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Speaker 2: Drop.
Speaker 1: With that business out of the way, I am so
Speaker 1: excited to introduce this episode's author and book. This week
Speaker 1: I got to sit down with doctor Wendy Klein, professor
Speaker 1: of history at Purdue University and author, to discuss her book,
Speaker 1: Exposed the Hidden History of the pelvic Exam. If you've
Speaker 1: ever had a pelvic exam, you know the drill, the discomfort,
Speaker 1: the vulnerability, the waiting for it to be over. There
Speaker 1: are myriad ways that people feel about these routine exams,
Speaker 1: from neutral to dread, and yet we don't really talk
Speaker 1: that much about them. We put up with them, or
Speaker 1: maybe we avoid them, but at least speaking for myself,
Speaker 1: we don't question their existence, how they originated, or ways
Speaker 1: they can improve. We just accept them as a fact
Speaker 1: of life. But as doctor Klein demonstrates and exposed routine
Speaker 1: pelvic exams are a relatively recent addition to preventative care guidelines,
Speaker 1: guidelines which are currently being revisited. To understand the present
Speaker 1: day landscape of routine pelvic exams, we have to explore
Speaker 1: their past, a past fraud with abuse and concealment. Doctor
Speaker 1: Clin takes readers through the murky history of pelvic exams,
Speaker 1: and in doing so, reveals how the field of gynecology
Speaker 1: has been shaped both by those who use shame as
Speaker 1: a weapon as well as those who seek to empower
Speaker 1: women through knowledge about their own bodies. Exposed is so
Speaker 1: much more than a history and current assessment of one
Speaker 1: of the most commonly performed medical procedures. It reveals how
Speaker 1: the paternalistic view that medicine has held for women harms
Speaker 1: rather than helps, and it also highlights some of the
Speaker 1: incredible advocacy groups working to ask the crucial question, how
Speaker 1: can we make things better? I had such a fantastic
Speaker 1: time chatting with doctor Klein, and I am thrilled to
Speaker 1: be sharing this conversation with you all. I do want
Speaker 1: to note before we get into things, that this episode
Speaker 1: does feature discussions of abuse and medical trauma, so please
Speaker 1: keep that in mind. With that, let's take a break
Speaker 1: and then get started. Klein, thank you so much for
Speaker 1: joining me today.
Speaker 2: It is my pleasure. I'm delighted to be here.
Speaker 1: In your book Exposed, you take readers through the history
Speaker 1: of one of the most commonly performed medical procedures, the
Speaker 1: pelvic exam. And before we get into the murky origins
Speaker 1: of this exam, I would love for you to set
Speaker 1: the stage just by taking us through how a pelvic
Speaker 1: exam is done today, kind of just an overview step
Speaker 1: by step, and importantly why they are performed.
Speaker 3: So a public exam consists of three parts. The first
Speaker 3: is the examination of external genitalia and then second is
Speaker 3: the speculum exam, and that's typically accompanied by a pap
Speaker 3: smear to test for cervical cancer. And then the third
Speaker 3: part is a bi manual exam, and that is when
Speaker 3: the healthcare provider inserts one to two fingers into the
Speaker 3: vagina while using the other hand to press on the
Speaker 3: abdomen with the other hand in order to evaluate organs.
Speaker 2: Fairly standard procedure. It hasn't changed a whole.
Speaker 3: Lot over the last century or so, and the primary
Speaker 3: purpose is to test for cervical cancer, but there are
Speaker 3: other aspects as well, right, just to look for any abnormalities, discomfort,
Speaker 3: and opportunity to talk with a provider if you have
Speaker 3: any questions, either about sex or discomfort or anything else.
Speaker 1: It is really remarkable and maybe a bit alarming, how
Speaker 1: little it seems to have changed since it was first introduced.
Speaker 1: And I would love for you to take me through
Speaker 1: the origins of how this exam came to be, especially
Speaker 1: the role that was played by the so called father
Speaker 1: of gynecology, James Mary and Simms.
Speaker 3: Right, yeah, And of course I could talk all day
Speaker 3: about this, right, And I mean it's such an interesting conversation.
Speaker 3: But I mean, if you think about it, for centuries,
Speaker 3: women's genitalia was hidden, right, unlike male genitalia, which is
Speaker 3: quite obvious, It was very difficult for anybody to see
Speaker 3: or know what a woman's reproductive organs actually looked like.
