Gynecological Procedures Can Cause PTSD

yyCaptureWomen’s experiences of gynecological/obstetric procedures can be sufficiently distressing to cause post-traumatic stress disorder (PTSD). 500 women took part in a study about the psychological effects of vaginal exams, pap tests, and other gynecological/obstetric procedures. Of the 500 women who took part in the study, over 100 women reported their experiences as ‘very distressing’ or ‘terrifying’. Of the 100 women who reported distressing experiences, 30 were diagnosed with PTSD.

PTSD is described as a “reaction to catastrophic trauma”, and includes symptoms of flashbacks and repetitious re-experiencing of the trauma, avoidance of similar situations, and extreme distress when faced with events similar to those that caused the trauma (Menage, 1993, p. 221).

The study highlights the similarities between the after effects of rape and women’s experiences with gynecological procedures. Following rape, PTSD can result from the associated feelings of powerlessness and of being with an unsympathetic assailant, and also painful, humiliating, and/or mutilating experiences.

Similarly, the women diagnosed with PTSD as a result of gynecological procedures reported:
-a lack of information and consent related to the exam/procedure
-feelings of powerlessness
-feelings of being in an unsympathetic environment, and
-experiences of physical pain.

Some of the phrases used by the women who took part in the study to describe their experiences include:
-‘dehumanizing and painful’;
-‘degrading and distressing’;
-‘my opinions were dismissed as irrelevant’;
-‘hurting and feeling violated’;
-‘very brutal internal was excruciating’;
-‘it felt undeniably like rape’.

The study also highlighted the similarity between post-war veteran’s PTSD diagnostic scores and women’s post-gynecological procedure PTSD diagnostic scores.  Post war veterans who completed the same questionnaire as the women in the study achieved similar scores.  Menages states the “severity of the obstetric/gynecological trauma can perhaps be inferred from comparing these scores” (1993, p. 223).

There is a lack of research related to PTSD following gynecological procedures. The study quoted above was published in 1993, and there does not appear to be any follow-up research specific to gynecological procedure- related PTSD published since that time. There has been some recognition in the literature given to the trauma of pap tests experienced by women with a history of having been sexually assaulted, but the trauma caused by pap tests themselves is generally ignored.

The traumatic after effects of pap tests and other related gynecological procedures continue to go largely unrecognized by the medical community. Perhaps the consensus among clinicians is that by ignoring the issue it can continue to go unaddressed, and will not interrupt business-as-usual.

 

320 comments

  1. I have been avoiding doctors for years because of the fear of being forced into a pelvic exam/pap smear. Before I found this site few days ago, I thought that cervical cancer was way more common than it actually is. I thought that pap smears were just “part of being a woman,” and that I didn’t really have a choice in the matter. The thought of getting one has always made me feel uneasy, nervous, and scared. I was fortunate enough to be able to avoid getting one all this time because when I finally did go to a doctor after about 12 years (because I was uninsured) I went to a clinic that was very busy and poorly organized. But when I went I was pretty much told I had to schedule a pap smear. Reluctantly, I did. When I showed up for that appointment, I was told she didn’t have time to do it that day because they were busy, thank god. There were actually five different times I was supposed to get one done but was lucky enough to get out of it every time for some reason. But after the fifth time, I decided I wasn’t comfortable with that procedure in the first place and I never rescheduled. I haven’t been back to the doctor since. But now that I know I have a choice and that I can say no, I’m not going to be afraid of doctors anymore. I don’t know who created this site, but thank you. This site had empowered me and has given me so much information about the dangers of these exams that the medical community doesn’t want us to know. I’m glad to know that I’m not alone and that there are other women out there just like me who say no to pelvic exams/pap smear.

  2. I am 17 years old and got my first pap last year when I was believed to have a bacterial infection. I am a virgin and have never been able to successfully insert a tampon, so obviously I was unnerved at the idea of a speculum inside me. Needless to say the experience was awful. We requested the smallest they had and they didn’t have nearly as small a speculum size as most do gyns do. It was immediately extremely uncomfortable and gradually progressed to THE most unbearable pain in my life- stinging, aching, bruising, burning, tearing sensations through my cervix all the way to my spine. I was sobbing an hour after the pap was over and during the pap because it was so painful. I begged the woman who was doing my pap to stop and take out the speculum, and she refused to even though I was told by my doctor that she would be sensitive and stop if I asked because she knew I was scared. The smear tested negatively for everything and we never found out what was wrong with me. The itching and irritation I had just continued and eventually stopped. A few months ago it came back but I was too terrified of going back to tell my mother to make me an appointment so I just waited it out a second time. I still can’t put a tampon in and cry even at the sight of one. I have no desire to ever have sex and am not sure if I ever will be able to. I have always wondered if something like this happened to other people and even though i wouldn’t wish it on anyone it’s very comforting to know I am not alone. Thank you so much for writing this article.

    • hi ally,

      i canso relate to you. my mm took to a gyn when i was 18. she didn’t know i ‘s been abused. they could not do an exam. i suffered for yrs with exam attemps. never found what my issue is, vaginimus possibly. ( spamong when pentration is attempted)
      i gave up on exams. had enough abuse fromm these drs. I am small can’t tolerate the speculum.
      I am sorry you suffered from these cruel Dr s. FGlad you are here

      diane

    • Hi Ally:

      Very sorry about what happened to you. How are you now? Are you still experiencing symptoms. If so, it sounds like you may have an infection, but one that can be cleared up by over the counter medications. If you’re not experiencing abnormal bleeding then it’s likely not cancerous or fibroids. Try the over the counter medications first. If they don’t help – I know you may not want to hear it, but go to another gyn. Please do get a female again. Just talk to her first – ask her your questions and listen to her manner with you. If you don’t like how she talks to you – then it’s a sign of how she will treat you; go to another one. Insist on a urine test and blood test and if need be, an abdominal ultrasound. That will tell you if you have anything. Nothing was ever diagnosed by feeling inside a woman’s vagina. They can skip that. The only benefit is the incentive payments to them for getting as many women as possible in the stirrups to do paps. What will diagnose is blood work, urine test, MRI, CT-Scan – and if really needed – laporoscopy through your abdomen if you had severe abdominal pain. All that other nonsense with colposcopys are just that – nonsense. And insist that they do not do a transvaginal ultrasound. It’s a modified sex-toy with the same mechanism as the abdominal ultrasound. However, on that they use a condom and gel on it before putting it inside you. An abdominal ultrasound will do just fine. It’s the same exact imaging, but from a different angle than the transvaginal.

