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?
 

FauxLiz

Sponsor
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.

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.
@that_1_girl and @Movingforward10 I can completely relate to this type of self harm and disassociating my body/genitals from who I am. For years I have blamed the parts of my female anatomy for making me an attractive victim to my abusers starting with my brother. I took multiple steps to hide/obliterate anything that could make me attractive as a female for years including gaining a significant amount of weight but probably the most extreme internal self-harm I did was convince my doctor to perform an unnecessary hysterectomy to remove the part of me that I felt was to blame for my multiple sexual assaults. It wasn't until a discussion in the last couple of years with my T that I recognized that this was a form of self-harm as I had already had my tubes tied after my son was born so that I never had to worry about getting pregnant again as my ex was using our kids and the threat of taking them away from me as one of the many ways to keep me stuck in that abusive relationship.
 

that_1_girl

Confident
probably the most extreme internal self-harm I did was convince my doctor to perform an unnecessary hysterectomy to remove the part of me that I felt was to blame for my multiple sexual assaults. It wasn't until a discussion in the last couple of years with my T that I recognized that this was a form of self-harm
Wow. I actually have been thinking seriously about doing this very thing. Didn’t realize it even possibly could be seen as a form of self harm. I DO have medical “justification” because my bio mother *almost* died from not taking care of hemorrhaging during menopause on and off for years and then constantly for weeks/days idk I wasn’t living there, and when she finally realized she was literally bleeding to death it was freaking New Years Day and an ice storm and the hospital is two hours from their house on good roads….yeah that was totally preventable and she’s full of shit. Also hemorrhaging has happened to at least 2 of her sisters in menopause, who *did* take care of it and had D&C’s or laparoscopic hysterectomies. So I have legitimate cause for *future* concern but I have zero issues and I’m probably years away from any type of menopause stuff. But I have no intention of ever getting another internal exam done. Ugh I just remembered—it’s worse than “just” the Pap isnt it? There’s internal actual touching. NO, that’s it. If my insurance will cover it based on my awful family history and my own bad history with my VERY irregular menses my whole life of getting my red enemy, or sometimes not even getting it at all because of various eating disorders (I’ve had it I think 3 damn times this past month! Yuck!), then I’m getting the thing taken out. I only have one ovary left but I guess that’s my only source of estrogen which I need to live apparently, so I’ll tell them to keep that. I don’t think that qualifies as self harm do you? Or do you??
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.
Hey, @StillPen thats a great username! At least two of my parts are poets but they aren’t allowed out, and I *thought* I burned everything I ever wrote but I guess not. So even though I have no idea what StillPen means to you and your system, it’s a very relatable name to us.

THANK YOU for the amazing response and I’m so sorry it took me an age to respond. This thread is obviously very triggering to me and I have seriously been trying to respond to things in order but my schedule is so hectic right now (IOP/skills building program 9am-12pm every weekday plus trauma therapy plus regular therapy plus trying to deal with my system on my own because there are zero DID therapists in my area. Plus trying to find one that either takes my stupid insurance that nobody seems to take or that has a sliding scale or a reasonable price, plus 1 academic (Phys Ed) online class so I don’t have to take medical leave (but I barely have time for it) plus maintaining my relationships with family, serious boyfriend who is a recovering drug addict in sober/dual diagnosis housing and also has CPTSD plus schizophrenia in addition and we are working very hard to support each other’s recoveries, plus nutritionist hopefully, plus accept this horrible new DID diagnosis that is setting my “collective” going haywire and they’re all fighting in my head, med adjustments every other week…it’s a lot. So I’m very sorry I’ve been so delinquent at getting back to y’all!!

Your ideas are great. Never thought of anxiety meds for the pain….hmm I’m already on 30 mg of diazepam (Valium)—10mg every 6 hours while I’m awake *not* PRN—and also clonidine ER 0.1 mg in the morning for anxiety, and another 0.1 mg at bedtime for nightmares (that’s just a blood pressure med, not a controlled substance), but I’m also on a stimulant (controlled substance too) for ADHD and I’m starting to feel like a drug addict…so I actually refuse to go up on either. I don’t have a history of drug addiction or chemical dependency but I DO have an addictive personality as demonstrated by my chronic relapsing with anorexia (currently in the worst relapse in idk how long although I’m currently in a larger body) and self harm (7 weeks if I make it to midnight today! 🙂)…point is I have no as needed anxiety meds…however I’m going back down on my stimulant a tiny bit today because I had a BAD reaction to a higher dose (started acting like an amphetamine would act on a neurotypical person)! I noticed immediately and so did a lot of people at IOP. That should help the anxiety some, overall, but idk what to do about next time IF I ever DO get that internal. For the love of God, it makes me feel gross just thinking about everything they do. I already made absolutely sure I’m having the same nurse practitioner as this past attempt at a yearly. The first time I met her it was an emergency appointment this past summer because a medication made me start lactating and triggered the (fill in your bleep of choice 🤬) out of me, and I refused to undress or let her examine me at all, so this time she gave me extra time, and I kind of interrogated her and the regular nurse to make sure they’d be there in a year. I refuse to see my regular gyn doctor even though she’s super nice because my biological mother (a narcissist and a huge creep and I don’t talk to her if I can help it) sees her and it’s a conflict of interest. Plus the nurse who works with that dr is awful and makes fun of me for “ liking her support” and has terrible bedside manner.
Naps *really* settle the collective down too (in the daytime only!) however I am pretty sure we spent the rest of the day first walking the dog and a part called Nobody who uses no subjects to their sentences when referring to themselves (“Did ___.” “Walked the dog with her safe mom.” Etc.) and only refers to me or the others as “she”/“they”/“he” (we have a lot of different gender identities.) and then I’m not sure exactly but I think we were curled up on the couch with either our “safe” Dad or “safe” Mom” (both non-biological!) sitting next to us for the rest of the night until night meds/sleep meds kicked in and I doubt up until that point sleep was possible, but you’re right sometimes “I” disassociate to the point of just being “gone” and I guess Nobody shows up and then sleep might be possible in a pinch..gotta go drive to IOP *NOW* and find my mask, shoes, keys, etc! So sorry this is abruptly ended.

