Asha Zappa had such a tough time with doctors that she went six years without getting a cervical screening.
‘When the clinic I really liked closed I tried seeing a GP but had a really uncomfortable, and, frankly, painful experience,’ Zappa told Gay Star News.
‘Then when I was pregnant I really got fed-up with medical professionals having anything to do with that part of my body when they weren’t queer friendly and trauma-informed.
‘It just felt like way too much effort, like I just could not be bothered to prioritise it, and there was a bit of fear about having yet another terrible experience.’
Cervical Screening Tests have replaces Pap smear tests in Australia, but LGBTI people still face great barriers in accessing testing.
People with a cervix – cis gendered women, non-binary or trans men – are at risk of developing cervical cancer. A 2014 survey found that 20% of lesbian, bisexual and queer women in Sydney had never had a Pap test.
Not participating in cervical screening is the biggest risk factor for cervical cancer.
Zappa explained her often experiences with doctors stopped her from getting a cervical screening test.
‘Practitioners who aren’t Queer-literate and trauma-informed, and practitioners who have physically hurt me. They say “this will be uncomfortable” which puts you in a position of not really being able to speak up – it feels like they’re saying “you know this isn’t pleasant so just be quiet”, and times when I’ve actually said “ow” the response has been to apologise but not adjust instruments or technique,’ she said.
‘And it can just be a mess of micro-aggressions – mis-gendering me, my partner, being sex negative, not understanding Queer sex, being body-shaming, not giving me control of the process.
‘It all adds up and really deterred me from making the effort to go back.’
The Inner Circle
But thanks to a campaign targeting LGBTI people with a cervix, Zappa finally felt comfortable to get the important test.
Australia’s leading LGBTI health organization, ACON, developed The Inner Circle campaign to raise awareness about the importance of cervical screening tests. With funding from Cancer Screening and Prevention grant from Cancer Institute NSW, the campaign also supports the Check OUT Clinic. The clinic offers free testing for LGBTI people.
‘To be honest, it was being part of the campaign and getting to learn a bit more about Check OUT: LGBTIQ+ Sexual Health Clinic,’ Zappa said about getting her first test in six years.
‘I’d been putting it off for ages – I didn’t have a clinic I felt comfortable with and finding a new one felt too difficult. Check OUT was exactly the kind of place I felt worked for me.’
The second stage of the successful Inner Circle campaign has laucnhed. It encourages all people with a cervix to get screened, and addresses some of the barriers LGBTIQ people may face in accessing testing.
‘We’re focusing on making sure our communities have the knowledge they need to understand the test, the reasons behind the changes to the National Cervical Screening Program, and how important it is to stay up to date with screening,’ said ACON Deputy CEO Karen Price.
Educating communities about the changes to the national program is an important priority for the Cancer Institute NSW.
Sarah McGill, Director of Cancer Screening and Prevention explained why.
‘The new Cervical Screening Test is a much more accurate than the old Pap Test, as it looks for the presence of HPV – human papilloma virus – which causes 99.7% of cervical cancers,’ McGill said.
‘Since we’re looking for the source of the cellular changes that can lead to cancer, we’ll be catching potential problems much earlier. This means the time between screening has been extended from every two years to every five years for those who don’t have HPV.
‘We know that accurate information and sharing knowledge is one of the most powerful ways we can reduce anxiety about testing and encourage people to take control of their health.’
Tips to overcome anxiety
Zappa offered some wise words for people who might be intimidated to get a cervical test screening. She recommended calling a GP clinic to find out how ‘queer-literate’ they are.
‘Or, if that isn’t something you’re able to do, ask a friend to call up before you and ask all the questions,’ she recommended.
‘Do they respect pronouns, avoid gendered language, incorporate trauma-informed practice? Do they offer self-collection or self-insertion? Make sure that they are able to provide all aspects of the service you need.
‘I know in some areas people’s options might be limited, so that’s a good time to tap into your community and ask for recommendations.
‘And if you know a great clinic or practitioner, tell others about them.’