The one place I hate going most is where the sexual abuse I experienced continues to be played out time and time again; a doctor's exam table. There isn't a memory I have where the appointment wasn't invasive or traumatizing. I think the first being from around the age of three. I was completely naked with my legs spread-eagle on a gurney as a nurse inserted her gloved finger into me. A few years later my already prevalent freeze response left me defenseless from a male doctor who lifted the hospital gown draped over me to view the private places of my body where chicken pox had spread.
Visits to a doctor's office became increasingly worse from there. I often ended up restrained to a table by the weight of a nurse or two sitting on my legs and chest. It takes quite a bit of discomfort to get me to see a doctor still today after having my childhood pediatrician threaten to lock me in the clinic's basement. He accused me of lying about an ear ache that I left school early for due to the pain. He walked me to the basement door, opened it to expose the darkens behind it, said "This is where we put liars", and he told me to go down. I was taken to the hospital sometime later where it was discovered that my eardrum was close to bursting from infection.
As I got older and the physicians I saw could no longer use physical force and threats to control me, I was labeled as a difficult patient and non-compliant. I was made fun of for my reactions to their presence and touch. In the midst of panic attacks so severe, I lost feeling in my limbs or I sat curled defensively in a corner, I was taunted and shamed. Few medical staff showed me compassion, yet I remember and remain grateful to those few who did. Not a single medical professional ever questioned my reactions during childhood or my teens, it was only labeled. Not once was I asked about abuse or if I'd experienced sexual trauma, though I exhibited plenty telltale signs that I had.
Becoming a woman has lead to a whole host of new medical visits and exams that have made it increasingly difficult to cope with how medicine interacts with the aftermath of experiencing childhood sexual abuse. The safety of adulthood hardly feels like much protection sitting in the waiting room of a gynecologist's office. I am no longer a child, they cannot threaten or restrain me without serious repercussions, yet the medical field has done harm to me so many times before that the intense fear remains. While becoming an adult offers a certain amount of physical defense from unwanted and unnecessary procedures, it alone cannot prevent psychological retraumatization from occurring at the hands of medical personnel and it hasn't.
Driving to my last gynecologist appointment I had one of the worst panic attacks I've had in years. I was going in for nothing more than a new script for my medication, but I had to inform my doctor that I still wasn't ready to go through with a pelvic exam. My therapist and I worked hard together to empower me and to help me feel both capable and safe to say what I needed to. We had a plan and as terrified as I was, I thought I was prepared for whatever was to come. I hoped that she'd be understanding and willing to listen to my needs, but worst case scenario I knew I had the right to walk out of the exam room without so much as an explanation.
Once at the clinic I sat in my car until it was time to check in. I was escorted back rather quickly by a nurse for my height, weight, and preliminary questions. In the exam room, the gown was folded neatly on a chair awaiting my arrival. Speculum, a smear of lubricant, and other instruments sat on the counter, prepared for use. All these things spiked my anxiety as I explained to the nurse why I was there that day and why I wouldn't be allowing an exam. To my relief, she asked no questions and made no remarks, and on her way out she took the gown with her. As I waited for the doctor, I tried to ignore the glimmering of the metal instruments only feet from my knees.
A knock came from the door which opened promptly before I could muster an answer. The woman who entered was of equal stature, but I felt small in comparison. It didn't take long for her to make it apparent that she wasn't pleased with me. I was intimidated by her demeanor and the line of questioning that ensued. She wanted to know why I still wasn't ready for an examination, but when I attempted to discuss it with her, she had no interest in hearing about the effects trauma had on me in a medical setting. Instead, she hastily interrupted me insisting that she was well informed about the nature of trauma and vocally made the assumption that it was myself and my therapist who were at fault for clearly not working through the issue.
I was becoming increasingly worried that she was going to refuse to renew my script, but as the interrogation came to a close, she announced that she would hold off on an exam for another year as if I should be grateful. She insisted that I needed a pelvic exam the following year, regardless if I was sexually active or not, and that if I still didn't feel ready I should undergo sedation. When the word sedation passed her lips I froze. This doctor truly believed that taking away all of my control over my body and my consciousness was a valid and less traumatizing option than listening to and working with me. She either couldn't see or didn't care that sedating me (so she could do what she wished to my body) was no different than not having control over what was done to my body during the sexual abuse.
I suddenly felt completely hopeless and powerless in the presence of this woman. She presumed that, in spite of the fact that I am the one who is continuously connected with my mind and body, that she was the expert on my needs. I could see that there was no getting through to her and I started to shut down. When she asked me to lay back so she could feel my abdomen, I sheepishly complied as I had begun to feel myself sinking. Looking at the light above my head, all sights and sounds around me blurred. Though I didn't understand what was happening to me at the time, I had entered a dissociative state.
For a while after the appointment I was numb. It took time for the anger, hurt, and fear to surface. My gynecologist's job was to care for my health and well-being, instead she played the role of another perpetrator who wanted to have her way with me. Since this incident, I have begun ordering my script online. Now a visit to the gynecologist is no longer required or a pelvic exam made mandatory just to keep my hormones in balance. It would be helpful to have the support and guidance of a medical doctor to assist me in maintaining and improving my physical health, but I'm not ready to handle another encounter with a doctor such as this. When I will feel safe enough again to attempt another visit I cannot be sure of.
I shouldn't have to rehearse lines with my therapist and practice self-empowerment in order to protect myself in the office of someone who is expected to do no harm. Yet, that is exactly what I have had to do and what I must continue to do until trauma-informed training becomes mandatory in all medical settings. It is not my job nor my responsibility to be the one to teach my doctors how to speak to and work with someone who has experienced trauma. It's unethical to reduce trauma survivors to little more than guinea pigs in the offices of poorly trained doctors who aren't up to the task of treating them or respecting their experiences. Despite everything I have gone through at the hands of doctors, I believe that the medical field is capable of doing better. Improvement can only happen though, when we hold them to higher standards.
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