Medical Cis-female CSA survivors, how do you cope with gyn exams?

that_1_girl

Confident
I am cisgender female (although I do have co-occurring DID as well as CPTSD) and a csa survivor…I have complete visual amnesia for everything csa related that happened before age 17, but I struggle a LOT with body memories, both external and internal in my lower body. Discomfort, unexplained internal pain, literal physical csa assault flashbacks with no visual where it literally feels like I’m being raped.

A few weeks ago I was having constant/near-constant body memories at the moderate-discomfort level internally for about a week, when I woke up one morning and they had become questionable medically. I actually gave in and went to the gynecologist (actually the gynecological nurse practitioner), which I had been using COVID as a very “valid, non-personal excuse” for NOT getting my yearly exam for about 2 years. I’m not quite middle age but close (I’ll be 38 in less than a month). I said on the phone that I thought I might have a yeast infection or something lovely like that, because I haven’t had actual intercourse or anything even close in about 7 years, so I wanted them to definitely check for that. They said I was overdue for my annual so I said ok can they just get it all over with in one go, I’m a csa survivor and I need to have a female NP and a female nurse in the room at all times during the exam. They said OK sure, and your “chosen/safe mom” can be on the phone with you but she can’t come in because of COVID regulations. They were as good as their word.

Anyway I did not have a definitive DID diagnosis yet but I did and still do have a definitive (C)PTSD diagnosis and all that. But the exam was a complete (pardon my language) sh*tshow. I asked her to please tell me exactly what she was going to do before she did it, and she did. I made it through the top half with little to no problem and the nurse was really nice and stayed as far away as the tiny room would allow. I told her NOT to touch me no matter what. But then the NP said I was coming due for my Pap and she said she could get it over with too.

At that point I totally panicked and dissociated and wouldn’t let her do ANYTHING and they got my phone for me (my safe mom was on standby on speakerphone and I had just enough presence of mind to put her on regular audio) and I talked to her. They all (all 3 of them) tried to talk to me and I still physically refused to allow anything more. The NP said the Pap could wait another year and she didn’t even have to do the yeast/bacterial culture if I wasn’t ok with it.
I kinda was like “just do the culture and skip the Pap and get me out of here!” (There was a lot of DID type dissociation but this isn’t the right forum so I’m editing that out based on what I actually remember of it.)

So eventually I allowed her to do just the culture, just barely, after I started to feel really guilty about how much of their time I was taking up. Of course I went through the whole thing for NOTHING because every test came back negative like a week later. The Universe has a sick sense of humor, idk.

I was severely dissociative and distressed and had flashbacks and nausea at times from then until bedtime. I have to go back for my Pap in September 2022. I also I have an IUD for medical reasons that I *have* to get changed or at least taken out in 2024.

It’s still September 2021 but I’m already worried about it. How do you all cope with necessary but NON-consensual touch?
 

Chris-duck

MyPTSD Pro
How do you all cope with necessary but NON-consensual touch?
So you can still consent, or not, to "necessary" medical stuff. So um, if you don't consent then you don't consent. If you consent cos you decide it's necessary, that is consent, even if it's triggering.

So yeah.. I guess it's a reframe. You can say no n that would be non consensual if they continued. But if you say yes cos *you* decide it would be beneficial, that is consent.

Saying that. This shit is insanely triggering for me. And all I can do is book it for early morning, get through it and buy myself a milkshake when it's done.
 

that_1_girl

Confident
Saying that. This shit is insanely triggering for me. And all I can do is book it for early morning, get through it and buy myself a milkshake when it's done.
Thank you, I really like and appreciate the reframe! You’re right and I DID NOT consent to the full Pap/internal exam and you’re also right, she didn’t force me. And I *did* ask her to do the culture because if they could give me a pill or medicine of some kind to make the by that day extreme discomfort verging on pain, I was all for it! I’m pretty sure I said something like “just do the culture and get it over with and skip the rest!” while crying/almost sobbing. That is DEFINITELY triggered but also DEFINITELY verbal consent. So excellent reframe! Thank you, that helps a lot. That is how I’ve always viewed it in the past. It’s always been super triggering but I was always able to make it through before…somehow. I guess since I went of insane levels of multiple antipsychotics when they redacted my schizophrenia/schizoaffective diagnosis in favors of CPTSD and being somewhere unspecific on the dissociative spectrum, and I’m now completely OFF all things that actually served to numb me out…the dissociation has gotten a lot more pronounced and the overt switching has “come back”, I guess, but I always thought I was just “watching myself lose my g.d. mind.”