      Please do not get a male gyn. Women get turned off of female gyn’s if they’ve had similar treatment that you’ve experienced. But, Ally, I guarantee you that going to a male will be much worse. You will feel like you’ve had a sexual experience. That will because it would be one if he does a speculum and bimanual exam – and he may insist thinking you’re naive and stupid given your young age. I don’t care how gentle he says he’ll be – that is only a “head’s up” of what he is thinking at the thought of touching your 17-year old virginal body. He can’t show it – he knows he’ll get fired and sued. Male gyns have mastered that act. Rather, it would come out with his manner if you let him touch you. Then you’ll get very confused and angry and like so many other women feel that you can’t do anything because he was “examining” you. He’ll think that all he has to do is feed you a line to make you think he has to go in there and feel for lumps or some nonsense. Sounds like a guy trying to get you to have sex, doesn’t it. Well, it’s extraordinarily similar. I’d hate for you to go through – that – refusing some bastard in a white lab coat who sweat through medical school, who is dying to be “your first.” He won’t act like it, but inside, he will be clamoring. Why insist then on having you go through that when he knows there are alternatives.

      No, go to a woman gyn. Your first test came back negative – so likely will any invasive test that they want to try. Read up on the articles here on the medical studies about pap smears being ineffective. Cervical cancer is rare, but gyn’s don’t want to tell you that as they know women and girls (who shouldn’t go near a speculum until 25….if that….) will decline the pap smears and there goes the financial gain from their suffering. I don’t know about you, but I don’t like being lied to. By not providing the informed consent that this site provides, they are lying every day to get women and girls into stirrups. According to World Health Order (WHO), maybe 445,000 women GLOBALLY may get cervical cancer. Out of those 84% re in developing countries. That means maybe 71,200 women between Europe and the U.S. may get it. Considering as of 2016 there were 318 million people in the U.S. – and half are women – that makes cervical cancer extremely rare. But see if a gyn in the U.S. will tell you that. Be empowered Ally.

      Keep us posted Ally and I hope for the best for you..

      Be blessed.

  3. Ally, the other women who comment on this blog may be more knowledgeable than I am and be able to give you better medical advice; But I fail to see how the hell a pap test would help diagnose a bacterial infection. I’m 25 and never had one of these perverted tests, but I always thought that they were just used to screen for cancer and other abnormalities in the cervix. What if the infection is not even in your cervix? Are your doctors THAT dumb?! 😠 Are you sure this isn’t a UTI? They can diagnose this with a urine test. Have they done any blood test at all to check for this bacterial infection they suspect you have? How about a self vaginal swab? I’ve read about those before on this blog and Women Against Stirrups

    • You’re right. It’s sad that every time that a woman presents with any vaginal discomfort or stomach discomfort, the first thing that doctors want to do is get her naked and get inside of her vagina when there are many other tests. In today’s world, imaging and other tests are so advanced that a pap smear or pelvic exam should be the LAST resort after they have tried every other test. Sadly, docyirs want to do this first.

      I knew a lady who had bad hemmorhoids and she begged for help. The doctor gave her a pap smear and sent her away with no help. These doctors are now boldly satisfying there s*xual urges with no intent to help the woman.

      • It’s like they are trying to tell us they can see all of our insides by looking up our vaginas and/or anuses. There are MANY other body parts, and most of them you cannot see through the vagina or rectum.

        It doesn’t even seem to matter what the complaint is about. A recent (male) doctor, who was filling in for my regular female doctor who is on maternity leave, insisted on doing a pap test for my diabetes and thyroid! Initially, his coercion sounded like he would NEED to do the pap test to fill my prescriptions for those (real) disorders. Nope. I’ve found out since, if he had, I would have both a complaint to the licensing board as well as a malpractice suit.

        The lady with the hemorrhoids also had a bonefide complaint against the doctor for malpractice.

  4. i read this today its scary A grand jury indicted two doctors and a third person on Wednesday in an alleged scheme to perform genital mutilation on two girls from Minnesota at a Detroit-area clinic.

    Dr. Jumana Nagarwala, Dr. Fakhruddin Attar and Attar’s wife, Farida, are charged with female genital mutilation, conspiracy and other crimes.

    The federal indictment alleges the trio tried to obstruct the investigation by telling other people to make false statement to authorities. The doctors are also accused of lying to investigators.

    Genital mutilation, also known as female circumcision or cutting, has been condemned by the United Nations and outlawed in the United States. But the practice is common for girls in parts of Asia, Africa and the Middle East.

    “This brutal practice is conducted on girls for one reason: to control them as women. FGM will not be tolerated in the United States,” said Dan Lemisch, the acting U.S. attorney in Detroit.

    Nagarwala is charged with performing genital mutilation on the two 7-year-old girls in February at a suburban Detroit clinic owned by Dr. Attar.

    Nagarwala’s attorney, Shannon Smith, denied the allegation last week, saying the doctor was performing a religious custom that didn’t involve cutting. Smith declined to comment on the indictment, which replaces criminal complaints that led to the arrest of the three suspects earlier this month.
    how many other exams did they do?

    • It’s interesting that people get so emotional about Female Genital Mutilation here in Western countries, when labiaplasty — which is basically the same thing as FGM — is so popular here. The same parts of the body are cut off — vaginal lips and often part of the clitoris as well, but when it’s called labiaplasty, it’s considered normal and even teenage girls submit to these surgeries nowadays. It’s considered okay to get under the knife to please your sexual partner, but when it’s done for religious reasons, it’s suddenly called FGM and people are sent to jail for it.