Speaker 3: And that all changes in the nineteenth century. James mary
Speaker 3: and Simms was a doctor in Alabama, and he claims he.
Speaker 2: Takes credit right for discovering quote a class covering speculum
Speaker 2: in actuality.
Speaker 3: There were other types of speculums in France in the
Speaker 3: eighteen thirties, for example. But Simms was a master showman
Speaker 3: and took all the credit for this. He gets the
Speaker 3: idea when he's looking peering into.
Speaker 2: A patient's vagina.
Speaker 3: She's fallen off a horse, and she's in all kinds
Speaker 3: of discomfort, and.
Speaker 2: He gets the idea of using a.
Speaker 3: Spoon and bending it to kind of reflect and inserting
Speaker 3: it into her vagina. And he says this like, I
Speaker 3: find it rather hilarious. He says in his memoir introducing
Speaker 3: the bent handle of the spoon, I saw everything as
Speaker 3: no man had ever.
Speaker 2: Seen before, right.
Speaker 3: So he kind of lays his flag this idea of
Speaker 3: this new territory that he had essentially claims right. And
Speaker 3: so it was in fact a fairly revolutionary concept that
Speaker 3: you could actually see what had been hidden for centuries
Speaker 3: and centuries.
Speaker 2: And you know, on the one hand, it's saved probably
Speaker 2: millions of lives. It's changed how we understand gynecology. But
Speaker 2: there are some repercussions.
Speaker 3: And I will also say that it didn't go uncontested.
Speaker 3: I mean, even many physicians or budding gynecologists in the
Speaker 3: mid nineteenth century were really uncomfortable with the idea because
Speaker 3: what's happening in the nineteenth century when you think about
Speaker 3: upper middle class white womanhood, Victorian morality, and this idea
Speaker 3: that it was appropriate to appear inside a woman's vagina
Speaker 3: was highly problematic. So there was actually debates among gynecologists
Speaker 3: about whether touch was more appropriate than the gaze, right,
Speaker 3: and that what a good provider should be able to
Speaker 3: sense from their fingers rather than the visual gaze. And
Speaker 3: it's debated among these doctors like should we should we
Speaker 3: go ahead and welcome this new tool or should we
Speaker 3: disdain it?
Speaker 2: And I think that's a really fascinating conversation and debate
Speaker 2: between these doctors.
Speaker 3: The other thing is some of them are concerned that
Speaker 3: it's going to turn women into like sex maniacs.
Speaker 2: They're going to start loving.
Speaker 3: Having this speculum put inside their vagina and it will
Speaker 3: essentially corrupt women. So anyway, it wasn't immediately accepted as
Speaker 3: the ideal tool, but it was gradually accepted and promoted
Speaker 3: by people like James Mary and Simms.
Speaker 1: We've come a long way in some in some ways
Speaker 1: and not so much in others. But you know, when
Speaker 1: I was reading your book, I found myself thinking a
Speaker 1: lot of course about public exams and how I relate
Speaker 1: to them and my experience with pelvic exams. And I
Speaker 1: was wondering, you know, what your experience was like with
Speaker 1: pelvic exams or is like, and whether that's changed as
Speaker 1: you have as you worked on this book.
Speaker 3: You know, that's a great question eron and I'm surprised,
Speaker 3: like nobody's ever asked me that before. Again, a lot
Speaker 3: of talks, and that is not a question I've actually
Speaker 3: I've had. And so, you know, I feel lucky because
Speaker 3: I feel like I'm one of those people that doesn't
Speaker 3: particularly enjoy it. It's unpleasant, but it hasn't been traumatic
Speaker 3: for me. I'm fairly comfortable with my body. I tend
Speaker 3: to have good relationships with the doctors that I visit.
Speaker 2: The ob ginds.
Speaker 3: I'll talk about what I'm researching as they're probing inside
Speaker 3: of me.
Speaker 2: You know, I love that. But so I wasn't.
Speaker 3: Drawn to the topic because of some horrible thing that
Speaker 3: happened to me, which is I know for some people
Speaker 3: it's raised their curiosity about it.
Speaker 2: For me, it was more, you know, why are we
Speaker 2: not talking about this procedure? Right? So many people endure
Speaker 2: this on a regular.
Speaker 3: Basis, and so someone like me, it's unpleasant, but for
Speaker 3: some people it's hugely traumatic, painful, terrifying, And yet we're.
