Episode 1
Eight years ago, I laid on a cold metal table in a diagnostic imaging center that my doctor’s office outsourced services to. My primary care physician had referred me here to get a transvaginal ultrasound in an attempt to rule-out various conditions as we hoped to figure out unexplained and worsening symptoms. (Spoiler alert: it was trauma).
I had done my best to advocate for myself and tell her I was a sexual assault survivor and that procedures like this felt scary and invasive; she nodded as if she understood but in action, my experience was different. The procedure was painful, in part due to my body bracing and nerves overtaking me, and the technician seemed wholly unphased that this invasive procedure should include tenderness and patience. When it was over, she told me she would send the results to my doctor while casually mentioning I had a couple small fibroids that I didn’t need to worry about since “all women have them.” Her aloofness about the findings combined with my significant lack of sexual health knowledge didn’t cause me pause or motivation to research more.
Days later my doctor echoed the sentiments and I never thought of it again despite none of my symptoms disappearing and in many cases, getting worse.
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When the Roe vs. Wade overturn was leaked in May 2022, I, along with many others, began to panic. I live in a red state with already extremely restrictive abortion care laws and another trigger law set to go into effect the moment the State of Tennessee would re-gain rights over women’s bodies.
I am careful and intentional when it comes to partnered sex: I communicate boundaries and consent. I decided a long time ago what I would do if I became pregnant unexpectedly and was diligent to make sure that this wouldn’t happen. Despite being sexually active, I never went on birth control.
Even though I was not sexually active until I was almost 30 (because, hello purity culture and fundamentalism!) my doctor put me on birth control briefly in my early 20’s to help with regulating my period. While the Pill did help, it caused far more problems than it solved. I was sick all the time and gained a lot of weight—which is a big no-no in fundamentalism. When your body is viewed as a living temple to worship God in, gaining weight meant I was idolizing food and giving in to the sins of gluttony rather than only worshiping Christ.
But the real tipping point came when my pack of birth control pills was found by someone close to me and the assumption was made that I was sexually active (I hadn’t so much as even kissed anyone!) Rather than engaging in conversation with me and asking questions, my prescription was reported to the church leadership. This only fueled narratives about my sinfulness and resulted in significant punishment. I was deeply ashamed and fearful of the potential consequences, so I decided that the symptoms were better to deal with than the stigma and I went off the pills.
As it pertains to this story I’m sharing with you, I have to wonder what would have happened if I had stayed on birth control. Would it have unequivocally meant I would have become sexually active? Probably not. But it would have ensured that I had regular gynecological exams, learned the cues of my body, how to advocate for myself and ultimately would have served me well as I journeyed out of religion in knowing how to practice safer sex.
Though this series is not about my sexual experiences after leaving religion, it is safe to say that my experience with birth control in my early 20’s was so overwhelming that I neglected my sexual health for over a decade—which included risky behavior, sexualized violence, less safe sex, and ultimately, trauma.
After these experiences and subsequently, years of chosen-abstinence and a lot of therapy, I began re-engaging in partnered sexual experiences with a renewed sense of confidence, boundaries, and empowerment. But because I was still wildly unfamiliar with birth control options and scarred by my past, I still chose natural cycle tracking as my form of birth control rather than medical intervention. To that end, while I was meticulous, I also suffered a lot of anxiety during and after sexual experiences.
When the Roe vs. Wade leak occurred, I sat on my back patio in absolute shock and horror, each moment feeling more unsafe than the last. I spent so much of my life believing—truly believing—that my body belonged to someone else: my parents, my future husband, God. Not only that, but deeply embedded in me was the belief that my body and bodily desires were inherently evil and because my body took on the female form, I was prone to making men sin. Because of this, I learned to silence my body’s cues, vilify my body, and felt a sense of relief that others had created rules to live by because it gave me a standard to achieve.
Leaving religion afforded me the opportunity to get my body back. And I did. Painstakingly and patiently over the course of years I developed a relationship with my body, healed my body, and loved my body. I was committed to listening to my body and living in such a way that honored my bodily cues, reflected my value, and prioritized continuing to untangle how messages of fundamentalism lived inside me.
But with Roe vs. Wade about to be overturned, the feelings of my body not being my own came roaring back in like floodwaters. It did not feel safe to be a woman in Tennessee.
Never could I have imagined that less than two months shy of age 40 I would need to weigh out options for birth control…and yet, on my patio in May of 2022 that is exactly what I was doing.
Through tears I talked with some of my dearest friends who helped me process through what was happening, my anger and terror, and the grim realization that using some form of birth control was the best of the worst choices I needed to make. Through those conversations, research, and talking with medical professionals, the choice became clear and I decided the non-hormonal (copper) IUD would be the best choice for me. I have an amazing OB/GYN who understood the gravity and timeliness of the situation and she agreed to get me in two weeks later.
This was an incredibly scary time—in addition to making my appointment with my OB/GYN, I made plans with friends and family in states where abortion care was not being criminalized, downloaded special software for my phone and computer to ensure I wasn’t being tracked, created a packet of resources for my clients, and ultimately began seriously considering moving. It’s unreal to recognize this was less than a year ago—so much has changed since then. And yet this was, for me, the beginning of the process of where I am today.
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As anyone who has had an IUD inserted will tell you, it was one of the most excruciatingly painful processes I had ever experienced. Despite this being a choice that I was making, I felt angry because in reality, it didn’t actually feel like my choice. I think my doctor knew that too–after all, it’s not often that an almost 40-year-old walks into your office to be put on birth control for the first time in two decades.