      I’m obviously not saying that FGM is good, but how is it any different from letting your teenage daughter get a labiaplasty? Only difference is that doctors who perform those do not go to jail.

      • Isn’t Labiaplasty slightly different i.e. just the labia minora, not the clitoris? Also a woman’s choice and not inflicted on her against her will by another persons decision – See link
        http://www.nhs.uk/Conditions/cosmetic-treatments-guide/Pages/labiaplasty.aspx
        A labiaplasty is surgery to reduce the size of the labia minora – the flaps of skin either side of the vaginal opening. Some women consider having a labiaplasty because they don’t like the look of their labia, or because the labia cause discomfort. This is a major decision you should weigh up carefully. Occasionally, a labiaplasty may be carried out on the NHS if the vaginal lips are obviously abnormal and causing the woman distress or harming her health. The procedure involves shortening or reshaping the vaginal lips. The unwanted tissue is cut away with a scalpel or possibly a laser, and the loose edge may be stitched up with fine, dissolvable stitches. A labiaplasty is offered as cosmetic surgery or as treatment for a medical problem, with the full consent of the patient.

      • CHASUK, the clitoral hood is often cut together with the labia minora. It’s extremely painful. I’ve read multiple stories from women who weren’t informed about this before they had the surgery. I’ve read about a woman who specifically instructed the doctor to not touch her clitoris during her labiaplasty, and the doctor ignored her request.

        Also, you talk about consent — it’s not consent when women are led to believe that there’s something wrong with them just because their genitals don’t look like those of a five-year-old girl. 99% of these surgeries are done for cosmetic reasons. Women are told to be ashamed of their genitals unless they look the same way they did before puberty. I don’t see how that qualifies as consent.

        And what about circumcision performed on babies? There’s no consent there, but nobody gets emotional about that and doesn’t put doctors who perform this operation in jail.

      • An argument like that would also be saying that waxing a bikini line is like FGM. Some doctor quacked at me that getting a pap test was like getting a bikini wax because both procedures would be done by a stranger while I was naked.

        The intention of FGM is quite different to that of labiaplasty. No surgery is without risk or pain. Gender altering surgery must be even worst yet no one protests that. Some people want it done on prepubescent children. For whatever reason, labiaplasty should not be considered “normal”. Male circumsion on children should be a crime. Adults can have done what they want.

  5. Some very good points made Evie, thank you. Personally I don’t agree with any kind of circumcision especially on babies or young children, boy or girl, as no consent can ever be sort from a child. I agree totally that no-one should be ashamed of their bodies or how they were born, no 2 people are the same. The woman who instructed the doctor to not touch her clitoris during her labiaplasty, I do hope she sued him! I can’t even begin to imagine how painful/traumatic these procedures must be, truly awful. What is going on in this world today, it beggars belief!

  6. I knew it Evie. I knew it, I knew it, I knew it.

    Thank you for the information – the enlightenment. There is a site from a cosmetic surgeon who does these labiaplasty surgeries. He posted the naked crotches of women who’ve had it – women who, like Nikita Levy’s victims, didn’t know they were being photographed. His guise is to show that the surgery “works.” So he’s trying to say that it’s not for sexual purposes – LAUGH – what a LIE – which is why he’s not in trouble yet with his patients. Or, maybe they have re-checked the site after their surgery and “recognized” their parts. And are now too ashamed to come forward. I hope that it won’t be long before a brave patient comes forward to have those pictures taken down; may even take legal action with courage from the Nikita Levy case.

    But, I knew that labiaplasty was just another ruse to lure women with low-self esteem, vanity, and shamelessness about nudity to allow men who are not their husbands or intended lovers to touch their genitals – while under anesthesia no doubt. I didn’t know about the clitoral part, but it figures. The cosmetic surgeon likely can’t resist touching the clitoris and then cuts it off to justify it to whoever the assistant is in the operating room. Likely they have many nonconsentual pelvics in those offices by interns while the women are under anesthesia.These cosmetic surgeons really are no different than ob/gyns who lie and withhhold the truth to get women to spread their legs; they want at women’s bodies, also. Someone once stated that if a man wanted to be a predator that he wouldn’t spend thousands to go to medical school; he would just be a predator. There are unfortunately different kinds of predators. There’s no level too high or too low to stoop that a man who really wants to harm will go to. Look at the teacher who just got caught after running away with the 15 year old girl. The difference between a garden variety predator and a gyn or cosmetic surgeon is brains and opportunity to go college. After all – the parents DID want them to make something of themselves and become rich doctors – a noble profession. General practitioner, heart surgeon, pediatrician et al – not one who makes a living between women’s legs. They also make high 6 and 7 figure salaries (once they rise in the ranks) and have lucrative careers because they haven’t been found out yet (that is changing). So, to them, if they can legally touch women’s genitals for a lifetime without risking jail (that is changing) – and get paid for it – why not medical school; it sets them up for life – power, pleasure, and financial security.

    The profession USED to be MAINLY for women who have real cosmetic needs; breast reconstruction after cancer, and such. Now it’s for any woman who wants something done to compete with the beautiful women they see at work, maybe – randomly on the street – in the clubs and restaurants – on tv – in movies – in entertainment. The air-brushed – took 3 hours in make-up and spandex – after a starvation diet before a major event like the Oscars – to get them to look like that – women. Some really may need a nose job or other procedure for a deformity, but not the majority that show up in those offices. However for labiaplasty, they said that it’s for women who’ve given birth and their lady parts are all askew now. Yes, appeal to their insecurity about their bodies after birth and watch the heron go to the pool; watch the $$$$$ roll in. It’s supposed to be for those who developed so-called “abnormally” after adolescence – but really it’s for vain-shallow women who believe these predators’ lies; believing that they HAVE to have this done or they aren’t beautiful women. Do they know or not care that they are paying to be molested. I should have known that they weren’t told the truth before signing the release form and going under anesthesia; that those who’ve had it done had their clitoris’ screwed with – and are now suffering in silence; too ashamed to come forward. There’s nothing to be done to help them now. Even if so, who wants to allow yet another man doctor to touch them (and so far it’s largely male cosmetic surgeons doing these – have yet to see a woman cosmetic surgeon hang out her shingle for this). Yes, you’re right Evie – the difference between this and genital mutilation is the legal aspect and women who voluntarily get it done – as labiaplasty – but because they’ve been lied to. The world screams in outrage over children who’ve been victimized by this and take action; it’s time they start screaming over victimized women and taking action..

