One week ago I got my first pap smear. I’m 29 years old.

I want to be able to write this more eloquently and thoroughly, but the truth is, it is hard for me to think hard about this even still. I wouldn’t say I crossed some healing finish line where now I’ll have what I perceive as a normal relationship with gynecological care, where one doesn’t look forward to it but gets it done anyway without distress. I’m not there. But having spent many, many years working up to the point I’m at, that’s okay. And I want to share the journey in case it’s helpful for anyone else.

* * *

My understanding in 2011 when I was raped was that people with vaginas should go to the gyno either when they turn 18 or when they start having sex. I see that’s not the current recommendation. I’m not sure if I misunderstood then or if that’s just changed now, and frankly I don’t want to deep dive into it. But that’s the context.

Additionally, as a combined result of both Avery repeatedly inserting his penis into my vagina without using protection as well as what I believe to be intentionally trying to convince me I was pregnant, the gynecologist was a thought in mind back then. It was a thought in my mind knowing I was a secret, not knowing what other secrets he might have, especially when he would list out all the people we knew that he wanted to have sex with, especially when he would then tell me stories that subtly implied he was working on making that happen. 

I continued to think about it over the four years afterwards where I did not have a menstrual cycle. I thought about it when I was getting ready to go off to college, trying desperately to picture myself getting to begin a life I always dreamed of in California, finally starting anew, meeting new friends, having a normal love life. 

Back then I didn’t have the vocabulary to understand why I never went to the gyno when I had the sense I should. While it’s true I would occasionally have thoughts about it, I didn’t want to have those thougths. I tried not to engage with them, and I was pretty successful. I avoided thinking about it, I avoided thinking about why I didn’t want to think about, I avoided analyzing how excessively I avoided thinking about it. Nothing to see there. Nobody likes the gyno! Simple enough.

Avoidance is a symptom of PTSD.

At some point, I looked something up about what it’s like to go to the gynecologist, and I broke down sobbing. If I wasn’t so quick to pretend that never happened and shove it even further down, if I had been able to communicate about it to someone who could’ve pointed something out about that reaction, if I had been able to analyze it myself, maybe it would have meant something, told me something. But instead, it was just a confirmation that that wasn’t something I was going to do, and I tried to leave it there.

But sometimes people talk about the gynecologist. Sometimes it comes up. And I have at least one memory of telling someone oh yeah, I’ve never gone, them responding that I should, me shutting down the conversation.

As I started to actually acknowledge that I had issues stemming from Avery, I started to also be able to mentally unearth the existence of vaginas, my vagina, recommended medical care for people with vaginas, which included me. When, five years after the rapes, I eventually had consensual sex for the first time, again I had the sense I should probably…

I didn’t want to think about it. Still.

When I accepted that it was trauma, that it was rape, reported that to the police, was told they wouldn’t prosecute, started processing it all, and was a mess, I started therapy. I was finally unpacking it. 

I’m not sure when the gynecologist first came up in therapy, but I think it was pretty early on. At first, I shut it down. It made me cry just to face the thought. My therapist made it clear that she would not push or pressure me but that it was something she believed was important to address eventually. She gave me space, let me take the lead, but always was encouraging.

I read some articles of people going to the gynecologist after rape. They made me cry. I found an email from 2018 where my therapist sent me one of those articles. I remember feeling like I wanted it to be inspiring but instead it gave me this intense emotional reaction which I then felt hopeless and frustrated about and stupid for having.

But I was healing. I was talking about everything. And in the opposite way that Avery forcing my silence and isolation fostered an environment of gaslighting, abuse, and trauma, talking openly promoted support, outside perspectives, and advice. Advice that I could choose to take or not.

I struggled with overcoming the thought that I didn’t want to go to the gynecologist. I didn’t want a doctor to stick something up me and feel around me. Even everyone who goes like they’re supposed to doesn’t want that. Haven’t I had enough stuck in me and threatened to stick in me that I never wanted and hated? Haven’t I had enough pain there? Why would I choose to replace my rapist’s hands with a doctor’s stirrups? I would never want to choose to have a pap smear, so how could I ever choose to do it anyway?

Someone once suggested that I could go with them to their appointment as kind of an exposure therapy. My therapist said it sounded like a good idea. I sat on the idea for a long time, tried not to think about it, but I was getting worse at not thinking about it the older I got and the more pressing it felt to actually go to the doctor. Eventually, I ended up shadowing someone to their appointment.

All I did was sit in the room. I was shocked at how fast the appointment was over. And completely irrationally and I knew it, it made me sob. I hated it. I hated my reaction to it. I hated not understanding why it was such a dramatic response. But it was a full body feeling of desperation. My therapist had been so supportive and communicative that day. And she followed my lead as I took a step backward, buried everything again.

I do think going to that appointment was probably net helpful. Although it caused me to have this intense reaction, it also showed me just how quick of a process it really was. It didn’t make it not a big deal. In fact, to some extent I think I felt even more meta-upset with myself for making it a big deal. But I learned some things that day, including that I wasn’t ready, clearly.