Speaker 2: Not really supposed to talk about it for many reasons.
Speaker 3: And so that kind of raised the question, why is
Speaker 3: it something that we just don't talk about it when
Speaker 3: it's something that we all experience.
Speaker 1: Yeah, just the expectation of this is what you have
Speaker 1: to do and that's it, and you just endure it. Yeah,
Speaker 1: and you know, but going back to the history of
Speaker 1: the pelvic exam and how it initially when it was introduced,
Speaker 1: it was not like you said something that a lot
Speaker 1: of people were like, absolutely, let's do this. And so
Speaker 1: who were the people who were likely to receive a
Speaker 1: public exam in these early decades and who was not
Speaker 1: likely to receive one?
Speaker 3: Yeah, great question and really important to this story. The
Speaker 3: first patients were basically the first guinea pigs.
Speaker 2: And you can probably yes who they were not.
Speaker 3: They were not white, middle class women, and this is
Speaker 3: fairly well known in the historiography. But James Mary and
Speaker 3: Zims did most of his procedures first unenslaved patients, and
Speaker 3: we know about three, in particular, Lucy, Betsy and anarka
Speaker 3: who endured multiple procedures countless times over a period of
Speaker 3: nearly four years without anesthesia. In part I should add
Speaker 3: that anesthesia was incredibly dangerous and not frequently used in
Speaker 3: the eighteen forties when he was doing this.
Speaker 2: But still, you know, extremely painful. These were enslaved women
Speaker 2: who had all were all suffering from besico vaginal fistulas,
Speaker 2: basically a tear between the vagina and the bladder as
Speaker 2: a result of prolonged childbirth, and possibly also the use
Speaker 2: of forceps. We don't know specifically in these.
Speaker 3: Instances, but you know, talk about tools that can actually
Speaker 3: really damage. Yeah, and so he claims that what they
Speaker 3: were suffering was worse than death. So it was in
Speaker 3: their interest to kind of endure these procedures because he
Speaker 3: was he believed to be helping them, but he was
Speaker 3: equally made the point that he was restoring labor to
Speaker 3: these women's quote unquote owners. Right, but regardless, and there's
Speaker 3: so much we don't know, because of course those voices
Speaker 3: are silenced. We only know through the absurd and through
Speaker 3: Sims himself what they experienced. And even if they were consenting,
Speaker 3: they can't consent by virtue of the fact that they
Speaker 3: had no power to do so. They were enslaved women.
Speaker 3: So what does it mean that a procedure that's considered
Speaker 3: immoral or an ethical or just distasteful to do on
Speaker 3: a white middle class woman is done on these bodies,
Speaker 3: but with the idea that if they could be perfected,
Speaker 3: then right then it would be appropriate to.
Speaker 2: Use on these other bodies.
Speaker 3: And that's basically what happens enslaved women, sex workers, basically
Speaker 3: women who were disempowered. And of course, if you think
Speaker 3: about it, one of the reasons Sims is interested in
Speaker 3: taking these tools and then applying them to the white
Speaker 3: middle and upper classes is money, right, That's where he's
Speaker 3: going to get his client tele that's where the concern
Speaker 3: learn about suffering and alleviating suffering.
Speaker 2: It's going to be focused on. But he needs the tools. First.
Speaker 1: Let's take a quick break, and when we get back,
Speaker 1: there's still so much to discuss. Welcome back everyone. I've
Speaker 1: been chatting with doctor Wendy Kline about her book exposed
Speaker 1: the hidden history of the pelvic exam. Let's get back
Speaker 1: into things. And then once he had those tools, you know,
Speaker 1: still though the pelvic exam, the speculum was not, as
Speaker 1: you said, widely adopted immediately. And so then what were
Speaker 1: some of the things that led to its increase in popularity,
Speaker 1: I guess, or it's acceptability.
Speaker 3: Yeah, I mean, there's a basic shift that occurs over
Speaker 3: roughly like a fifty to seventy year period, from the
Speaker 3: emergence of gynecology as a medical specialty, which I should
Speaker 3: add comes hand in hand with the development of the speculum, right, it.
Speaker 2: Was the tool that justified.
Speaker 3: The need for a male medical model to differentiate themselves
Speaker 3: from say, female midwives. So most of their work was
Speaker 3: done either with obstetrics with childbirth or with patients.