    Thanks again, Evie.

    Be Blessed.

  7. I know this is an older post, but it comes up on the first page of Google results for “ptsd for medical procedures”, and I’d just like to say that having loads of pictures of speculums on a page dealing with gynecological procedure ptsd is pretty damn insensitive, I don’t know about anyone else but those things give me a hell of an anxiety reaction.

  8. I agree with you, anonymous! Those things give me the exact same feelings! Somebody in my facebook friends posted a picture of a speculum; She wanted the women to send it to their male partners asking what it is, and comment their answers on her post. That s.o.b turns up in my newsfeed and boy did I become so distressed that I got physically ill.

    • i agree those pictures are awful. i have ptsd because of so many exam attemps.
      i ptsd any time i go to a dr which isn’t too often U S medical system has lost patient care. IT all about paper work and $$$$.
      Sp many suffer from dr ptsd and go unheard.

    • Someone posted a speculum to my news feed last year saying emplying that woman with stds didn’t know what this is.” Like they didn’t get tested. It worked me so bad and others were going along with it and making fun of woman that” didn’t know what it was.” I unfollowed this woman. It upset me so bad.

      • I saw this kind of post and they also said that any woman who didn’t get one has a “nasty vagina”. Strangely, doctors on the pages allowed this, but were quick to chime in if a woman said that she would never get the exam or said that it hurt. They quickly said that women who claim that the test hurt were lying…

        Yet, they didn’t dispel the myth about the “dirty vagina”.

  9. Did any of the UK ladies see the ‘One Show’ yesterday evening? There was a ringing endorsement for more men to sign up as midwives due to the shortage of midwives in the UK. One guy said that it shouldn’t be seen as ‘women’s business’ but instead be considered ‘people’s business’. If more men become midwives, then it means women’s choices will be curtailed, with more chance of labouring women being in a position of having to have a male midwife even if they are uncomfortable with it.

    • I didn’t see the One Show, but the answer to the shortage of midwives is to increase salaries and improve working conditions, so that more women will want to take up this career.
      There was a male midwife on my team during the 1990’s and he was very, very gay. I didn’t get him for either of my births. There was also a male gynaecology nurse when I was in hospital, and I have to say he was the kindest and most caring of the lot. On the other hand, my worst medical experience ever was a female doctor, very much a lesbian, who brutally assaulted me at a smear test. Absolutely couldn’t have cared less about me or baby. I’m very suspicious of men going into Obgyn jobs, but I also know from experience that women cannot be trusted either.

  10. Having read a few accounts, what tends to happen, women refuse the male midwife and then someone young, shy or vulnerable ends up with the male midwife. If they’re happy for the male midwife to stand around while the female ones are run off their feet, fine, but they should never force a male midwife onto any woman.
    That means a quiet and private chat with the woman, or tick a box, not embarrassing her or putting her on the spot. It should never be assumed that a woman with a male doctor should be okay with a male midwife either…there are a lot of factors at work.
    I read a sad account online where a young couple had a male midwife forced onto them after he’d been rejected by a number of women, they said it ruined the birth, they felt distressed, not at the birth but at the presence of someone who was not welcome in the birthing suite.

  11. My oncologist has examined me without a nurse on several occasions. I’m happy I had my daughters with me. This past year I chose not to go after my mamma gram. I have yet to tell my medical doctor. Felt violated.

  12. Hello! I am entering here anonymously because I just need to vent about this. I am so glad I came across this website and the amazing articles you post about UNNECESSARY GYNECOLOGY APPTS!!! I am a 24 year old happily married woman and I have still never been to a gynecologist, nor have I ever even had my own family practitioner exam my private areas. I am so glad I can come here and know that my feelings and anxieties about this are valid, and reasonable. I have dreaded going to an appointment since I even first heard about it, especially since I looked into what goes on during the exam. I have been pressured by so many women, including some of my sisters and even my own mother into going “just in case.” So… is the female body just designed to get cervical cancer and kill itself over time? Why do we HAVE to have this done if we sincerely feel like there is nothing wrong? I feel generally healthy. I feel like my reproductive system is in pretty good health as well. My husband has been my only sexual partner ever, and I STILL feel that I don’t really need to get anything examined.
    I came to renew my prescription on my birth control pills (which I’m mainly using for my once extremely heavy, irregular, and painful periods, but since I got married I’m also using it to prevent pregnancy) and literally the third question the nurse asked was “what’s the date of your last pap smear?” I said “uh, I haven’t had one yet.” Like…??? THAT’S NOT WHAT I’M HERE FOR, WHY IS THAT MORE IMPORTANT THAN WHAT I ACTUALLY CAME HERE FOR. Then when we were talking about my general health since it was my first time visiting, they said “so you haven’t had a pap smear yet?” I said “no” and they were like “well you really should probably be getting one soon especially since you’re sexually active now” like my only sexual partner’s semen is going to poison my insides or something -_- and they said “we can do that here and get it over with if you want” and I was like “I’d rather just wait, I’m not ready yet” and though I’m glad they were nice about it, why is that the highlight of my visit? I didn’t come here to talk about my vagina. I just want my damn pills so my periods don’t murder me.
    I have cried even in ANTICIPATION of going. I’ve still never been, and I just don’t want to go unless I just know that there really is something wrong with me. I can’t get over how violating it is. Also, if you need someone else’s consent without force to have sex with them, why don’t doctors do the same with their patients in doing pap/pelvic exams? How often do they ask men “when was your last prostate exam”? Why is it more “important” for women do get their legs forced apart during a physical and emotionally painful practice than for men to have their buttholes gazed at? I strongly believe that this practice is very sexist. I have so much more to say about this but that’s all I have time for. Thank you for making this blog a reality so I can vent about this!

