This article is authorized to be transferred from: Panker Workshop (ID:thesparker)
"Aren't you going to take off your pants?" Hurry up for me! "What's it called, does it hurt so much?" "Haven't you all had sex?" How can it hurt? "What are you calling so loudly?" People will laugh at you when they hear it! ”......
They lay on the gynecological examination bed, listening to these harsh words, accompanied by the doctor's rough examination techniques, physical and mental violence overlapped, tension, anxiety, fear and shame rolled inside them, but these bitter fruits could only be swallowed by them alone.
Examinations of gynecological diseases have become an unspeakable pain in the hearts of some women.
On July 7, 2021, the Douban group "on behalf of the moon to eliminate the shadow of women's examination" was established, the problems that had been covered up were gradually exposed, and those women who hid fears and shadows in their hearts found a space for self-writing and expression, where they exchanged their experiences of women's examinations, shared and summarized experiences, and passed on encouragement and kindness.
However, the causes of the "shadow" and "violence" of gynecological examination are not simple and direct, and the many deep contradictions hidden behind gynecological diseases and gynecological examinations still need to be paid attention to, and on the road to protecting women's reproductive health, the stigmatization of diseases, traditional gender values, and the lack of medical humanistic care are still obstacles that need to be crossed.
Usurgo gynecologists harass tens of thousands of female students and file lawsuits
When those shadows fall
When Xiao Xin walked out of the examination room, the emotions of shame, fear, helplessness and anger mixed together, stirring her heart fiercely, until she left the hospital, she was silent for a long time.
It was supposed to be a perfectly normal superstition.
There were many people who came to check on the day, she stood outside the curtain of the examination room, playing with her mobile phone while queuing, and the sharp roar of the doctor came from the other end of the curtain from time to time: "Why lie on it, lie down!" "Hurry up for me!" ”
Xiao Xin did not hold back, the probe looked inside slightly, vaguely saw a very young girl lying on the examination bed, Xiao Xin could feel the panic and shyness wrapped around the girl's whole body, she was yelled at by the doctor stunned, even after the end of the examination also forgot to leave from behind the curtain, this process naturally accompanied by a new round of reprimands from the doctor.
At this time, it was not Xiaoxin's turn to check, but she began to feel uncomfortable, especially looking at the girl's thin back, "her heart was like being poked by a needle."
Xiao Xin sent a message to a friend waiting outside the examination room, describing the situation that had just deteriorated, and the friend replied lightly: "Maybe the doctor is in a hurry." Seeing this news, some of the words that had just reached her mouth were swallowed by her and choked in her heart.
Just when she was still hesitating whether to say anything to her friends again, she suddenly heard the doctor open the curtain and shout at the people in the examination room: "People standing behind the curtain, standing so far away, what are you doing, you take off your pants in advance, now the examination is a pregnant woman, she is done, you immediately come up, hear no!" The curtain was never pulled back.
Hearing this order that there was no room for resistance, the air in the examination room froze for a second, everyone looked at each other, and then began to undo the pants buckle in their hands one after another, Xiao Xin felt that this request was very outrageous, but out of fear and obedience to the doctor, she still did it.
"Maybe in her (doctor's) eyes, what was standing in the examination room was not a patient, but just a walking organ."
Lying on the bed to be examined, the curtain that was originally used as a partition was also useless, and the others lined up, waiting in front of the bed at close range, the shame was too strong, and finally waited until the doctor disdainfully threw toilet paper on her stomach, and Xiao Xin finally survived until the end of the examination.
"Obviously everyone is a woman, why is it so uncomfortable?"
It is not only Xiaoxin who has experienced this "discomfort", Li Ximei also left an unspeakable "shadow" of gynecological examination when she first did the internal examination sample in a top-three hospital in Beijing.
