Girls: what do you think of #smearforsmear? Do you avoid your pap smears and why?

My friend recently underwent a speculum exam she did not ask for or consent to, only expecting an examination of an irregularity, but did not feel she was in a position to ask him to stop. She felt violated and raped as a result.

She raised her concerns with the hospital, and made a complaint, however they said he was just trying to do his job and make sure he doesn't miss any illnesses. They did not seem bothered by the fact that she did not agree to it. I found this strange, as clinicians have to ask permission for any other examination, even just listening to your heartbeat. Why is it that a clinician has to ask whether they can, I don't know, check for any lumps on the sides of your ears, for example, but they don't need to ask before they insert a plastic object into your vagina? Doctors are allowed to rape?

*I would appreciate if male posters could just leave this thread, this is a chance for you to just listen and learn- if you want to discuss this you can start another thread. I would really appreciate if people could ignore male posters and not encourage them by responding, as someone will surely decide to post anyway.

but we never hear about why young women and teenage girls don't want to go and do them in the first place. Personally, especially after what happened to my friend, I think we need to more education on what exactly a smear test is, and what a girl's rights are during the test, what to expect during the examination. Not a slightly rapey sexualised campaign with smudged lipstick encouraging girls to be penetrated when they clearly don't want to.

Anyway, I want to hear from you now.

Weak trolling.

Feel free to opt out of cervical screening yourself, but seeking to erode the scheme by using intentionally provocative language is just downright harmful.

Uptake of screening in young women is already poor and subsequently treatable pre-malignancies are allowed to progress into fulminant cancer. By pushing this bilge and discouraging women to attend makes you, in part, responsible for that.

Medical student here, if she felt violated then obviously that's terrible and I hope she feels better.

I don't think the smear for smear campaign is rapey, it a terrible campaign and annoys me a lot but since the "Jade Goody" effect has now ended and the % of women going for smears is dropping there needs to be a campaign of sorts.
It's not about penetrating women who don't want to be, it's about preventing cancer by picking up on abnormal cells..

I bet if there was a less invasive way to do that than the current methods doctors would prefer it.

I don't know exactly what happened to your friend, but calling it rape is unnecessary scaremongering.

I don't know exactly what happened to your friend but

The doctor should have explained better what they were doing and why, but consent for an examination would be implied by someone following instructions to e.g. get on the couch and remove underwear. If your friend didn't want the examination or didn't understand why it was being done, then she could have said so and they would be happy to explain.

That campaign looks a bit naff, tbh, but I see no harm in it. And no, I wouldn't refuse my smear tests, because I don't want to die of a preventable condition.

Hi,



I did not intend to upset anyone, and sorry if you felt scared, but she was raped.



You should reserve judgement if you don't know what happened, rather than offer you opinion on why it wasn't rape.



It sounds as if you have a set scenario of how rape plays out- most of the time, it's not a violent struggle, like in the movies.




That's nice for you, but clearly, the fear of death hasn't compelled enough women and girls so far. I am suggesting the health community needs to change its approach to how it examines women's bodies, because it' clearly not working for most women.

She wasn't raped
She wasn't even sexually assaulted as there was no sexual context
She was possibly assaulted in legal terms.... it depends how the law views consent in a medical context.

I am very sorry to hear about how your friend felt after her speculum examination. It is an intimate examination which can leave you feeling vulnerable and your friend clearly didn't feel that the examination was explained to her clearly enough. If she had her concerned then reporting it was definitely the right thing to do. However I would like to point out the informed consent is required for all examinations and if an examination is performed without consent it is referred to as assault. As a doctor I disagree with your statement that we do what we think that we need to do ignoring our patients wishes. My role is to advice my patients of their options and then it is their decision. Do my patients sometimes make decisions that I think are the wrong ones? Yes they do but that is their right and all I can do is to inform them of the options and try to help them make the correct decision for them whatever that might be.

However while an intimate and sometimes uncomfortable procedure smear tests do save lives so I think it is important to present a balanced view of them. In the last few years I have had a smear test. It was performed by the practice nurse. I was fully informed of what to expect before it was done and I was also treated with dignity and care and given the privacy to undress and prepare behind a curtain before she came in. The smear test itself was slightly uncomfortable but not painful and lasted less than a minute. I have also had a number of internal and speculum examinations during my pregnancy and labour with my son 7 months ago. Again all of these were performed with care and respect.I have had intimate examinations from both male and female practitioners (doctors, the practice nurse and midwives) and I can't say that any of them performed in anything but a professional way.