    • Hi Anon. we are here for you. Post anytime and get our support Practice nurses are persistant little toads you will have to stand firm with them. Doctors somehow think they are above the law and believe they can intimately examine a woman when ever they feel like it. even if she is clearly upset by thier actions. Don’t stand for it.

    • My advice is to tell them quite simply and firmly, that you have made an informed decision not to screen. End of discussion. As tempting as it may be, don’t try to justify or explain your decision. You don’t need to and it may result in a long, drawn out discussion.
      Nurses in particular, will harp on and on about screening. Cut the conversation dead, and they lose the advantage. It gives you control of the situation. If they persist, you can politely ask them to desist from discussing it further, and ask that they concentrate on why you’re there. If they push again, you can inform them that you need to seek legal advice. Most of the time, they will back down.
      All this can be incredibly daunting but woah, it is a great feeling to regain control in the consult room. There are other subtle tips you can use to further empower you such as body language techniques – sit upright, stand up, put your coat on and be ready to leave if needs be! Good luck to you x

    • Welcome Anon,
      Vent away, you’re very welcome, and in the company of like-minded people.
      I should mention that I’m almost 61 and have never had a Pap test. I weighed up the risks and benefits a very long time ago, surrounded by pap test hysteria, and decided not to have them. Of course, that wasn’t considered an option, a NO was never respected or accepted, women were basically ordered, misled and coerced into screening.

      My husband and I decided not to have children, that decision had nothing to do with pap testing, but I would have been forced to have a Pap test, breast and pelvic exam back then if I wanted pre-natal care. (and from my preferred female doctor)
      It’s only been in recent years that these “clinical requirements” at the first pre-natal appointment have been wound back by some doctors.
      Also, we knew the Pill was out for us, that consult was routinely used to coerce women into the works, Pap tests, pelvic and breast exams.
      So it wasn’t just a Q of making an informed decision not to participate in this elective screening program, my legal right…we were forced to live around this program and testing.

      I always felt only a misogynistic medical profession could engage in this sort of treatment of women, sadly, things didn’t change much with more female doctors, I think the unacceptable attitudes toward women became a feature of medical teaching and training.

      The language was always insulting and grossly inappropriate, “it’s for her own good”…”a doctor should not be forced to pressure a woman to screen”…”would she prefer to get cancer?”…the criticism was always aimed at the woman who didn’t want to screen, no matter how badly a doctor had behaved. Screened women felt free to verbally attack and judge women who chose not to screen, so that meant most women were silent about their decision not to screen. This made some women feel very alone, like they were on their own – risking their life, being silly etc. There was also zero support for women who chose not to screen, it was only the release of some research by Angela Raffle and comments made by Prof. Michael Baum that reassured me and gave me enormous comfort.
      (both from the UK) Think that was in the 1990s…

      Coercion was common and it was encouraged, women were routinely denied the Pill if they refused a pap test, some were denied non-emergency medical care, and in the UK, some were removed from patient records. The aim was to get as many women screened as possible, women were treated like mere numbers, the cervix was public property.
      it was an ugly, ugly time, I hope we never see the likes of it again.
      I felt quite fearful as a young women, surrounded by this irrational and hysterical fear of a rare cancer. It was the hysteria that scared me, not the rare cancer.

      Things have improved, but we still have a long way to go…some academics still ponder whether now might be a good time to start respecting informed consent in cervical screening. Why is it that our rights can be ignored when it suits the medical profession or the government?
      That’s the degree of brain washing when educated women might suggest…perhaps, it’s time to respect the legal rights of women – but that’s what brainwashing does, people can’t SEE what’s happening, that something is actually unacceptable, unethical and/or unlawful.

      My advice to you: do your reading, it’s much harder and never safe to pressure, mislead or coerce an informed woman, that knowledge have helped me enormously in my life.
      A calm and firm refusal from an informed woman is devastating to all the tactics employed by this program and it’s supporters and promoters. Head over to our reference area, it’s all there for you. AND, we’re no longer silent, we’re no longer alone!

      • I should add most women here did not see the research by Angela Raffle, it didn’t make the papers here, the program would have made sure of that, keeping women in the dark was all important. Censorship was common back then, it still happens but not as often.

    • Anon,

      Know that you are not alone. I too, have recently gone to a doctor’s appointment for other (diagnosed) physical problems and the whole visit was spent on them pressuring me to get inside my vagina. My physical conditions have nothing to do with my reproductive system. I stuck to my guns too, and talked to this (fill-in) doctor over the phone the next day about how it makes me question whether to seek medical care at all.

      My husband gets pressured too about prostate exams – which have proven that digital-rectal exams are just as medically useless in finding any condition as have pelvic exams.

      • Interesting that men are also now getting pressured to submit to equally invasive tests! Equality is alive and well I guess! I’ve heard that male exams are pretty common in Canada and some parts of the US. Soinds like musguided liberalism to me! Which part of the world are you in?

      • Very low key pressure here for men, bowel screening is low key full spot. A GP raised prostate screening with my husband and brother when they turned 50, they were handed real information on the risks and benefits, including over-treatment
        There was really no pressure to have the test. Also, prostate screening is not recommended here, both the DRE and PSA test are unreliable. (of course, that doesn’t seem to matter in women’s cancer screening, it’s a plus for vested interests!)
        I’ve often wondered why attitudes are so different, I think it comes down to the history of the medical profession, the all-male club, deeply entrenched sexist attitudes combined with power and few checks, meant the abuse of women and their legal rights was no big deal. The medical profession could do pretty much as they pleased, thankfully, that’s changing…

      • I personally think that some of the thinking around smears and pelvics (from a medicinal paternalist perspective) is that they keep women in their place. That’s not the same line of thinking for everyone, as there are lots of gullible people out there who think they are necessary to save lives. And if they’re also pushing prostate exams in certain parts of the world, then that sounds like liberalism gone wrong to me.
        But it’s no coincidence that screening seems to have evolved hand-in-hand with the pill (although they’re not clinically related). It wouldn’t have been hard for men to jump on the “screening saves lives” bandwagon and push their own interests without suspicion.
        I think that in their minds, it was the price women needed to pay for their new found freedom. It was done for control, power, money, exploitation and to keep women in their place.