I do think, though, it’s possible it could have delayed things further. I’ll never know, really. But I can also see how it became the thing I pictured when I did think about going, and the feelings I felt were attached to that. I didn’t want those feelings. 

In hindsight, I think it might have been helpful for me to take some kind of anxiety medication even when shadowing that appointment. There’s a drug called Propranolol, which is a beta blocker that can be off label prescribed for anxiety and has been researched about its potential beneficial effect for specifically PTSD, specifically when something might be retraumatizing. Speaking as myself in modern times, I have taken it when I knew I was going to be exposed to something triggering as well as when triggered, when actually having a flashback, and when having some kind of mix between a panic attack and a flashback, and I’ve found it to be effective. I think it could have been really, really helpful in a moment like that.

Years went by. In those years, I healed some things, and I also went very far backwards in others. I hit rock bottom and kept digging. And then I healed again. In those years, I continued to think about it. I started being able to think and talk about it without crying.

I also continued to heal sexually. I got to a place where now I actually enjoy the physical act of sex instead of just the intimacy of it. I got to a place where I genuinely want it rather than really wanting to want it or wanting it to prove something. There’s maybe a lot more to say about that that maybe someday I’ll say, but the point of it now is to say I do think that also made a big difference for me. As dumb as it might sound, I think I finally have positive associations with my vagina, which makes it a lot easier to acknowledge its existence, and maybe it’s new that I genuinely want to take care of it.

I started searching for trauma-informed gynecologists in my area and came up with nothing. I couldn’t engage with the search for long periods at a time, but I was able to do it until I reached my limit, and my limit meant stopping rather than breaking down. 

When the trauma-informed search yielded no results, I switched to just looking for someone that my insurance covered that I felt goodish about. This is a process that even unrelated to trauma is always frustrating and overwhelming for me, and that made it hard. But I was trying. I wasn’t really pushing the thought away anymore. It would come up, and I would sit with it. I let myself respond by knowing that it is going to happen someday, that I’m wanting it to happen someday. 

Someone that I knew who was too fucking young died of ovarian cancer last fall. I know that there’s not any great way to screen for ovarian cancer and that’s not what a pap smear is for, but her death gave me more motivation to get the damn pap smear done. I don’t in any way want to make her death about me and I hope I’m not doing that by sharing this part of the story, but it is part of the story that Casey dying made an impact on me in this way: I decided it was time.

And even in deciding that, it took me eight more months to actually do it. In those eight months, I thought about getting it done (what felt like) a lot, and I also found ways to put it off a lot.

In that time I finally saw a primary doctor, which I hadn’t done since moving to Colorado. At my first appointment, my doctor mentioned that they do pap smears there, too. I told him what was up. He said no pressure, but it’s an option. At my follow-up appointment to go over blood test results, when he brought it up again, I let myself say okay, let’s do it. I didn’t know him that well but I knew him a little and I liked him so far. I wouldn’t need to search anymore. And I could even try to tell myself I was just going to my regular doctor, take the pressure of going to a gynecologist’s office out of it. It was both the path of least resistance and also a good one. 

He said you can always back out and just make it a follow-up appointment, and I appreciated both that fact and that he was doing what he could to maximize the feeling of choice for me. He said it was fine for me to bring my partner with me. He said it was fine to take Propranolol for the appointment and also offered to prescribe Xanax specifically for the appointment instead since it’s stronger, and I took him up on that. 

So the appointment was made. I told my partner. He put it on his calendar. And then I tried to let the thought go peacefully until then. 

And a few weeks ago (because it took me weeks to get myself to finish writing this), I finally went. Frankly, I think the Xanax could have been stronger. I cried. But it was quick, and then it was over, and then I went home and slept for hours and woke up to my partner having dinner ready. A few days or a week or something later, I got the news that I don’t have signs of cervical cancer. And now I can not think about this for three years just like anyone else.

* * *

Healing isn’t linear. Cliche, but true. Sometimes it takes a really big zoom out to notice the changes. Like how a few years ago, at every single moment there was a part of my brain that was reliving Avery, with the exception of generally during races. Races used to be my freedom, a thing big and exciting and distracting and wonderful and heady and exhausting enough to truly make me present. 

That’s not true anymore — racing is still freedom, but sometimes, so is just life. And yes, sometimes, I’m in two places at once; sometimes I’m only in one place, and it’s not the present. But being able to see the difference between how it shows up for me now versus even just a few years ago, I can start to believe that the ratio of present vs past will continue to balance out. And even though it wasn’t a proper gynecologist, even though I needed to be medicated to do it, even though I cried through it, I did it. After all these years. And the journey to it frankly sucked, and the appointment wasn’t fun, but it was not that bad, and it was not assault. It was safe and caring. It was meant to make sure that I am healthy. And that is something that I truly want.

* * *

Thank you for reading this whole thing. I hope very much that someone somewhere finds it helpful, at least knows they’re not alone in really struggling with this.

Second, I linked a memorial fundraiser in honor of Casey that if you’re looking to donate to a really incredible cause, please check it out. Undue Medical Debt buys the medical debt away from Americans who have it. It’s a mission I would be happy to know anyone reading this has contributed to and a way to honor a person who I was lucky to cross paths with, if only briefly.