These Days I Hate Going to the Gynecologist

30 May

Oftentimes women complain that they hate going to the gynecologist because they don’t like the procedures.   Sometimes it is likened to going to the dentist but more uncomfortable and personal.  I can’t say that my reasons are related to the procedures.  In fact, what makes me most uncomfortable about the speculum is the historical exploitation of black women whose bodies were violated as subjects in the development of this tool.

I also cannot say that I dislike the intimate discussions about my personal life and habits.  Ideally this space should be like going to a mental health therapist where I would have an opportunity to learn about my body, my habits, and my emotional well-being without feeling less than or abnormal.  Unfortunately this is not what happens.

Why do I have such idealistic notions regarding the possibilities of a gynecological visit, you might ask?  Well I have had phenomenal experiences early in my life that suggest that my ideas about gynecological safe spaces could be the norm.  I want to take a quick moment to shout out three good experiences out of numerous horrific encounters.  Nurse Fuqua at Spelman College Health Center, a black woman who taught me to feel powerful as a sexual being and to be cautious.  Dr. Martin Dukes, a retired black male doctor who always made sure to have another person present and was deliberate about making me as comfortable as possible in the exam room.  The Feminist Women’s Health Clinic in Atlanta has been a “breath of fresh air.”  I engaged in real-talk with the white female nurse practitioner (whose name I cannot remember) and was treated like a grown up worthy of dialogue and not health-insurance-speak.  Unfortunately I the FWHC cannot function as my primary health provider.

The Feminist Women's Health Center Logo

So I have told you the good, now here are three ridiculous scenarios I have experienced myself and one disturbing story I have been told by many friends, who are black women.

1.  Most recently I went to a gynecologist at a clinic and the black female doctor was so extremely rude and rough that I literally left in pain and with an unhealthy fear of returning.  When I came back to get test results I brought a friend, who at one point actually asked the doctor to leave the room.  I wanted to do violence, and those who know me know that is out of character.

2.  In 2009 I went to black female doctor and during my examination I requested an AIDS test, and she replied, “but aren’t you married.” (Strike one, two, and three–you cannot be my doctor).

3.  In 2008 I was having pain in my uterine area and was going to “holistic” black female doctor who gave me an ultrasound which indicated that my ovary was attached to my uterine wall.  Even though the pain was on the opposite side of my uterus she suggested outpatient surgery.  The background story is that she had identified that my estrogen levels were high and that I drank soymilk regularly.  It turned out nothing was wrong, I stopped drinking soymilk and the pain went away instantly, and realistically as second ultrasound (which is cheaper and less invasive) would have revealed that my ovary was not attached to my wall.  Needless to say that was my last visit there.

4.  Over the past few years I have been having this discussion about finding a good gynecologist.  I am very disturbed that one of the main reasons why many women I know indicate that they stopped going to the gynecologist altogether is because they would go for an annual exam and get a lecture on weight loss and BMI.  Now it is one thing for a doctor to have a holistic discussion about healthy bodies.  It is something totally different to peddle weight loss programs and pharmaceutical drugs in a gynecological space, especially if it has no bearing on the concerns that bring women into the space.

What am I looking for in a gynecological relationship?

1.  Access–I don’t want to wait 6 months to see my doctor about a yeast infection.

2.  Dialogue–I need them to respect me enough to give me non-scripted explanations provided by pharmaceutical and insurance companies.  I want to know why you are asking particular questions about recreational drug use and how that is related to my uterine health.

3.  Be gentle and kind–Recognize that internal investigations and treatments are intimate and have emotional costs.

4.  Be supportive–If I am in good health, don’t target me for weight loss products and leave my body esteem intact.

5.  Respect me–If I have particular concerns address them to the best of your ability and refer me to someone else if you cannot.  Furthermore, don’t require me to fit into a normalized lifestyle to receive excellent care, know your craft and treat me as an individual.

As you can see, I have a commitment to supporting black female and women-of-color doctors, but honestly my best experiences have been with female nurse practitioners.  It is not my intent to suggest that black female doctors are not good gynecologists, my experiences suggest this but I simply refuse to believe it. Ultimately, I want to open up some dialogue about the right to have good gynecological experiences.  What are some of your good/bad/ugly stories?  What are you looking for?  What have you found?

55 Responses to “These Days I Hate Going to the Gynecologist”

  1. Shani May 30, 2011 at 8:18 AM #

    My own experiences with black female gynecologists have been equally disturbing despite the fact that they took place in the Caribbean rather than the United States. I have found that black female gynecologists have been unsympathetic, rigid and almost incapable of being gentle. In my own search for a good gynecologist i have opted for black man, who made me feel comfortable and has been open to discussions about sexual, emotional and general health.

  2. k May 30, 2011 at 8:34 AM #

    This article is so on point, there are so many nuances to having a shitty/decent/exceptional experience at the doctor. The doctor’s office should be one of the safest spaces, a place where you can talk about anything that you do in full honesty without fear of judgment and this is all being done for the sake of your health. Being a woman of color in the doctor’s office comes with a lot of assumptions that the doctors (and even nurses) make about your practices, habits, sexual and medical history. I feel you on the wanting to support doctors of color but I’ve had disappointing experiences that made me never want to see a woman doctor of my own cultural background again.

    I went to two Arab, Muslim female doctors (I’m Arab & Muslim too) and both asked me the essential questions so rhetorically that -really- I almost didn’t need to provide a response. Both said: “You don’t smoke, right?” “You don’t drink, do you?” “And you’re not sexually active, right?” with pen in hand and not even daring to look up at the eyes of their smoking, drinking, sexually active (and, at that point, lying) patient.

  3. Qalil May 30, 2011 at 8:37 AM #

    It is difficult indeed to find a good OBGYN. I went to a male doctor who leered at me! Needless to say I “got” a phone call and went ghost! I got a furious email message after that.

