Hello little grasshoppers! Natalie here. How is everyone doing? Blergalicious? Great, me too! Get your paper gown on ’cause we’re gonna dive right in to some very messy paradigms via the health of your cervical canal: gender, sex and sexuality.
See, most people understand gender, sex and sexuality in the context of an imposed binary system. This system ignores our varied experiences, desires and expressions in favor of simple, one-dimensional norms and arbitrary delineations. The result is an uncomfortable compression and homogenization of the spectrum of human experience.
Case in point: going to the gynecologist. We saddle up, feet in stirrups, ready to go and…bamn! suddenly all become heterosexual women with one interest: reproduction! There are a million areas in which the gender binary structure cheats people of their individuality and violates basic human rights, and the experience of queer women at the gyno is just one example of the overarching and pervasive heteronormativity structuring our daily existence. (sidenote: Microsoft Word does not recognize the word heteronormativity. Just saying!)
Heterosexuality and babies are obviously fine, lovely even. But, when these norms begin to obscure the realities of our differing experiences, the office visit becomes oppressive: we lose space to articulate our needs, confusions, desires and health concerns.
Some norms are important, like “don’t cut me in line at Pinkberry” or “don’t clip your toenails on the subway” (this actually happened last week, I saw it!). But, short of these? Meh! Why dictate how people live and love?
According to Reality Check, the queer community faces unique challenges when accessing health care. These include widespread provider misconceptions about STD risks for women who partner with women and doctors who tailor their medical advice to stereotypes of lesbians’ lives and needs.
Several of our wonderful readers wrote to me about their gyno experiences. So what’s it like for queer women? Obviously, the answer varies greatly. Here’s a snapshot of some of the responses:
Heteronormativity is present within gynecological practices (and at the sea!): “The gynecologist I used to visit had these pictures on the ceiling of men surfing in Hawaii. And as [the gyno] was about to stick a very cold speculum up my vagina she used to say ‘relax and imagine yourself surfing with those gorgeous men on the ceiling.’ I don’t think any image other than my own parents fucking could make my cervix tighten up faster than that statement.”
Not only do some gynecologists assume that sex with men is the only (and/or preferable) item on the menu, many gynecologists also assume that reproduction (preventing or facilitating it) is at the forefront of women’s minds. I suspect this experience is true for all ladies, queer and straight alike. According to another reader’s comment, “…that’s the one thing that peeves me about the gyno, that it seems like the whole emphasis on you being there is to prepare for reproduction, or to prepare you against it. I don’t like that aspect. I wish they could just check out my lady parts and make sure everything is running smoothly without trying to find out if I’m planning to bring a child into the world at 20.”
Of course, I’m not saying that reproduction is not a relevant and important topic; for many – queer and straight alike – it certainly is. My point is simply that other realities exist (some women don’t want to have children! Waaaaaaa!) and these realities should receive as much understanding, legitamacy and respect as the more “traditional” ones.
“Also I just found out today that women can transmit HPV to other women? Um how? I have no idea how this works.”
The blatant judgment/discrimination queer women experience precisely for identifying as queer was also noted: “My primary complaint with the gyno, back in my hey-day of youth as a bisexual, was that I really felt judged or treated as slutty because I had to check off ‘men’ and ‘women’ on that little form that asks you about all the things you’ve done so they can judge you and the nurse can raise her eyebrow at you like ‘mmm hmmm you probs have SARS in your cervix,’ you know that look.”
Are these negative and discriminatory encounters keeping queer women away from the gyno? Yes! And understandably so.
According to an article published in 2001 in the Annual Review of Nursing Research, lesbian women are less likely than other women to seek health care, partly due to expected or actual negative interactions with health care professionals.
Due to a variety of reasons, some queer women are and/or feel under or mis-informed on the topics of sexual and reproductive health and well-being: “I don’t think we need to be using anything like a dental dam or female condoms or whatevs but I think I should at least know what they look like…[but I don’t]. Also I just found out today that women can transmit HPV to other women? Um how? I have no idea how this works, no doctor, gyno, etc. has ever talked to me about safe sex and I have never thought to ask. This all scares me a bit.”