That's 2019. When the female doctor put a cotton swab into the vagina propped open by the duck-billed tongs and scraped the sample hard, Li Ximei "hissed" in pain, but the doctor did not lighten the action, but said to her in a disgusted and slightly sarcastic tone: "Haven't you all had sex?" How can it hurt? ”
Li Ximei suddenly did not dare to make a sound, reflecting on whether she should not cry out in pain, she even began to feel that she had lost money, "Is it not in line with the values of doctors like me who are unmarried but have sex?" She finally endured the pain and went through the whole sampling process.
On the way home, Li Ximei's physical and psychological discomfort has always existed, especially the doctor's sudden words.
At first she thought, "Am I being too sensitive?" But a feeling of being judged still lingers in my mind, "Why do you say that there will be no pain in having a sex check?" Why can't I just have some feedback that I feel pain? ”
After that "shadow", Li Ximei never went to the gynecological internal examination again, and she was afraid that she would encounter a similar situation again, "Before, I may have been a little uncomfortable and went directly to the hospital to see it, but now, I think it is not very serious anyway, or forget it!" ”
Time moved forward two years, in July 2021, Li Ximei accidentally brushed a post in the group called "Eliminating the Shadow of Women's Examination on Behalf of the Moon" on the home page of Douban, which described the experience too similar to what she encountered two years ago, and she spread a kind of empathy and resonance in her heart: "It turned out that I was not alone!" ”
She immediately applied for an extra group and shared her experience in the group.
Self-writing of the female experience
"Why are we so afraid?" "Why do we suddenly lose the ability to resist on the checkpoint?" "Why are we ashamed?" "Why do gynecologists talk badly?" ”...... These are the issues that the "On Behalf of the Moon To Eliminate the Shadow of Women's Examinations" group prefers to discuss.
Group leader Gu Liguo wrote in the introduction at the beginning of the creation of this group on July 7, 2021: "Sisters who have encountered the shadow of women's examination are welcome to write about their experiences, others can completely think that your words are false, or a memory that is not real enough, just as you can be sure that the harm you have suffered is deep and real." ”
As of the date of writing, 20,362 members of the group have gathered here, including Xiao Xin and Li Ximei, who share and exchange their unique gynecological examination experiences in the group.
"Shame and pain and unhappiness" is Li Ximei's depiction and summary of the shadow of the women's examination in the post, and for many members of the group, these feelings are not unfamiliar, and most of them are also portrayals of their inspection experiences.
Guliguo, who launched a poll on July 17 titled "Do You Have a Shadow of Women's Examinations?", wanted to understand how harsh the gynaecological examination environment around the group members was, and she divided the "violent factors" contained in the questions into three levels: attitude violence, verbal violence and inspection violence.
As of now, the results of the vote still show a minority (18%) of the cases in which "doctors are encountered are milder".
The result of the vote initiated by Guliguo
Let more people pay attention to the problem of "women's examination violence" is the original intention of Guliguo Group.
She once left this passage under the post of one of the team members: "On the one hand, fertility, pain and blood, guilt and shame, on the other hand, there are bystanders, accusations and insults, insults and ridicule, I want to expose the problem, I want everyone to see that there are such strange and cruel and unreasonable things happening, to think about why these things are happening; I want to create a group, precisely because there is no place to expose the real problems, and at the same time, let everyone provide experience and advice to each other, Protect yourself from physical and psychological harm. ”
Clamp once had an early morning gynecological emergency experience - the pain of the body, intertwined with the mental oppression of the doctor's black face, made her feel as if she was in hell.
She lay on the examination bed, listening to the doctor on duty impatiently questioning whether she was wrong, and pinched in her heart and asked herself: "Shouldn't I go to the emergency room in the early morning?" Does it bother them to rest so badly? Was it because I was wrong about this that she would give me a black face? She was even worried about the teasing of doctors and nurses.
Because the doctor did not diagnose the definite result, only gave the recommendation of inpatient surgery, conservative treatment or non-hospitalization, the clip finally left the hospital because of fear, hurriedly signed the refusal of treatment.
The next morning, she switched to another hospital and found that there was already a lot of blood in her body, she was diagnosed with a ruptured yellow body, and the receiving doctor told her that if she did not stay in the hospital any longer, her life would be in danger.