    An Asian doctor treated me like an 8 lane highway, a Lebanese one refused to use a smaller speculum. I hVe yet to be treated with dignity and consideration by a gun. doctor.

  4. BrownGirl May 30, 2011 at 9:08 AM #

    This is so wonderful. The length, style, and content of this post is perfect for sharing with young women all over and hopefully before they have a bad experience.

    And I too have had more pleasant encounters with nurse practitioners than gynecologists. I wonder if it’s that nurse practitioners are less jaded and maybe make themselves more accessible.

    There should be some PSA videos on this via Youtube much like the “It gets better” campaign and make them viral.

  5. Melinda May 30, 2011 at 9:22 AM #

    I am so excited that you have posted about this topic! I have had horrifying experiences with doctors and, especially, gynecologists! I once had a GYN judge me and my history as she was giving me a pelvic exam. Let me elaborate. My doctor did not take a personal history before my annual exam, and when she finally got all-up-in-my-junk, she realized that I had been pregnant before. She quickly asked if I had given birth or miscarried (there were no other options), so when I responded that I had terminated my pregnancy, she stopped, grunted, and used as few words as possible after the exam.

    I am so excited that you wrote this post because it is something that definitely needs to be addressed.

  6. Jay Blue May 30, 2011 at 9:54 AM #

    I too have had great experiences with nurse practitioners. However, for a short period of time I was seeing a gynecologist and requested an HIV/AIDS blood test and she looked at me in shock and told me, “You are fine…you are too young.” Surprised by her response, again, I requested a blood test and she provided the necessary information. As a Black women, I was flabbergasted that she was reluctant to provide information regarding HIV/AIDS testing especially when I receive constant messages in my community about the importance of getting tested and “knowing my status”. Needless to say, that was the last time I went there. After that appointment my experiences to date have been great.

    When I see my current nurse practitioner she always provides a space for me to asks questions and constantly inquires about my comfort level. The last time we met, I asked fertility questions and she expressed what she knew about fertility but suggested I speak to other doctors in the complex who are more knowledgeable about this topic. She provided names, numbers, backgrounds and the whole nine.

  7. mzmkali May 30, 2011 at 10:01 AM #

    Thank you for this article. It is something I talk with my 17 yr old daughter about and will someday with my 5 month old daughter.
    I have had similar experiences with doctors v. nurse practitioner. I think it has something to do with how and why nurse practitioners enter the healthcare field versus how and why people become doctors. Nurse practitioners often want to interact directly with patients and don’t necessarily want to work with doctors who tend to be sterile, cold and pompous. I have always called my NP’s by first name and never have I been invited to call a doctor by their first name. It’s this kind of status and expert approach that usually always turns me off to doctors.

  8. Naima May 30, 2011 at 10:23 AM #

    Love this post! Totally identify with it. Respect includes not being subjected to weight loss, hygiene, and lifestyle lectures on every visit (I was trying to get some exercise in by walking a few miles to her office in 90 degree weather and apparently she did not appreciate this…lol). This is why, even though I have a choice of many gyn’s covered by my insurance, I am trying to figure out how to get to Planned Parenthood (even though there isn’t one close to me). The nurse practitioners there seem so much better than any gyn – at least on an interpersonal level…I feel like they care and am not being judged.

  9. filmfemme May 30, 2011 at 11:04 AM #

    The timing of this post is uncanny. For the most part, I have had good relations with my OBGYN doctors, in the sense that I felt like I was respected and my questions were answered. Ironically, the best visit I probably had was when I had a exam done at Planned Parenthood in Brooklyn a couple of years ago.

    But last week, I had a visit with a new OB/GYN near where I live. The issue wasn’t the pelvic or breast exams, or even his demeanor. The issue was that neither he nor his nurse took my blood pressure or weighed me. To me, that’s BASIC doctoring 101! I don’t know how you can even evaluate someone’s health without doing those two key routine things.

    When I asked him why it wasn’t done, he said that the nurse he uses–who weighs and takes blood pressure for other doctors’ patients at this office–does NOT do that for GYN patients. And he didn’t offer to do it himself even after I brought it up.


    It took everything to not yell at this guy (and in hindsight, I probably should have). It was such an incredulous statement! Are doctors under that much pressure to SAVE $$?! My blood pressure is ALWAYS normal, but the fact that he didn’t bother to CHECK was offensive and shocking to me (he didn’t bother asking if I smoked either). Also, I have a friend who was just hospitalized for a deep vein thrombosis (aka severe blood clot)…so that made me even more through.

    Dr. Louis Camilien of Bedford Medical Group in Brooklyn. Visit at your own risk.

    • mero May 31, 2011 at 8:16 AM #

      I’m not sure if taking your BP or weight is useful for a gyn exam? If you had records transferred over from where your usually get your physicals they could have seen that your stats were stable. I think that what he did was actually beneficial as per the authors point #2 – don’t ask for unnecessary information.

      I get my GYN exams done with my primary care physician who specializes in women’s health, so I get a routine physical the same day as the pelvic exams, but when I got them done in college by a nurse practitioner she never took my BP/weight either.

      • filmfemme May 31, 2011 at 10:10 AM #

        @Mero: I disagree that BP and weight are “unnecessary information.” In fact, they are absolutely useful in ANY medical workup–if for no other reason to have it on the record for future reference if needed. Specifically related to women’s health, it can be important in determining 1) fertility, and 2) risk in taking birth control pills. This is especially important for women over 35, who are at higher risk of blood clots if they are overweight and/or smoke and/or have high blood pressure. Furthermore, hypertension is quite prevalent among Black women: weight and high blood pressure plays a big part in that as well.

        I would not trust <any health care provider who wouldn’t do those two very basic and unintrusive things. It’s how doctors react and approach patients with that information that can be disconcerting. Also, for the record, said doctor did not have my previous medical records. And even if he did, I would still expect him to take down my current weight and BP. To me, to do otherwise is cutting corners for no good reason.