Held within the anger was a sense of pride; I was proud of myself. Proud of myself for advocating for what I wanted, proud of myself for seeking safer options, proud of myself for understanding my own sexual health despite all I had been taught and what the State I live in was trying to take away from me.
And I was proud of myself for allowing space to feel anger. So. Much. Anger. Anger that this was the best of the worst choices. Anger that despite having chosen to not have children many years ago, my life was less valuable than an unborn fetus. Anger that there were many other women who would need to suffer because they didn’t have access to things like birth control. Anger that after working so hard to resolve the trauma that had been committed against my body, it felt like my body was, once again, not my own.
I had done my research and knew what to expect after the IUD insertion: cramping, spotting, heavy periods, and things getting worse before they got better. That all happened. But for a few months, I learned to live with it and there was an automatic reduction in anxiety knowing that this little T-shaped device in my uterus would prevent a pregnancy.
But then things started to get bad. Despite people telling me that a non-hormonal IUD wouldn’t cause issues traditionally attributed to hormonal birth control options, people’s lived experiences told me that what I was living through was absolutely a result of this contraption. Zero emotions and flat affect except for incredible irritation; extreme insomnia; difficulty concentrating—even forgetting words frequently; no sex drive (in fact, I wondered if I had suddenly become asexual as I was disgusted by sex); heart palpitations; blurry vision; pelvic and sexual pain…each day it seemed that something new popped up. For a while I resisted the urge to go down the Google rabbit hole but eventually the physiological symptoms I was experiencing were so bad that I had to begin researching to see if what I was experiencing was, in fact, tied to having an IUD.
After a couple more months of worsening symptoms, I reached out to my OB/GYN again. I felt a tinge of shame; I had advocated so hard to be on this form of birth control and six months later I was begging them to take it out of me. However, I have an amazing gynecologist who believes me and she scheduled an appointment to have it removed.
With one condition.
She asked me to come in and have a transvaginal ultrasound to make sure that the IUD was in the right place in order to rule out any of the symptoms being caused by a mis-placed IUD. My mind instantly went back to the ultrasound I had so many years ago and dread descended on me. My mind started racing as I remembered the discomfort and how dismissed I felt by the medical professionals that were supposed to be helping me. This was not an experience I wanted to go through again, yet, I trusted my doctor–the doctor who had a proven track record of listening to me, never doubting me, and respecting how I advocated for myself.
***
A week later I hit the road at 7am and drove into Nashville for what I believed was the hoop I needed to jump through to get my IUD taken out.
Turns out that getting a transvaginal ultrasound at a women’s clinic that specializes in female reproductive health is a much better experience than what I endured years prior! The technician was pleasant, and we laughed as she got everything set up and started taking measurements. Though I was prepared to use all of my therapy tools to ensure my body felt safe, when the procedure started, I hardly noticed! A large computer monitor was placed in my vision line so I could see what she was seeing and despite my lack of knowledge of how to read ultrasounds, I found it to be a fascinating experience.
The technician intuited that I was curious to know what she was doing and so she explained what various terms meant and what we were looking at. I noticed that she was taking measurements of the left side of my uterus and spent a long time in that location. I assumed she was measuring my ovaries; she asked me if I experienced pain when I ovulated. “Yes,” I said, “So much pain that it takes my breath away.” She nodded and seemed to understand what I meant.
When she began taking images and measurements of the right side of my uterus, again, thinking she was measuring my ovaries, I marveled silently at how two organs (ovaries) could be so different in size.
Before I knew it, the appointment was over and she assured me that my doctor would be in contact with me later that day or the following Monday. I thanked her, got dressed and before leaving the clinic, confirmed my IUD removal appointment for two weeks later.
***
I am a big fan of patient portals for doctor’s offices. Goodbye to the days where we have to wait on hold forever to try and get an appointment with the doctor. Not only that, but it’s also so nice that the nurses, staff, and even doctors can upload results and send messages so that we have even more timely access to what’s happening within us!
I was anticipating getting my ultrasound results back and was anticipating the “all clear” when said results came in. Monday afternoon rolled around and I finally got a notification that I had a message in the patient portal and I clicked over to read what it said.
It took me some time to understand what I was reading; I was having to google every other word to figure out what the report meant. I clicked back to my inbox to find another message—from my favorite nurse—who put the results in layman's terms: I had two fibroids. One was extremely large and the other was big, just not as big as the other one.
My mind floated back to a few days before at the ultrasound and I quickly started putting the pieces together. The technician had not been measuring my ovaries. Nor was my left ovary significantly larger than my right ovary. In fact, my ovaries were perfectly sized and in the right places. She had been measuring the fibroids in my uterus.
Ding.
I snapped back to reality to see that the nurse had sent me another email with some possible treatment options, noting that it was likely that I would be asked to consider hormonal birth control. My experience of being on the pill two decades ago came roaring back into my mind; there was no way I was going to put my body through that again. My cheeks started to feel hot with shame and I had to re-orient to my surroundings, reminding myself that even if I did have to go on the pill, I wouldn’t need to explain my decision or plead with others to believe me in order to prove I wasn’t living in sin.
I emailed the nurse back and explained that at over 40 years old I wasn’t sure if going on a hormonal birth control pill would mess with the already growing list of symptoms and asked for other treatment options. I still wasn’t able to wrap my head around the dimensions of the fibroids in the report I had been given but intuited that surgical removal could be an option and asked my nurse about it. My kind nurse affirmed that this was absolutely an option and that it could be further discussed at my IUD removal appointment the following week…
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Stay tuned for the next episode of The “Glory” of Suffering. Episodes will drop every Tuesday.