I have a TMI question and you DEFINITELY are NOT obligated to answer…after necessary—consented to, by your definition and (hopefully) now mine again—VERY MINOR procedures like cultures for yeast infections, etc…do you experience horrible pain inside for like hours (in my case I had the last appointment of the day and it continued until bedtime)? Even WAY up past where any kind of culture swab of that sort would ever go? And then the next day you’re back to your current baseline, like the horrible pain is gone? I don’t want to trigger you further than I probably already have but I honestly wanted to SH, just to make it stop. But I DIDN’T.

You do NOT have any obligation to answer that question at all or if you do with as little detail as you feel will keep you SAFE.
 

Chris-duck

MyPTSD Pro
do you experience horrible pain inside for like hours
It's a weird thing for me. Like yeah sometimes at the time, but not every time. And it's a kind of pain that um, I can't ever remember when it's not currently happening. N afterwards I'm a bit wtf n uncomfy, but I'm probably the wrong person to ask because my body awareness is uh lacking at best.
 

Movingforward10

MyPTSD Pro
I went for my pap a few months ago: it was disaster. I made her stop. I kept it together there but as soon as I got home I needed to wash myself, and couldn't touch myself to do it. And I felt pain - which I think was stress and who knows what else
I don't remember what being raped feels like as I disassociated during those, so I don't know wmif this pain was that or what.

My next pap is booked for December at a clinic for survivors of sexual assault. I will meet with a psychologist and together we will come up with a plan for how I want it to go. It sounds a much better place, and whilst I nearly cry why I think about going, I already feel safer that they are already putting me in control.

For me:
I need to know what is happening
I can not deal with someone inserting something inside me, whilst talking about something unrelated as I need them to acknowledge they are inserting something rather than pretending they are not.
If they are going to use lube: I need it off my body asap.i can't cope with the feeling of that on my body.

So I now will be armed with that list of what not to do and fingers crossed I can get through it.

I hope you find a way through.
 

Mee

MyPTSD Pro
…do you experience horrible pain inside for like hours (in my case I had the last appointment of the day and it continued until bedtime)? Even WAY up past where any kind of culture swab of that sort would ever go? And then the next day you’re back to your current baseline, like the horrible pain is gone? I don’t want to trigger you further than I probably already have but I honestly wanted to SH, just to make it stop. But I DIDN’T.

You do NOT have any obligation to answer that question at all or if you do with as little detail as you feel will keep you SAFE.
I’ll answer this :). And I want to start by saying I don’t think it’s tmi . I think that it’s part of what we are here to support each other with if we are able. 🌹

yes, I get bad internal pain afterwards. Like you I find internals triggering and I had one and a coil fitted two days ago . I thought I was ok yesterday morning but then was in worse pain yesterday afternoon. Today I’ve got a hot water bottle on my back , a small dog curled up by my front ( acting like a hot water bottle ) and have taken some strong painkillers ( which are helping)

I have vaginisimus- which adds to this discomfort- do you think you could too? Even though mine is now mild it still leads to pain .
Also , I don’t think it was a waste of time getting the culture . You were brave. You exposed your self to a trigger and had the experience of knowing you could trust yourself to do that, to advocate for yourself ( remove consent and give partial consent- that’s pretty good going when triggered and in that position in my opinion! ) , and to check something. It is great it came back as unproblematic, That doesn’t mean it wasn’t worth checking- and you have learnt you can trust yourself to give consent for this kind of check in the future.
 

StillPen

Confident
I think you did all the right things and am rather impressed that you were able to stay present enough to verbalize what they could and could not do to your body whilst your smack in the middle of a PTSD episode It sounds like it was hell on you and I feel for you deeply on that, but Kudos for self-advocating.
I feel for you that your body memories include physical pain...mine are all arrousal-based.

