Hi, so I'm not really sure how to ask this idk, it feels very personal and maybe tmi, and I guess it depends on one's level of bottom dysphoria, but basically, do you (or anyone else who wants to share) have any advice or anything with how to cope with having to go through a physical exam for bottom stuff/ a pap smear for the first time?
I'm asking this as someone who has and always has had severe bottom dysphoria to the point that I've never done anything with those parts and literally never even touched myself. I've just lived painfully aware that I have that stuff but simultaneously pretending as much as possible that I don't. So just the thought of "having to" get that done, being touched there by someone etc, makes me sick and gives me anxiety and I just full on do not want to do that. Ever. But apparently I have to if I'm ever gonna get a hysto, which I really really want.
So now I just feel like it's lose/lose. Either I have to let someone touch me in a way that just thinking about me makes me sick, or I can never get a part of transition that I've been wanting forever since I was kid and learned about my anatomy.
And I just.. mentally, emotionally, physically in every way just really don't know how to deal with that.
I guess it's not that big of a deal for people who don't have bottom dysphoria or not that much of it, and honestly sometimes I feel kinda alone (and almost guilty? Like it's wrong somehow?) in how extremely uncomfortable I am with bottom stuff compared to how I've seen other people be chill with it, but yeah.. idk what to do or how to cope with this.
Don't feel bad about feeling bad -- I may like my dick, but that hole gives me panic attacks and I'm not looking forward to my own exam coming up soon. I worry every time that I am going to kick someone in the face by accident. :/
A pelvic exam/pap is not required to begin HRT, but you will need one for most hystos. Plus, it's just good preventative care. Also, if you are young enough, get your HPV vaccine (a 2 shot series, iirc) to help prevent cervical cancer.
Things that have helped me during gyn exams:
Take the entire day off, if you can. Have a treat set up for after your appointment.
Go with a friend, if possible. They may not be able to be with you in the exam room, but they can at least drive you and wait for you.
Be firm that this is hard for you and anything they can do to make it easier will be helpful.
Put your shirt back on after the breast exam. I don't take "no" for an answer here. Having an extra bit of clothing on makes me feel better.
Ask for the "pediatric" speculum -- it's smaller and won't hurt as bad. Insist on it.
Have something you can grip to take your focus off below.
If they want to do a sonogram, refuse the transvaginal one. Do it the old fashioned way, which will require drinking a lot of water. They can deal.
Don't be embarrassed if your self-care afterwards requires crying, or similar. This is an exhausting thing to do, no matter how brave a face you put on in the exam room. I usually just crawl back into bed to sleep it off.
Above all, never take comments like "just man up" or whatever from the medical team. If that happens, be mean back, or simply get up, get dressed, and leave. Find someone else if you have to.
Scripts I have used. Workshop your own and practice them:
"This is my first time. I'm worried this will be a very uncomfortable exam physically and emotionally for me and I would appreciate anything you can do to make it easier. It helps me if you explain everything as we go."
"I do not have penetrative sex, so would like to try the smallest speculum lubed up best you can."
"I am going to put my shirt back on. It will help me be calmer for the rest of the exam."
If they are rude: "You are being unkind and I will walk out of here and find another provider if this attitude continues."
If they insist on a transvag sonogram: "I will only do an external sonogram. We can schedule it another day for me to prep, or give me time to drink the necessary water." (This is hard, btw -- it is enough water to make you vomit.)
Do whatever mental larping you need to do to get through it all. It's important to psych yourself up so you can control as much as possible. Remember, you can stop things whenever you want. If they are mean, all bets are off.
If you're like me, it will suck, but please try not to put it off. But getting through it means you can tackle anything else related to transition, should you go that route. Seriously, if you can do this, you are fucking golden. Take care. <3
(Additional stories/advice are welcome from folks, being trans masc not required!)