things to think about

Today I am thinking about: my vag***
December 24, 2011, 2:14 pm
Filed under: Uncategorized

BIG CAVEAT TO LEAD: This is going to talk a lot about non-trans vaginas, by which I mean my vagina, by which I mean the vagina of a non-trans woman. There are a lot of other vaginas out there – both trans man’s vaginas and trans women’s vaginas. Since this is personal, I am focusing on my own vagina and its particular experience, but these other kinds of vaginas get erased and that feels wrong. Also, especially for trans women, gynecological care information is incredibly hard to find (on Google? Everywhere?), which is its own whole topic. Which I will probably write about at some point. I tried writing this with “non-trans” in front of every “vagina” but it became unreadable. So every time I say “vagina” remember that I am just talking about one kind. END CAVEAT.

I am a professional well woman exam getter. I help med students learn to give gyn exams as a patient instructor. I did it in college and I’m getting back to it now. I have received approximately 15 speculum exams since September. I have a really reassuring voice when faced with a speculum and I can tell you exactly where my cervix is.

People are really surprised when I tell them this. I think they expect that, because I look like a man, I am supposed to be profoundly uncomfortable with the existence of my vagina. I feel weird sometimes about my vagina professionally for a ton of reasons that can be boiled down to “I grew up a woman in America.” I am a weirdo even in this work – hairy, fat, and I look like a man with my clothes on. I try to push past that out of a sense of righteous nobility – that no matter how fat, or hairy, or unexpected, practitioners are obliged to treat every patient with respect, and there are a lot of people that look like me who have a vagina and who deserve good care.

Given my funny job, I am something of a connoisseur in the vagina exam department. When I go for my annual exam, I am paying attention to the skill of the provider. Steady touch? Good with a speculum? Reassuring? Empowering? We take students through a script that is incredibly demanding in its level of detail and its ritualized patient interaction moments, but it is all to help future providers approach their patients with grace, dignity, and in a way that empowers and involves the patient. This knowledge – the gold standard in vagina exams – is knowledge that I wish everyone had because everyone should know the kind of care that they deserve.

I have never — never — had an exam that is nearly as empowering as the exam I teach students to give. I had my annual exam yesterday – make that 16 specula – and it was a textbook example of what not to do. She walked in on me while I was still changing! Suddenly there her finger was in my vagina! She would not have passed the exam I grade.

If I was not a professional vagina haver, I would have been freaked out, embarassed, and unsure what was happening. I was still these things, although as much out of a sense of professional rage as personal discomfort. I like to think she was like this because there was a note in my file saying “this person is chill and comes in annually” so she figured I didn’t need much care. But I have no proof of that. All she had to do was say “do you mind if we work quickly” and it wouldn’t have been so bad. Instead there I was, on the table, trying to decide how much of a fight I wanted to pick.

We have to learn to fight with doctors when we need to. We have to get over the idea that healthcare should be disempowering or that we ought to feel alienated and out of sorts Kelli Dunham and Jessica Halem talk about this as just one resource – there are tons more – but I just want to say it. I am a professional and I still felt bad fighting back, knowing I was getting treated poorly. The doctor/patient relationship is intense and power-laden and we have to find ways to force our own empowerment and understanding.

I am mad about the exam I got yesterday for everyone who has to push themselves to go to the gyn at all. I am mad that I wasn’t paid more consideration or engaged in the exam. I am mad for everyone who doesn’t know they deserve better, who expects it to hurt, who is embarassed and afraid and who has no idea why there is a finger in there or why the doctor didn’t ask before putting it in.