It’s your first OB/GYN appointment, and you have heard that it is essential, and maybe you even have some specific concerns you need to cover, but you are still hesitant. To complicate matters, you worry that as an LGBTQ person, your visit may be full of inaccurate information. While this fear should not keep you from the crucial screenings and exams performed during your OB/GYN appointment, indeed, some healthcare professionals are not well versed in LGBTQ health.
Luckily, you are not alone. Every person with a vagina, cisgender or not, has anxiety about their first gynecologist visit. Because of this, there are countless resources at your disposal to prepare you for this experience. Remember that your concerns are valid, and it is vital that you feel in control of the situation to have the best experience possible. This article serves as a “one-stop-shop” for LGBTQ individuals who plan their first OB/GYN exam, hopefully addressing your questions and providing you with information you need to know before going in.
Why the OB/GYN Visit is Important
Several studies have shown that members of the LGBTQ community tend to have lower healthcare outcomes than their cisgender counterparts. Annual screenings such as those performed at your first OB/GYN exam help in preventative care, and putting the appointment off can be dangerous. To shorten the gap between the LGBTQ and cisgender community health disparities, it will take both self-advocacy and OB/GYN specific knowledge.
Unlike the regular family doctor, OB/GYN practitioners have specialized training in these areas of health:
- Breast cancer screenings
- Preventative care for female reproductive systems
- Healthy lifestyle habits
- Screening for HPV (cervical cancer)
- Mental health
- Sexual and reproductive health
- Birth control
- Some vaccinations
Though some of these areas may not seem applicable to you if you are not having sex with a cisgender male or aren’t sexually active, all people with a vagina can contract HPV.
Having the Right Conversation
It can be uncomfortable for some people to start a conversation about your sexuality, especially if you are an LGBTQ person. Some healthcare practitioners have had specialized training to talk about queer sexual health properly. Others may be less educated. While you may opt to research and find a healthcare practitioner who is an LGBTQ advocate, this isn’t always possible (insurance doesn’t still allow for alternative options). For either situation, explaining your pronouns is an excellent way to start the conversation and get a read on the doctor’s LGBTQ knowledge. Begin by informing your OB/GYN of your preferred pronouns and then follow up by asking for theirs. This may help to eliminate some of the more frustrating questions and begin a dialogue. Once again, if you feel that the doctor is not the right fit, you can always stop the appointment and re-schedule with someone else.
What Exactly is Going to Happen?
Your first visit to the OB/GYN will include both screening questions and a physical exam, geared towards helping your doctor determine the state of your general and sexual health.
Screening Questions: Before the exam, and while your clothing is still on, the healthcare practitioner will ask you questions about your general health, your sex life, and your menstrual cycle (if you have the equipment), as well as screening questions specific to reproductive health. It can be uncomfortable to answer such personal problems (and these will get very personal) but, it is essential, to be honest. Your answers will help the doctor give you accurate information and determine any health issues.
Some examples of the types of questions they will ask are: “do you have irregular periods?” “Are you having sex? If so, how many partners?” “What type of protection do you use when you have sex?” “How is your mental health?” “How are you sleeping?” Good OB/GYN doctors will care about your whole health, and the doctor’s queries may take up a majority of the visit. Always remember that the information you tell your doctor is confidential.
Are worried about asking these questions while your parents are in the room? Most healthcare practitioners will ask you, as the patient, if you would like the family member or friend to step out during the questions. If the practitioner doesn’t do this, you can request that they leave the room. Remember, this appointment is under your control, and the healthcare practitioner should be supportive of your directions.
The physical exam: If you are under 21, you probably won’t need a pelvic exam or pap smear test unless you are having specific health problems.
This exam will begin with the nurse or doctor handing you a gown to cover your body and tell you to remove all of your clothing, and then they will step out and let you change. The healthcare practitioner should explain precisely what they are doing, and it will often include both a breast and pelvic exam. The breast exam is to look for irregularities as well as a screening for breast cancer.
Understanding what is happening to your body during the exam can help you feel less anxious about the experience. These exams will be performed as you lay on your back with your feet resting on an extension at the end of the exam table, called stirrups so that the doctor can have a full view of your vagina. The three steps of the pelvic exam are explained in more detail below.
External Exam: The doctor will begin by doing an external genital exam by looking around the area around the vagina called the vulva.
Speculum Exam: A speculum is a device used to keep the walls of the vagina apart to allow the doctor to view the opening of the cervix. If a pap smear is performed, the cervix’s opening is where the brush is used to check for abnormalities. A speculum comes in different sizes, so let the doctor know if you have not had anything bigger than a tampon in your vagina and request the smallest size.
Bimanual Exam: During this exam, the doctor will lubricate two fingers and insert them into the vagina. On the other hand, they will put slight pressure on your abdomen. This exam allows the doctor to feel the uterus and ovaries to check for cysts and abnormalities.
Getting the Important Information
Your Healthcare practitioner should inform you of safe sex practices and preventative medicine. Depending on their training and understanding, it may be that you need to ask these questions before getting the answers you need. Be sure to ask about safer sex practices with your preferred partner(s). The more honest the conversation, the better information your provider can give you. If you use sex toys, ask if the sex toy material is safe and how you can clean it.
Preparing for Your Visit
One of the most common questions for any first-timers is, “do I need to shave down there?” Remember that your OB/GYN sees many patients and will tell you just to do what you usually do. If it makes you feel better, you can do a bit of landscaping, but you have nothing to worry about.
Another tip, your feet will be beside the doctors’ face, and if you tend to have smelly feet, it might be a good idea to deal with that, so you feel comfortable (some people opt to bring an extra pair of socks.) Another way to deal with this is to schedule your appointment in the morning so that you can shower before your visit. Ultimately, how you prepare your body for the exam should be based on what makes you comfortable during your visit.
Know this Before You Schedule Your First Visit
When you schedule your visit, know that you are in control of several factors. If you have a preference for a male or female OB/GYN, let the scheduler know. This is a very common request for the medical office, and you shouldn’t feel weird making it. If you are unsure about the provider, you can also arrange to meet your OB/GYN before the first exam. Request this extra appointment with the scheduler. By doing this, you can make sure that you feel comfortable with your provider before having an exam with them.
You may also arrange to bring a friend or family member to accompany you to your first exam. Once there, they can wait in the waiting room or stay with you throughout the process. The whole appointment is under your control. It’s good to know your options.
You are in control of your healthcare; you can stop at any time, and you can change doctors if you are unhappy with your current one. These appointments are essential for your overall health and contribute to a healthy lifestyle. Do not be afraid to advocate for yourself as you and your healthcare practitioner learn together how to treat you better.
Disclaimer: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek your physician’s advice or other qualified health providers with any questions regarding a medical condition.