"Colposcopy experience"

Recently, I went in for a colposcopy, an experience which left me extremely distressed and triggered. I am only now able to recount all of this to write about how this procedure was delivered.

For context, I am non-binary and my pronouns are they/them. I was a young adult at the time of my appointment, and my partner is only a few years older than me. My partner had their first cervical screening recently and was told they had HPV (not type 16 or 18). As I'm their only sexual partner, I opted to have a cervical screening done before the typical age, which showed some cell abnormalities, leading me to get referred for a colposcopy.

On the day of my colposcopy, when my partner and I spoke to the doctor before the procedure, I felt they were dismissive of my concerns due to my age and said that this is why they don't do cervical screenings before the typical age, to which I explained the reason why I had the screening in the first place. I went on to say I was extremely nervous about this procedure due to having some sexual trauma, and also about having a biopsy taken. The doctor then told me that during the colposcopy they would ‘only look’, and would only take swabs or biopsies if something appeared abnormal and would ask me before doing so. I recall they also said that the procedure/any biopsies wouldn't be painful as the cervix doesn't have many nerve endings and there's only pain during childbirth. (This last statement immediately raised a red flag with me and my partner as we are well aware of how sensitive a cervix is.)

My partner and I were then taken to the examination room, and two nurses, one of whom was a student, were also present. I wasn't really asked if I consented to this, more than I was told that KEMH is a teaching hospital and there would be a student present. After getting in position and having the speculum inserted, the doctor immediately proceeds to take swabs of my cervix with a cytobrush without asking for my consent or even telling me they would be taking swabs. This was painful and caused my cervix to bleed, which made me feel very distressed, especially because I recall they had assured me that they wouldn't do anything without checking for my consent first, and I saw my cervix dripping blood onscreen.

After, the doctor applied acetic acid and iodine to my cervix, which showed a small area had turned white. The doctor told me they would take a biopsy of this area, and I immediately began to panic and cry. My partner asked if the tool the doctor was holding was a punch biopsy. The doctor confirmed this, and my partner (who I had discussed the procedure with beforehand and who was very aware of how distressed I was about it) asked that I was given anaesthetic, as I was having trouble speaking. The doctor said that they don't have any here and tried to say it wouldn't be painful, but my partner stated "they need anaesthetic or we won't be able to continue with this".

One of the nurses then left the room to get anaesthetic and a syringe, but not until after it seemed I was made to feel like my request was unreasonable and that I was being a burden. After several minutes of waiting while the doctor and other nurse tried to find the correct size needle, they returned with the anaesthetic. The first needle they attempted to use was too short so they had to change it, but eventually my cervix was numbed and the biopsy was able to be taken. The doctor also made a comment about if they didn't take a biopsy, the procedure wouldn't be finished.

Once the procedure was over, the doctor left the room and I was given a panty liner for any of the iodine that had yet to leave my vagina, and a wet washcloth to wipe my vulva. I was feeling extremely triggered and asked my partner if they could wipe me clean, which they did as I laid there and cried. The nurses reassured me that I wasn't asking too much by requesting anaesthetic and stated that it wasn't uncommon for women to react the way I had. After a few minutes to collect myself as best I could, we left the clinic. I continued to cry and ended up vomiting due to the distress I was feeling.

Overall, I feel this procedure was extremely trauma-uninformed. When I went for my initial cervical screening at another health service, the doctor was compassionate and told me exactly what they were going to do every step of the way, making sure I was feeling safe and consenting to what was happening. This experience at KEMH was the opposite. I also find it extremely unprofessional that this doctor seemingly tried to convince us that I wouldn't be able to feel what was being done to my cervix. I believe if they had been honest and said that it would be uncomfortable or even a little bit painful, I would have at least been able to mentally prepare for that beforehand. Thankfully, my partner was unswayed by the doctor's claims that it wouldn't hurt and demanded anaesthetic on my behalf when I was too triggered to ask for it myself. If my partner hadn't been present, I would not have been able to advocate for my needs and the experience would have been far more traumatic than it already was.

As a side note, I was misgendered throughout this entire experience. As stated earlier I am non-binary and use they/them pronouns. The doctor and nurses only referred to me as a woman and with she/her pronouns - granted, the nurses may not have read my file and I understand this is a gynecology clinic, but the doctor should have at least acknowledged my gender as that information was included in my referral.