Speaker 2: That are suffering, not on healthy women.
Speaker 3: Gradually, there's a shift from pathological or surgical gynecology to
Speaker 3: preventive gynecology, and there are a couple of reasons for that.
Speaker 3: The most kind of blatant in terms of developing gynecology
Speaker 3: as a specialty is obvious. They want to expand their
Speaker 3: patient base, right, They don't want it to be up
Speaker 3: to the patient to determine when they think they need
Speaker 3: to see a doctor. By pushing for preventive medicine and
Speaker 3: an case, preventive gynecology, you're widening your patient base. You're
Speaker 3: encouraging you know, every woman of reproductive age should see
Speaker 3: a doctor on a regular basis, and boom, suddenly you've
Speaker 3: got a much wider patient population.
Speaker 2: Now, I mean, that's the cynical part. Obviously.
Speaker 3: You know, they believe that they were helping, and oftentimes
Speaker 3: they were so, but it was a smart way to
Speaker 3: expand their patient base. I have an entire chapter about
Speaker 3: one doctor, doctor Robert Dickinson, who is the president of
Speaker 3: the American Gynecological Society in nineteen twenty, and he makes
Speaker 3: a big case. He's, you know, like, what separates us
Speaker 3: from surgeons. We need to define ourselves as something other
Speaker 3: than surgeons of the female reproductive tract or organs, and
Speaker 3: we should be talking about sex and birth control and
Speaker 3: all these topics that male doctors, because most of them
Speaker 3: were male, are kind of skirting around as kind of
Speaker 3: again inappropriate. We shouldn't be talking about these things. We
Speaker 3: want to show that we are morally upright, upstanding citizens.
Speaker 3: We're not perverts, and therefore we should avoid talking about
Speaker 3: these things. Dickinson's like, no, that's exactly what we should
Speaker 3: be doing. We should step in and he basically suggests
Speaker 3: that doctors. Gynecologists should also be marriage counselors. They should
Speaker 3: be talking about sexual discomfort, they should be asking about
Speaker 3: birth control, et cetera, et cetera. And again it's a
Speaker 3: way of widening their base of asserting their authority. But
Speaker 3: it paves the way for this notion of prevented gynecology.
Speaker 3: Then on top of that you have the development of
Speaker 3: the pap smear, right, and so that's a little bit later.
Speaker 3: It becomes kind of standardized in the early nineteen forties.
Speaker 3: George Papa Nicolau, that's why we have the name figures out.
Speaker 3: He's not even looking for this, but when he's taking
Speaker 3: cervical smears first out of guinea literal guinea pigs, and
Speaker 3: then he uses his wife, who volunteers cervical smears daily
Speaker 3: for decades decades.
Speaker 4: I couldn't get over that. It was like literally.
Speaker 3: Human gay pig in the name of science, and realizes
Speaker 3: that by taking these smears, by looking at the fluid,
Speaker 3: you can determine whether there are any signs of cancer,
Speaker 3: basically of tumors. So once that is established, then there's
Speaker 3: a very clear reason why preventive gynecology makes sense. Right,
Speaker 3: This is a way of early detection, trying to see
Speaker 3: if there's any signs. So it's kind of a gradual process,
Speaker 3: but I'm really interested in those kind of those years
Speaker 3: in the twenties up to the forties where there is
Speaker 3: talking as much about sex as they are about vaginal health,
Speaker 3: I would say, and offering, among other things, pre marital
Speaker 3: pelvic exams, like getting a woman ready for her wedding
Speaker 3: night to ensure that she will kind of be comfortable
Speaker 3: with sex, et cetera.
Speaker 1: That was a fascinating chapter about Dickinson and that quote
Speaker 1: that you include where he says there is never a
Speaker 1: precise way of separating the woman from the doctor's idea
Speaker 1: of her. It just has been rattling around in my
Speaker 1: head ever since reading that.
Speaker 2: Yeah, he kept me up.
Speaker 3: There are many nights that I did not sleep when
Speaker 3: I was doing research for that chapter.
Speaker 2: And it came gradually because he has.
Speaker 3: Terrible handwriting, and all of this was scratched, scribbled onto
Speaker 3: tiny little note cards that I found in the archive,
Speaker 3: and so it took a long time to piece together
Speaker 3: exactly what he was saying and how he was saying it,
Speaker 3: and so the horror was kind of gradually emerging. You
Speaker 3: know and until I was realizing that he was in
Speaker 3: fact sexually abusing some of his patients and acknowledging it
Speaker 3: in his own handwriting. And he's also a great case
Speaker 3: for a historian because he took prolific notes of every
Speaker 3: because he saw his patients as case studies.