  10. Marie May 30, 2011 at 11:13 AM #

    Thank you for writing this and sharing. I, too, have good experiences with NPs and bad ones with MDs.

    When one MD refused to give me an ultrasound to rule out cysts, etc because I was having pain, I told her, “I know how to and will advocate for myself.” Her reply? “What is that supposed to mean? Are you threatening me?” And this was soon after 9-11 and I’m North African and told her I’ve been stressed because of political climate!

    I did not have pap smears for years because I was sexually molested during an exam in my early years of college by the school’s health center male gynecologist. I was too traumatized and numbed out to tell anyone and didn’t for years. It led me to do anti-sexual assault work and become more involved in women’s communities and activism. I will never see a male gynecologist again.

    For sure there are bad NPs out there but as a nurse, I can tell you that nursing education is very focused on holistic care of patients, meaning emotionally, spiritually, socially, culturally, etc.

    I expect:

    -Culturally respectful care

    – No assumptions about my sexuality (check your homophobia and heteronormativity at the door)

    – Truly holistic care

    – Listening to me as I am the expert on my body

    – Read my body language!

    – Tell me what you are doing, step-by-step

    – Be a true advocate for women’s health. Don’t just buy into biomedical industrial complex’s guidelines and protocols for women’s health.

    – Know the resources in your community so that you can make appropriate referrals. Of course this means you would have done a full assessment and built trust!

    I need to make an appointment for a pap actually. Thanks for reminder!

  11. Simone Lovelace May 30, 2011 at 1:27 PM #

    I would just like to join the chorus of women who have had much better experiences with nurse practitioners and PA’s (physician assistants) than with doctors. All of the providers I’ve seen have been White or Asian women, so I don’t think this trend is unique to Black medical professionals.

  12. drlawmom May 30, 2011 at 2:13 PM #

    I, too have had excellent experiences with nurse practitioners, and not so with Ob/Gyns. In fact, all three of my children were born with the assistance of certified nurse-midwives, without physician assistance. My daughters were both born at home. Interestingly, when I visited my back-up physician (a legal requirement for home birth in my jurisdiction), a black woman, who at the time was considered one of the best Ob/Gyn’s in my area she asked me, “Why do you want to have a baby at home? It’s so messy.” Plainly, she knew little about the ordinary process of giving birth. I was very happy I did not have to rely on her services.
    So I have repeatedly come to the same conclusion about MDs vs. Nurse practitioners. The training a medical doctor receives is still primarily designed by men and for men. By contrast, for better or worse, nursing has been a traditionally female profession. In the area of caring for women, I have simply found that nurses (regardless of gender) have been more knowledgeable, caring, respectful and sensitive, than any MD, male or female.
    Thirty years after my first visit to a nurse practitioner for gynecological care, I still seek out nurse practitioners, e.g. certified nurse midwives, as my primary woman’s health care providers.

  13. Kathleen May 30, 2011 at 3:11 PM #

    I too will say the timing of this article is uncanny. My provider of 12 years, a nurse practitioner, recently retired from patient care to teach full time. I loved her. She was pleasant, gentle, willing to listen, didn’t treat me like a child, and discussed health and my body as a whole, not broken into its various, isolated parts.

    In my search for a new provider I went to a white, female MD ob/gyn. I was not weighed. The history was brief and we did not discuss my dietary habits and only briefly touched on my exercise habits.

    Before the exam she looked at her BMI chart posted on the wall (should have been my first clue that she was going to be problematic) and immediately declared that I needed to lose 20 pounds so she would feel more confident treating me. I…what? Yeah.

    Anyway, rather than walking out then (which I wish I had done, but that automatic dominant doctor/subservient patient relationship brainwashing kicked in), the exam proceeded. During the pap and pelvic exam she started lecturing me again, telling me I needed to take nutrition courses to improve my eating habits (which, as mentioned above, were never discussed) and that I needed to join a structured cardio program at a gym to loose weight.

    I was shocked. I was horrified. I was traumatized. I returned to work and went to my friend’s office were I broke down in tears.

    I was less angry at the doctor (although she certainly deserves my ire) and more upset with myself for not standing up for myself, for not saying something. I wrote and mailed letter later that day describing everything she did wrong during that appointment and that I would never be returning.

    And my search for a ob/gyn continues.

  14. Jaleesa May 30, 2011 at 4:14 PM #

    FWHC in Atlanta is the bomb. The cost and travel that it takes to get to that clinic is slightly rough on me, but I make a point of going there because I never feel disrespected or patronized whenever I’m seeking a service. That’s really important to me when I’m looking to medical professionals for anything, sexual health related or not.

    I love it when the professional talks to me like an intelligent human being, and doesn’t talk down to me or talk over me. Specifically when dealing with sexual health, I’ve found that anywhere else I go I’ll have to deal with being treated like half my brain is missing or like I’m 12 years old. Or being roughed up, as I have been with OB/GYN exams that weren’t performed at FWHC.

  15. Siobhan May 30, 2011 at 4:23 PM #

    I have had the best of luck getting pap smears through my GPs. If I find a good GP, they tend to be gentle when doing paps. I find OB/GYNS in general to be officious and rough. I’ll stick with GPs, thanks.

  16. xtinApdx May 30, 2011 at 4:25 PM #

    I’m an old person and have had a gamut of experiences. My best ones were at Planned Parenthood clinics but they kick you out once you’re perimenopausal. I had an exam by a nurse practitioner that was so awful my complaint led to her firing. My present GP practices the ideal medical model way (it’s awesome-look it up if you’ve got time) so we have plenty of time to talk over issues. But we had a major miscommunication recently.I thought she was put off by my weight gain and couldn’t quite manage to give me a thorough pelvic exam when in fact she was worried about some symptoms I had. She wanted me to have an ultrasound, which I hate both because I had issues with an earlier one and I’m an abuse survivor which I don’t think I told her. Anyway, it was a near disaster and I’m hoping to come to an understanding when we meet next time.

