If you are a survivor of, or currently going through sexual abuse, what does that mean for you at the gyn office? A place where you willingly go to get your vulva, vagina, and breasts examined. Areas that may be really hard for you to have touched.
First, you may not even want to go and have been avoiding the appointment to begin with.
But if you can go, here are some tips that may help the process:
TELL THEM. Please, please, please be upfront with the person who is going to examine you. We need to know this. It directs the conversation to one of safety (checking for sexually transmitted infections, pregnancy, physical trauma).
Even more important is HOW we approach the exam. Knowing ahead of time that there may be triggers for you or anxiety-provoking touch we can limit is the only way we can modify the exam or walk you through it in a way to minimize trauma.
This applies to a problem visit, a regular well visit (when you have gotten to the point where you feel ready for that), and to labor and delivery.
Bring a sweater or jacket (that opens) to put over your exam gown if that will make you feel less exposed. Keep on your socks/shoes, or even a skirt. Sit in the chair first, rather than the exam table if that makes you feel less vulnerable.
When it comes to the actual exam, the doctor should go slow. Starting with touch, letting you know what they are going to do each step of the way with frequent check-ins to make sure you are still able to continue. An internal exam with a speculum may be very difficult and may not even be necessary. Smaller sizes can be used if needed. If STD testing needs to be done, many (not all) can be tested via blood or urine so you can ask for that if you want to limit any unnecessary gyn exam but still make sure you are tested for infections you may be at risk for.
Also, there’s HIPAA. We have confidentiality laws. We can’t tell anyone what you tell us. It’s literally against the law. A medical assistant may bring you into the exam room and take your history. You don’t have to tell them about the abuse if you don’t want to, you can wait until your doctor comes into the room to explain. But PLEASE let us know.