  13. Hi Anon, Stand firm and don’t ever give in. You do not need a pap or any kind of intimate exam! It is not mandatory and can never be! Screening is optional and elective, just quote this to them the next time, “Informed Dissent”, state you have fully informed yourself and have decided not to screen at all. They absolutely cannot force you to do something against your will and you could report them for it! Your family and friends have no business getting involved in your private body parts so be firm with them too, stating not up for discussion! No decision about you without you. Ensure you chat with your husband about this so he can support your decision, maybe if you do need the doctors anytime it would be a good idea to take him with you, this might even stop the harassment. Feel free to vent as much as you like here.

    • I definitely will when I get the chance! 🙂
      And I don’t understand!! It’s like… I remember going in when I was first being prescribed birth control and when I was ABOUT to have my first pap test done, they said I didn’t really need it because at the time I wasn’t sexually active. I was relieved but still… what did they need to do it for anyway. After going on the pill, EVERY problem with my periods have been solved. My mom wanted a test to be done because she said “I just want to make sure everything is anatomically correct” uh, what do you mean by that exactly???? I’m PRETTY sure my vagina, uterus, cervix, ovaries, etc are all in the right place… the problem was my hormones were out of whack. It had nothing to do with my actual uterus and vagina! Because once the pill fixed my problems, there was no reason anyway to get it checked. What would they have to look for anyway, seriously???? For me, I have to be practically on the verge of death before I consider going to a doctor. If you go to a doctor every time you get sick, you’ll just keep getting sick more after that. All they do is give you antibiotics and it kills so much of the bad stuff that it kills the good stuff too, so your body doesn’t get the chance to develop antibodies for the virus that you caught. I can’t even remember the last time I got the flu shot and it’s been YEARS since I’ve had the flu. The flu isn’t even that bad anyway lol every time people say the flu has been going around, I never caught it because my body has finally become mostly immune to it. And since my last visit to my new doctor, I’ve been staying away because of my fear of being coerced into a stupid pap test. Sorry for this to be so long but you know what else pisses me off?? Is that I get more crap from OTHER WOMEN, NOT MEN, if I refuse to go!! Aren’t we supposed to be empowering each other instead of shaming each other for EVERYTHING???? “Ugh just suck it up and do it. You’ll get used to it.” Do you tell rape victims to suck it up and that they should’ve enjoyed it? NO, so why is it so different with doctors?? If we have to consent to have sex with someone, why won’t doctors do the same? “I’m the doctor” I don’t care. That does not give you automatic entitlement to touch my body if I’m not comfortable with.

      • Hi Anon, you are right about other women being the worst when it comes to bullying and shaming other women to get these tests. I honestly think it is because they feel very insecure in going through it themselves. If the attendance figures dropped to below 50% and they became the minority, would they be so outspoken about it? I very much doubt it. In the UK we’ve just had a screening awareness week and they have been promoting it very aggressively. Uptake is below 50% in some age groups and when women hear they are going but their friends aren’t, they either attend in secret or give up going at all. The game goes into reverse as the attendees are made to feel small and guilty. They are so terrified of this happening that they’ve been running these dreadful campaigns, and it seems we’ve got more coming in March when another load of events are planned. This really isn’t anything men have to live with at all. It really is sexist.

      • Anon – Women really are their own worst enemies and they don’t see it. For the most part, the majority of non-medical men don’t understand the fuss at all. They think if you want to go then go, if you don’t then don’t. Pretty simple ideology. Far too simple for the screeniacs here in the UK.

      • Lol anon i think you could be my twin! I love this website too- it’s pretty much the only safe haven i’ve found amongst the storm of pro-gyno BS that women our age get caught up in. Once I started getting to “that age” i couldn’t for the life of me understand why any half intelligent/self respecting woman would put up with all this! I feel like these gals are family in a way since they’ve guided me through the process of being an independent woman and armed me with the knowledge and confidence to say no and really mean it with Drs lol. I am also pissed that they feel they have a right to touch us without consent just because of their profession! Whatever happened to simple human decency and respect? There really is no rant long enough for this vile practice and the brain washed sheeple women who support it instead of supporting each other!

        My very caring hubby also deserves alot of credit. We were complete virgins and been together since i was 20. Luckily my periods were never troublesome enough for birth control but we did look into it at one point. He was shocked to learn what the process entailed and i was terrified! He said he’d hate for me to feel violated and hurt by the gyno industry when condoms are so easy. He chose to protect me from them and put my comfort ahead of his pleasure.

        I’m now 29 and never had a pap/pelvic exam! I’m also approaching 6mos pregnant and i’ve had a lovely time with my midwife. She respected that i opted out of cc screening and said there wasn’t much point to an exam without it so i won’t have any exams until labor. I think by then I’ll be ok since there will actually be a point to it.

        So don’t despair dear! It is possible to live your life as a free woman without submitting to the whims of greedy/power hungry Drs and the insanity of the gyno industry. And if all else fails you could consider projekt ruby!

