I wrote a super detailed post on gyno appointmentsĀ for a trans guy on reddit so here'sĀ that
I care a lot about the health of trans folks, and as a trans anxious person myself I know how daunting these appointments can be. So I wrote a super detailed post on what an annual visit to the gyno is like, maybe it will help some of yāall if youāve never been.
The āwhen you have to startā depends on who you ask. It used to be 18, or 20, or even 25. It used to be a year after you became sexually active. I believe the current recommendation is to have your first pap done by 21, regardless of sexually activity. That being said, anyone can and see a gyno at any age regarding their sexual health. I started at 17 for birth control and testing, and continue to go annually.
There is something called an annual visit, and it is a yearly exam youāre kinda expected to do. They are about the same every year (until you also need to start getting mammograms, but you start that at a much older age and isnāt necessary if you have had top surgery). You should go to these annual appointments regardless if you are on birth control, sexually active or not, on hormones, or even had a hysterectomy (unless your doctor has told you youāre clear). In fact, it is believed that because trans men are less likely to go to these appointments, they donāt receive the preventative healthcare they need and are more susceptible to illness and cancer. So please find a doctor youāre comfy with and make sure you can see a doctor if youāre able.
Here is how an annual visit might go. Iāll also mention that Iāve seen a handful of doctors for pelvic exams now. All have treated me with respect, most I have been out to. They understand that they do a vulnerable and intrusive thing and really try to be patient. They tend to walk me through each step and keep me informed, and you can ask for the same.
First I always give a urine sample, for a pregnancy test among other things (insurance will literally not run anything without this test, even if it is impossible for you to get pregnant like myself). Typically they tell me to head to the bathroom and there will be instructions (write your name on the cup, wipe with this, pee a little then in the cup, seal and put in this box).
Then I might have a blood test, since I am typically there for STD testing as well. I sit down, they take a few vials of blood. I sign a lot of paperwork about what happens if I am positive for certain things.
Then I am taken to an exam room. A nurse typically asks me if there is anything I want to talk to the doctor about that day, and takes my vitals (temp, B/P, HR, etc). Then they will leave while I change. I typically get full undressed and change into a gown. The gown normally has buttons at the top and may have ties in the back, Iām also normally given a blanket. At this point I sit on the exam bed and wait for the doctor.
When (Iāll say she because I always seem women doctors, but this is standard stuff) she arrives for the exam sheāll have me lay down, there are two big things from here, other than just talking. The breast exam and pelvic exam. She also normally has a nurse or assistant with her for the exams, and I have always been able to have someone with me if I wanted.
The breast exam is really fast and painless, but awkward. I have always been laying down for this, but you could be stood up. My doctors tend to talk to me during it to kinda ease tension. She will undo the buttons on the top of the gown, to a quick visual inspection for anything out of the ordinary, and then lay the gown back down. Then she does a phsyical exam by pressing with her palm or fingers around my nipple and circularly out, checking for bumps and issues. It takes under a minute for both sides typically. Awkward, but painless, and everyone who ever gave me one was very polite about it.
Then the pelvic exam. Youāll be laying in an exam bed. Youāll be instructed to put your ankles in some stirrups and move your butt all the way to the edge of the bed. The blanket they gave you goes over your knees so youāre totally covered for all this. The doctor will take a seat at the end of the table, and might have an assistant nearby to hand her things. Obviously, this is vulnerable and no fun for anyone, but your doctor knows this and wants to be polite and get through it too. She will lift the blanket so that she can see, but anyone else in the room couldnāt. Another quick visual inspection of your nethers, and then usually they put the blanket back down unless they need to see something. There is a digital (that means finger) exam. Sheāll put on gloves and lube and put 1-2 fingers inside your vagina and feel your cervix. My doctor also normally does this and stands up and presses on my uterus and ovaries to feel for something. Obviously how penetration feels depends on the person, but for me this is uncomfortable but not painful. After that is the speculum (i think is what its called) part. This is a tool used to open your vagina a little so that the cervix is easily seen and found. My doctor has a warming bed for hers so the tools she uses are not ice cold and then going in my body, which is nice. The speculum doesnāt rock, it can hurt a bit especially if penetration isnāt typical for you, but isnāt terrible. She will also try and get this part over with safely and quickly. Using a lamp she will take another quick visual inspection of your cervix. If you are getting a pap smear, this is when that happens. Sheāll take a swab, kinda like a mascara wand, and rub it against your cervix for about a second. The swab she gets is then sent to a lab for tests. The prick of the pap smear is considered the worst part of the whole exam. It is not awesome but over quickly. Then everything can come out and youāre pretty much done.
I have also had a vaginal ultrasound before (one where I did not need a full bladder though) and that was also pretty simple. They have a small wand that honestly looks like a thin gspot vibrator, they put a condom on it and lube it up. No need to look at my anatomy as they put it inside and then just twist it to get the visuals (in this case my ovaries and uterus when i got my IUD placed). Wasnāt painful at all, but penetration doesnāt bother me typically.
If you want to talk about anything youāll get a chance for that before or after the exam. I also promise your doctor doesnāt care about hair, piercings, or tattoos. They use plenty of lube to make it as easy as possible. Warming stuff up, nice blankets and socks, and plenty of other things to make the experience as best it can be. Finding a trans informed doctor is of course a good idea too if you can, and in my experience they have been very respectful of my trans identity and anatomy. I hope this helps! Your sexual health is important, so try and get these exams if youāre able !