Speaker 2: He was kind of.
Speaker 3: Interested in learning from them, and so as soon as
Speaker 3: he would examine them, he would write down, describe what happened.
Speaker 3: He would even quote the conversation. He would quote, supposedly
Speaker 3: verbat him what the patient had said to him. So
Speaker 3: even though we don't have.
Speaker 2: A record of these individual women.
Speaker 3: Most of the time, we have his quoting his memory
Speaker 3: of what took place, and he's very upfront about what
Speaker 3: he's doing. So yeah, that was really really disturbing in
Speaker 3: terms of that. I also just want to add on
Speaker 3: top of it because I think this is really interesting
Speaker 3: because my first book was a history of the eugenics movement. Well,
Speaker 3: Dickinson was a eugenicist, and he embraced not only sterilizing
Speaker 3: certain women, but encouraging the right time of women to
Speaker 3: have more children. And that's why he was so interested
Speaker 3: in pre marital pelvic exams and the idea that he's
Speaker 3: a marriage counselor because he wants to ensure that these
Speaker 3: women stay in stable marriages, why so they have more children,
Speaker 3: And it's the quote unquote right kind of children. Right,
Speaker 3: So that's partly why he's kind of putting his foot
Speaker 3: in the door opening this like wider conversation about women's roles,
Speaker 3: believing that gynecologists should in fact be these moral arbiters
Speaker 3: that come in and help stabilize marriages by having these
Speaker 3: kind of hidden conversations to ensure that women continue to
Speaker 3: have sex and reproduce.
Speaker 4: That lens I feel like is so important.
Speaker 1: You know, his work or ideas or notes or practice
Speaker 1: and abuse didn't happen in a vacuum, like he was
Speaker 1: a product of that, how eugenics was had a hand
Speaker 1: in every everything. He seems to approach his patients from
Speaker 1: this framework of I am not going to believe what
Speaker 1: they say, like I am already doubting what this person
Speaker 1: is going to say to me. And I feel like
Speaker 1: this is again part of this larger trend that was
Speaker 1: happening around this time with the speculum and then other
Speaker 1: instruments being utilized by physicians to learn about their patient's
Speaker 1: bodies without having to actually talk to, or listen to,
Speaker 1: or believe the patient themselves. And what do you feel
Speaker 1: like were the consequences of this shift where suddenly a
Speaker 1: woman becomes an unreliable narrator about her own body.
Speaker 3: I think it's a really important shift, which is again
Speaker 3: one of the reasons why I wrote this book. I mean,
Speaker 3: if I just step back for a moment and we
Speaker 3: think about science and technology doesn't happen in a vacuum.
Speaker 3: It is all about context and agendas and professionalization and
Speaker 3: attitudes about women in a particular time and place. So
Speaker 3: if you take a particular tool or procedure and you
Speaker 3: track it over the time, while the procedure may not
Speaker 3: change that much, I mean, that's one of the first
Speaker 3: things we said. The tool is pretty much the same,
Speaker 3: the examination is pretty much the same, and yet the
Speaker 3: meaning behind it changes radically depending on different contexts. So
Speaker 3: in a time period in which eugenics was extremely popular,
Speaker 3: the tool and the procedure.
Speaker 2: Are going to be used in a very different way.
Speaker 2: So back to your.
Speaker 3: Question about moments in which tools kind of replace listening
Speaker 3: to the patient, in this case, the female patient. I
Speaker 3: think it's a reminder of the extent to which this
Speaker 3: was a paternalistic, fairly misogynistic culture in which women's voices
Speaker 3: were not always taken seriously.
Speaker 2: And they weren't always believed.
Speaker 3: And so for Dickinson, it's like, your genitals can tell
Speaker 3: me the truth more than your voice or your experience.
Speaker 3: And that's a very disturbing message, right, And this is
Speaker 3: among white, educated, middle class women. This isn't even you know,
Speaker 3: wouldn't it be great if Sims had kept a diary
Speaker 3: the way Robert Dickinson did. What was he saying about
Speaker 3: Lucy Betsy and Anarcha?
Speaker 2: Right?