Thank you both SO much for your kind and thoughtful replies!
 

FauxLiz

Sponsor
I don’t think that qualifies as self harm do you? Or do you??
This is not for me to say. I can only talk about my situation. I fudged the information to my doctor about how heavy my periods were and the intensity of the cramping. I stayed on birth control even after my tubes were tied because of my absolute terror of becoming pregnant again. During one of my SA's when I was 20 I became pregnant. I was so ashamed and embarrassed, I hated my body for allowing that to happen I thought I was being punished. I terminated the pregnancy but have guilt and shame around that as well. Then later on when I was married to my abusive ex again while using birth control it failed and I became pregnant again twice. I love my two kids, I would never tell them I didn't want them but I had never in my life wanted children so again a situation which I am ashamed of every day because I have these amazing kids and I know so many people that were never able to have children, but I had my hysterectomy because I couldn't wrap my head around the idea that I would never be assaulted again and that if it happened I would be punished again with a pregnancy. Yeah some really messed up shit goes on in my head.

I will tell you though that I am dealing now with the consequences of having had the hysterectomy a decade later as I have to have another surgery this month to fix urethral, bladder and rectal prolapse. So I get to have another very invasive surgery that includes the surgical team going in through that area and requires an overnight hospital stay due to the complexity and length of the surgery. So I would just say if you do have the hysterectomy talk to the surgical team and your doctors about what can be done at that time and long term to prevent you from needing another surgery to fix the consequences because I have been putting this off since before covid and am at a point that I really can't any more as I don't leave the house without knowing where every public restroom along my route is and in every place I will be for longer than 15 minutes. I always have a change of clothes with me including underwear and use the stupid "incontinence" pads but they don't help much when you have fecal incontinence and there is nothing more embarrassing in the world than being out in public a full grown adult accidentally crapping yourself to the point there is no way to hide it and the clothes you are wearing have to be thrown away because they will be permanently stained.

Again, This is just my story, I still would have gone through with the hysterectomy because it has given me the peace of mind that if I am ever assaulted again I will not get pregnant and no man could ever try to attempt to control my life again through a child but it doesn't make it suck any less.
 

Friday

Moderator
Ugh I just remembered—it’s worse than “just” the Pap isnt it? There’s internal actual touching. NO, that’s it. If my insurance will cover it based on my awful family history and my own bad history with my VERY irregular menses my whole life of getting my red enemy, or sometimes not even getting it at all because of various eating disorders (I’ve had it I think 3 damn times this past month! Yuck!), then I’m getting the thing taken out
Getting a hysterectomy doesn’t -in any way- stop the pelvic exam requirement of women’s health. You’re just as much “supposed to” be getting annual pelvic exams without a uterus, as with one.

Leading up to, post-op, and following the surgery… you’ll also have a whole lot more pelvic exams. Years/decades worth, in the space of a few months.
 

that_1_girl

Confident
Getting a hysterectomy doesn’t -in any way- stop the pelvic exam requirement of women’s health. You’re just as much “supposed to” be getting annual pelvic exams without a uterus, as with one.

