What if No One's Watching?

First, let me come right out and admit that this post is my submission to the #3 Carnival of Feminists. The theme is 1970s feminist thought, or, more specifically, relating 1970s feminism to modern issues, "1970s into 2000s." Which, of course, made me think of my cervix. Because really, who were more into cervixes (cervi?) than 1970s feminists? With all of those hand mirrors and speculums, you'd think they'd invented the damn things. Plus, being born in 1979, my cervix was made in the 1970s, so what could be more appropriate?

In the 2000s, though, my 1970s cervix has been nothing but trouble.

It started in 2001, when I was very poor, having just graduated from Reed and not having any kind of job, or any real prospects for one. My poverty drew me to try to sign up for several medical research studies. I was hoping to get in on one of the ones where you spend a weekend there, they examine your sleeping patterns or whatever, and then they give you $500. What I got instead, though, was an afternoon in a well-appointed waiting room, answering a long list of questions about my pap smear history (I'd gotten one every year since I was 13 and they were all normal) and my number of sexual partners (I'm not going to tell you how many, but it was under the cut off for the study). After going over my questionnaire, a nurse practitioner informed me that I was eligible for the study. It would require a series of appointments, each with an injection, then monthly pap smears, then pap smears at 3 month intervals, then 6 months. With some stuff about taking my temperature every day and keeping records of it, and later on some "vaginal self swab samples." They'd pay me $50 for each appointment.

I agreed before I even knew what the study was for, or what they'd be injecting me with.

As it turns out, they were testing a vaccine for HPV. Something which, even three decades after my feminist foremothers sat in circles and looked at their cervixes with hand mirrors, I knew absolutely nothing about. Though I'd been getting annual exams with pap smears for eight years at that point, no doctor had even uttered the acronym in my presence. It never came up in a health class. I never discussed it with a friend.

And, I'm retrospectively ashamed to say, I went about my merry way and got my injections and my first few pap smears and collected my $50 checks without bothering to learn much. After all, this was just a way to buy groceries. I wasn't actually interested. Why should I be? Sexually transmitted viruses, after all, were something that happened to other people.

And then I got my first abnormal pap.

It was, the kind nurse on the phone explained, Class 2 atypical. This meant that the atypical reading could be caused by an infection or injury of some kind, but another pap would be required to make sure there wasn't something else going on, so I'd need to come back in. No problem, I said, not particularly worried, assuming I'd scratched myself or something. I went back in.

The next reading was clearer. This time, the nurse on the phone called it Class 3, or "low grade dysplasia." What that meant, she explained, was that there were changes on my cervix that were considered "pre-cancerous."

I freaked out. I'd already lost enough people in my life not to take the c-word too lightly.

The nurse calmly went on to explain that these kinds of changes are thought to be a direct result of one of the few "cancer causing" strains of HPV, the sexually transmitted virus the study was vaccinating against. These pre-cancerous changes on my cervix were, effectively, a positive test for HPV.

So I not only had cancer, I ranted, I had sexually transmitted cancer! I immediately gave my boyfriend the third degree. How had this happened? I'd been fine in previous months! What had changed? What did he bring home? He swore up and down that he'd done nothing, and finally talked me into calling the nurse back to get more information. When I did, she explained that HPV can live dormant in your body for years, and that there was no way to know if the virus was new or old. So Mark was off the hook.

But I was still faced with the frightening and oddly humiliating prospect of pre-cancerous cervical changes, caused by a sexually transmitted infection. And I was scared.

When I'm scared, I research. So that's what I did. I scoured websites, called the nurse back a couple of times, and bought a new version of Our Bodies, Ourselves. Over the course of the next few days, I became an expert in HPV, its transmission, and its treatment. Sadly, this makes me an unusually commodity among my peer group.

A few weeks later, I had a colposcopy and a cone biopsy. The biopsy itself removed the abnormal cells, so I didn't have to have a LEEP procedure. Since then, I haven't had more than one abnormal pap smear in a row, though I have had a couple of scares. My 1970s cervix has been behaving fairly well.

And now, I'm an advocate. I've been involved in more conversations than I can possibly count about pap smears. I know many feminist women who consider the requirement of an annual pap smear in order to get a prescription for birth control to be invasive and patriarchal. Frankly, I don't. While I understand that pap smears are unpleasant experiences (I've had over 30 of them by my count, and they don't get much easier with quantity), I still don't have much sympathy for women who don't want to have them done. The truth is that the great majority of us are at risk for HPV-caused cervical cancer, even when we think that, due to our monogamy, or our lesbianism, or our religious condom use, we're not. And serious consequences, or even death, from this affliction are almost completely preventable with regular pap smears. Yeah, having the colpo was unpleasant, and the cone biopsy hurt, and it bled, and I don't think LEEP, which I accept that I'll most likely eventually need, will be a picnic either. But it beats the hell out of the alternative.

In the 1970s, there were strong, brave, smart women who learned about their own bodies and took charge of their own health, and as a result of doing so, felt compelled to help other women do the same. These women did things like start the Boston Women's Health Book Collective, open women's clinics, lead workshops, and even learn to perform abortions. Intellectually, my feminism is deeply indebted to these women. I strongly believe in the sort of do-it-yourself ethic they exemplified, and I try to be a feminist who helps to create needed institutions where there weren't any before. I think there is a danger, however, in my generation of feminists misinterpreting the work that feminist women's health activists before us did. They advocated for increased knowledge about the female body, both by health practitioners and by patients, and for women demanding their own say in what happens to them when they are pregnant, birthing, or sick. They did not, however, advocate for ignoring the health of a body part because getting to it is unpleasant and uncomfortable, or ignoring sound reasons for tests. They did not advocate forgoing preventative care. Sadly, this is what I see too many women my age making of their work. Resisting the patriarchy means being proactive, insisting that your medical practitioner speak to you openly, insisting that you make your own medical decisions. It does not mean ignoring your need for medical care all together.

At the moment, my 1970s cervix seems more or less healthy. I went for my annual exam just two weeks ago, actually, and everything looked fine. It wasn't my ideal way to spend 15 minutes, but that was all it took, and I can rest assured that the three strains of HPV that were eventually identified in my body are not currently causing any problems. What's better, though, is that I am secure in the knowledge that if they do start to cause problems, I'll be ready to fight them. I am getting the preventative care I need to catch any new abnormalities early, and I am very well-educated as to what my options will be if and when that happens. In part, I think I have those 1970s feminists, with their mirrors and speculums, to thank for my being so educated. Because of them, at least in part, the information I needed is available, even if I never got it from the sources that maybe I should have. Moreover, because of them I feel comfortable sharing this story with other women. I may not be ready to hold the flashlight while another woman performs the speculum and mirror routine on herself, but I am more than ready to drive her to the doctor, hold her hand in the waiting room, and even sit with her during her colpo if she wants me to. I am ready to volunteer to be a patient teacher, helping medical students learn to do thorough, compassionate pap smears. I am ready to foist copies of Our Bodies, Ourselves off on any woman, of any age, who doesn't already have one. I am ready to speak out about HPV, how we don't need to be embarrassed about it, and how it kills women and it doesn't need to. I will do whatever I can to teach other women about HPV and cervical cancer, and to help them through it if they are in the same boat I've been in, or a worse one. We're all in this together, and we can help each other, teach each other, learn from each other. That's a message worth transcending generations.

feministcarnival