Weblog for Sexual Assault Victims Emergency Services (SAVES)

An interesting article written by a survivor of sexual assault about how to help women who are nervous or afraid of pelvic exams and ways it may help to overcome these fears. The article was originally posted on Jezebel.com

There are many online resources about pelvic exams, but they’re not always reassuring. As a woman who was raped many years ago I went online to find reassurance, and what I read had the opposite effect. But I’m happy to say that the exam was fine, I didn’t notice any discomfort, there was no pain and I felt respected. Here’s how I prepared for it.

I should start off by saying that I went through successful therapy after being raped and I have a normal sex life. But the thought of getting a pelvic exam was horrifying. I dreaded the idea of trusting a stranger not to hurt me while I was in a position that doesn’t inspire a sense of control. I cried every day during the week leading up to the appointment.

The key to a good pelvic exam is communication. The very first thing you should do when you schedule the exam is to let the people know you have been raped or assaulted. These people know damn well what this means, so don’t be worried about being judged in any way. Telling them about your history will allow them to schedule in more time for you. You can use so that time to ask questions and relax, while they will have the time to be extra gentle and careful. When I arrived at the center I also reminded them again of my history. If you don’t like to talk about it, then slip them a written note.

Try and figure out for yourself if there are any particular things you are worried or scared about. Is it the thought of pain? Are you scared of being in the vulnerable position? Are you afraid you are not in control and can’t make the exam stop once it starts? These concerns will probably depend on your history and are rather personal, so only you can try to determine what prospect scared you the most.

Don’t let the exam begin until you raise these issues with your physician and talk about it. I decided that I would not get into the chair and be in a vulnerable position until I felt confident that the physician understood me. For me there were two major concerns: pain, and the fear that the physician wouldn’t stop when I told them to. I wrote my concerns down on paper so that I wouldn’t forget if I panicked.

To minimalize the possibility of pain I decided that for every stage the physician should use lubricant — no lube, no exam. There is no medical reason lubricant cannot be used. Lube is standard in some health centers but not all, so ask for it if this worries you. There are also differently sized speculums, so ask for a smaller size if you think you need it.

The most loaded question emotionally was whether the physician would stop when I asked her to. I didn’t like to ask or think about such a situation. I’m happy I did ask though, because her answer was brilliant. She answered that I was in total control and she would stop as soon as I asked her to. She said the position might not feel empowering, but that if I said stop she would listen immediately and the exam would end.

Another concern I had was the chair, especially the stirrups. I asked the physicianwhether I had to use them. She told me I didn’t have to, but it would help me achieve a comfortable position that would make her job easier, and the examination more comfortable for me. I translated ‘more comfortable’ as ‘less chance of pain,’ and I was still more worried about the pain than the weird position. I was sure she would stop the exam when I asked her, so I decided I was okay with the stirrups. If they would mean less discomfort I’d happily use them. She also told me how to sit in the chair, and where I held tension. Next time I will definitely ask the physician how to lie down/sit well. She also told me what she was about to do, before she actually did it. This felt very empowering for me and next time I will ask my physician to do the same.

If you have a physician who doesn’t address your concerns, who seems to rush you and doesn’t seem to work with you, then find another physician. There will be plenty who will understand that with a history of assault you may need a bit more time and you will have concerns specific to you, and they will be happy to reassure you. Because I told them about my history and how nervous I was, they took precautions to make me feel more in control and less scared even without me asking. For instance, they also covered up the whole stack of speculums.

So what did I actually feel during the exam? Very little I didn’t feel poked or prodded. The only poking they do is on your stomach at one point and that just feels silly. The first part of the exam uses a speculum. They come in various sized because every woman is different. Remember, you can ask your physician to start out with a smaller sized one. I didn’t feel a thing when the physician placed the speculum inside me. It was a little cold, but that was all. When folded these things are TINY, smaller in width than a finger or a sextoy. The speculum does open, but not very far. When I finally sensed something going on, it was already over. I heard a metal sound and that was it. It was a split second between ‘hey I actually feel something’ and ‘oh its gone and now she tells me it’s placed.’

When the exam reaches this stage they will take cells from your cervix. The physician said I might feel something like a menstrual cramp. I would describe it as a twinge — seriously, just a twinge. It’s a little strange, like butterflies in your stomach, but not painful nor uncomfortable.

After the speculum adventure it’s time for the bimanual exam where they use their fingers. Again, thanks to lubricant and the professional aim and angle of the physician, I did not notice much. No pain, no discomfort. The only part I noticed was when she pushed my stomach, three short pushes. I just looked puzzled, wondering if that was it. If you do feel pain, you should let your physician know. You are there for a health check, so if you feel pain you should tell them. For me this was the last part of the exam. The whole thing was comfortable and respectful, which is what everyone deserves. Remember, if your physician is not sympathetic to your needs, don’t do the exam. Don’t convince yourself to try it if you don’t trust your physician. Find another one who will help you safeguard your health — physical and mental.

Chantal Alexandra is a sexual assault survivor who wanted to share her experiences with others.

Stalking generally refers to harassing or threatening behavior that an individual engages in repeatedly, such as following a person, appearing at a person’s home or place of business, making harassing phone calls, leaving written messages or objects, or vandalizing a person’s property (Stalking in America: Findings From the National Violence Against Women Survey, National Institute of Justice).

According to results from the 2010 National Intimate Partner and Sexual Violence Survey, 1 in 6 women (16.2 percent) and 1 in 19 men (5.2 percent) in the United States have experienced stalking victimization at some point during their lifetime in which they felt very fearful or believed that they or someone close to them would be harmed or killed (National Intimate Partner and Sexual Violence Survey: 2010 Summary Report, Centers for Disease Control and Prevention).