Leading up to, post-op, and following the surgery… you’ll also have a whole lot more pelvic exams. Years/decades worth, in the space of a few months.
🤬🤬🤬🤬🤬🤬 NOT the answer I wanted…however, **thank you very much** for the info!! 🙏🙏🙏 because I hate Hate HATE being under anesthesia and therefore defenseless *almost* as much as pelvic exams. If it isn’t too triggering for you to answer this…can I ask why it’s still a requirement? I mean couldn’t they take out your cervix too and idk, just do something or idk how do I get out of internal pelvic exams without being at higher risk for dying from estrogen related cancers…which I have a maternal line history of (not my mother specifically as of yet though…not that I even talk to her…) I only have one remaining ovary and I’m semi-ok with the external part of the exam like the abdominal/upper body exam on the LARGE spectrum of relative OK-ness with invasive medical procedures. As in its tolerable and I don’t switch though I might dissociate a little or get “floaty”. Is there ANY way to avoid it if your at high risk for estrogen related cancers? I know you ultimately need *some* estrogen or testosterone to be alive. Testosterone was hell when I briefly thought I was trans or one of my male parts was fronting unknowingly. Wrecked my singing voice for years and I fought and prayed for a really long time to get it back and it still isn’t 100%…and singing in choir is my biggest connection to my God and my church, both are a huge part of my mental health “recovery” (if you can call getting a brand new diagnosis a week ago recovery at all…) and a huge part of my life. So testosterone is OUT. I honestly don’t know what to do…it was a shitshow last time and all they did internally was the one culture for yeast/bacterial infections. I have already had one upsetting trauma dream (not a nightmare technically) about that exam… 😕😕
 

joeylittle

Administrator
If it isn’t too triggering for you to answer this…can I ask why it’s still a requirement?
Body parts need examining. Just kind of goes with having a body.

The way to manage this isn't through medical procedures to remove parts of yourself - I mean, do that if you want, but it's not the answer. The answer is, start working on de-escalating your trauma response.

PTSD can be managed. That's what you want to work towards. Finding ways to avoid all the stressful situations isn't going to help you get better. You can go slow and steady, but need to be dealing with the real issue, which is unprocessed trauma.
 

that_1_girl

Confident
The answer is, start working on de-escalating your trauma response.

PTSD can be managed. That's what you want to work towards. Finding ways to avoid all the stressful situations isn't going to help you get better. You can go slow and steady, but need to be dealing with the real issue, which is unprocessed trauma.
Damn, I don’t like it at all—but truer words were never spoken. Thank you 🤝☹️😶
 

that_1_girl

Confident
I have to have conscious sedation for an exam. It makes it a pain. I didn't get them done at all for awhile.
That’s actually a good idea. Thank you! Hmm though…I take 10 mg of diazepam 3x/day on schedule anyway AND clonidine extended release 0.1 mg in the morning and bedtime and my anxiety is still pretty much out of control and the ADHD hyperactivity is pretty much under control with my current dose of Vyvanse but any more makes me agitated and anxious beyond belief. I’m not sure I can be sedated much more without it being lethal. But maybe by September 2022 I’ll be on a more reasonable dose of diazepam. I HATE my brain…
 

joeylittle

Administrator
and my anxiety is still pretty much out of control
You can work on managing that from a skills perspective - you may not get the anxiety down to nothing but getting off the daily diazepam and either being able to rely on the clonidine, or have that plus an occasional (situational, only as-needed) use for diazepam....that's an achievable goal.

Have you done any CBT or DBT skills training?
 

DharmaGirl

MyPTSD Pro
Conscious sedation is putting you out. You have to have a nurse anesthetist there. You get medicine in your vein. When you wake up, you aren't aware that any time passed and you don't remember anything.

I also work hard at my grounding skills and keeping myself from getting out of control but this one is too hard for me. I had uterine cancer, and I was aware I probably had it but it took me 5 years to get it taken care of. I had a hysterectomy and they got all of it, thank goodness.
 

joeylittle

Administrator
ADMIN POST:

I'm replying here to a post you made in a different thread, because it is connected to this thread.
You're a new member, and as Admin, I believe it's worthwhile to clarify a few things.

You said:
this whole forum is intended as a safe space for all people with PTSD regardless of demographics.
No. This forum is not meant to be 'safe space'.

Our intentions are clearly spelled out in the Community Constitution:
MyPTSD exists to...[provide] peer-to-peer support and educational resources.
Peer-to-peer support.

Your thread title is: Cis-female CSA survivors, how do you cope with gyn exams?. That's fine. It means exactly what it says. Members will respect that peer-to-peer request, and they'll weigh in if they have something to say.

@Muttly's thread is talking about wand ultrasounds, and Muttly specifically asked to not be referred to your thread...And yet, here you are - referring them to your thread.

Your feelings about them being welcome to your thread aren't relevant - Muttly's feelings were made quite clear, and its good forum etiquette to respect an OP's boundaries.

/(end of) ADMIN POST.

Posting now as a member...the Community Constitution also says:
MyPTSD's personality ranges widely within a candid, empathetic, challenging, yet supportive membership. Diversity is the spice of life, and this community respects diverse opinions. A community philosophy often read here is "use what helps you, and ignore the rest."
Support doesn't always look like validation. That's what a 'safe space' would be. Sometimes - and for some people - being challenged is a really helpful kind of support.

Respect doesn't always look like agreement. Sometimes, it's agreeing to disagree.

Now: to bring this post back around to you and what you're working through - I think you may find this article useful, as there's been a fair amount of fawn response that Muttly's thread triggered for you, and it could be useful for you to see it through that lens.
 
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