Breast and cervical cancer and heart disease affect all women. Lesbian women are at risk for many of the same STDs, including HPV, as heterosexual women. Lesbian women can transmit STDs to each other through skin-to-skin contact, mucosa contact, vaginal fluids, menstrual blood and the sharing of sex toys.
A 2000 study found that the vast majority of self-identified lesbians in his study – 80-90% – have had at least one male sexual partner, increasing the chance of contracting an STD. Yet, lesbian women are less likely than heterosexual women to have had a pap test, due, in part, to a misconception that they do not need Pap tests exam.
Pages: 1 2See entire article on one page
just when I get done with my women’s health course – BAM! here comes natalie. This is so awesome and informative/ obvs. important stuff. I’m fairly certain that first screencap is from TEETH, yes?
yes! yes it is. if there was any doubt about the invisibility of lesbians in healthcare, or the invisibility of non-pregnant women at the gynecologist, it was quickly confirmed by the five hours it took me to find any imagery online anywhere that would go with this piece. apparently there is no fear of the gynecologist, no “lesbian doctor” no “gynecologist anxiety” or really anything at all besides that one girl we found for the feature graphic (“girl with anxiety on exam table”)(probs she’s preggers) and some screenshots from that movie teeth, which looks like a misogyny festival. oh, and the SEXUAL EXPERIENCES! movie cover, which was amazing. clearly by the end i had resorted to just sticking a naked jessica alba photo in. Oh, the tangled webs we attempt to weave.!
I am so happy that you found the article at least a bit informative:) Yay! I wish it could have been a bit more timely for you.
How did you find your women’s health course? Did it discuss health issues from a queer perspective?
Riese and Lynne
Yes! I too had such a hard time finding things (articles, photos etc) on gynecology anxiety in general, never mind the experience of queer individuals at the gyno/with the health care system. It clearly illustrates the huge gap present in societal thought, political thought, medical/social science research.
We will fix that!
My class was generally really good, my prof. couldn’t help but lean towards the getting prego / not getting prego aspect, but sometimes she would catch herself and backtrack. Nada on the gay front unfortunately, we got a whole paragraph in the textbook though!
Yea…Don’t ever watch teeth.
wonderful wonderful wonderful piece, natalie! we have ALL been in those situations, and i applaud you! clap clap clap clap clap
I second that. clap clap standing ovation clap clap
I really like what you did with all the info. I was a bit surprised by the stats I found so yes we need to step up and demand better treatment and understanding. Even I, a European (Belgian) girl been there with the gyn. And they say Europeans are open about those things right?
Fav autostraddle article of the month, possibly even ever.
Hiii daphne! thank you so much for all your help; your resources were invaluable; i know, the stats are really startling and telling. we have to be loud and demand better treatment and accountabiltiy fo’ sure. and we all can do it! yay!
so happy you liked the article!
awww, hiiii, haviland! thanks so much. i have to say, when i saw clap clap clap I sort of could only think of gonorrhea. But how apt!
loveee you, thank you for reading! hope you are doing well!
Natalie – great article! You raise excellent points about gynos not being good to the gay ladies and gay ladies not going to the gyno.
From having worked at a gyno, I that many straight women hate it just as much. The hook: most docs won’t refill a birth control prescription until you come back for a yearly exam. This is a VERY useful tactic to get people to come in, and I think part of the reason many straight women go.
The good news about cervical cancer is that you can prevent it with regular screening. Try to find a local gay-friendly doc and get it done, folks!
amen to that, shannon! thanks for your comment. it’s so impt to go get screened. i have to go to the gyno soon–actually I will make an appt today!
and, i agree: i think ladies across the board-gay, straight, anywhere in between-have had disappointing (to say the least) experiences with sexual/reproductive health care. i don’t know, i suspect it has to do with a very intimate mix of bodies, selves, power relations, stirrups, misconceptions, fears, discrimination etc.
thanks, again! get ‘er done!
