I remember going to the doctor the summer after sixth grade, complaining of stomach aches. The nurse asked me the standard questions, including whether I had started my periods yet; I had, just a couple of months earlier. The nurse smirked knowingly to herself and then went out to send the doctor in. “She thinks you’re not sick,” my mom said to me. “She thinks it’s just your period.” Luckily, my doctor took my complaints more seriously. This was only the beginning of a longer story of troubles in the doctor’s office – a story that would come to include medical trauma, and tension with my Catholic Faith as I sought healing.
Please read with discretion, as this post includes a detailed account of medical trauma during a gynecological exam.
My Experience of Medical Trauma
I don’t remember what, exactly, my doctor diagnosed me with – something gastrointestinal. But I do remember how invalidated the nurse made me feel. Now that I had started my period, I was no longer a child, but a woman. Ironically, this passage into adulthood made medical providers take my concerns less seriously, not more. My valid concerns could be minimized as normal period pain, a natural part of being a woman – not taken seriously as a medical problem.
The issue with that minimization – as I would discover months later when my period started coming more heavily – is that I did have a real medical problem.
By age 13, my periods lasted eight or nine days out of every three weeks. I was suffering from debilitating cramps. I wore two pads at a time, changing them frequently, and still leaked. It’s hard enough to be a seventh grader without worrying about blood stains on my khaki Catholic-school uniform bottoms and going to the office twice a day to get Tylenol.
My beloved pediatrician referred me out to a gynecologist. When I had my first appointment at age 14, I was told I needed a full pelvic exam and a pap smear, despite the fact that I wasn’t sexually active and that the American College of Obstetricians and Gynecologists had advised that the procedure not be performed before age 21, regardless of sexual activity. Despite this guidance, millions of teenage girls have undergone these invasive exams unnecessarily – including myself.
That gynecologist appointment turned into an experience of medical trauma.
I still remember the day clearly. I had stripped from the waist down and was sitting under a sheet. The doctor (whom I’d just met that day) told me to scooch to the bottom of the table, put my heels in the stirrups, and spread my legs “like a froggy.” I remember being annoyed that she said that, like I was a little child. I tried to do what she said, but my knees clamped together involuntarily. “Relax and take deep breaths,” she said, “You may feel some pressure, but it won’t hurt.”
She shoved the cold, dry metal speculum inside me. My legs clamped together around the doctor and I screamed out in pain. She should have stopped then, but she didn't; she kept going. I felt like there was a burning pole the size of a flagpole being shoved up my vagina. I remember that image inside my head as I screamed like I hadn’t screamed since I was a child having a tantrum. I started to black out and felt like I was going to throw up.
When it was finally over, she pulled the speculum out and said something to the effect of, “It’s over now. See, that wasn’t so bad.” Then, she left the room.
My vision was fuzzy as reality came back into focus. While I got dressed and walked back to the reception desk, I wondered if everyone in the waiting room had heard my shrieks. I avoided eye contact. When I got into the car, my knees involuntarily clenched together again and I couldn’t separate them, even if I tried. I felt like I’d been raped – and then I felt bad for thinking that, because rape victims obviously had it worse. I wondered if I had PTSD. I wondered how I could possibly be expected to go through this again every time I saw a gynecologist. I think my mom took me to get ice cream like we did after I got my shots as a little kid.
I started seeing a different gynecologist after that. I asked her if she could prescribe me an anti-anxiety medication for the next time I needed an exam. She said she didn't think I would need one until I became sexually active or turned 21. What a relief.
By the time I had my next pelvic exam, I was 23 and living in a new city, seeing a new doctor. I warned her that I’d had a bad experience before, so she was extra gentle. She explained to me what was going to happen and that she would stop whenever I asked her to. She showed me the speculum, which was plastic instead of metal and slimmer than the one my previous doctor used. I felt better that time, but by the time she had put her finger inside me – even before the speculum – I already felt lightheaded. She stopped and said we didn't have to finish. The nurse brought me an ice pack to put on my forehead and sat with me until I felt better.
My Healing Journey Created Tension with Catholic Sexual Teachings
I still hadn’t had a full pelvic exam since that first one, but once I started having sex, I realized that the trauma remained in my body.