She was especially glad that she did not resist the gynecological examination because of this emergency, otherwise she might have died in the shadow of fear.
Clip shared this experience to the group, other members of the comment area of the message made her more and more convinced that it is not her fault, then the self-blame and obedience is just the subconscious self-preservation psychology under fear, especially some comfort is still from the same gynecologist members, they also told clips to encounter similar situations after the solution, everyone's encouragement and help also made her become firm, gentle, rational, slowly heal and dissolve this shadow.
The spontaneous disclosure of their own gynecological examination by the members of the group is the self-writing of the female individual experience, and it is to abandon those symbolic cognitions, so as to complete the exploration and search for the female self in the collective empathy of the body and spirit, which needs to be valued.
Chen Yan, a professor in the History Department of Fudan University, whose research direction is gender history, believes that "this kind of individual sharing can make women's experiences be seen and heard, which in itself is a kind of empowerment for women, especially when no one around can understand, and there is such a support channel on the Internet, which is both convenient and decompressing." ”
Yanan once suffered a relatively rough vaginal ultrasound examination 42 days after giving birth, and although she could understand the doctor's impatience, she could not help but send a message to her husband after the end: "Married pregnant women have no dignity!" The husband replied, "The examination is for your body." ”
Such comfort could not really calm her depressed heart, and all that remained was helplessness under the emotional gap.
So in the unit physical examination that could not escape two years later, she plucked up the courage to encounter the same rough examination and posted the first post after entering the group in the group, before which she just silently observed, usually drawing some comfort and strength from other people's posts and comments.
After the post was posted, she had a kind of relaxation after the talk.
More than 20,000 members of the group, like Yanan, found such an exit, where they saw each other and spread and harvest kindness.
Behind them, however, there are more silent women, and under the shadows are more shadows, perhaps they have not found a suitable channel of speech, or they may be ashamed to speak because of some old constraints, or they may even be confined to backward ideas and thus limited to the threshold of health.
The end of the problem is not to explore how to build a huge media platform to absorb all the women who have experienced violent women's examination, as Chen Yan said: "Any channel of sharing is one-sided, and there is no so-called comprehensive communication channel." ”
What needs to be asked is the deep reason behind these shadows and injuries, why do people acquiesce to the status quo and pain? Why do women always have a hard time in protecting their reproductive health? Why are gynaecological examinations and the disease itself not properly valued and recognized?
Only when the meaning behind these "whys" is eradicated can a healthy female healthcare environment be expected.
After the disease is metaphorical
"My mother didn't do so many examinations in that era, didn't I already have a good birth?"
"Good girls don't have to get the HPV vaccine!"
As an obstetrician and gynecologist, Su Yu almost "died of anger" when she saw these comments on Douyin, and she half-ridiculed and half-seriously sighed: "The task of popular science is still a long way to go!" ”
Ruohua said the words "gynecological examination" and "gynecological disease" themselves frightened her, even though her children were now in college.
She is not the only one who has a sense of exclusion, she usually rarely talks about these topics with her friends, "After all, this is a private matter, it is not easy to ask and answer, it is stained with those diseases, who knows what others will think of you?" ”
Afraid to return to the house, Ruohua still insisted on checking at least once a year, which was related to an incident she had witnessed with her own eyes.
That happened around 2009, when she was hospitalized with a woman about her age, Ruohua called her "Sister Chen."
Sister Chen was doing farm work at home to hurt her waist, it was very serious, she came to the hospital in the city for surgery, and by the way, she also wanted to check her own vagina itching problem.
She used to give birth to a child in a country home, it was a normal birth, and her vagina was torn, but she never went to the hospital for examination since then, first, she was afraid of being ugly and humiliated, and second, she did not have time. Whenever she was uncomfortable, she simply took the medicine and wiped it off, so that she could cope with it for more than ten years, and she always felt that it was no big deal.
