Health Care, Love + Sex, Love, Life Stories, Wellness

This is what it’s really like visiting a OB/GYN in the US – as a Pakistani woman

"You are a 'smart and educated' woman," he said, "You should know better."

I was late. And not just a few days late – I had pretty much skipped a month. And I was nervous.

And not for the reasons you would think. You see, I was 100% certain I wasn’t pregnant because I’m 100% queer and have been in a long-term monogamous relationship with my non-binary female-assigned at birth partner for the last three years.

Don’t get me wrong though, I’ve had erratic and wonky periods before – my monthly visitor has been both late and early, with varying levels of flow ranging from a barely-there trickle to a bloody scene reminiscent of The Shining. However, this irregularity usually coincides with finals, midterms, and other stressful times in my life. But this time was different – it was the summer, I had a great internship, and no real exams to think about. It just didn’t make sense.

And as a highly anxious person, I feared and expected the worst.

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To make matters worse, this anxiety was coupled with an intense dislike of hospitals, possibly inherited from my doctor-averse parents, so it took me a while to make an appointment. Moreover, if I’m totally honest with myself, this wasn’t my regular antipathy towards healthcare systems and doctors in general.

I was afraid of going to a gynecologist.

Growing up in Pakistan, gynecology was an elusive concept; a gynecologist someone you would only meet on the eve of your wedding in order to obtain birth control, and then again when seeking post-wedding pregnancy care. The concept of going to see a gynecologist for a pap smear or a regular check-up was blasphemous. Gynecologists were inextricably linked to a woman’s marital and childbearing status (barring, of course, the clandestine visits for unintended pregnancies and abortion services). Given these internalized patriarchal notions, it is unsurprising that, even as a sexually active 25-year-old, I had never been to an OBGYN before. I had been conditioned to believe my vagina was an inconsequential, almost extra-physical, part of my anatomy.

It didn’t warrant the care and attention I gave to the rest of my body or even my mental health.

When my anxiety (coupled with much cajoling from my understanding-but-concerned partner) over my missed period finally trumped internalized misogyny, I made the dreaded appointment.

When the day arrived, I took time off work and trekked over to the doctor’s office, several neighborhoods away. I was so anxious and nervous I arrived half an hour early. Squirming in the waiting room, I relentlessly texted my partner in an effort to calm down, whiling away the time until I was finally called into the exam room.

I sat on the examination table awkwardly, doing my best to stay calm, when in walked the resident: a young, South Asian man.

My stomach dropped.

Not only was I going to have to come out to a complete stranger and discuss my menstruation woes, but the stars had aligned to make it as awkward an encounter as possible for me. Still, I attempted to make do.

We made some small talk. I took a deep breath and narrated the problem that had led me up to this anxiety-inducing moment. Before he could ask (and I knew he would ask), I cut off any pregnancy-related questions by informing him I was queer.

It was awkward as fuck.

Because I look (and generally dress) in a “feminine” way, people generally make inaccurate assumptions about my sexuality. So, needless to say, my doctor was surprised. This was clearly not his best day. Not only did he have to talk about menstruation (a kind of medicine he told me he wasn’t interested in at all), but I had to make this experience even more taxing for him.

Queer girl with period problems.

Welcome to your afternoon appointment.

Queerness, of course, was integral to my issue. I emphasized to the doctor that I don’t sleep with men as an explanation for why I was so worried that something else was going on. If it wasn’t pregnancy, then why was I late? He awkwardly listened to me describe my menstrual flow and sexual history and tried to break the uncomfortable pauses and silences with jokes about immaculate conception.

Strike one. Not funny, asshole.

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Continuing this downward spiral, my new adversary asked me if I had gotten a pap smear recently. I helpfully explained that I never had. Here, again, the conversation took a turn for the worse.

Instead of being cognizant and understanding of all the possible reasons that could have prevented me (a queer, Pakistani woman) from seeking gynecological treatment before now, the doctor gave me an admonishing stare.

“You are a ‘smart and educated’ woman,” he said, “You should know better.”

This was the wrong thing to say. My anxiety and fear spiked, further exacerbating my concern and discomfort in an environment that was becoming more uncomfortable by the second.

Strike two.

We didn’t get a chance to get to strike three; though I’m sure we would have gotten there soon enough.

He brought the attending physician in to deal with me.

Here, finally, thankfully, things took a turn for the better. My new caretaker was warm and understanding and didn’t bat an eye at my sexuality or medical history. She explained how normal it is to sometimes skip a period, offered to run a blood test to check for any issues, and suggested that I make a pap smear appointment for added reassurance.

Calm descended.

For the first time since I had arrived, I felt safe, at ease, and understood. I left feeling more reassured than I had in weeks and ran home to schedule a pap smear appointment. (In case you’re curious about my health: my tests came out fine, I got my period a week later, and my very first pap smear was with a great doctor and went well, so it wasn’t any more awkward than one would expect.)

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For months I’ve been turning this experience over in my head.

To be honest, my experience at the gynecologist wasn’t an anomaly. For members of the LGBTQ community who are privileged enough to have access to health insurance and doctors, uncomfortable experiences like mine are routine, and can often involve much more than just discomfort.

According to a 2009 survey conducted by Lambda Legal, a national organization working on LGBTQ civil rights issues, almost 56% of LGB respondents had experienced some form of discrimination while seeing medical care. Experiences cited include the use of harsh or abusive language, as well as, in some extreme cases, refusal of care and/or treatment.

The situation is much worse for transgender and gender-nonconforming individuals. Lambda Legal also found that almost 70% of respondents in this community had experienced some kind of discrimination in care. These experiences become even more frequent when accounting for other marginalized identities. Queer and trans individuals who are also racial and ethnic minorities often experience the most severe health disparities within the LGBTQ community – a clear sign that intersectionality in queer health care is an essential consideration.

My experience, and those of many members of my community, is a testament to the dire need queer people, especially queer people of color from backgrounds like mine, have for culturally sensitive doctors. We need assurance our healthcare professionals are not only aware but accepting, of our many intersecting identities and will provide the best care possible regardless of personal views.

I was lucky that my experience was just limited to awkwardness, that I could afford to go to a doctor, and that I turned out healthy. Others are not so lucky.

For many, this is a matter of life and death.