Cervical Screening: Dee’s Story

As a sex educator, you’d think I would be less nervous about having my first cervical screening, but when I got a text message saying it was time for my test, I was filled with anxiety.

Luckily, my nurse was truly amazing. We started the appointment by discussing my anxieties about the test because she could see I was clearly nervous. She comforted me saying that most women and AFAB folks feel nervous the first time, but that the procedure is quick and that I was in control and could stop the test at any moment. Her use of inclusive language was also a big green flag. She then asked me general questions about my most recent period and where I was in my cycle. It’s best to have your smear test when you’re not on your period, avoiding the two days before and after your period. 

We started chatting through my sexual history, focusing on if or when I last had penetrative sex. This question allows the nurse to decide which size speculum to use. I told her that I hadn’t had penetrative sex in a while, preferring outercourse over intercourse. I also struggle with any penetration, even inserting a tampon can be difficult for me, and it’s something I’ve always struggled with – which is probably why I felt so nervous about the cervical screening.

But she listened and didn’t judge me or my sexual history, opting to use a smaller speculum.

Then it was time to remove my trousers and underwear, and get into position. I did this behind a privacy curtain. Once I was ready, my nurse guided me into the best position for the screening, laying on my back, placing my feet together, my knees bent and apart. This is a really vulnerable position to lie in, especially in a nurses room, but she was lovely and allowed me to cover myself until we were ready to start.

As she prepared the speculum, we spoke about my own work in sexual health which really eased me. It also reminded me how important cervical screenings are – these tests take a sample of cells from your cervix to test for certain types of HPV (human papillomavirus) that are ‘high risk’, meaning types of HPV that could potentially lead to cancer. Cervical screening is not a test for cancer, it’s a test to help prevent cancer. It’s something women and AFAB folks between the ages of 25 and 64 should do to help prevent cancer.

But even with this in my head, when the test was about to start, I felt anxiety consume me.

I followed her guidance, breathing in deep as she inserted the speculum, letting her know when I needed to pause. She placed her hand on my knee which was really comforting. Unfortunately, even with the deep breaths, the extra lubricant on the speculum, and her kindness, I was struggling with the insertion. I felt too tight for it to go any deeper and was becoming more anxious with every moment. So I asked her to stop, which she did immediately, and withdrew the speculum. She asked me if I wanted to try again, but I knew my mind was too busy for my body to relax.

At that moment I felt like a failure. I had come so far, pushed through so much anxiety, and yet couldn’t complete the screening. I was also incredibly embarrassed, but my nurse was a star, and reassured me that this happens all the time. I was in control of the screening, and if I thought I couldn’t do it right now, she wouldn’t pressure me into trying again. Instead she handed me a new speculum for me to practise with at home, giving me a demonstration on how to insert and use it.

I haven’t had the best experiences with sexual health services in the past, being misgendered or feeling as if I couldn’t speak my own truth, but this nurse heard me and aided me with the tool (literally) to successfully take the test another time.

Her kindness really helped, and even though I felt embarrassed, I left with renewed positivity about practising at home.

I learnt that advocating for myself, pausing, stopping, or rearranging an appointment is okay, particularly for something as sensitive as a cervical screening. It happens more often than not! Life gets in the way, you may get your period or you may feel mentally unable to attend the appointment. Finding a nurse or sexual health clinic that is supportive and hears your fears and anxieties is key. 

My ‘failed’ cervical screening could have made me even more anxious for next time if my nurse wasn’t so kind. I truly felt heard by her, and now, with her tips and a practise speculum, I am working my way up towards successfully completing my smear test.