  14. Ada
    I’ve always felt the women who engage in shaming, bullying and insulting women who choose not to screen, have climbed mental mountains. Many of these women had to travel to another place to endure annual, 2 or 3 yearly testing, often with a variety of experiences. (and often a colposcopy, biopsy etc. as well)
    It’s almost like they’ve been to battle, they were braver and stronger than others but their reaction to others choosing not to screen is telling, they HAVE to believe these women are idiots or risk takers.
    It would be interesting to know how most of these women, including the “survivors”, react when fewer than 50% screen – do they feel even more superior? How could so many women be irresponsible with their health? Or does a nagging doubt arrive that has to be managed by the woman?
    Many of the women I know who no longer screen stopped due to the painful process after menopause – the speculum exam meant pain, bleeding, being left very sore, some ended up with some damage – minor tears. Also, a few mentioned the extreme humiliation, needing a doctor to locate the cervix, needing a nurse to help them into position, passing wind – some women have vulval issues after menopause, these women might be sore anyway without someone trying to insert a speculum!
    One online friend told me her last pap test was dreadful, the nurse couldn’t find her cervix, then the doctor had the same problem, after a very painful 15 minutes, she told them to stop…she walked out not giving a damn about cc and has never been back, some women reach a point of no return, they’ve simply had enough.
    Most of these women were not offered an alternative, they were simply told it was a test that was recommended until age 70 – I imagine now they might be offered HPV self testing. (depending on the country and the doctor)

    So if the screening rate falls under 50% – that’s great news; it’s taken a long time to get to this point. The minor celebrities shouting the virtues of testing or talking about their near miss are no longer helpful, more women have worked out abnormal cells are not cancer and never likely to be…
    Must say I’m enjoying the final scene of this ugly and harmful play – watching the wheels fall off screening…it’s a great day for women!

    • I’m loving it too. I also sense panic in some of the screeners and campaigners. More women are also finding their voices and now feel more confident than ever to stand up to a pushy nurse and say, “NO”. There’s little as empowering as the feeling that you (and NOT THEM) are in control when you leave that office.

      I also sense that there will be some ramifications when HrHPV testing is introduced. For some, the penny will drop, for others, there will be some major confusion and I suspect most of the militant screeners won’t notice the change.
      My fear is that docs will say that the unreliability factor is no longer a reason to refuse screening. They will argue that the only barrier left is embarrassment, which is no reason to refuse screening, which is why highlighting the NHS’ dishonesty over the programme and withholding self-testing will continue to be paramount.

      • On the unreliability of pap screening, which is just slightly more accurate than reading your horoscope in the newspaper, I’ve had several doctors (2 women and 1 man) outright LIE to my face, and tell me that it’s anywhere from 95-99% accurate, false-negatives almost NEVER happen. What a bunch of BS.

        If they lie to me about that, which is easily obtainable information, what else will they lie about concerning my physical condition?

    • Thank you so much for this, Elizabeth. I think screeners fear non-screeners. The policy of the programme has always been to de-stigmatise the programmes by emphasising everybody should take part. The fact that some people have refused for some time is making the pro-screening lobby very insecure. You can almost hear some women thinking, “so I’ve been through all those smears and others haven’t been bothering at all, and got away with it all this time”.

      • And as more and more women walk away, others might start to say, “so, is it actually true that it’s not that reliable”, or “so you can self-test for HPV”. Others might even say, “what were all those procedures that I had done, did they actually save my life? Or have I been lied to?” And bam! The penny may drop.

        I think this is what the NHS is most scared of. I read somewhere that any changes introduced to the Cervical Screening Programme should be done so gradually. When you initiate gradual changes, many people don’t recognise the immediate impact. The bu***rs are just trying to avoid a backlash.

  15. I went to a very very pushy male doctor, who seemed bound-and-determined to get to look at the insides and outsides of my female parts before prescribing treatments for diagnosed conditions. At the end, he said that he would not hold my diabetes treatment hostage, but still recommended CC screening “because you could die”. Yes, I thought that was a given since my conception. He looked very… strangely… when I knew this was a rare cancer, and HOW rare.

    Hubby, who was with me, wasn’t much help, but then he’s bought into the “Pap saves lives” thing too.

    • There’s a reason men avoid doctors like the plague, and most of the time, they find them just as intimidating as us! Brilliant that you stood your ground. Male dr now knows to back off with you in the consult room.

  16. BBC today: “Having human papilloma virus (HPV) is not rude or shameful and is extremely common, experts say.”
    https://www.bbc.co.uk/news/health-47211262
    “Charities are concerned this could put women off getting smear tests.
    Sara Hiom, from Cancer Research UK, said: “Busting the myths and removing the stigmas surrounding HPV is vital to ensure people feel more confident to book and turn up for their cervical screening appointment.”
    “HPV doesn’t just affect women. It can also cause a number of different types of cancer in men, such as cancer of the penis, anal cancer and some types of head and neck cancer.”

    Not asking (demanding) men to come forward for regular testing as usual, just let them pass it on to us!
    And a video of a god dam test….No need for this!!

      • Yes, I’m there as well!

        It’s crazy to see how things have changed over the last year or so. While there are still the militant and ignorant pro-screen fanatics there are many more women understanding choice and overtreatment etc.

    • They’re inventing problems about screenings in order to give an answer nobody asked for. Because if they admitted women don’t go to screening because the women themselves don’t think it’s worth the hassle, not because they feel so much shame, the world would end or something.

      • I reckon they don’t want to acknowledge what’s staring them down the gun barrel because it will become a self-fulfilling prophecy.

        Admit why women don’t really go, and they’ll be forced to confront all those claims about unreliability etc. If they’re forced to address them, they only have one option, which is to lie to women, because they can’t come up with anything solid to refute all those claims, so they spin a yarn about a nation full of embarrassed and ignorant women. Problem is, that little yarn is beginning to grate and annoy a lot of women who can think for themselves.
        Oh, what to do if you’re an NHS Cervical Screening promoter.

  17. Well done to you, your comments are brilliant! But my word are they all so dim with little knowledge! All of them that have been treated feel like they are special in some way, I honestly believe a lot of them actually enjoy the feeling of “it saved me”.

