Feminist ruminations while in stirrups

So, today was that one day of the year that all women know they need to suck it up and face. The day when a gal goes to the doctor to have her cooch poked, prodded, and examined in the austere clinical surroundings of a health center. Yes folks, today was my annual gyno exam. I've been having one each year since I turned 18 at the recommendation of the many medical folks in my family. And at the ripe old age of 26 I now feel like something of a pro. I've seen a wide variety of doctors, and even one who was a "real" gynecologist, but so far the best I've ever had is the woman I see now who is a registered nurse. Now, I don't know if other gals rate their pap providers but I do. I think that there's a bit of an art to performing a good gyno exam. Truly. Firstly, the examiner needs to have some real understanding of the vagina. Not textbook stuff folks. You'd be surprised how many medical professionals don't seem to have come close to pussy in their entire lives. Because let's face it--it's a sensitive place down there and having a plastic instrument inserted in it, cranking open your holiest of holes, is not a particularly pleasant experience. Then of course there's the whole swabbing of the cervix and then the pelvic "finger" examination. And all with someone you don't know very well. Quite frankly men have it easy with the prostate exam and the medical establishment isn't particularly forceful in terms of making young men go get examined once a year despite increased rates of testicular cancer among younger dudes (we all know about Tom Green, yo) and despite the fact that they routinely spend money on getting women to go have annual exams which frequently aren't covered by insurace providers. To me that seems indicative of yet another gender bias in the system. Because if more men were getting tested regularly, STDs on their end could be found out much more quickly. For example, the pap test checks for HPV--an STD particularly dangerous to women that can lead to infertility and cervical cancer--and yet men aren't being tested for carrying it and thus being able to give it to any of their partners. Although it seems HPV doesn't really affect men in a dangerous fashion, it is a major cause of cervical cancer in women. So why aren't men being tested as well? Why aren't they routinely encouraged, through various media and medical campaigns, to have an annual exam? This would be a preventative measure that would help women. When women are tested if they find out they have it there isn't really anything they can do. It's not curable. When I've talked to guys about this they all get very uncomfortable with the idea of an exam that requires a finger up their hiney. Many straight guys think it's a "humiliating" kind of exam while others of the more homophobic variety have more virulent responses. But what is so infuriating to me is that they aren't willing to sacrifice a bit of their pride for a few minutes once a year to have their genitals examined. I'm angry that they don't worry about testicular or prostate cancer for themselves. But I'm even angrier still that they care more about their perceived masculinity than about protecting their partners. It's just total bullshit. Because conversely they want their girlfriends to get tested. I say, you can't have it both ways you fucktards.

Needless to say, my feminist fist o' fury gets a hankering to pummel some patriarchal ass when these kinds of things flit under my radar. Regulating and controlling female sexuality is still the modus operandi of the state, even more so these days under Bush and his conservative cronies. Yet straight male sexuality is still streated like an inalienable and untouchable right. Female sexuality is made to seem in need of state intervention, examination, regulation, and control. So as these thoughts were going through my mind while I was lying prone in stirrups today I began reflecting back on Rachel Maines' excellent book The Technology of Orgasm: "Hysteria," the Vibrator, and Women's Sexual Satisfaction. I highly recommend this book, as not only an interesting historical read but a thought-provoking take on a feminist issue. In it she talks about the medicalization of female sexuality, in particular with the bourgeois malaise of hysteria. Women (well, only those with money really) went to doctors to treat a wide variety of symptoms all classed under the broad but mysterious umbrella of "hysteria." But namely, it was believed that fatigue, headaches, body pains, and just about any other complaint from a female meant that she was suffering from hysteria (or womb frenzy). Doctors believed that "fluids" had become blocked up in the womb and needed to be expelled. So they'd treat women with genital massage. That's right. You could go to your doctor and get him to wax on, wax off your clitoris. Of course, at the time this was not seen as sexual. Only vaginal penetration was considered to be sex (and frequently still is seen this way today). Doctors didn't believe the clitoris to be a critical part of the female anatomy and generally didn't think women could achieve orgasm--or if they did, it could only happen during penetrative sex. Ironically enough therefore, men were more concerned about the creation of the speculum than manual massage. They thought that women would potentially become lust-crazed whores who wanted to have the speculum used on them every time they went to the doctor. Today we might find this incredibly humorous, but in many respects men and the medical establishment still don't know a lot about female sexuality or the female genitals. We still don't know about all the nerves that connect to the clitoris and how they work (hence situations in which some women end up losing clitoral sensation after having C-sections when nerves are unexpectedly cut). And yet for as much as we don't know about these things, we don't spend a lot of time and money on research about women. Much more seems to be spent on helping cure erectile dysfunction in men, because their sex lives are evidently so much more important.

This has repeatedly hit home for me at many of my Feminst Reading Group meetings and with various friends over the years. I keep meeting women who have never looked at their genitals. Women who have never had an orgasm. Women who don't know how to masturbate. Women who feel shame over their vagina. Women who think their sexual needs don't matter. Women who believe a lot of male bullshit and endlessly assuage fraile male egos by faking orgasm. In the twenty first century this is unacceptable. We need to be teaching girls from a young age to take pride in their vaginas and to become more intimately familiar with them. They need to know that masturbation is healthy and that most women achieve orgasm through clitoral stimulation, not penetrative sex. And men need to know this to and work to develop an ethics of mutual sexual pleasure with their partners. I like Margaret Cho's concept of putting up a score board and not finishing things until there is an equal tally on both sides. Because really, once a guy gets off that shouldn't be the end of the deal. You gave him his, he should damn well make sure you get yours. As Sue Johanson says, "he has a tongue and ten fingers sweetie."

Coming full circle (I think I'll end this rant before it gets too long) I want to stress that despite the gender bias I perceive in medicine, I still believe the yearly gyno exam is critically important. Many women have died because they didn't get a yearly pap test. Cervical cancer if detected early with a pap test can be cured, but if not it can kill. The same goes for the breast exam that accompanies your pap test. Women need to be examining their breasts once a month. Directly after you've finished your period is best as this is the time your breasts are less likely to be naturally lumpy. Doing a self exam takes less than five minutes of your life once a month and yet so many women, young and old, don't do it. So I encourage any women reading this blog to check their breasts once a month and to get a pap test once a year. It could save your life. And as for any male readers, show how much you respect yourself and your partner by getting an annual exam yourselves.