Speaker 3: And what were they thinking? I mean, this is historians
Speaker 3: greatest tool and biggest frustration is the clues and then
Speaker 3: the absence of clues and what we wish we knew,
Speaker 3: And there's so much we don't know, but we can expect.
Speaker 3: You know that the power differential wasn't just my male female.
Speaker 3: It was white black, It was enslaved slaveholder because Sim's
Speaker 3: himself owned slave. So this kind of dismissal is so
Speaker 3: much linked to power. Yea, the more disempowered a person is,
Speaker 3: the less likely their voice is going to be taken seriously.
Speaker 3: So my point is that even among white middle class women,
Speaker 3: they were not necessarily listened to. The tools became kind
Speaker 3: of the translator almost or the interpreter to kind of
Speaker 3: displace the voice of the woman herself, and in turn,
Speaker 3: very gradually, this disempowering makes women less confident that they
Speaker 3: have the right to say, or that maybe they don't
Speaker 3: understand their bodies or what's going on, they need the
Speaker 3: doctor or the tool to kind of explain to themselves.
Speaker 3: I'm jumping ahead, but that's what eventually leads to the
Speaker 3: feminist movement kind of pushing back and saying, hold on
Speaker 3: a minute, we do know what we're doing. These are
Speaker 3: our bodies, so we are the experts of our own
Speaker 3: bodies because we embody them. We don't need your interpretation,
Speaker 3: which we believe to be misogynistic, inaccurate, etc.
Speaker 2: Et cetera.
Speaker 1: Let's take a quick break here, we'll be back before
Speaker 1: you know it. Welcome back, everyone, I'm here chatting with
Speaker 1: the wonderful doctor Wendy Klein about her book Exposed. Let's
Speaker 1: get into some more questions. How did it go from
Speaker 1: like an informational perspective of you seek a gynecologist because
Speaker 1: you need it to then preventive care. How did women
Speaker 1: learn or like come across that that's what they should do?
Speaker 2: Ooh, that's such a good question.
Speaker 3: You know before obviously there was cervical cancer existed before
Speaker 3: the pathsmerror right, uh, right to have a diagnostic screening
Speaker 3: procedure was really exciting, right, genuinely exciting. It did save
Speaker 3: a ton of lives even before that takingsygnostic tool. There's
Speaker 3: a recognition that just being seen by a doctor and
Speaker 3: examined an internal examination, even without the smear test, could
Speaker 3: save some lives. The problem, as you've said, is how
Speaker 3: do you spread the word? Okay, So, like in the
Speaker 3: nineteen twenties nineteen thirties, you have gynecologists trying to push
Speaker 3: for early prevention and preventive gynecology, but they're not allowed
Speaker 3: to talk about it.
Speaker 2: Right.
Speaker 3: So a doctor at Johns Hopkins is complaining because he
Speaker 3: wants to publish information in newspapers and journals, but he's
Speaker 3: told the newspapers really don't want to see the words smear,
Speaker 3: cervical fluid, men sees, cervix uterus, right, I mean all
Speaker 3: of these words that have all the stigma attached to it.
Speaker 3: And he's like well, how do I get the word
Speaker 3: out if I'm not even allowed to talk about it?
Speaker 3: So he hires an assistant. Her name's Florence Becker, and
Speaker 3: basic says, you know, it's up to you go spread
Speaker 3: the word in women only circles, like tell your friends,
Speaker 3: organize women's groups to talk about it, kind of behind
Speaker 3: people's backs because it's not seen as appropriate to talk
Speaker 3: about it. Do you see how we get to where
Speaker 3: we are today where we still can't talk about it, right?
Speaker 2: I mean, this is the problem. People were told they
Speaker 2: can't talk about it, so it becomes.
Speaker 3: This like women telling their friends their sisters, you should
Speaker 3: really see a doctor.
Speaker 2: It saved my life.
Speaker 3: And that's still kind of a message in cervical cancer
Speaker 3: advocacy today. And I'm not saying it's a bad message,
Speaker 3: but it was the only way to spread the word
Speaker 3: because these doctors, you know, couldn't talk about it. Once
Speaker 3: you have the paps mirror, I think they have more evidence,
Speaker 3: scientific evidence to kind of prove, and they're able to
Speaker 3: be a little bit more open about it. But it
Speaker 3: was it was essentially a word of mouth campaign decades.
