I had my first pap smear at the age of 20. I had been so afraid to get one that I waited until I was worried about something my body was doing, and impulsively booked an appointment. It was damage control, not preventive healthcare.
On the way to my girlfriend’s tiny and bedbug-infested apartment, I parked outside a medical centre on Bondi Road. I was led into an examination room, where I was met by an Orthodox Jewish doctor.
“Why have you come in today?”
“For a pap smear.” I explained the issue I was worried about and fell silent.
“I see. Come over to the bed, please, and remove your pants and underwear.”
I didn’t know anything about the procedure, and waited for him to explain what he would be doing. He didn’t.
When I was a teenager, I had seen a poster reminding women to have regular pap smears every two years after turning 18 or after becoming sexually active. The poster worried me, and I asked my mother about the procedure. She had been honest and detailed in her description, but I was still scared and uncertain what it would feel like.
“So, you are sexually active?” he asked. He covered the lower half of my body with a sheet for privacy, prepared the speculum, and then applied lube.
“Are you married?”
“Do you use condoms? Or are you on the contraceptive pill?”
“Well, my partner is a woman, so no.” I hadn’t planned on coming out, but his question about condoms and the pill made me think he was more progressive than he looked. It hadn’t occurred to me that I had to worry about his professionalism.
“You’re in a homosexual relationship?” he asked. He paused, with the speculum partially inserted.
What he said next was disgusting and triggering. I don’t want to write the words, and I especially don’t want LGBTIQ people to have to read them. Suffice it to say, he shamed me. He told me that I was living an unnatural lifestyle that would make me unhappy. Knowing I was Jewish, he brought up my parents, and told me that I was letting them down after they had sacrificed everything for me.
For a long time, I didn’t tell anyone other than my girlfriend about this. I didn’t get another pap smear for a while.
I didn’t confide in a medical professional about my mental health issues for another six years.
It wasn’t until I reached my thirties that I gained some confidence in dealing with the medical establishment. It isn’t just being queer that makes it difficult to communicate confidently with doctors. It is also related to gender, and the way that young women are conditioned to be polite and passive in a patriarchal society.
I had always assumed that doctors offered the same treatment to their patients, regardless of their own views. However, the LA Times published an article last week about a study recently conducted by researchers at Yale University. “The study results suggest that patients can expect to get different kinds of medical care depending on where their doctor lies along the political spectrum,” the article explained.
It is important that we consider the impact medical professionals can have on people’s self-confidence, self-esteem and sense of self. It is essential that medical care is inclusive of all genders and sexual identities, particularly if, as a society, we wish to promote mental health and reduce suicide.
Last year, I wrote about my bisexuality, in response to beyondblue’s report, Going Upstream, and the Australian Bureau of Statistic’s General Social Survey. Both reports revealed the higher statistical likelihood for LGBTIQ people to have poor health, a disability, a long-term health condition, or a mental health condition.
Medical professionals need to understand the negative impacts that even one experience can have, both short and long term, on the health and wellbeing of LGBTIQ people especially. If current professional development and regulations aren’t sufficient, then it is time that we explore what else could be done to ensure that all doctors are trained, observant, empathetic and able to put personal judgments aside in their practice.
The Australian government’s Mental Health Commission, established in 2012, aims to promote mental health, prevent mental illness and suicide across all sectors, and ensure that mental health is embedded in government policy and reform.
Despite so much funding and promotion, the information isn’t reaching the right people. I spoke to a bisexual woman in her 20s who had been brought up in a Christian community. She believed that pap smears were not necessary if the patient had regular checks for STDs. When I explained that the pap smear was actually a test screening for cervical cancer, she was astonished and concerned.
For those concerned about seeing a doctor, I suggest doing some research about the clinic and reading any available reviews. Some will mention that they are LGBTIQ-friendly specifically. Bring someone along to your appointment for support, if possible. If a medical professional makes you feel uncomfortable, there are avenues in which you can follow it up, including your state or territory’s Health Care Complaints Commission or Health Services Commissioner, and the Australian Health Practitioner Regulation Agency.
In my case, it took many years, and a lot of money, to find a GP who suits me and makes me feel like my health is the priority. I don’t want a doctor who prioritises their political stance or religious ideology over my wellbeing, like that religious doctor who filled me with shame and sent me back into the closet for almost a decade.
I implore readers to think twice about continuing to see conservative, judgmental, condescending and unhelpful doctors. If you have a great doctor, and know that a loved one has one of the bad ones, text them the details. You just might save their life.