Totally worth the wait.
aww, thank you! i am so glad you feel that way. i really want the readers to relate and feel connected to what i write/is written here. and i am sorry it took so obscenely long to get this up. the next one (on what, i don’t know! i need suggestions) will come much faster.
lots of love, natalie
Natalie (and Daphne of course)! This piece was wonderfully insightful and informative. Great job ladies!
So nice to see you here:)
Thanks so, so much. I am glad you found it useful! thank you.
I also really enjoyed your recent photos of Fanny Pak. Amazing! i want a pair of the shoes they are rocking!
This is so important, Natalie! Thank you!! The most feminist, empowering thing a woman can do is play an active role in her own health! Yes yes yes!
hear, hear! absolutely. and i think that many women – against incredibly difficult odds – are playing an active role in their own health. but also many more want to, but are unsure how to go forth/lack the resources/time. i hope that some of that was addressed here. yay! thank you so much for the comment.
lots of love and….we must meet one day soon.
There are 2 genders and that’s it. Male and female. It’s unbelievable but strangely amusing the amount of effort put into this nonsense of more than 2 genders as if there was really more than 2 and as if there was individuality in gender. There isn’t. There is individuality in a personality but the gender is one of 2. Do not waste your time trying to wrap your mind around this nonsense.
I somehow managed to post a reply after only writing two words!
Anyway, I was trying to say that I know of a woman who went to a gynecologist who told her that because she wasn’t having sex with men, she didn’t need an annual check-up.
Is it any wonder there are so many misconceptions when it comes to our health when medical professions give out incorrect advice?
this is sooo awful. i can’t even believe it (Actually i can…and it makes me want to vomit up my latte). thanks for raising this point. it’s ridic that the precise people (i.e. doctors) charged with providing the population with equal and honest health care are exactly the people perpetuating discriminatory, uninformed and incorrect perspectives, information and advice.
blergh. thank you again.
Sadly, this article came a few years too late for my friend’s sister. She passed away a couple of years back after losing her battle with cervical cancer. It was simply that she never visited a gynecologist until the cancer was so far along it was too late.
Being a guy, I never understood why she didn’t have a gynecologist. This opened my eyes to things I never really thought about.
Thanks for this piece. I’m sure it will save more than a few lives.
Thank you very much for your comment. Please accept my sincerest condolences. I too hope that this article in some way helps a bit toward pushing women (and men) toward accessing regular sexual/reproductive health care. It’s so critical.
Thank you again.
I won’t put ‘clap clap clap!’ because, y’know, in context that seems a little unfortunate.
hehehe. i commented exactly that above:)
thank you so much for your kind comment. I am glad you enjoyed the article.
Awesome article… and not just because you finished on a big quotation from my comment – huzzah! I feel famous!
yeaaa! your comment was terrific. i am raising it to my gyno when i see her next week.
thanks, BioGal! I am super glad you liked the article.
Thanks for this, Natalie. It’s an eye opener for sure. I’ve yet to be in the stirrups because I’m only 18 and not sexually active, but when the time comes for me to have someone all up in my under-carriage I’ll def use the “find a practitioner” search, which I probs would’ve never known about if it weren’t for this article. So again I say thanks! And you are pretty much made of win. :)
amazing! i am really glad the article was useful. yes! i too thought the “find a practitioner” search was particularly useful.
you are made of win!
Great work Natalie (and Daphne!), loved this. Just out of curiosity – is a family doctor able to conduct gynecological exams in the USA? Do you have family doctors? I don’t know much about the US health system.
hiiii crystal! so nice to see your comment. thank you, thank you! hmmmm, good question…i actually don’t know. i suspect that technically a family doc/GP/internist could…let me find out and get back to you.
hope you are doing really, really well. come visit;)
so I’m not a doctor yet, but I am in medical school and I am planning to take a residency in OB/GYN so I enjoyed the article. But I can answer the above question. Yes, Family Practice physicians do routinely perform pelvic exams in the US.