The day after the gynecological examination, she was preparing for waist surgery, the doctor suddenly came to the ward, told her that the cells in the screening sample were not quite right, the initial suspicion was cervical cancer, and she needed to do another biopsy, "I remember that Sister Chen's face was scared white, suddenly cried out, and I was almost scared to death!" ”
Ruohua saw this incident as a very powerful reminder, "Shame and ignorance, I don't know how many people have been harmed!" ”
There are not a few women who are similar to Sister Chen, and there are also many people who are afraid of medical treatment, and even they may not know anything about basic gynecological knowledge.
Fei Fei said that once when he talked to a friend about cervical cancer, his friend could not even distinguish the difference between HPV and HPI; and in Yanan's cognition, gynecological examination should still be done for married women, unmarried girls or women without sex were excluded; and team members had posted that they were always misunderstood because of after they were infected with HPV.
Knowledge about women's diseases has long been misinterpreted and even stigmatized.
Chen Yan believes that the reason is: "From the source, gynecological diseases are different from other diseases, such as heart disease, it is a male and female comorbidity, is the universal experience of human beings, and gynecological diseases belong to only a single biological sex, coupled with the history of human development women are in a weak position, and these diseases in the process of being recognized, always associated with sex, so these knowledge often become a content that is not openly discussed and cannot be learned as common sense, which will only deepen its secrecy. Also facilitated its stigma. ”
The American writer Susan Sontag believes in "The Metaphor of Disease" that the metaphor of disease has never been neutral, the more mysterious a disease is, the worse the metaphor it produces, and the disease and its metaphor represent the stripping of phenomenon and essence, and the disease itself is obscured by metaphors, which becomes evidence of depravity. The consequence is: "Blame the patient for the mistake, regardless of whether the patient himself is a victim of the disease." ”
These views also apply to gynecological diseases, because due to the moral criticism imposed on gynecological diseases, female patients have to bear the "stigma" marks on the disease in addition to the pain caused by the disease itself, which will also prevent them from receiving treatment correctly and effectively.
If we want to face up to and solve the disease, we must restore the disease as a natural physiological phenomenon, and the related gynecological examination needs to be normalized.
Su Yu has seen too many patients because of shame, the complaint did not make it clear, and finally led to the doctor's misdiagnosis, missed diagnosis of the situation, she repeatedly stressed: "It is not that your patients because of some stigmatization reasons to avoid talking about health, normal to look at it, normal to talk about, that is a normal thing, after all, the hospital has never been a place to judge the patient's morality or not, it is more of a place to objectively diagnose physiological conditions." ”
Behind this, proper sex education and physical knowledge science are the foundation. Xiao Zhou recalled that when he first received sex education, he was in junior high school, and the teacher asked the girls to stay alone after school, and they talked very sloppily.
"I think boys should actually stay and listen, boys and girls should receive a complete sex education, only to understand and recognize each other's physiological structure, will find that the sexual organs are only a part of the body, and our hands and feet, why should they be specialized?" Why give an extra moral concept to a part of our body? Only with enough knowledge will we better respect each other. ”
In addition, male doctors in gynecology are also a controversial topic, and in the third season of "Heartwarming Offer", a hot topic that has been rushed to the hot search is "Should we promote the feminization of obstetricians and gynecologists?" ”
Inevitably, there will be women who mind that the doctor who has a gynecological examination is a man. Two months ago, Fei Fei went to a third-class hospital for a routine vaginal discharge examination, and after finding out that it was a male doctor, he asked for another female doctor, but the other party refused: "You don't know how busy it is now!" I came specifically to help, and I usually have to wait for a long time if I want me to see it! Fei Fei could only endure shame and helplessly compromise.
The situation of male gynecologists not only bothers some women, but also men will have a lot of minds.
In Zhihu, Douban and other platforms, there will always be seen such as "the daughter-in-law goes to the hospital to check the gynecology department, is examined by the male doctor, what if the psychology is very uncomfortable?" "Boyfriend said that I see gynecology chose a male doctor to break up" and so on, and so on, and the replies under these questions often accuse the "men" in the question: they regard the female body too much as their own property.
