‘About as comfortable as a stranger putting their finger up your nose’: speculation about the (extra)ordinary in gynaecological examinations

In public health education, gynaecological examinations are presented as a routine and ordinary procedure. Medical research addressing women's reasons for screening reluctance emphasises underlying psychological categories of ‘anxiety’ and ‘poor coping’. Minimal attention is paid to the effects of clinicians' interventions upon women's decision-making. Normalising promotes women's participation as speculum examinations are an essential part of many contemporary diagnostic and treatment procedures. In-depth email interviews were conducted with 26 women with diagnosis of either of the two commonest viral sexually transmitted infections, human papilloma virus and herpes simplex virus, and 12 sexual health clinicians. Data were analysed thematically. Findings indicate that women's screening compliance is influenced by clinicians' (in)attention to power relations, rapport-building, attentiveness to bodily (dis)comfort, technical skill and gender. Women's feedback is a valuable resource in devising interventions that may promote participation in examinations.