I feel like my school does a good job of teaching us to to be sensitive to all patients by asking if their partners are “men, women, or both” when taking a sexual history and adjusting the follow-up questions and procedures accordingly. I hope you aren’t right about the ladies not coming to the doc; I was counting on using my witty bedside manner to impress the gay ladies (just kidding!)
i fully support you using your wittiness to seduce, errrrr, i mean…make the ladies on your table feel comfortable. heheh. anyway…thanks for the info. I was unaware as to whether this was the case.
Maybe you’ll find this interesting (I’d never heard of this before): paps can be done without the stirrups, at some clinics England and New Zealand at least – http://is.gd/IEHX
Thanks for the comment and the article suggestion…I will take a look at it for sure.
Glad you liked the post!
Thought I’d provide a link to a website, regarding a self-administered pap test kit, that women can use in the privacy of their own homes.
It’s the most innovative thing that I’ve seen, regarding helping women take control of their own healthcare. From what I read about this kit, you don’t have to visit a gynecologist to do this. Here’s the link:
Very interesting. I’m happy that you found the article at least a bit informative:) Yay! I wish it could have been a bit more timely for you.
If you’re a gynecologist, you should be concerned. After all, if these pap test kits catch-on with women, and I hope that they do,
the you gynos will become obsolete. And then women can handle their reproductive healthcare
with more dignity and autonomy. Using these pap test kits at home, is a better alternative than having to submit to degrading, painful pelvic exam in a gyno’s office.
Ok, so I definitely feel the pain of the queer women who’ve delt with the abnoxiously heteronormative structure that exists in healthcare- but one thing that is inexcusable is for queer women to fail to start the conversation (isn’t that what we’re best at?).
If we don’t take an active, assertive role in finding out what’s in our health interests, no one will tell us (this is applicable in SOOO many areas, for straight and gay women, for gyn. care to immunizations).
I strongly suggest that queer women look for midwifery practices in their area (I know, that sounds conter-productive, but its not). Their staffs are often the most open, knowledgeable, and friendly about all variety of health issues (and big plus- they believe in HOLISTIC CARE! No, staying healthy isn’t just about packing your system with antibiotics!) Pittsburgh has a fantastic practice called “The Midwife Center” and I’m sure many other cities have similar groups. They are very sensitive to the needs and anxieties of women and try to make inspections like pap exams and mammograms as comfortable as possible.
I’m just now finding this article, but I don’t think I’ve ever laughed harder than when I read “mmm hmmm you probs have SARS in your cervix”. BRAVO… I mean, really.
So this is half a year late, but thanks for the article! I’ve started volunteering with the Lesbian Health Action Group here in Brisbane and everything in this article is exactly the sort of stuff we’re trying to work through. I’ve just passed the link on :)
This helps me understand my partner’s gyno-phobia. I lived in the SF Bay area since I came out until January and never worried about it because… it’s SF. But… yes.
I had a super great experience with a surgeon who worked with my lady bits. My partner went with me to my pre-op appointment and he totally talked to her as my partner, I was shocked! Granted, the forms for his office asked, among other things, for my “husband’s profession,” but once the misogynistic forms were through the actual appointment was great and he was delicate (if embarrassed) when he asked detailed questions about our sex activities (because of the surgery). … Then I found out he does MTF gender reassignment surgery, so I guess he’s a little less in the heteronormative mindset than most. YAYYYYY good gynecologists!
Good article, however.. here’s a question–and something I NEVER see included in any articles about the subject.
My partner and I have been together since we were young teens. We have never, either of us, been even a little sexually active with anyone else. It’s been ten years.
Clearly, we’re not getting STDs. We don’t belong to the subgroup of lesbians that have ever (or would ever–yuck!) had sex with men. We’re not at risk for pregnancy.