Knowing the question
Xu Biao, a professor of epidemiology at the School of Public Health of Fudan University, believes that on the one hand, there is no need to be too harsh on the shame of doctors of the opposite sex, "after all, there are still some difficult places between science and culture, because society has not yet jumped out (from the traditional concept), and it is unrealistic for individuals not to mind at all", as to whether it is possible to change doctors, patients naturally have rights, but hospitals are for the public, and the services they provide are also fair and open. The ability to meet the patient's specific requirements also needs to be handled as appropriate. On the other hand, "we women must have confidence and autonomy in our bodies, if we are overly constrained by traditional concepts, it is really unnecessary, it is best to put down gender in the face of disease, or let technology first, health first!" ”
"It's meat in the doctor's eyes"
Crossing the barrier of concept and consciousness is only the first step, when women really enter the hospital, the implementation is the relationship between doctors and patients, so that women who bravely enter the hospital will not be blocked outside the hospital door again because of the doctor's "violent" shadow, which requires the manifestation of the doctor's humanistic care.
Xiao Zhou's first gynecological examination was at the age of 19, and what she can't forget is that the doctor actually looked disgusted at her vaginal discharge sample and made a vomiting sound.
"To tell you the truth, when I saw the doctor's expression, I had no self-confidence in treating the disease, and my self-esteem was also very devastated, as if I was something very dirty."
After Yang Yang sent one of her bad women's examination experiences to the group, she received a very special private message with only one sentence: "The doctor's eyes are meat." The sheep did not know whether the private letter was comforting her or refuting her, and in any case, the sentence itself made her very disapproving.
In her opinion, this sentence depends on what situation it is placed in, and the indiscriminate treatment of doctors when doing examinations is the embodiment of professional and technical standards, which is beyond reproach.
But the premise of "no difference" is that the doctor should regard the patient as a person, "if there is no such premise, the doctor simply treats me as something like meat, then I think this sentence is just an excuse, as if to erase my subjective feelings and rights as a person from a seemingly objective position." ”
After Su Yu joined the group, sometimes brushed some posts in the group, and felt that the attitude and operation of some doctors were too rude.
She has always believed that unlike most other departments, gynecological examination is more special that patients are more likely to directly feel the doctor's emotions, which is directly reflected in the entire examination process, so naturally more respect and empathy are needed.
"Especially like the kind of first-time come, basically very nervous, she doesn't know how to cooperate, if you ignore her feelings, or use some of your own moral concepts to impose on the patient to condemn her, then she will only be more afraid, and the examination will be even more difficult to do!" 」
Qiancao is an ultrasound doctor, and she often deals with intraluminal ultrasound (including transvaginal ultrasound and transanal ultrasound), and admits that after seeing some posts in the group, she will also reflect on whether there is something wrong in her work.
One of the great insights she has since she started in the industry is: don't act with evil and small, don't act with kindness and smallness, "Sometimes you just tell her that it doesn't matter, then she will be at ease a lot, like those words that can be said but not good, I will avoid, maybe I will casually say a word, she will pay attention to it for a long time." 」 ”
The ideal doctor-patient relationship is one of mutual respect, mutual understanding, and punctuality. What she expects is that change doesn't just come from doctors, but also from patients.
According to her description, the ultrasound department is particularly intense, the environment is noisy and fast-paced, and it basically maintains a state of chicken blood, with non-stop mouth and hands.
Sometimes she would hear the people at the door complaining loudly: How come it took so long, how come it has not been to me! But even if you work for a morning or an afternoon, even if you don't drink water, don't go to the toilet, or even work overtime, the patient still can't finish watching, not to mention sometimes encountering patients who are messing around. In such a state, it is actually difficult for doctors to take into account everyone's feelings, and can only say that they are as caring and considerate as possible.