Here are my thoughts
*set a clear thought in your mind the procedures you will have done at at appt way ahead of time. Too many 'lets get this done while your here" overwhelmed you, your parts, and your body.
* have a plan in your head before the appt on what you will do for self-care once the appt. is over to minimize the body memories...like, your fav. things your parts like (especially for your littles if you have them). Sticking anything anywhere successfully, for the sake of your physical health, is damn near miraculous for our type and imho should be celebrated.
* ask for the same dr. and staff to perform the procedure so you'll have familiarity with staff who helped you through the last episode and were respectful of your boundaries
* ground, ground, ground, during the procedure. Either outloud or internally I say my name, how many children I have, the date, what day it is, and ask myself and parts 'What is true right now?, telling my parts, 'We (or I) am having a procedure on my body. I am safe, right here, right now'. I say that to my parts a lot. 'I am safe right here, right now.'
* If you don't have any eating disorders, plan for ice cream, your fav, coffee, etc., something rewarding for a successful procedure.
*For the aftermath of body memories, hot/cold grounding, or cold/cold grounding to interrupt the nervous system. I use a frozen orange or lemmon, hold it in one hand (I squeeze hard) for about 5 seconds (or more if I can tolerate), then switch it the other hand and repeat. I do this until the fruit has thawed, and then use the smell on my hands as a secondary grounding tool.
*Anxiety meds if the pain is too severe.
*Afterwards a nap if possible. (sleep works to settle my parts 99.9% of the time as I rapid switch a lot during meltdowns)

Again, I commend you on how you did (including the meltdown), taking care of your body, especially because your results showed no issues. It feels as though you wasted time and caused an unexpected upheaval in your system, but the outcome is exactly what your positive intentions were for yourself(s)...to catch something early on if results came back with anything other than good news.
 

that_1_girl

Confident
I went for my pap a few months ago: it was disaster. I made her stop. I kept it together there but as soon as I got home I needed to wash myself, and couldn't touch myself to do it. And I felt pain - which I think was stress and who knows what else
I don't remember what being raped feels like as I disassociated during those, so I don't know wmif this pain was that or what.

My next pap is booked for December at a clinic for survivors of sexual assault. I will meet with a psychologist and together we will come up with a plan for how I want it to go. It sounds a much better place, and whilst I nearly cry why I think about going, I already feel safer that they are already putting me in control.

For me:
I need to know what is happening
I can not deal with someone inserting something inside me, whilst talking about something unrelated as I need them to acknowledge they are inserting something rather than pretending they are not.
If they are going to use lube: I need it off my body asap.i can't cope with the feeling of that on my body.

So I now will be armed with that list of what not to do and fingers crossed I can get through it.

I hope you find a way through.
Hey, @Movingforward10 , I had the same thing with having to wash myself even though it was literally a tiny q-tip sized swab that went in maybe an inch or inch and a half at most. I can only wash myself with my hands when it’s urgently necessary and there’s no washcloth available. So I just got a fresh clean washcloth and scrubbed, don’t really remember but maybe until it hurt? Usually I have to make it hurt when I go anywhere near that part of my body to scratch an itch or wash or anything. I can’t touch myself for anything other than necessary touch, tried a few times but ended up once and only once deliberately “raping myself with a sex toy because that is what I deserve” as a form of self harm (how messed up is that?? That’s like a solid 11 out of 10 in my book.) I’ve only told one person. I don’t remember a second of it, likely disassociated the entire thing but I really only remember feeling like a rapist afterwards, not a “victim” (hate that word with a passion🤬) that was the end of me and any type of sex for a long long time. Huge digression, sorry—now that I’ve triggered everybody on here including me…so sorry 😣 I truly hate myself for that…and this)
Love your list. Totally agree. Lube is out of the question or else it needs to be GONE before I put my clothes on. For me what has worked before is staring at a picture on the ceiling or wall, and trying to daydream my way inside the picture, while having the examiner describe what theyre about to do (every tiny itty bitty step!) and then saying something kind and reassuring while their doing that step, kind of alternating. Idk..ugh ugh ugh
 

Movingforward10

MyPTSD Pro
I'm sorry you went through that @that_1_girl .
Don't worry about triggering anyone here. There are no trigger warnings. I hope you are feeling ok after being triggered.

I totally understand the feeling like being a rapist. I felt that about myself too. I think it's about blame. It's far easier to blame ourselves about what happened. We are bad etc etc etc. So I felt I had raped me, and my genitals allowed it to happen. So therefore I am a rapist. It's a very distressing thing to think about ourselves.
If it helps any: I no longer think I am a rapist. And that is due to work I did in therapy to shift the blame and shame and responsibility for what happened onto the people who did it. Away from me and my genitals.