My legs involuntarily clamped shut when my husband tried to enter me. My doctor gave me a numbing cream for the vaginal pain, but it wasn’t just my vagina that was the problem – my whole body had become a defense mechanism. She referred me to a pelvic floor physical therapist. I was a little freaked out because the gynecologist told me that the PT might do internal therapy with trigger points through my anus. I almost didn't go because that sounded awful, but being a newlywed who couldn’t have sex with her husband after years of waiting was even worse. So, I decided to give PT a shot.
My physical therapist is beyond great. She immediately put me at ease, despite the fact that the first appointment was incredibly awkward. She asked me questions about everything from my masturbation habits to my husband’s penis size to whether I’ve had an orgasm. She kept the conversation light and assured me that everything I said was completely normal.
She asked me about my history of sexual trauma and specifically asked about pelvic exams. When I told her about my experience, she put a name to it: medical trauma. She told me it makes complete sense that my body is on the defensive now, because my body remembers that trauma and is trying to protect me. I felt so validated to finally have a name for what I experienced. Even though it feels like my body is out to get me, she is just trying to protect me from experiencing that trauma again.
Knowing my history, my PT didn't do a pelvic exam. In fact, she told me we could do the whole treatment together externally. I go in to see her every week for a trigger point massage of my legs and I do some strengthening exercises with a trainer. I get to do the internal part of therapy from the privacy of my own bed, working my way through progressively sized dilators and training my body to not see them as threats. My PT encouraged me to get my husband involved in this practice, as well, but only once I’m comfortable on my own. Even though I trust my husband with all my heart, my body doesn’t realize this because it is in trauma mode and it sees everyone but myself as a threat.
In order to do the therapy my PT prescribed, I have to get myself aroused so my vagina opens up; that’s a physiological necessity. Growing up Catholic, my immediate thought was, “That’s masturbation.” I had always heard that masturbation is sinful under any and all circumstances, that it is “an intrinsically and gravely disordered action.” But the Church also says that masturbation is “the deliberate stimulation of the genital organs in order to derive sexual pleasure.” If the exercises weren’t for the purpose of getting sexual pleasure, was it still masturbation?
Throughout this journey, I realized that women’s experiences and the unique complexity of our bodies demonstrate the need for nuanced, pastoral formation around teachings on sexuality.
When you look more closely at what the Church teaches about masturbation, it says that “[t]he deliberate use of the sexual faculty, for whatever reason, outside of marriage is essentially contrary to its purpose.” In my case, this kind of pelvic floor physical therapy allows my husband and me to have healthy sexual intimacy within our marriage. Until I work through this physical aspect of my sexual trauma, my husband and I can’t fully live out our marriage vows.
I often wonder how many faithful women have suffered because we failed to provide important nuance.
Realizing the Need for Women-Led Dialogue in the Church About Sex
The Church provides few resources for navigating nuanced issues related to uniquely female health and sexuality.
In one of the few circumstances in which I heard a story like mine addressed, it was made into an irreverent joke by a priest who did marriage prep. He was having an informal conversation with my group about the crazy couples he’s worked with over the years, and he told us about a couple where the man was “too big” for the woman. He claimed that they almost had to get their marriage annulled because they couldn’t consummate their vows. He was making light of their predicament and mentioned that they had to use giant dildos to stretch the woman out. The priest and the young guys were howling with laughter.
Looking back on it now, being in the position of that woman from the story, I want to vomit thinking about how insensitive and inappropriate that priest was. I imagine him bro-ing it up with the husband, patting him on the back for having such a big package or a tight wife. But the thing is – it’s not funny. It’s not a joke. It’s an actual burden that some couples have to bear, especially those who wait for marriage like the Church instructs us to do. Responses like those are a huge part of the reason why women often don’t feel comfortable confessing sexual sins or talking about sex with a priest. The fact of the matter is, as wonderful as some priests are, many celibate adult men simply don’t have the understanding they need to counsel women about sexuality.
When maleness is the norm, women’s needs can go unintentionally ignored. That is why we, as women, must use prayerful and thoughtful discernment in matters of sexuality. We must continue to call for better and more nuanced conversations about sex within Catholic communities.
The Church is referred to not just as the Body of Christ, but also as the Bride of Christ. This image of the Church as a bride should be a reminder for both men and women to do a better job considering the reality of women’s experiences and the need for more nuanced conversations and formation on these topics.
Not only do we need women to speak out and share their stories, but we also need the rest of the Church to listen with respect to women and their experiences. We need Catholic men, including priests and other Church leaders, to respect the unique expertise that women draw from their embodied experiences – from the female bodies God gave us.