    • Thank you! It feels like hard work though! I haven’t been on there since this afternoon. Things have changed a lot. There was a pro-screening woman on there who also believed it should be an individual choice. The two rarely go hand in hand! She also felt that the article wasn’t informative. I thought, how refreshing! Debating with some of these women exposes their ignorance and belief system the more they reveal. It makes them sound really ridiculous when they mention “mandatory screening”. Do they imagine we live in a dictatorship that drags women off the streets to undergo screening? Someone should point out to her that we don’t have enough prison spaces for those who commit real crimes, let alone for women who don’t have smear tests! 😂

  18. https://academic.oup.com/aje/article/178/7/1161/211254

    The 2013 study by Vink et al. 2013, revealed that those with CIN 2/3 had a 1.6% chance of developing cervical cancer within ten years and a 12% chance of developing cervical cancer within 20 years. It was not known what the prognosis was beyond 20 years although the median rate of time for developing cervical cancer was 23.5 years. A study in NZ in 1965, that involved witholding treatment from women with CIN 3 lesions, saw 31.3% of them develop cervical cancer within 30 years, but these lesions were reportedly already advanced in comparison to the CIN 3 normally observed via conventional pap smear.

    Should have quoted this in the DM comments section but used up my allowance for the day! Will try and re-post tomorrow, although I suspect they’ve stopped accepting comments!

    • Yes, slow moving, if it moves at all, the very rare case in someone under 30 is usually an adenocarcinoma of the cervix, that type of cc moves a lot faster…and it’s usually missed by pap testing. I’ve heard the argument that women in their 20s should be offered HPV testing to catch these rare cases, but the fact is a lot of young women are HPV+ and produce “abnormal” pap testing while actual cancer is very rare, so testing means you end up worrying and harming huge number to possibly help a couple of women. The Dutch and Finns have always advised young women to see a doctor with unusual and persistent (or worsening) symptoms – they’ve never offered screening to women under 30…that’s far more effective than misleading them into thinking cervical screening will save the day.
      We’ve always done the latter, pap testing from teens and now HPV testing from 25…

  19. AQ
    Not really sure but there’s lots of articles that mention self-testing so they certainly don’t have an issue mentioning it to women. My guess is if you prefer self testing, so be it.
    Looking at the Rovers Medical website, who market the Delphi Screener, it sounds like you can order it online or buy it at a pharmacy, you might also, get it through your GP.
    I get the impression they don’t have our hurdles to clear, there isn’t this insane need to control women.
    The Dutch system seems more low key to me, they’ve never offered more than 5 yearly pap testing from 30 to 60…and that goes way back. Compare that to what was happening here or in the States, and it’s like day and night. Now the Dutch offer 5 HPV tests or HPV self tests at 30,35,40,50 and 60.
    We only decided it was safe to move from 2 yearly pap testing last year…interesting the Dutch worked that out in the 1960s! I firmly believe, we knew, but we looked the other way, too many were very happy with the over-screening/over-treating regime. Now we’re doing the same thing…HPV testing from 25, and too many HPV tests.

    A Dutch woman who followed their pap testing program would have had 7 pap tests in total, and of course, leaving out young women and stretching it out to 5 yearly, they have MUCH less over-treatment. (and fewer “survivors”)

    Their programs are much cheaper and more effective…they save lives AND spare huge numbers of women from excess testing, biopsies and over-treatment. (and the health and psych issues that can follow) Consider the burden of annual or 2 yearly pap testing from teens to age 70 versus 7 tests in total, 5 yearly from 30 to 60. An Aussie woman might have had 26 or 27 pap tests, an American woman might have had more than 50!
    So the Dutch have always been light years ahead of us…and the rest of the world. The Finns had the same program but they haven’t moved to HPV testing yet. (surprising…)

    From the expat site:
    “Do Dutch women get routine check-ups? A second female GYN based north of Amsterdam laughed when asked this question. “Check-ups aren’t done. We don’t believe in it if there isn’t a problem. If there are no complaints, don’t fix it. We wait to see if something develops and then call a GYN only after some time passes.” The first gynaecologist added, “Unlike in the States, women here do not get annual pap smears or checks for cervical cancer. What if we checked for every little thing a patient wanted and found a benign cyst? The patient would then wonder what to do. She’d ask herself, do I get an operation, do I need more investigations, do I take antibiotics… It is not our job to induce worry. We solve problems when there is a problem.”

    What about routine check-ups during pregnancy? “No pap smears during pregnancy for cervical cancer because hormones aren’t at normal levels then, also during breastfeeding. Plus it takes 15 years to develop cervical cancer, not nine months.”
    https://www.expatica.com/nl/healthcare/womens-health/womens-healthcare-in-the-netherlands-100752/

    Pregnancy is viewed as a normal, not a medical event, many Dutch women still give birth at home.
    Because cervical screening was never a huge feature of their lives, and the attitudes are different, I don’t think you’d see too many brainwashed Dutch women or hysterical, irrational pro-screeners – it would be more…”you want to screen, then screen”.

    The Dutch appear to have kept out vested and political interests, they’ve been able to focus on the evidence and what’s best for women and their healthcare system.
    I doubt that could ever happen here.

    I notice that close attention to value for every health dollar means attitudes are different with premature babies too.
    “Doctors in the Netherlands will generally not undertake intensive treatment for premature babies (24 to 25 weeks) with low survival expectancy”
    I’ve read this is because these babies are likely to die anyway or be left with continuing sickness or disability, whereas here, we spend huge sums to try and get these babies over the line. I think most here would be more comfortable with our approach.
    I think this focus on the best use of every health dollar makes it difficult for vested interests and others to turn screening into something in their best interests.

    • The value for money thing is interesting. I think it’s no coincidence that (some) attitudes towards screening here in the UK have started to change at the same time as the onset of austerity. The NHS doesn’t seem to want to let it go but with massive overspending, budgets to save and the inefficacy of screening, cervical screening has quite clearly been identified as an early casualty of the wastages cull (not before time). After all, all those letters, summons, lab works, overtreatment etc. must be costing an absolute fortune, and for what? They are probably also forking out for after treatment associated with these procedures; caesareans, counselling etc.

      A lot of other things are driving this change also; increased testing ages (25 year olds are more assertive than 20 year olds), more awareness of the evidence, harmed women.
      But changes on the inside may be driven by austerity and the need to do “more with less”.

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