Take it from someone whose routine trip to the GYN turned into a kerfuffle of mis[fat]diagnosis--when a doctor is supposed to be treating you for something and launches into the fat talk you can politely tell them "I am not here to discuss my weight with you. I am here to discuss my bits, my HIV status and whether I am at risk for cancers." I like to have a mantra to prepare ahead of time.
My straight BFF says she’s annoyed when she gets screened for STIs because it’s often as a result of a break-up and she thinks you should get banged after you get a clean bill of health, as a reward. Except you sometimes get this stuff taken care of at the end of the road because maybe you were cheated on or you realized you had some miscommunications with someone about fluid bonding and probably you should get tested for your own peace of mind. And then there’s no one to bang you when it comes back clear. Just maybe a little bit of relief and an iced coffee when you don’t get a call that anything is wrong.
Herstorically I have gotten my Sexually Transmitted Infection (STI) tests as part of my annual pap smear. And I say annual but I really mean when-I-was-sure-it-had-been-over-a-year-and-I-got-around-to-scheduling-it. So probably ever 18-24 months, unless there was a risk factor situation like a break-up, cheating, etc… I haven’t had health insurance for almost two years and in these lean times I often regret all the time I had health insurance and I squandered it by not doing things as much as possible that at the time I had the financial ability to get done.
I’ve always had similar experiences. Small office, used to seeing straight people, who are monogamous/married/parents or otherwise not particularly sex positive in any way. I have had to explain why I wanted a full panel of STI tests many times. I don’t think you should have to explain why, if you’re at the doctor you should just be able to get tested for what you ask for. It’s mildly infuriating but I’m at a point in my life now where I don’t let it get to me. I just calmly say, “Because I’m a responsible sexually active adult, that’s why, now test me.”
So this time I needed to get screened, I took my uninsured responsible sexually activish* self to the local LGBT health clinic that I feel fortunate to have as a resource. I was curious what it would be like to get screened there, in an environment that is actually sex positive and won’t look shocked when I tell them I’m a lesbian. They even have all of the check boxes about sexual orientation on the intake form. I even felt free to check off both lesbian and queer.
After the intake I saw a counselor who asked me a lot of questions I didn’t expect. This was my first experience at a sex positive environment getting tested, I’ve barely ever talked about my safer sex practices in a doctor’s office, let alone at length with a counselor. It was kind of cool, because even if you know all the stuff you think you should know sometimes you wonder and it’s nice to have someone give you feedback.
She asked me some startling questions about what my support system was and whether or not I was suicidal. I didn’t expect it to get into my mental health. But that’s part of the risk factors when doing an HIV screening and they cover their bases at the health center. She asked me if I wanted to have a rapid HIV test, where the results are available that day or if I wanted to do a blood draw. The difference was that the rapid test would only cover me through April, not through present day and the blood draw would cover me through the week prior. I decided to do both, to “cover the spread.”
She pricked me on the finger for blood and it unexpectedly hurt pretty bad. I was bruised for a couple of days. I said, “Ow ow ow, sex hurts.” Because I make a lot of jokes when I am feeling awkward.
After my poke test, I went in to see a doctor for blood draws and urine for everything else.
I didn’t schedule a pap at the same time because I was afraid I couldn’t afford it and there’s a sliding scale that the clinic doesn’t determine until you go in. But the doctor suggested I come back to do a pap because I had an abnormal pap two years ago. Callen Lorde is now suggesting paps every five years based on the CDC’s recommendations about waiting up to five years for a pap smear, but not if you’ve had an abnormal screening.
I had to meet with the counselor again, once all of the blood was drawn, to go over the results of my rapid test. It was nice to get the results in person, since usually test results are “if you don’t hear from us it’s clear.”
I made another appointment to go in for the pap (now that I knew how much it was it was significantly less scary financially) so I scheduled my follow-up results appointment for the blood draw with the same counselor. The pap was interesting because the new doctor was a lot more brusque and not compassionate in any way. I have a lot of coping mechanisms around the medical industrial complex but times like that, when your doctor is kind of cold and not very nice about you not having prior medical test results with you (no one asked me to bring them in), it feels extra vulnerable when you’re doing a medical exam that is as personal as a pelvic.
Also at that visit I had a new weird interaction about weight at the doctor’s office. No one mentioned my weight at all except when the nurse asked me how much I weighed last time I weighed myself. I had a break-up (I usually can’t eat much when I’m devastated) and I’ve been doing this anti-candida eating so I’ve lost some weight and I’m at a pretty low number for me. I told him the number without the background and he looked me up and down and said, “I don’t see it.”
It was weird. Like a backhanded compliment of “Your number is high but you don’t look like you carry that much weight.” I used the moment to casually say, “Everyone carries weight really differently, it’s impossible to eyeball someone’s weight.” But still, so weird, that I’m at this low for various reasons that aren’t really by choice and he’s indicating the number is still high. But luckily he didn’t tell me I had to lose weight or die or anything. Just such a weird interaction. Can’t just getting my weight be the only conversation we have about it? Or can it be accompanied by the health practitioner asking, “Do you have any concerns about that number?”
I’m still waiting on those results and hoping the pap finds nothing abnormal. I hope that writing this up helps encourage other folks who need to get screened (or have been nagging themselves about getting screened) to call up wherever and make it happen. I find these things much less scary when I know what’s going to happen.
I also wanted to pass along this personal narrative from Scarleteen about safer sex practices amongst folks who have queer sex, it touches on a little how-to, barriers to talking about safer sex and advocating against the invisibilizing of STI risk amongst female assigned at birth folks who have sex with other female assigned at birth folks.
*When the nurse asked if I was sexually active I said “sorta.”