The Smear Test

Posted: October 4, 2015 in Uncategorized

This one may be a bit TMI for some people.

But it needs to be done, so here we go.

On Friday, I had a smear test.

Yup, that delightful ‘let’s stick a toothbrush up your vagina’ experience that, in the UK, ladies are auto-invited to have regularly after you turn 24 or 25. Seriously, the NHS sends  you letters about it.

(They even sent me one right after I changed my name and title. Apparently changing your title from Miss to Mr gets you an invite to have a stick shoved somewhere sensitive in the NHS.)

Now don’t get me wrong, I get the idea. Preventative screening is  important, especially when the various cancers that can affect the plumbing department for women are generally not caught early, and lead to lots of unnecessary deaths. And I would generally encourage people to go if they’re due, or if they’re told to go thanks to abnormal symptoms.

And transmen – except those who’ve had the type of bottom surgeries that remove everything feminine between your knees and your ribcage – need to have it too. Not using your lady plumbing for periods, sex and babies doesn’t mean that nothing can go wrong down there. So transmen need to have smear tests too, and should go.


I wouldn’t follow my own advice.

The fact is, I walked out of the nurse’s office feeling like I was dirty, disgusting, and a total freak of nature. I felt humiliated and embarrassed. I went straight home, had a hot shower, lounged around in full pyjamas for an hour, then had another shower. I felt like I’d been sexually assaulted – and before anyone goes mental, I do know what that feels like, and that’s all anyone needs to know on that subject. And to top it off, I felt angry with myself for overreacting. It was just a bloody smear test. People have smear tests all the time.

Cisgender women do, anyway.

That’s a large part of the problem. Not only am I asexual – meaning nobody ever touches my vagina except for me, and even I’m not doing it for pleasurable purposes – but I’m transgender. Meaning I don’t feel like I should even have a vagina to touch, never mind have something inserted into it. It’s awful on two different levels. It’s awful because I’m asexual, and it’s awful because I’m transgender.

And did the nurse help?

Did she hell. She hadn’t even read my notes as to why I was having the test done (hint: not routine checking, as I refuse to go for my routine ones). And yet, this is what the NHS has to say on the matter of transmen needing smear tests. Yeah. A measly paragraph. The equality analysis simply said to increase the uptake, they ought to remind GPs that transmen need these tests too. Duh. It wasn’t worth the time it took to find it, although it must be said that wasn’t just for transmen. (Seriously, I’m an analyst. I would strangle any colleague who handed me this analysis.) And a Google search for ‘trans men’s experiences of smear tests’ gets you, you guessed it, women’s experiences.

TL;DR – the nurse wasn’t trained, wouldn’t have been trained anywhere except West London thanks to the Charing Cross GIC working with nearby hospitals and clinics, and wasn’t interested. I was simply Patient Number Whatever, not a person with more-complicated-than-usual feelings on the matter.

And yet, this kills people. People are literally dying because they feel too uncomfortable, too afraid, too downright traumatised, to go to get their smear tests done. Dysphoria plays a big role, but for Christ’s sake, we get our tits out for the surgeon who’s going to cut them off. Most trans men can be persuaded easily enough in a medical situation that something is necessary, if you treat them with respect, dignity and a little bit of compassion. I went because my symptoms were ticking the boxes for something I really don’t want to have.

And frankly?

I’ll wait it out next time. I know I will. I know if I get those symptoms again, I won’t get a smear test. I won’t go for my next routine one. And part of me knows that it’s stupid and dangerous and I would go mad if a friend told me the same thing, but…I still won’t. It was a horrible experience, and I won’t do it again.

All because there is no humanity, no time, and no compassion for anyone who’s different.


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