  17. Alli May 30, 2011 at 5:07 PM #

    I consider myself very lucky in the fact I’ve been going to the same female Gyn since I was 19. She has always been very understanding and non-judgmental. Her attitude when I was diagnosed with high risk HPV and through the procedures following was “this happens, it’s no big deal, lets focus on getting you well again.” She always spends time talking to me about how I’m doing overall and chit chats with me during the actual exam to distract me from the discomfort. She also always uses the smaller speculum.
    (Trigger Warning for bodily harm)The one experience I had with a NP she was a much older white woman with a perpetually sour face at my college clinic. I’d never had a gyn exam before (this was before Dr. B), but I was concerned about having possibly contracted HPV. She grumped at me that I’d need to have a pap smear. Ok fine. She took my history glaring at me over her glasses in that cranky church lady way especially when I told her I hadn’t had intercourse. She didn’t seem to believe me. Once she got me on the table she hardly said a word to me until right before she inserted the speculum. “So you’ve never had intercourse?” “No..” Pain! I actually considered kicking her in the head. After I told my mom what happened she insisted I go to Dr. B (her doctor). I told her my worries about the exam and why and she looked positively horrified, hugged me and assured me it would never be like that when I visited her. And it never has. 🙂 I dont’ know what I’ll do if I move and have to find a new Gyn, but I’ve always heard great things about the people who work at Planned Parenthood.

  18. Joan May 30, 2011 at 6:35 PM #

    Love this post. I’m wondering ( and feeling very Moya Bailey in this moment) if we couldn’t make it a feminist initiative to post contact information of great OBGYNS we’ve had experiences with. I think it would make a great resource.

    Just a thought.

    • Tori May 31, 2011 at 12:16 PM #

      Something sort of like this?

      (With the caveat that some entries on that list are old and might be out of date. Also, it’s pretty US-centric.)

      • crunktastic May 31, 2011 at 1:52 PM #

        Sort of like this would be nice, but a program with a better format where folks can locate providers more quickly by state without having to scroll through the entire list. But it’s a start.

    • moyazb June 2, 2011 at 9:02 AM #

      Agreed (&thanks for the shout!)! SPARK Reproductive Justice in Atlanta has an amazing access guide that they update each year or two with resources that relate to GA. It would be amazing to be able to support them and similar projects in making their documents more accessible than PDF searching and even available via phone as not all of us in need have computer access.

      Thank you Sheri for bringing such an important conversation from behind the curtain!

  19. sheridf May 30, 2011 at 7:55 PM #

    @ Joan. I agree an online resource would be great. I was hoping people would share that kind of information on their own. I hesitated in the post to put the names of people who I felt mistreated by in the exam room, but I think it would be powerful to share/support the “feminist tested and approved” locations. I am also wondering about supporting any initiatives to get more insurance support for increased access to nurse practitioners as a choice.

  20. Kate May 30, 2011 at 8:52 PM #

    I actually really love my gynecologist. He’s an elderly man, he’s very gentle and careful, his tone of voice never changes. He is a bit businesslike but I feel like he always tells me the truth and doesn’t try to sell me on procedures and medication I don’t need. Nobody loves going to the gyno, but I don’t mind because he is so good at what he does.

  21. buttercup May 31, 2011 at 6:28 AM #

    Here via Shakesville.
    I recently had a great exam experience at the local Midwife center with a nurse practicioner. This was my first exam in nearly 20 years, as a result of so many of the things discussed in the main article and in the comments. They were respectful and careful, explained everything they were doing, and took the time to talk to me about all of my concerns. Not all midwife centers do well-woman care or perimenopausal (which is what I am) care, but the one in Pittsburgh does. And when I needed a referral to a gynecologist, they sent me to one who got me an appointment in less than two weeks and was very similar to them in attitude and bedside manner.
    Full disclosure, I’m white, fat, and 50. The only context my weight was discussed in was as a contributor to my estrogen being unbalanced, giving me a slightly higher risk for endometrial cancer. I was never prescribed diets or WLS.
    @Marie, The term “expert on my own body” is great, I’m going to adopt that!

  22. Marie May 31, 2011 at 8:11 AM #

    I didn’t realize I’d developed the NP preference until I was talking to my boyfriend, who said he usually tries to get an MD when he can instead of an NP, and I looked at him like he was speaking gibberish — it had never occurred to me that somebody would ever PREFER an MD, as opposed to getting STUCK with one.

    I haven’t had a “bad” experience with an MD (depends on your definition), but I’ve never had a good one. They’ve always spoken to the nurses instead of me, and my vagina is the only thing they interacted with — I usually don’t even get eye contact if I don’t force it.

    In my experience, MDs don’t want to answer my questions. If I have a question about birth control, problems with my periods, sex, minor tears, hygiene, I don’t bother asking the MDs anymore, because they’ll just mumble that it could be a lot of things, and then refer me to another MD to set up another appointment (another copay, another day off — do they realize I’m just going to go home and look this up on the internet instead?). I wait until the nurse comes back, and then I ask her (I’ve only had female nurses so far), and she’ll answer what she knows, ask somebody else when she doesn’t, print out information or pamphlets, and give me the *option* of making a follow-up appointment with another MD.

    One thing NPs have always done with me, which I love love LOVE, is start with their fingers somewhere on my mid-thigh and begin trailing in while explaining what they were going to do, so my first point of contact with them wasn’t immediately and surprisingly on my genitals. Never had a doctor do that, they’ve always just dove right in — the ones who try to have bedside manner sometimes pair a really out of place chit chat question with first contact, so it’s like *boom* all up in your vagina, “So, what are your hobbies? Ha ha, yeah, books are cool.”

