Lying across a turquoise rubber plinth, my legs in stirrups, a large blue sheet of paper draped across my pubes (for "modesty"), a doctor slowly pushes a clear plastic duck puppet up my vagina and, precisely at that moment, Total Eclipse of the Heart comes on over the radio and it's hard not to love the genitourinary medicine, or GUM, clinic.
I mean that most sincerely: I love the GUM clinic. It is wonderful beyond orgasm that in the UK anyone can walk into a sexual health clinic—without registering with a doctor, without an appointment, without any money, without a chaperone—and get seen within a few hours at most. It brings me to the point of climax just thinking about the doctors and health professionals who dedicate their life to the nation's ovaries, cervixes, vaginas, and wombs.
And yet, not all women are apparently so comfortable discussing their clitoral hall of fame with a doctor. According to a recent report commissioned by Ovarian Cancer Action, almost half of the women surveyed between the ages of 18 and 24 said they feared "intimate examinations," while 44 percent are too embarrassed to talk about sexual health issues with a GP. What's more, two thirds of those women said they would be afraid to say the word "vagina" in front of their doctor. Their doctor. That is desperately, disappointingly, dangerously sad.
In 2001, I went to see a sexual health nurse called Ms. Cuthbert who kindly, patiently and sympathetically explained to me that I wasn't pregnant—in fact could not be pregnant—I was just doing my A-Levels. The reason I was feeling sick, light-headed, and had vaginal discharge that looked like a smear of cream cheese was because I was stressed about my simultaneous equations and whether I could remember the order of British prime ministers between 1902 to 1924. My body was simply doing its best to deal with an overload of adrenaline.
Back then, my GUM clinic was in a small health center opposite a deli that would sell Czechoslovakian beer to anyone old enough to stand unaided, and a nail bar that smelled of fast food. I have never felt more grown up than when I first walked out of that building, holding a striped paper bag of free condoms and enough packets of Microgynon to give a fish tits. My blood pressure, cervix, heartrate, and emotional landscape had all been gently and unobtrusively checked over by my new friend Ms. Cuthbert. I had been given the time and space to discuss my hopes and anxieties and was ready to launch myself, legs akimbo, into a world of love and lust—all without handing over a penny, having to tell my parents, pretending that I was married or worry that I was being judged.
My local sexual health clinic today is, if anything, even more wonderful. In a neighborhood as scratched, scored, and ripped apart by the twin fiends of poverty and gentrification as Hackney, the GUM clinic is the last great social leveler. It is one of our last few collective spaces. Sitting in reception, staring at the enormous pictures of sand dunes and tree canopies it is clear that, for once, we're all in this together. The man in a blue plastic moulded chair wishing his mum a happy birthday on the phone, the two girls in perfect parallel torn jeans scrolling through WhatsApp, the guy with the Nike logo tattoo on his neck getting a glass of water for his girlfriend, the red-headed hipster in Birkenstocks reading about witchcraft in the waiting room, the mother and daughter with matching vacuum-sized plastic handbags talking about sofas, the fake flowers, Magic FM playing on the wall-mounted TV, the little kids running around trying to say hello to everyone while the rest of us desperately avoided eye contact—the whole gang was there. And that's the point: you may be a working mum, you may be a teenager, you may be a social media intern at a digital startup, you may be a primary school teacher, you may be married, single, a sex worker, unemployed, wealthy, religious, terrified, or defiant but whatever your background, wherever you've come from and whoever you slept with last night, you'll end up down at the GUM clinic.
Which is why it seems such a vulvic shame that so many women feel scared to discuss their own bodies with the person most dedicated to making sure that body is OK. "No doctor will judge you when you say you have had multiple sexual partners, or for anything that comes up in your sexual history," Dr. Tracie Miles, the President of the National Forum of Gynecological Oncology Nurses tells me on the phone. "We don't judge—we're real human beings ourselves. If we hadn't done it we probably wish we had and if we have done it then we will probably be celebrating that you have too."
Doctors are not horrified by women who have sex. Doctors are not grossed out by vaginas. So to shy away from discussing discharge, pain after sex, bloating, a change in color, odor, itching, and bleeding not only renders the doctor patient conversation unhelpful, it also puts doctors at a disadvantage, hinders them from being able to do their job properly, saves nobody's blushes and could result in putting you and your body at risk.
According to The Eve Appeal—a women's cancer charity that is campaigning this September to fight the stigma around women's health, one in five women associate gynecological cancer with promiscuity. That means one in five, somewhere in a damp and dusty corner of their minds, are worried that a doctor will open up her legs, look up at her cervix and think "well you deserve this, you slut." Which is awful, because they won't. They never, ever would. Not just because they're doctors and therefore have spent several years training to view the human body with a mix of human sympathy and professional dispassion, but more importantly, because being promiscuous doesn't give you cancer.
"There is no causal link between promiscuity and cancer," says Dr. Miles. "The only sexually transmitted disease is the fear and embarrassment of talking about sex; that's what can stop us going. If you go to your GP and get checked out, then you're fine. And you don't have to know all the anatomical words—if you talk about a wee hole, a bum hole, the hole where you put your Tampax, then that is absolutely fine too."
Although there is some evidence of a causal link between certain gynecological cancers and High Risk Human Papilloma Virus (HRHPV), that particular virus is so common that, 'it can be considered a normal consequence of sexual activity' according to The Eve Appeal. Eighty percent of us will pick up some form of the HPV virus in our lifetime, even if we stick with a single, trustworthy, matching-socks-and-vest-takes-out-the-garbage-talks-to-your-mother-on-the-phone-can't-find-your-clitoris partner your entire life. In short, HRHPV may lead to cancer, but having different sexual partners doesn't. Of course, unprotected sex can lead to an orgy of other sexually transmitted infections, not to mention the occasional baby, but promiscuity and safe sex are not mutually exclusive. And medical professionals are unlikely to be shocked by either.
We are incredibly lucky in the UK that any woman can stroll into a sexual health clinic, throw her legs open like a cowboy and receive some of the best medical care the world has ever known. We can Wikipedia diagrams of our vaginas to learn the difference between our frenulum and prepuce (look it up, gals). We can receive free condoms any day of the (working week) from our doctor or friendly neighborhood GUM clinic. We can YouTube how to perform a self-examination, learn to spot the symptoms of STIs, read online accounts by women with various health conditions, and choose from a military-grade arsenal of different contraception methods, entirely free.
A third of women surveyed by The Eve Appeal said that they would feel more comfortable discussing their vaginas and wombs if the stigma around gynecological health and sex was reduced. But a large part of removing that stigma is up to us. We have to own that conversation and use it to our advantage. We need to bite the bullet and start talking about our pudenda. We have to learn to value and accept our genitals as much as any other part of our miraculous, hilarious bodies.
So come on, don't be a cunt. Open up about your vagina.
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