Does STD testing need to include a vaginal exam?

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Someone asked us: 

Hello, I am a female-bodied trans* person under the age of 18. I need to go get tested for STDs at a Planned Parenthood office and I would like to know if that would have to include a vaginal examination because I have really bad body dysphoria and I would like to avoid that at all costs.

First, the good news:  Current medical guidelines recommend having your first pelvic exam (where a doctor checks the vulva, vagina, cervix, uterus, ovaries, and fallopian tubes) and Pap test (where the cervix is tested for abnormal cell changes) after you turn 21, so you have a few years to go before you should start getting regular pelvic exams, as long as you’re not having any problems before then.

Most STDs can be detected using a simple urine or blood test, so you may not need to have a vaginal exam. However, some STDs are diagnosed by looking at your genitals (genital warts), or with fluid taken from a sore (herpes, syphilis). Your nurse or doctor may need a sample of vaginal, cervical, or anal discharge or cells to diagnose some other STDs.

So your STD testing experience depends on the types of STDs you may be at risk for. However, nurses and doctors will do everything possible to make your appointment more comfortable. For example, some doctors now allow patients to collect certain discharge samples themselves by having them swab their own genitals privately, so you can ask if that’s an option for you.

Body dysphoria is serious stuff, so getting support to help you cope is an important part of being healthy, just like STD testing. Your nurse or doctor could be a good source of support, so talk with them about your concerns before or during your appointment. They can give you tips to help you feel better prepared for pelvic exams and Pap tests when you’re old enough to get them. If you don’t feel comfortable talking about your concerns with a nurse or doctor, a trans-friendly counselor is another good source of support.

-Mylanie at Planned Parenthood