  23. Alyssa Crow May 31, 2011 at 9:04 AM #

    This article is so spot on. An urgent care doctor found a cyst in my cervix so I went to see the gynecologist. The nurse practitioner informed me that it was benign, but that most doctors don’t inform their patients of these things because they are “normal.” I was outraged! This is my body and I have the right to know what’s going on with it. I then asked her how she knew it was benign and she said, “Because I know what they look like.” No explanation of it, how I get it, why it’s considered “normal.” Nothing.

    Also, if you haven’t, you should check out “Killing the Black Body” by Dorothy Roberts. It’s amazing.

  24. damidwif May 31, 2011 at 3:53 PM #

    I feel your pain, sheridf. And that is what I keep in mind every time I’m in the clinic.

    For gyn care, midwives can be utilized and there is usually a huge difference between that care and the care of an MD because they embrace different models. Also, not all midwives are nurses (aka nurse-midwives, CNMs)–some are CMs, or CPMs or LMs. BUT, not all of them do, or can practice well woman care.

    I’m not excusing the behavior of any professional that anyone has come across but picture this: med school is brutal. For women and doctors of color the experience can be extraordinarily painful. This also applies to nurses and midwives. I speak from the experience of a student. The culture in health care professions for people of color is one in which an abusive education translates into abusive practices (i’m not saying that white people aren’t abusive, too). I continue to speak to my peers about needing a break after I graduate in order to reflect on why I took this journey, what happened, and what my goal is in providing care. I know myself and with what I have experienced and what I have seen, the outcome could be horrendous. White people run this system and we try to help our people but the lack of power that exists is overwhelming and daunting.

    Anyway, it is a pretty standard part of a complete annual visit/physical to talk about “weight issues.” However, using the BMI charts, most Black women I come across (including myself) are at least overweight, if not obese (which is also correct according to statistics). Yes, you can be healthy and overweight BUT this is not the reality in the Black community. Yes, it is multifactorial. Also, even if your BP is good and all other things seem okay in your 20s & 30s, being obese puts you at risk for x,y,z which comes around to slap you in the face as you age. I know people get tired of hearing about dietary change, and I don’t know of any pharmaceutical weight loss methods that are being recommended…but what to do?

    During the vaginal exam

    I want you to remember that you are in control of your visit. When I do history taking, I tell the women that I will ask questions, some of them very personal, that it is for me to be able to put things together for the most accurate diagnoses, but that they are not obligated to answer anything. I take all the information given to me at face value: it is what you say it is. But sometimes, there are still things we must question. For example, a woman comes in for STI (chlamydia) testing. She says that she is a lesbian. She doesn’t mention (but it is later revealed) that she has slept with a man though in the past 3 months because she identifies as a lesbian only. So, we must make assumptions sometimes because of the lack of information given up front.

    The vaginal part of the exam is certainly anxiety provoking. Do we have idle conversation? Maybe, if the woman is clenching up some distraction may be helpful. Lying there in silence–are you wondering what is going on? I find it helpful to use it as a teaching opportunity that way it doesn’t feel so invasive. Exhale. This is what I’m going to be doing…this is what I’m doing…this is what I see. Are you okay? Some women just want to shut their eyes tight and get it over ASAP, no conversation. I try to make sure I am visible to the woman and not just some hidden head peering at her. We were also taught to provide mirrors in case she wants to see. Obs don’t have time for this.

    Asking about partner violence and sexual abuse is part of the history. Some providers are afraid to ask these questions so they phrase it like this: “You’re not being abused, are you?” Which evokes almost an immediate “no” under most conditions.

    I tried to address most of what I read here, including comments but surely I’ve left out something. Anyway, choose your providers carefully. You have the right to receive gentle, compassionate, safe care. These experiences affect your intimate life as evidenced by what I call the dissociation from the pussy.

  25. damidwif May 31, 2011 at 3:53 PM #

    OMG. I didn’t mean for it to be that long.

  26. Havlová May 31, 2011 at 4:42 PM #

    Here is my comedy-horror story:

    I found a gyno NP at a sliding-fee clinic (no insurance). She was a young South Asian woman. During the routine questions, it was revealed that I had recently had unprotected sex with another woman (!). She looked deeply worried, demanded that next time I have sex with a woman I use a female condom, and said “and you must get an AIDS test right away!” LOL. Except not, because sexual health is supposed to be her area of expertise.

    At a different appointment, another NP, white and older, asked me during the routine questions simply “Are you gay or straight?” I asked if those were the only two options and she looked at me like I had two heads. Then she asked me if I had a current partner. I answered “Partnersss”. (I’m poly.) I might as well have had 3 heads by then. How can I hope for a decent standard of care if the basic details of my life are so disturbing, misunderstood, or simply unheard-of by these people who are supposedly trained, experienced professionals?

    Do gynecologists WANT us to lie to them?

    • Natasha July 14, 2011 at 8:24 PM #

      If she thinks a female condom will protect while having sex with another woman (!) she needs to lose her license.

  27. Chantal May 31, 2011 at 7:31 PM #

    This post was great and touched on a lot of issues that have been on my mind! I wrote a post myself for a blog called SQUAT. It’s about how the medical establishment often fails to respond sensitively and appropriately to women with past histories of trauma. Read and share!

  28. LaToya/gradmommy May 31, 2011 at 8:58 PM #

    I hate doctors. Most of my experiences with them have been awful, especially when a doctor I’d never seen before entered the delivery room for my first child and pretty much ripped him out of me. Since then, doctors and me don’t mix. After I had my second child with a nurse-midwife, I’ve been relying on her for GYN care and I couldn’t be happier. She does the routine stuff – weight, BP – and will check for STDs, even though I’m married and say I’m in a monogamous relationship – it’s just standard protocol. When I was having pain in my lower abdomen, she provided great care and referrals when she didn’t think the problem was GYN-related. During Pap smears she ALWAYS talks me through it and is very gentle. My last Pap was abnormal and was HPV, but she was so compassionate and educational about it.

