one as I had made clear when I made the appointment. She went onto ask if I was sexually active which I informed her clearly no. She didn’t let up until she came to the conclusion that I am a virgin.
    This exchange made me highly uncomfortable. She takes my blood pressure and leaves.
    Next tge doctor comes in and its the same question “when was your last pap smear? You should probably have one?”
    I once again told her I wasn’t getting one which she responds with “well we’ll do it next time.”
    At this point I just grit my teeth and do not respond. The rest of the appointment was awkward as I wanted to get out of there ASAP.

    • Mint says:

      With respect to you Samantha, I do not understand the need for a “routine wellness checkup”. I assume that I am “well” until I feel otherwise. Too many people seem to spend too much time worrying about what may happen. I’m of the opinion that if I did see my GP for a “wellness” check, I’m sure she/he will find something to biopsy or test and of course go through the inevitable check list that will pop up on my record – smear test, weight, alcohol, smoking etc etc. Personally, I rather not know.

  75. ChasUK says:

    It’s high time that we stopped screening healthy people, over diagnosing, over treating and turning people with no symptoms into patients, performing needless tests and procedures, handing out drugs like sweeties….which also causes many side effects which then need more drugs/ops to fix and so on. Thousands get treated for no benefit, yes agreed some may be helped but so many more are not. What a complete waste of money and resources which could be put back into the system to treat people with REAL health problems, employ more frontline staff etc. Screening is not perfect, Screening will never be perfect, there will always be more false positives than there will be false negatives, that is a fact! Cervical cancer risk 0.65% with an unnecessary treatment risk of around 60-70% – no guess as which I prefer! 0.65% risk is good for me! I’d just like to stress that word again “RISK” – this does not mean it will happen, risk is simply just a risk! We risk crossing the road, driving, flying, tripping, falling, eating junk food, drinking, smoking – our lives are full of risk every minute of every day! Can we not just start treating the sick that need help instead of putting them to the back of the queue. Okay thanks, my little rant is over.

  76. katrehman says:

    So true mint and chas uk. I’m an intelligent women and I know if I feel ill or in pain. I prefer not to screen even for cholesterol. .as I’d never take statins anyway. And I agree weless checks is the ideal opportunity to harass about smears and mammograms. I refuse both

    • ChasUK says:

      Cholesterol……..LOL. Blood test showed mine was 5.6 and I was sent a letter asking me to go on a low fat diet “this instance”, yes that was the wording! I was at that time 47 kilos for goodness sake, that is 7st 6. My GP got an earful that one and I stated I would not have another cholesterol fasting test which I did not ask for. Another case of box ticking which could have lead to me being offered Statins…………….no thank you very much! I thought about all this further and realised it was a “health check”, I wasn’t informed of it and I did not ask for it, fuming I was. No Cancer screening of any kind either, no smear tests no mammograms no colonoscopies!

  77. moo says:

    Some call the wellness checkups “fat shaming and cancer blaming”. I refuse them too.

    Statins are pushed as well as other drugs after these visits by the “pharma whores”. There is great controversy about some cancer screening tests as well as the issue of blood cholesterol testing and treatment or dietary changes for high cholesterol. Cholesterol is the building block for many hormones so for example if a person has high stress due to their profession then they are going to be producing more cortisol which is made from cholesterol. If the diet does not have enough cholesterol then the body will make it so the other hormones can be made. So their blood test will show high cholesterol if they have high stress.

    I also believe that type II diabetes is over diagnosed and overtreated as well as high blood pressure.

    Another beef I have is antibiotic overuse. I was pushed antibiotics recently for bronchitis. I actually had a bad case of flu (fever, cough) but I know that flu is caused by a virus so why the antibiotics? I did some research and the AMA recommends that antibiotics not be given for bronchitis because 90% of the cases are caused by a virus. So are all these doctors pushing antibiotics missing their lunch lectures or emails? All I really needed was a cough syrup that would thin out the mucus.

    • Dr.Sunshine says:

      You’re absolutely right about everything except for hypertension and diabetes mellitus 2 being overrated.
      It’s a major wrong thing to give antibiotics in cases that are most likely caused by viruses. This has more side effects than good (sometimes it doesn’t even have a positive side to it). I have no idea why doctors keep on prescribing antibiotics this easily for simple flu cases.. This could lead into more resistant bacteria as well as loss of important bacteria in our bodies “normal flora” (and also secondary infections).
      Other than that, I’m not that much into statins to be honest because I have some doubts about it being helpful in case of heart diseases. And you can say that I’m not convinced of the fact that cholesterol is the real enemy (in the case of atherosclerosis). But still, doctors don’t really prescribe statins unless the patient reaches a specific level. Remember, that doesn’t mean that i support the use of statins! I’m planning a research about the whole statins-cholesterol-heart disease relationship thing because I think it’s full of gaps that once filled, everything will completely change.
      Didn’t think that I’ll find myself again on this site again (despite believing that I’m hated on this blog, I found notifications in my email and thought of checking out what’s going on). I probably should start my own blog about heart diseases, because I think I really enjoy discussions.