Smear tests are an effective way of detecting early signs of cell change which can lead to cervical cancer. Because of their introduction into our healthcare system the number of both young and older women who are dying of cervical cancer has dropped dramatically. The following quote is from an article on patient.co.uk which though written for professionals is useful for those wanting to know more about the rationale behind screening.

"Incidence of cervical cancer in the UK fell by 43% between 1987-89 and 1997-99, apparently attributable to the screening programme introduced in the late 1980s.Three-yearly screening up to 39 years of age prevents 41% of cancers. Five-yearly screening between 40 and 54 years of age prevents 63% of cancers. It has also been shown that the cervical screening programme is associated with improved rate of cure of invasive cervical cancer." Source

So there is a lot of evidence that smear tests are effective at preventing cervical cancer. There currently isn't a non-invasive method of screening if there was I am sure that the NHS would be looking into whether it was a viable option to introduce it. The way that we screen for risk of cervical cancer will change a lot over the next decade with the introduction of the HPV vaccine and also the introduction of screening for HPV in smear samples. However we aren't there yet and I think it is important that we continue to encourage not just young women but all women within screening age to attend for them. I do agree with you that it is important to look for the reasons that women might not be attending and try to provide them with the information that they need to make an informed choice. This process is starting already as the information leaflet that I received with my letter about my smear test told me the rationale for doing it and also explained the procedure and what would happen with the results very well.

I think that the campaign that you linked to is trying to encourage women to learn more about smear tests which is a positive thing. They are trying to use social media to help raise awareness and are slightly jumping on the ice bucket challenge and the no make up selfie idea. It is also not that dissimilar to the "got milk" campaign that has run in america. I don't see anything inherently wrong with it, but it isn't something that would personally appeal to me.

This is great, you sounds like a great clinician, and I am pleased that you were treated with dignity, unlike my friend. Unfortunately, this is not the case for all clinicians, and moreover, a girls/ woman's experience of healthcare varies, according to age, race, class etc. Whilst I would agree with you that carrying out such an examination without informed consent is assault, this has not been the case in my friend's instance. I am not certain of why so many responses take issue with this, especially when they know so little about what happened.

I disagree. I also know that the usefulness of screening increases with the number of people that do it, similarly to breast cancer screening- it may not be accurate for each individual that undergoes screening, but more people being screened increases the chances of abnormalities being detected overall.

To address both the point campaigns and the examination itself, I don't agree with the idea ends justify means, I really think we need to keep the end in mind when we try to achieve it. So these campaigns might mean well, but that's not enough, they need to be properly thought out, for the sake of our health and wellbeing. It's good for you therefore you should do it is just not convincing, and slightly authoritarian.

This is great, you sounds like a great clinician, and I am pleased that you were treated with dignity, unlike my friend. Unfortunately, this is not the case for all clinicians, and moreover, a girls/ woman's experience of healthcare varies, according to age, race, class etc. Whilst I would agree with you that carrying out such an examination without informed consent is assault, this has not been the case in my friend's instance. I am not certain of why so many responses take issue with this, especially when they know so little about what happened.

I disagree. I also know that the usefulness of screening increases with the number of people that do it, similarly to breast cancer screening- it may not be accurate for each individual that undergoes screening, but more people being screened increases the chances of abnormalities being detected overall.

To address both the point campaigns and the examination itself, I don't agree with the idea ends justify means, I really think we need to keep the end in mind when we try to achieve it. So these campaigns might mean well, but that's not enough, they need to be properly thought out, for the sake of our health and wellbeing. It's good for you therefore you should do it is just not convincing, and slightly authoritarian.

Hi,

Re read my response to the above post. You do not know the details of her appointment, so your opinion on whether or not it is sexual assault is invalid. I'm not about to share the details of what else was said and done, it's not my place.

I'm here making a point about the way these examinations and the apathy towards them more generally.

if a woman thinks she was sexually assaulted then she was. whether it is a stranger in a dark alley or a doctor in a clinic. she should report the assault to the police.