    For general care, I also find NPs to be so much more helpful. I’m a grad student on a college campus, and one of the NPs they have here is so excellent, I might wait a day to see her. Most people hate to go to the college clinic, but she is just so on point. She is so holistic in her care, and follows up with everything, no matter how trivial another doctor has made me feel about it. Sometimes I cannot understand why the other doctors even want to be there.

  29. Rebecca S. June 1, 2011 at 1:45 AM #

    I’ve also had excellent experiences with GPs. I grew up in a rural area where there were no OB/GYNs, so my GP has always taken care of all of my health concerns. Granted, I’ve been lucky enough to have an uncomplicated health history, but the GPs I’ve had (and shadowed–I’m a Pre-Med student) seem much more focused on treating patients as people instead of treating them as body parts, and take time to make their patients feel safe, comfortable, respected, and accepted in their office. I hope to demonstrate the same level of competency and compassion when I’m a GP!

    The only NPs I’ve encountered were at my (urban) university’s student health center. They made my lesbian friend take a pregnancy test before they let her see an MD for acute pelvic pain, and tested me three times for chlamydia when I inexplicably ran a fever for a month (despite the fact that my BF and I are monogamous, use condoms, and had no previous sexual partners). The MDs there weren’t much better–maybe it’s a rural vs. urban thing?

    I now travel home to see my GP whenever I have a health concern–being treated by a clincian I trust is worth taking a day off and driving several hours one-way.

  30. Danielle June 1, 2011 at 10:28 AM #

    This post is great! Though I have been lucky enough to have seen two very patient, helpful, gentle, non-judgmental and thorough GYNs, I know how difficult the trip to the gynecologist can be (it took me years to work up the courage to actually go). Both of my doctors (both Asian – Indian and Filipina) have been wonderful in suggesting ways to help keep me safe, healthy and most importantly, engaged in my health care. Its sad to see that my experience is not the norm.

  31. sheridf June 1, 2011 at 11:51 AM #

    @Chantal. I really appreciate your blogpost at squatbirthjournal. I had not thought about PTSD and after reading many of the previous posts I am learning much more about the depths of issues that women are faced with in the gynecological exam room. All of the comments and stories have prompted me to revisit this topic in another month and look into resources with other CFs that we can circulate through the blog. Thank you for your contribution to this discussion and for your and many other responders decision to prioritize women’s care in your life’s work.

    Thank you to everyone who has shared stories and intimate experiences with us and CFC readers. This has been a very rich discussion and the responses indicate that there is much work to be done. Thank you Tori for sharing the vaginapagina as a possible model for an online resource. We will look into organizations that do this work and try to promote more resources and organizations in the near future.

  32. Bigtab June 1, 2011 at 12:25 PM #

    Where do you live? I can suggest an awesome one in Chicago.

    I’ve actually had several great doctors (knocks on wood). Even though the majority of my gynos have been white (my GP is a black woman) they’ve always been up on issues affecting black women’s health and tried to provide me the best possible care, They never just throw drugs at me-they always want test results before they reach a diagnosis. I never feel like a piece of meat or feel racial discrimination.

    • SuccessSW June 3, 2011 at 10:13 AM #

      I’m in Chicago, and would love to hear your recommendation. I’m on the search for a new gyno.

      • Bigtab June 7, 2011 at 1:29 PM #

        Dr. Patricia Gale at Northwestern (downtown) is excellent…which is why it’s so hard to get in to see her 🙂 She has her own lab people in the office, too, so you get results sooner than you would if they used an outside lab.

  33. Medusa June 2, 2011 at 10:49 AM #

    I, at the age of 26, have only had 2 experiences with gynecologists. The first time, I attempted to visit one in college, at the age of 21. I was a virgin, and she couldn’t get even a finger inside, so she told me that I could leave, and I should try again when I feel more comfortable.

    This year, at the age of 26 (still a virgin), I got into my first relationship, and we as of now are unable to have sex. I have vaginismus. My male partner urged me to go the gynecologist and get checked out, since seriously at 26 I was far too old to never have had a gynecological exam. I went, and it took several tries for the (male) doctor to get the speculum in, and when he did it was so INSANELY painful, and you know what he did? He LAUGHED at me. Unfortunately, I live somewhere where I am very, VERY restricted into who I can go see, so I don’t have many other options for going to see anybody else.

    • Healy June 4, 2011 at 9:10 AM #

      Hi Medusa,
      Having had vaginismus in the past severely and still experienceing it occaisionally… I completely sympathise with you, what a horrible experience to have to go through, and what a shocking lack of support from both your boyfriend and your doctor. Your first gynecologist was absolutely right – no-one who finds the exam traumatic should go through with it unless the health risks of not having one outweigh the pain of the experience. Unfortunately vaginismus is still largely un-talked about in medical training, but even so it is no excuse for your doctors behaviour – clearly he gets off on the unequal power balance.
      Have you checked out the vaginismus awareness network website? They are FANTASTIC, and there’s so many great articles, at least one on gynecological appointments.

      • Medusa June 6, 2011 at 10:54 AM #

        Hi Healy,

        Thank you for the support. I have checked out support groups on the web, because it seems where I live I have no other options.

  34. Lynx June 5, 2011 at 8:20 AM #

    I hear you about access—my gyno is more than happy to answer questions over the phone—but during my work hours. I’m sorry, the last thing I want to do is talk about my genitals at work.

    It just irks me that I can see my dentist after work, but holy shit, see my gyno after work or on a Friday? Forget it!