I also understand the form of self harm that you describe in your post. Makes total sense to me.
 

that_1_girl

Confident
I’ll answer this :). And I want to start by saying I don’t think it’s tmi . I think that it’s part of what we are here to support each other with if we are able. 🌹

yes, I get bad internal pain afterwards. Like you I find internals triggering and I had one and a coil fitted two days ago . I thought I was ok yesterday morning but then was in worse pain yesterday afternoon. Today I’ve got a hot water bottle on my back , a small dog curled up by my front ( acting like a hot water bottle ) and have taken some strong painkillers ( which are helping)

I have vaginisimus- which adds to this discomfort- do you think you could too? Even though mine is now mild it still leads to pain .
Also , I don’t think it was a waste of time getting the culture . You were brave. You exposed your self to a trigger and had the experience of knowing you could trust yourself to do that, to advocate for yourself ( remove consent and give partial consent- that’s pretty good going when triggered and in that position in my opinion! ) , and to check something. It is great it came back as unproblematic, That doesn’t mean it wasn’t worth checking- and you have learnt you can trust yourself to give consent for this kind of check in the future.
Hey :) I read your answer days ago when I first got it and didn’t answer right away because I went and googled that condition because I’ve never heard of it. Yeah I think I definitely have to have that and also the one that means “painful sex” because it ALWAYS hurts no matter what it is or how small. Tampons are so painful. This culture swab was basically a special q-tip, and it didn’t hurt at the time much but afterwards WOW omg for hours, and WAY up in there where the swab didn’t even go. I haven’t had any kind of sex with anyone of any gender in 7 years (mostly because I turn into a preschool age child but also because it freaking HURTS, and I usually bleed (the first time I had sex—consensual—with a girl in college I had to I think throw out my blanket because there was so. much. blood. all. over. it. …and I have no idea why… I had no idea about trauma at all at that point and I blamed it on me having a low sex drive and going very long periods of time with no sex. Probably true but my body remembers a LOT of csa now. My brain remembers none. Who knows about the parts.
Anyway got super triggered by the medical terms and couldn’t answer for a few days. Gotta run or this response would be longer. But really, THANK YOU for normalizing it!! 🙏
 

that_1_girl

Confident
I also understand the form of self harm that you describe in your post. Makes total sense to me.
Thank you for the whole response, @Movingforward10 :)
But this part of the response especially. Upon thinking about it more I am wondering if it was one part hurting another—or if it was self harm. I am not really sure at *all* when that happened/when someone inside me—*I* as a part, I identify myself as “the mod” online when I talk about parts, but I do have an actual name, do NOT self harm.) Others definitely DO or did (we are all currently 6ish weeks clean? AGAIN!)—did that to themselves or whoever else (inside), when “the” body was mid-late 20’s, early 30’s? Honestly zero clue. I say “the” body not “my”/“our” body because none of us identify with it, not for LGBTQIA+ reasons, although some of us are, but because of trauma. Hope that makes sense…

Does that form of self harm or “internal harm of another part” *honestly* make sense to you? I’m not completely crazy? I feel like such a horrible person.
 

Movingforward10

MyPTSD Pro
Makes total and utter sense!
You're not completely crazy or crazy crazy or a tiny bit crazy. You're recovering from trauma.

It honestly makes sense to me.

I did different types of self harm, but I think similar ish: I sought out pain in particular areas of my body. And mainly wanted that pain inflicted by others. I don't know which part of me wanted that. Because I have no memory of pain in the rapes I experienced. I must have felt pain in at least one of them given certain things that resulted from that, but I only remember the pain after, not during. So I think for me: my acts of seeking this pain out was self harm in a way. If that makes sense?
And I think "consenting" to things when I didn't want to was also self harm for me.
My T says that the things I did sound like I was punishing myself. Which I also think is linked to this blame.
So is a part punishing you by that form of self harm?
If that reasonates, is there a way of re-framing that part and helping it learn compassion for you somehow?

I also get the distance with the body.
I viewed my genitals as entirely separate from me. And I had to work to sort of integrate them into my body (not sure I am articulating this right). It was like they didn't exist so I didn't think about them. And when I did think about them: it was filled with hate, anger, blame, shame. It's only in the last couple of months that I have finally been able to actually *see* them for what they are: away from this lense of trauma and blame.
 
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