How I've Learned to Cope With Pelvic Exams as a Survivor of Sexual Violence

When paired with the HPV test and a Pap smear — screening tests for cervical cancer — pelvic exams can save lives. But they aren't fun for anyone, and they can be especially unpleasant for survivors of sexual violence.

I speak from experience on this. I've cried my way through pelvic exams. I've walked out of those appointments shaking uncontrollably. Historically, pelvic exams have been so traumatic for me that I almost canceled my most recent one even though it had been several years since I'd been checked out down there.

I kept the appointment, and while it was definitely rough, it was less traumatic than any of my previous ones, thanks to proper preparation. What works well for me might not work as well for someone else, but I hope I can help make pelvic exams easier for fellow survivors.

With that in mind, here are my tips for handling pelvic exams easier as a survivor of sexual violence.

If possible, schedule a pre-exam appointment with your provider to discuss your history of sexual trauma and your concerns about your upcoming pelvic exam. This will allow you and your doctor to devise the best possible care plan for your specific needs as a survivor of sexual violence.

If a pre-exam appointment isn't possible, ask the person who schedules your appointment to make notes in your chart regarding your history of sexual trauma, your concerns, and your special requests. When your provider's office calls to confirm your pelvic exam appointment, remind the person you speak with about those notes to ensure they're in your chart.

It was a difficult thing to disclose, especially as someone who's experienced medical gaslighting, but I'm so glad I told my provider I'm a survivor of sexual violence. The topic came up when she was ultimately unable to complete my pelvic exam and cervical cancer screening tests because my muscles were too tight. That's when I told her about being a survivor. Her response was kind and validating, and the details of my experiences weren't requested. We scheduled a future appointment, and that appointment was successful.

I would highly recommend other survivors share their history of sexual trauma with their providers as well, ideally at a pre-exam appointment.

After I told my provider I'm a survivor of sexual violence, I asked her to use the smallest speculum available. She did. She used a speculum designed for children, and it was significantly less painful and less traumatic than a larger speculum would have been. Ask your doctor to use the smallest speculum possible.

Also: on exam day, your provider should apply a lubricant to the speculum without being asked to, but don't be afraid to ask them to.

My provider prescribed me a one time dose of Xanax to take ahead of my pelvic exam, and it made a big difference. It didn't keep my vaginal muscles from tightening and it didn't keep me from crying, but it absolutely eased my anxiety. Consider asking your doctor to prescribe you a one time dose of Xanax, or a similarly strong anti-anxiety medication, to take ahead of your appointment.

I prefer morning appointments for pelvic exams, because a morning appointment means not dreading your exam all day. It also means having time to emotionally process and recover afterwards. Ask for a morning appointment if you think it will benefit your mental health.

Having a trusted friend or loved one chauffeur you to and from your pelvic exam is crucial if you take a strong anti-anxiety medication ahead of your appointment, but it's also comforting to have someone you trust along for the ride. My sister drove me to and from my last pelvic exam. She stood next to me and held my hand during my exam as well — and I'm sure I'll ask her to repeat the favor in the future.

If it's an option, clear your schedule on exam day. No one should feel guilty for prioritizing their health, and pelvic exams can be enormously anxiety-inducing when you're a survivor of sexual violence. At least a clear schedule means your exam is the only thing you have to worry about that day.

Post-exam, treat yourself! Whether you take food home from your favorite restaurant, draw yourself a luxurious bath, binge watch your favorite TV show, take a long nap, read a book, listen to a beloved podcast, do all of these things — or none of them — you deserve to treat yourself. Relax and take care of yourself after your pelvic exam, whatever that looks like for you.

Elizabeth "Liz" Enochs is a queer writer from southeast Missouri. She's the author of the nonfiction prose chapbook "Leaving the House Unlocked.