  35. Carole June 5, 2011 at 6:57 PM #

    I’m really happy I stumbled upon this blog. I’m a 25-year-old black female with an extensive history of sexual abuse, vaginismus, as well as the low and high-risk HPV. In my Cincinnati hometown, I have been completely unable to find a decent gynecologist. I went to my female former GP a couple of times for STD testing rather than try one of several bad Gynecologists at a popular clinic locally and she was very unsympathetic and acted like she was doing me a huge favor to switch to the smaller speculum. Can anyone please explain why doctors seem to be really put out by doing this? Do they just all get off on hurting us more than they need to? I can’t wrap my mind around their issues with this. I’ve had two positive experiences with vaginal exams in my 25 years, one involving a doctor at a mental hospital in Houston and the other was a (you guessed it) Nurse Practitioner at the Clinic of Horrible Gynecologists. I’ve since switched GP’s to a man who is nice enough but I really wouldn’t like to go the GP route for my vaginal health with all my complications. I switched to a pretty highly-rated gynecologist recently and am still very unhappy. He’s an older white male, talks down to me like I’m a child when I have a genius I.Q. and my pelvic exams and paps are still horribly painful. I always leave in tears after I have one. I wish my doctor was someone who I could trust to respect me as an adult, not only take the time to answer my questions but pro-actively offer me information about my procedures, results, and conditions in a non-condescending way, and for the love of god be gentle with me and understand that I have a history of sexual trauma. I feel like in Cincinnati, that’s just asking far too much. Despite my ongoing concern about my high-risk HPV, I haven’t been to see my current doctor this year because I’m so traumatized and fed-up with my experiences at this point, and I don’t have the time nor money to keep going from doctor to doctor to doctor in the hopes of finding one who is actually good at what they do and doesn’t condescend, slut-shame, or the plethora of common but idiotic attitudes these doctors seems to take with us.

  36. Helle K Tumbridge June 6, 2011 at 4:30 AM #

    I wanted to stop by and share my story, as no matter who you are, where you’re from, or where you’re going, my-oh-my, women’s health care needs to improve! I am a thirty year old white woman from London UK. When I was 22, I was pregnant and went to seek an abortion. On my first appointment, the white female doctor told me I would not be allowed to have one unless I had a smear test (which was false). I had never had one before and was terrified. I spent half an hour trying to relax before I could go back into her room. She proceeded to try to ram a freezing speculum inside me, with no lubrication. I cried out in pain and asked her to stop several times. She wouldn’t, and in the end, I had to grab her wrist and pull her away. I sat up, she paused, looked at me, and asked me if I had been abused as a child, insinuating that that was why I was unable to be comfortable during the test.

  37. Alli June 7, 2011 at 1:04 PM #

    While I agree with the point being made in this article, I simply don’t understand why the race of each person described must be explicitly stated. Race should not even be a factor when finding a doctor and I feel that by emphasizing this factor of whole persons, this author separates and categorizes human beings.

    • sheridf June 7, 2011 at 1:33 PM #

      @Alli. I am a believer in race-consciousness and I do believe that race and gender impact this discussion in ways that many people either do not want to or do not feel comfortable discussing. Talking about race in this context also illuminates the intersectional politics of the gynecological exam room in ways that are deeply intertwined with the history of medicine, treatment, and social issues related to the black female body (speaking for myself). To be clear, I do not “separate and categorize human beings,” human beings are separated and categorized by everyone. There are simply two major ideological ways that people go about doing it: faux colorblindness or race-consciousness. For me, colorblind ideology has never worked to my advantage, it simply leaves important details unspoken. If I was talking about how I was treated by my hairdresser or a grocery store manager race might still be a factor, but these encounters do not invoke the same level of intimacy as my gynecologist. Race does matter in positive and negative ways, rarely is it a neutral factor.

    • Jackie June 9, 2011 at 4:06 AM #

      Considering the extensive research that has been done with regards to health disparities across race, class and gender as well as sexual orientation, posters pointing out their race (and other particulars) is very important. How you’re treated by your health practitioner can be influenced by all of those things. As much as we’d all like to think that ‘a doctor, is a doctor, is a doctor’, research and people’s lived experience has not borne this out.

  38. sheridf June 10, 2011 at 12:09 AM #

    Went to the Feminist Women’s Health Center in Atlanta today for my annual. Met with a white female nurse practitioner, Maria, and had a wonderful hour long discussion followed by a thorough and thoughtful exam. I came in near tears from anxiety and left feeling healed in more ways than one. She allowed me to discuss my prior experiences, to cry, and to ask unanswered questions. She did not rush me or give me cookie cutter answers. I felt genuinely cared for and supported. I left feeling reassured about my general state of health and about my personal choices regarding my body.

    Today was a good day.

  39. dlb2 June 28, 2011 at 6:33 PM #

    I feel American women have been misled – almost all of these gyn visits are completely unnecessary and harmful. As an Australian woman, (and I’ve lived in the UK as well) we don’t spend our lives in stirrups. I’ve never seen a gyn, because I’ve never had a gyn problem. Asymptomatic women don’t need this sort of medical surveillance and control.
    The well-woman exam makes a lot of money for your doctors. I saw an American medical program where the doctors were scolding women for not having routine pelvic exams – snake-oil salesmen – they KNOW these exams are unhelpful and harmful.
    I’ve never had a routine pelvic exam in my life and I’m middle-aged….it’s never been suggested and I’d get out of the consult room if it were ever suggested – I’d assume the doctor was incompetent or unethical. This exam is not evidence based – it’s of poor clinical value and not terribly helpful even with symptoms, but it risks your health with the possibility of false positives. More of your doctors are speaking up and warning women, but many of you have been conditioned to accept these invasive exams as vitally important to good health. Your Dr Carolyn Westhoff makes some interesting comments in, “Questioning the value of the routine pelvic exam”- there are many medical journal articles pointing out it’s poor clinical value.
    ROUTINE clinical breast exams, rectal exams, recto-vaginal and visual inspections of the genitals – not recommended, unhelpful/of poor value and expose you to risk…in the absence of symptoms.
    Also, our doctors don’t use stirrups in the consult room – just during procedures and surgery.

