I am currently a sexual health avatar and also on my way to becoming a connoisseur of public sexual health provision. This morning I went to get a smear test at my local GP; last night I went to the Dean St clinic to get the second of my Hepatitis B jabs. The differences between the two were striking and worth discussing.
Similarities first, however. Both were very busy (has anyone ever been to an empty NHS clinic?) and the staff members were generally lovely, if a little frazzled. I was in and out in around ten minutes and barely had to wait. Other than those things I may have been on different planets.
The experience at Dean St was much the same as before, except I had a lovely chap instead of a lovely lady, and his injection style was a little different (a stabbing dart-throwing motion which I complemented him on, and he was duly unflustered but instead gave a big grin).
My local GP is in a converted house, which was probably once a very nice house but is now a GP surgery. The furniture is cheap, institutional office seating and chipped tables covered in copies of Take A Break from three years ago. The receptionists sit behind (probably) bullet proof glass with a tiny sliver through which you might be able to talk to them if they weren't radiating a general hatred of humanity or on the phone. They have an ability to instantly make you feel as if you have done something wrong, like being told off by the school secretaries when you were running in the corridor, age thirteen. You don't talk to them. You sign in using a touch screen machine which has a bottle of antibacterial spray hanging next to it on a grimy bit of string in a futile gesture that might hope for irony were it not for the circumstances. Everywhere are large, slightly panic-inducing notices about Swine Flu and other diseases you can get if you have the temerity to be around other people.
I went in to see the nurse, who was rather jolly and had "women's health" written all over her. Not necessarily a bad thing - I want someone who is an expert, frankly. She asked me whether I was happy with the pill and I nodded, given that the other option is having no control over whether I have babies or not, it seemed a fair response. She then chatted about how they'd (the nurses, one assumes) have been told to tell people about other options: "the coil, you know, blah, blah - but if you are happy then there's no need for us to do that!" Right. Now perhaps asking me some questions on my lifestyle, a leaflet or some direction as to where to go and research these things might have been helpful, rather than just brushing it aside? There is still a general assumption in the profession that the pill is the best thing since sliced bread, frankly I'd rather not take it but a better option has not materialised (my campaign to sterilise all men at birth to keep control of their unruly sperm is strangely unpopular) and I would be rather keen to go through different choices. However, I was whisked on to the bench for the procedure. For reasons that are unclear, after stripping to the waist I had to put some paper towel material over my stomach and the top of my cunt so I couldn't see what was going on. I'm not sure whether this was meant to be a gesture towards my supposed sensibilities or potential embarrassment at having my cunt held open by a metal speculum - both of which seem rather moot points. And to be honest, outside of the context of a play environment, if someone is doing something to my body, I want to see what is happening.
The usual fiddling about occurred as she put the speculum in place - it always amazes me that something which in a BDSM situation would be exciting and hot, manages to be uncomfortable and irritating. Surely this woman is more practiced at doing this than almost anyone else on the scene, yet she manages to make me feel as if it is a grotesque and unpleasant activity that "we women" have to suffer because that is the fate of our sex. Because of this narrative and perhaps because of the horrible curtains that are pulled around the bed it does manage to be both grotesque and unpleasant - especially as she reminds me how I might get "spotting". I want to say "do you mean a small amount of blood?" but that would be rude and she doesn't know how much the infantilising and sanitising of the female body pisses me off. No-one else in the entire animal kingdom "spots" - it's only human women. Men don't "spot" (and if they did, medical science would have fixed it by now). If we're discussing blood, let's say blood. We're all grown-ups here, we all live with our bodies and we don't need to be protected from the perfectly natural and normal things that they do.
I digress. The main point is that here are two clinics, both run by the NHS, both in London, yet the atmosphere could not be more different. The more I think about the provenance of Dean St (championed by gay men, who were very demanding and active in getting the services they needed) the more I think that a similar clinic, but for women, would be very attractive. A place where smear tests could be done in a comfortable environment, where sensible conversations could take place over contraception which would not viewed as merely "family planning", and where the focus would not be just on women as baby-making machines as is sadly currently the case - The London Women's Clinic is not about women, as you'd imagine, but instead about fertility for women, the only aspect of female health that ever seems to be talked about. As long as we can churn out the next generation (god help us if we don't want to) then it's all alright. Thank goodness for Marie Stopes - more of that please.
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