      • adawells says:

        Dr Sunshine, thank you for joining the blog again, it is always a sign of failure if something cannot be discussed, and I, for one appreciate your honesty even if we differ. I hope that many more medics have taken the opportunity to read the posts on this website and know how many women feel about women’s health care. It is a pity they are too shy to contribute to the discussion. Do you discuss this website with your colleagues and do medics know about it? I hope you will continue to post and won’t be put off by some of the comments.

      • ChasUK says:

        Yes but the Cholesterol “Specific Level”? Isn’t this determined by a Computer after ticking all the boxes? What about the “threshold” that’s used 20% / 10% – if you drop it from 20% to 10% immediately they have just created millions of patients overnight? Big Money for Pharma! My thoughts straight away come back to “Over diagnosis & Overtreatment” – this frightens me more than the condition one is supposed be at risk of, and yes I go back to that word “Risk” not a definite outcome. This is why every year there is The Preventing Overdiagnosis Conference – 2017 is Hosted by the Quebec Medical Association, shame it is only for Health Professionals/Students
        Good to see you came back.

  78. Chrissy (UK) says:

    I’ve just seen our friend Robert Music of Jo’s Trust on the local evening news. Apparently screening numbers are down….. they must be worried. Yet again they site the primary reasons for this as women being “too embarrassed” or “worried about pain” and the same old “get yourself tested ladies” mantra.
    It seems to be completely beyond their comprehension that maybe, just maybe women are actually researching the pros and cons of this screening and deciding that it is not for them.

    • adawells says:

      Bloody hell, it’s cervical cancer awareness week again. How many times a year do they have them? We have one group of women bemoaning the fact that over a quarter of women don’t attend, and another promoting the big petition to lower the screening age, yet again. It has already passed the number required to be debated in Parliament so perhaps they will finally make it clear to these misguided fools that the test doesn’t work.

      • Elizabeth (Aust) says:

        As the screening rate continues to fall, we’ll see more and more money being spent on “awareness” – more scary stories, more pressure, it feels like the program desperately fighting for survival, vested interests fighting to protect market share and profits etc. We’ll see a real push here with the new program to keep those already in the program and to round up the non-screeners, they can self-test now after all, so, what’s the problem? The lack of respect for our right to simply say NO never ceases to amaze me. I don’t care what’s being “offered”…I don’t want it and never will, got it! I have nothing but contempt for the cervical and breast screening programs and will have nothing to do with them – both programs have treated women appallingly, violating legal rights, operating with no ethical principles (misleading women is almost a sport for these programs) and worrying and harming so many women.

      • moo says:

        The reason that cervical screening is such a hot topic is because it deflects attention for other “women’s issues” in the political forum such as equality in pay, abortions, maternity leave pay, daycare, tax issues.

      • ChasUK says:

        That’s another group of women bemoaning the fact that over a quarter of women don’t allow a complete stranger access to their vagina, like they do or feel they have to! Twats! Just because they have been duped into it what gives them any right to bemoan anything that other women should do, specially that private sensitive area! Like you have all said before, there are no other healthcare areas that they feel it necessary to take the same approach. Again I’ll call them Twats!

    • Elizabeth (Aust) says:

      ” just maybe women are actually researching the pros and cons of this screening and deciding that it is not for them”
      They’ll deny that possibility for as long as possible because they know if enough women reject the propaganda and actually get to the evidence, they’re doomed…they also know they can put road blocks around self-testing alternatives, but that will get harder and harder over time. When you’ve operated with no consent and no informed consent from the very beginning, and got away with it…it must be hard to accept that women do indeed have legal rights and they do indeed have ethical obligations to present both sides of the screening argument and accept our right to choose. A very bitter pill to swallow…

    • ChasUK says:

      http://www.bbc.co.uk/news/uk-wales-38685267
      And they use here a woman who had “abnormal bleeding & pain”, actual symptoms that do warrant investigations of the diagnostic kind not screening. Then use her to promote “keen to encourage women to attend smear tests – despite worries it “might hurt” or fears over the outcome.” Same old crap!

  79. ChasUK says:

    http://www.bmj.com/content/356/bmj.j228 Margaret McCartney: Swapping systematic reviews for celebrity endorsements
    A good read, she references PSA in this, however he same applies to cervical cancer screening and all other screening! No online response from the Professionals as yet.

    • Elizabeth (Aust) says:

      They use celebrity endorsement here for mammograms, I find it culpable, when they know it’s a very fine line, over-diagnosis and over-treatment may mean the risks of screening outweigh any benefit. It should be an informed decision based on something like the NCI summary, not something flippantly recommended by celebrities.
      The program has zero chance of reaching the target, even screening older women won’t get them over the line.

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