Why should I go to the gynecologist? Despite being very open about my sexuality, I have doctor after doctor get huffy about my not going to the GYN. What exactly is it, that a gynecological exam is going to benefit me with, that can’t be done via a standard pelvic ultrasound (which would show cysts or god forbid tumors anywhere within my girly bits.)?
No doctor seems to respond to that question with anything other than “HPV”. I understand that my situation is unique, but the response from doctors isn’t. If I am having and have only had sex with my girlfriend, and she is having and has only had sex with me, and we’re not planning to have children any time soon–why should we go?
I think your situation is unique because you are monogamous and really not at risk for any sexually transmitted infections. I think the reasons to go would be the following:
a) If you were to get some type of UTI or bacterial vaginosis, this would probably necessitate consulting a health care provider
b) It’s always a good idea to have yearly breast exams to screen for breast cancer, though this is somewhat age dependent, because as women get older their risk increases.
c) If you happen to have any reproductive health problems, really severe cramps, endometriosis, hormonal imbalances, these are all areas in which the OBGYN can be helpful.
I think more than anything else, your doctors are probably trying to avoid giving the impression that lesbians do not need to seek reproductive health care, because this is already a common misconception and a reason why many gay women don’t seek care. In your situation, aside from the exceptions I just mentioned, I would agree that there does not seem to be a whole lot of necessity.
Thank you so much for the superfast response, Sarah. I was starting to feel crazy over here! My primary takes care of pretty much all my regular stuff–I’ve been to the GYN one time (I’m 26), and it was extremely painful and traumatic–not an experience I’m looking to have again. I don’t want to put my health at risk by not going (at least once in a blue moon) if it’s absolutely necessary (my gf might kick my butt for that!), but I’ve never understood how necessary it really was in my particular situation. Thanks for confirming that I’m not totally crazy! XD
The last two gyno’s I saw were men. One of their first questions was “what do you do for birth control?”
Uh… not have sex with men?
Blank stares. And then one went on to say “but what about if you do?”
Dude, what the fuck? If I ever did then I’d wrap it up, duh. But as for now treat my lesbianism legitimately and understand that only ladyparts touch my parts in ~*homosexualness*~, and leave it at that. Geez.
My gynocologist is definitely sub-par and definitely has the attitude of “if you’re not trying to make a baby, why are you here?” I realize now that I deserve better. I followed your link to the gay and lesbian medical association’s directory of gay-friendly doctors, and one of them is a gynocologist literally 2 minutes from my house. Thank you for this fantastic resource!
And…. that’s why I’m glad to be french, living in a country where gynecologists, or doctors, don’t care about your sexuality, and provide you the right informations. ( BWT, here, when you’re under 18, you can take an appointement with any gyno, he/she won’t call your parents)
curious to know, what the French know about lesbian health!???
Is that ironic ? :D
This is of so0o0o much interest for me because I’m in med school and I’m super interested in going into OB/GYN, lesbian medicine, and fertility. So YAAYY! to this piece!
Sharing from my own experiences, my gyno didn’t have a form that asked what sex I was having sex with (uh-Duh). To me it seems like such an obvi thing to ask, but not to my gyno. I think, on that note, that one of the problems is that going to the gyno, which is already so uncomfortable, involves coming out to yet another person.
What I have learned from being in school and learning the most effective ways of getting a complete medical history from patients and building a good rapport is that good Doctors really are not judgmental, could care less about who you are having sex with, and are only trying to get all of the information from you that they can to treat you the best way that they can.
Sad to say, but at the end of the day, primary care physicians (most) are rushed and trying to see as many patients as they can so they can get as much money as possible (depending on where they work and what the payment method of where they work is). With this being the fact, I think lesbians go under the radar because assumptions are made, which should NOT happen, and little is known about Lesbian health which is also a HUGE problem. While my gyno was never as assumptive as that physician who told her patient to look at the surfer dudes on the ceiling, there was still a lack of communication between the two of us, which could have been me the patient’s fault in not disclosing of that information, but then again, I think if my gyno had asked more questions that opened up the discussion, I know that my visit would have been more beneficial for me. After all, obtaining information correctly in a medical interview is the most important part of being a primary care physician.