"Gold eye, silver surgery, dirty and tired obstetrics and gynecology..." Su Yu frankly said that in the huge workload and experience increase, the doctor's empathy will be slowly flattened, or slowly become "numb", but the bottom line is of course normal consultation, do not bring irritability and fatigue to work, "because in the final analysis, it is not the patient's fault." ”
This is very similar to Xiao Zhou's idea: "When it comes to the humanistic care of doctors, especially if they are as busy as public hospitals, I actually don't ask doctors to have extra, meticulous care for me, as long as there is a minimum of respect, I think it is enough." 」 ”
"Everybody's working in this direction"
On December 21, 2021, the National Bureau of Statistics released the final statistical monitoring report of the Outline for the Development of Chinese Women (2011-2020).
The report pointed out that in 2020, the screening rate of common diseases among women reached 86.6%, an increase of 25.4 percentage points over 2010, and achieved the goal of "reaching more than 80%" in the "China Women's Development Program (2011-2020)", which not only means that the level of women's reproductive health services has been significantly improved, but also shows that women's awareness and ability to self-care have improved.
Screening rate of common diseases among women nationwide from 2010 to 2020
In Xu Biao's view, "a patient with 'health literacy' is the doctor's favorite type of patient, which essentially depends on the improvement of women's own health knowledge, scientific and reasonable attitudes and behaviors, and from the perspective of society as a whole, it is also necessary to promote women's health topics to get more attention, and it is a positive and rational focus.
While acknowledging the enthusiasm of the group, Chen Yan is also worried that the group will evolve into a collection of negative information.
Gu Liguo also noticed this potential tendency, she left a message under a group member's post: "I sincerely hope that the sisters can see useful things in the post, not a pull down, it is all emotions, it is all anger, that can not solve the problem, and even make the problem worse." ”
After Xiao Zhou posted the "unfortunate" experience of the gynecological examination, she actually regretted it a little, feeling as if she was just staying on the negative spit and catharsis, and she was worried that it would deepen the fear of other team members.
Four days later, she posted a new post about her experience of meeting a good doctor in a late-night emergency room, hoping to give some confidence to the sisters in the group.
Posts published twice before and after the week
In the group vote titled "Do you have a shadow of women's examination", although the proportion of "encountering violence and leaving a shadow" is still as high as 57%, the proportion of "encountering a mild doctor" and "having encountered both conditions" has reached half, which may also enlighten women who have shadows on women's examination and evade women's examination: not all women's examinations are very painful, do not have to choke on food, and treat all doctor-patient relationships negatively.
Li Ximei likes the atmosphere of the group: on the one hand, the sharing of those experiences and popular science can make her more aware of gynecological examinations and diseases; on the other hand, she feels that everyone in the group is not right or wrong, "I remember once seeing someone complaining about the breast examination doctor touching her chest, and someone in the comment area will correct her, saying that this is normal, it is that she thinks too much." ”
In addition, she often sees people working in gynecology who are in small groups answering questions and sharing practical situations and ideas about the profession. She also paid attention to the fact that some medical students, after seeing a lot of experiences in the group, hope that when they become a real gynecologist, they can be more considerate and respectful of each patient, "I think it is very good, so that patients and doctors, including those who are future doctors, have a communication channel, even if it is not large." 」 ”
Qiancao said that the purpose of both doctors and patients is to efficiently and accurately diagnose and treat diseases, and in the final analysis, it is also to improve the medical and social environment and jointly protect women's reproductive health. ”
Gu Liguo wrote under the July vote: "Please believe that it is precisely because we have the courage to raise this issue now, and because of these efforts we are making now, so that in the future, our mothers, sisters, and daughters will no longer experience violent women's examinations, let alone evade women's examinations because of shadows, delay their own illness, and can pay attention to and value women's health without worry."
* Xiao Xin, Li Ximei, Guli Guo, Jia Jia, Yanan, Ruohua, Feifei, Su Yu, Xiao Zhou, Yang Yang, and Qiancao are pseudonyms; Chen Yan and Xu Biao are real names