    Pap tests – you have too many and have them too early – it’s a rare cancer, always was and it was in natural decline before screening started…there are also no randomized controlled trials for pap testing, but if women are helped, the numbers are very small. Less is more with pap tests…the test produces lots of false positives that can lead to biopsies and LEEP and damage the cervix, so be cautious (cervical incompetence – miscarriages, premature babies and c-sections) and cervical stenosis (infertility, endometriosis, infections)….your doctors have the worst reputation for over-screening, over-treating and inappropriate testing. (women not yet sexually active, women who’ve had full hysterectomies for benign conditions, the very young and very old etc)

    The lifetime risk of cc is 0.65% and less than 0.45% are “possibly” helped (taking out false negative cases and considering other factors are at work – more hysterectomies, better condoms and hygiene, less STD, fewer smokers etc) YET 95% of you will be referred at some stage after an “abnormal” pap test – 95% referred to possibly help fewer than 0.45%. (Dr Richard DeMay refers to the 95% lifetime risk of referral in his article linked from Dr Joel Sherman’s site, “Medical privacy” forum under women’s privacy concerns Parts 1 to 6.) Dr Sherman also wrote, “Informed consent is missing from cervical screening”.
    We have issues in women’s screening as well – there is dishonesty, over-screening and unethical conduct, but it’s not as bad as the States. (our referral rate is 77%)
    I feel so sorry for American women who are routinely coerced into gyn exams and elective cancer screening “in exchange” for the Pill – to think women are routinely DENIED the Pill if they refuse unnecessary gyn exams or optional cancer screening! The only things clinically required for the Pill – your medical history and a blood pressure test.
    Again, your ethical doctors are speaking up….Dr Robert Hatcher from the “Managing Contraception” site (google his name plus pelvic exam and birth control and it should appear) and “Women after birth control get unneeded pelvic exams” WSJ…An unplanned pregnancy, abortion or miscarriage carry far greater risks to your health and well-being.
    If you want to have pap tests – consider a schedule that protects you (as far as possible) from false positives. Finland has the lowest rates of cc in the world and sends the fewest women for biopsies (fewer false positives – almost all referrals are false positives) They offer 5 to 7 tests IN TOTAL – 5 yearly from age 30. Your Dr Sherman mentions his wife has had more than 40 pap tests! The Netherlands follow the same program and women can use self-test kits – infrequent HPV tests instead of pap testing may even be sufficient for some women…there is even a HPV blood test available in some countries.
    The cervical specific antigen blood test (CSA test) was also patented in the States quite a few years ago, but I understand its development was blocked even though it would have been far more reliable and produced fewer false positives – sadly, there are many vested interests in the unreliable pap test that generates so much money. I was shocked to read one billion dollars is generated in the States every year from excess cervical biopsies. Many of these alternatives therefore will never see the light of day.
    Women under 30 don’t benefit from pap tests#, but produce lots of false positives due to the pap picking up normal changes in the maturing cervix or transient and harmless infections. Dr Angela Raffle’s research covers the latter points – “it is unethical to test women under 25.” Her research was also amazing, “1000 women need regular smears for 35 years to save one woman from cervical cancer” BMJ 2003/4 and linked from Dr Sherman’s site. 1 in 3 pap tests in the under 25’s will be “abnormal” – false positives.
    (#See: “Cervical cancer screening” in “Australian Doctor” July 2006 by Assoc Prof Margaret Davy and Dr Shorne) Facts: Screening does not change the very small death rate in women under 30.
    As a low risk woman, my risk of cc is near zero – the risks are too great for me – I have always declined pap tests. That article may interest some of you…it also suggests a woman over 30 who tests negative for high grade HPV can forget about pap testing, but will still be tested in case her risk profile changes. (her husband has an affair or she takes a new sexual partner)
    I disagree with doctors making decisions for us, assuming risk on our behalf and concealing important information. These women should be given the facts and left to make their own informed decisions – some of these women may no longer be sexually active – give them the facts and leave it to them.
    Anyway, some of you may care to do some research – you don’t need to cope with these exams – IMO, they are more likely to damage your health and happiness.
    I have American friends (including on line friends) who get the Pill over the Internet to avoid your doctors or are locked out of all healthcare because they refuse to “co-operate” and submit to these exams….that should not be happening – every man and woman is entitled to have an equal and respectful relationship with a trusted health professional.
    Mammograms – see, “The risks and benefits of mammograms” at the Nordic Cochrane Institute website for an unbiased summary. Also, listen to the 35 minute lecture at the Medphyzz site, “Breast cancer screening: the inconvenient truths” a lecture given at UCL recently by Prof Michael Baum, UK breast cancer surgeon.

  40. dlb2 July 13, 2011 at 8:50 PM #

    Prof Baum’s lecture has been taken off the medphyzz site, but you’ll find it at Prof Baum’s website or on utube.

  41. damidwif July 13, 2011 at 9:00 PM #

    dlb2, your comment has been sitting on my conscience ever since you left it. you said so many things ive been thinking and wanting to say but hadnt yet found the words to speak it on my site. and im so mentally burnt out right now, i dont have the energy to research the articles that you mentioned.

    i feel like im caught in a web of deceit…in this midwifery education i am pursuing…i recognize it, but dont know how people will respond to how i am interpreting it. it is like talking about hiv/aids…


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    […] These Days I Hate Going to the Gynecologist « The Crunk Feminist … It is not my intent to suggest that black female doctors are not good gynecologists my experiences suggest this but I simply refuse to believe it. Ultimately, I want to open up some dialogue about the right to have good […]

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