I cried before, during, and after, my latest routine Pap. I expect it will always been an emotional experience for me. As a trauma survivor my nervous system is primed to get cranky during vulnerable situations. Despite the tears, it was actually a very okay situation – which is due to having a great provider and following many of my tips outlined below.

Whether it’s something we need to do or part of regular maintenance, heading to the doctor for gyno stuff is no-ones favorite time. Add in our various trauma and it can become a difficult task.

Here’s a few tips that I hope will help.

Pick a practitioner -Within the constraints of our current system, (and if choice is possible) find a trustworthy provider, who preferably is trauma informed If you don’t have someone on your team you can go to places like a Sexual Health Clinic. Likewise the folks at Sexual Assault Centre’s, LGBT+ centers, and so on can often help with navigation.
Pre-Appointment – If possible, consider booking a “pre-appointment”, or several. This can be your chance to evaluate the clinic & staff. Likewise to discuss whatever you wish, ask questions, have them explain the process, show you the instruments, share your concerns, and let them know you find this difficult.
Trauma-Informed Honesty – If you know or suspect this will be difficult for you it’s often helpful inform folks -either before or on the day of. Keep in mind that while it can be useful to share you’ve experienced trauma you do not need to disclose the details - as this can be retraumatizing. If you do have relevant triggers it’s more than okay to talk about possible work arounds.
Support – Bring someone you trust as support. A friend, family member, partner, social worker – whatever is right for you. You may or may not want them to stay the whole time, it’s okay if you do – but if not just knowing someone you trust is in the building can be nice for some people. You can also ask for an assistant or nurse to join if you’d prefer.
Self-Advocate – Did the doctor decide to bring in a student? You can say hell no! Weird joke that makes you uncomfortable? Bye. Body just not feeling it? Try another time. It can be challenging to standup to medical folks but you have the right to do so.
Outfit of choice – One way to maintain a bit of control and comfort is to bring your own outfit. Grab a nightshirt, old summer dress, robe, caftan, or whatever will work. Throw on a cardigan or something that keeps your top half warm and cozy. Bonus points if your outfit has a funny or powerful slogan. I also recommend fun socks.
Take em if you got em – If you’ve cleared it with your team – and you feel it would help, take an as needed anxiety med or calming substance before going. If you don’t regularly take something you could ask about this in a pre-appointment. You don’t want to be incapacitated but using something to take the anxiety down a notch is okay! People do it all the time.
You are the expert on you – It is not okay for anyone to downplay the anxieties or fears you might have. It is not okay for someone to say you aren’t in pain if you are. (FYI: A pap typically feels uncomfortable or weird and shouldn’t be painful – but for some it can be for a variety of reasons.) Your abilities should be respected. Such as if you say you can or cannot do something that should be listened to.
All emotions are valid – You might cry, laugh, or feel not much of anything. That’s okay, and whatever comes up you are not alone. When you are done or gave it your best try, do something nice for yourself! Be proud!
Avoid Trauma/Pain Olympics – A good portion of people have bad experiences with the medical system. When you are chatting with someone about your fears you may hear something like: “you think that’s bad, trying having kids”, “that’s nothing, let me tell you about this thing I went through” or even “you’ve done this many times before!” . These type of statements are typically unhelpful even if they mean well. It’s okay to mention that while their experience is valid, so is yours, and you can choose to changed the subject if you aren’t getting the support you need.
Up To Date Practices – If you haven’t been keeping tabs on things, or it’s been a long time since you’ve gone in – there may have been some changes in the medical system you aren’t aware of. Of course these things will vary based on location, policy, and the doctor’s awareness/preference.

For one, getting a Pap yearly is no longer recommended, (unless it’s otherwise determined to be needed) – you can go 3 or more years between visits. Additionally it may be helpful to know that in some places the system is moving away from Regular Pap tests, and towards HPV tests that can even be done from home!
The dreaded stirrups are losing popularity, and while still common in some areas, they are not used in others. There’s been research that indicates not using them improves the experience. As someone who has done a Pap in both positions, I can personally say without stirrups was much better for me. This may or may not be an option available to you, but it is worth asking about.

So yes, even though I did cry at my latest appointment, I’d rate it as an 8 out of 10. I had some pre-appointments, brought my own outfit, held the and of the assistant, didn’t use stirrups, and got a juice box and hug out of the deal. I feel proud of me for finding my way through, and I find it empowering to be in charge of my health. I hope you’ll find your way too!

Just a quick note here to mention that I recognize that these various tips may not be possible for everyone, especially based on personal circumstances and urgent need. Take what’s best and leave the rest!

If you enjoyed this article and if you’d like to follow along with my journey,
you can find me on Instagram as @Mentalhealthyxe,