Stalking between intimate partners is widespread and often associated with lethal abuse. Despite the enactment of anti-stalking laws in every state, relatively few stalkers are cited or arrested by law enforcement, and even fewer are prosecuted (A Statewide Study of Stalking and Its Criminal Justice Response, final report of a study sponsored by the National Institute of Justice).

In recognition of January being National Stalking Awareness Month, NCJRS invites you to view its Stalking Awareness Special Feature, an online compilation of stalking-related publications and resources.

BY JOSEPH L. COBB

The Penn State and Syracuse University child sex abuse scandals, as horrific as they might be, are not isolated incidents as we would like to believe. Every city and town in this country is being stalked by child predators who use the very organizations designed to build young boys into men as their hunting grounds.
Institutions like Little League, Scouting, churches, schools and mentoring programs are frequently used by predators to identify boys who have little or no parental oversight or who are considered at- risk, to methodically and quite effectively lure them into a sexual relationship. I use the word “relationship” because that is what it becomes. I know because it happened to me.

I was 11 years old when my best friend, Richie, invited me to attend church with him and his family. The church in a small Florida town was arguably the biggest and most influential church in my hometown. I was excited to go. Before long, I was attending the church regularly, and I felt like I belonged.

I started singing in the youth choir, led by the charismatic, sometimes silly, always entertaining Cal, the minister of music. It didn’t take much time for Cal to learn that my parents were divorced, my mother was an alcoholic, and my father didn’t have much to do with his children.

I was excited when Cal invited Richie and me to go fishing with him. He asked our mothers for permission to spend the night at his father-in-law’s house so we could get an early start the next morning. Shortly after a home-cooked Southern-fried meal, Richie and I were led to a bedroom with two wooden frame twin beds on opposite sides of the room. Richie, Cal and I would be sleeping in the room, but as an 11-year-old boy, I didn’t think anything of it.

Cal played “eeny, meeny, miny, moe” to determine who he was going to share a bed with, and I lost. After Cal got in bed with me, I recall a little bit of tickling and playful wrestling. Soon Richie was asleep, and I was nearly asleep when I felt Cal’s hand slide between my stomach and underwear. I lay there paralyzed while he moved his hand farther down and started fondling my genitals.

That was the first incident in what would become years of sexual abuse, which happened three to five times a week until I was around 14 years old. It happened at his house, at the church, at my house, in his van, camping and all the way to Portland, Maine, and back while on a church-sponsored mission trip with 40 other kids. Basically, anywhere he could get me alone.

I used to wonder how my life would be different if Richie lost the “eeny, meeny, miny, moe” that night, but now realize that it wasn’t random at all. Cal used Richie as a tool to get to me. Richie belonged to a close and loving family, and his mother would never have tolerated the amount of attention Cal began to lavish on me.

Soon, I was part of Cal’s family. I was spending the night at his house often, where I felt loved and welcome. He was taking me camping and fishing, buying me things and letting me drive him around town at the age of 12. I learned to mentally detach myself from the 15 or 20 minutes of abuse I was subjected to every time we were alone in exchange for all the things I received and got to experience in return.

I didn’t know at the time I was training my mind to avoid intimacy, which would haunt me the rest of my life.

I remember Cal waiting for me after school one day. He was visibly shaken. He told me that the pastor of the church suggested we were spending too much time together, and it was making some people at the church uncomfortable. Cal sobbed as we sat in his van behind my house when he told me we couldn’t see each other any more.

Secretly, I was happy, but it did hurt to see Cal so devastated. Within a month, he was dominating my time as much or more than before. There were so many people who knew or should have known there was something inappropriate about our relationship. Cal’s wife, who interrupted him sexually abusing me at least a dozen times but never quite caught him in the act, had to know. Clearly someone at the church said something, but no one ever intervened or bothered to pull me aside and ask me a few questions.

It was easier, apparently, to believe that what they suspected wasn’t happening than to find the courage to rip a young boy from the clutches of a predator. Or was it something more sinister? Did people know what was going on and not say anything in order to protect the church from controversy? I guess I’ll never know.
As I got older, I was finally able to free myself from Cal’s control and influence, but he didn’t give up easily. Before long, another young boy from church was going fishing and camping with Cal.

It wasn’t until I was 36 that I told anyone about the years of abuse I endured. I had run out of excuses for my inability to be intimate with my second wife, so I started seeing a psychiatrist. With her help, I began peeling away all the layers of guilt, shame, betrayal and resentment. It wasn’t my fault. I was an innocent prepubescent boy who was manipulated and used.

At the time, I was at the height of a stellar career with the Marion County, Fla., sheriff’s department. I confided in the sheriff, who I also considered my friend, about my childhood abuse. He responded by saying that I was lying and that I was gay. Later, during a civil litigation, Cal admitted to sexually abusing me for years, just like I had said.

Child molestation is a nuclear bomb. I can easily name two dozen people who were directly affected by my abuse, and each can name several more who were indirectly affected. It is every community’s dirty little secret. As you read this, some of you are thinking about someone in your town or maybe even in your own family who makes you uncomfortable when they are around children.

Are you going to say something or say nothing? Speak up. Ask awkward questions. Demand explanations. Do background checks. Explain boundaries to your children. Bookmark the National Sex Offender Public Website (www.nsopw.gov) and use it often. I wish someone would have done that for me.

JOSEPH L. COBB retired from a career in law enforcement in 2007 after 24 years. He now lives in Costa Rica.

SAVES would like to wish all of our community members and readers a happy and safe Holiday season. We would also like to remind everyone that our offices will be closed the last week of December (26th-3rd). However, if you or someone you know needs support or assistance, you can always call the 24 hour a day, 7 day a week, 365 day a year helpline at 1-800-871-7741 or on a cell phone at 1-866-740-9516.