(sorry this is so long…passion here =P)
Great article. My only critique is that you left out transmen of any sexuality who also need to go to the gyno but are scared too because they are queer. Please be more inclusive next time especially because transmen need to take care of their bodies too!
^This. It can be even more overwhelming to see a gyno or “women’s health provider” when someone doesn’t identify or present as a woman.
Love it! I’m glad to read this and thank whomever it was that linked me here (someone on Jezebel). Straight but not narrow and am so glad I looked up providers near me so I can applaud them and thank them. If someone is going to be judgy and and idiot, why should I reward that?
Great article and definitely a topic that merits more awareness and discussion. One note: I’m wary of the HRC’s healthcare provider recommendations. I’m sure many of the doctors they recommend are fine, but my gf went to an HRC-recommended doctor and he basically knew a ton about cis men’s penises and nothing else. He gave her blatantly incorrect info based (I think) on the misconception that cis women can’t communicate STIs to other cis women.
I highly recommend Planned Parenthood. Everyone I’ve interacted with at PP clinics has been welcoming, knowledgeable about queer identities and health concerns, and accepting.
Good god this is me. I’ve just kind of always used the excuse of “No penises, no problems” but then my ex admitted that her ex had herpes and I freaked the fuck out, and around the same time I donated my eggs so there was a lot of gyno action going on. I still haven’t *willingly* gone; dragged my feet the whole time and I haven’t been back.
Planned Parenthood is ALWAYS the way to go, though. Or a specific “women’s health clinic”, the feminist sort, because those always rock.
I’ve had some pretty bad experiences at the gyno. I was taught to always go for pap smears, and am pretty good about getting tested after all the sex I have. So after going for about 15 years now, I have encountered lots of homophobia. Hetronormativitiy is the least of my worries.
I always mark that I have sex with women only, because this is true.
I have been refused STD tests by doctors who normally would test straight women, a nurse actually said to me “we don’t do that here” when I asked for tests after I had vaginosis from a violent encounter (yes sexual assault happens between women too, and if you rip something with a finger nail it might get infected). I’ve had gynos wear masks during the entire process so as to make it as clinical as possible, another gyno asked me once if my having “this much” discharge was normal and then used the speculum (which usually is painless) in such a way that it was very painful. I did not have a yeast infection, but I was close to ovulation, so yeh, duh I had discharge.
It seems like a lot of straight gynos are really uncomfortable touching my bits, and it shows, and it’s cost me in various ways. I’m pretty normal looking, very healthy, and I get tested when needed. At the very least, it always feels like they don’t think I should be there either because lesbians don’t get STDS (false), or all homosexuals are diseased (false) or I’m not having babies so I don’t matter. But I go anyway, about 2 times a year. If I didn’t believe in preventative health, I would have stopped doing this a long time ago, because they obviously want me to/don’t care.
So gonna just throw this out and then leave it there. And before anyone says anything I am a lesbian studying gynecology, I’m in my final year of study and have done a lot of study and research myself. I only have comments on two things. One the way the chair is set up is not to be derogatory to the women on them, it’s meant to make the process of the examination require as little time and as little movement of the inside of your vagina as possible. Say we were to start doing it as you suggested it would require the examiners to be in a position that is physically taxing to there neck and back and it would require them to use more painful and uncomfortable tools like spreads or clamps to force the vagina open as they worked. And secondly I want to know who in the world thought having someone shove their examination tools into your vag was supposed to be comfortable. It’s not. It’s never going to be comfortable. There is someone literally probing the most personal part of your body inside in out with tools. It’s not going to feel comfortable unless you just ignore it really. And trust me it’s no more comfy from our side either especially during the first year or two
Well done on missing the many points by a country mile! And dear GODS I hope you have more sensitivity with your patients, especially considering how many people with vaginas are sexual assault survivors ( yes, I know it happens to other people too but statistically…)