Speaker 1: Of course, that word of mouth doesn't make it everywhere,
Speaker 1: and so you see these disparities both historically and today
Speaker 1: in who is getting access to papsmeres, and there are
Speaker 1: I mean, there's a myriad of factors that determine whether
Speaker 1: or not someone can get a pap smeer has access
Speaker 1: to a perapsmere, doesn't want to get a papsmere. But
Speaker 1: you know, what were some of these disparities that emerged
Speaker 1: with these early studies trying to examine who was getting
Speaker 1: routine public exams and who wasn't.
Speaker 2: Huge massive racial disparities.
Speaker 3: And I think there are a couple of reasons for that,
Speaker 3: accessibility and racism. So and they're obviously overlapping, but by
Speaker 3: racism I also mean mistrust that even campaigns to kind
Speaker 3: of reach out to women of color were problematic because
Speaker 3: black women understood historically how racism and mistrust had led
Speaker 3: to all kinds of problems. If most of the providers
Speaker 3: and scientists and practitioners are white and white men, of
Speaker 3: course there's going to be a reluctance what do you
Speaker 3: really want from me?
Speaker 2: And why, right, I shouldn't trust you?
Speaker 3: But primarily access, you know, health insurance, availability, access to
Speaker 3: any kind of treatment, right, particularly in regions in which
Speaker 3: a two tiered healthcare system which prevented these women from
Speaker 3: entering most hospitals. So that combination meant that this was
Speaker 3: primarily reaching white women. Oh, I should add the third
Speaker 3: is who are the women primarily with some exceptions of course,
Speaker 3: who are spreading the word. When I talk about the
Speaker 3: word of mouth campaign, Florence Becker is going to talk
Speaker 3: to university women, I forget is that the American Association
Speaker 3: of University Women.
Speaker 2: I think she.
Speaker 3: Talks to a primarily white, middle class educated group.
Speaker 2: Right. They're spreading the words their friends, their sisters, their
Speaker 2: club groups, right, but not among others.
Speaker 3: Again, there are some exceptions to that and some awareness,
Speaker 3: which is why you get some black women being tested
Speaker 3: and seeking treatment.
Speaker 2: But it's to a much smaller extent.
Speaker 1: All problems that still exist in some form or another today.
Speaker 1: And I want to talk about that in a bit.
Speaker 1: But I also want to get back into this idea
Speaker 1: of how the feminist movement and women sort of reclaiming
Speaker 1: the knowledge that should have been theirs all along, and
Speaker 1: so who were some of the pivotal players in this time?
Speaker 1: And I would love for you to tell me more
Speaker 1: about self help clinics and how they came to be
Speaker 1: and how those also changed the patient doctor relationship.
Speaker 3: Yeah, oh my gosh, well do you have like seventeen hours,
Speaker 3: because that's how long I can talk about it.
Speaker 2: I've written a lot about this and other books as well.
Speaker 3: I think it's more to set the stage to how
Speaker 3: we get to this moment.
Speaker 2: So I talked about Robert Dickinson in general.
Speaker 3: These gynecologists until nineteen seventy are male, primarily white male.
Speaker 3: Ninety three percent of all gynecologists in nineteen seventy were male,
Speaker 3: which is very different from today right, where the majority
Speaker 3: are female, And so these are women that are going
Speaker 3: to see male doctors. Nineteen sixty of the introduction of
Speaker 3: the birth control pill, it's intended for.
Speaker 2: Married women only, so a lot of women are.
Speaker 3: Going to the gynecologist only to get access to the
Speaker 3: birth control pill.
Speaker 2: Or that's a primary motivator.
Speaker 3: And initially the requirements of getting the pill included getting
Speaker 3: a pelvic exam. That has since been uncoupled, right, but
Speaker 3: that was the rule. And so you've got millions of
Speaker 3: women going on the birth control which means there are
Speaker 3: also millions of appointments made right and millions of PEPs.
Speaker 3: Marriage pelvic exams, and many of these doctors have inherited
Speaker 3: this kind of marriage counselor role, so they think it
Speaker 3: is their right to make moral claims about why this
Speaker 3: woman is seeking the birth control pill.
Speaker 2: Is she married?
Speaker 3: Some women would actually wear fake rings and pretend they
Speaker 3: were married, but more generally just being paternalistic, making all
Speaker 3: kinds of claims about a woman's sexual behavior because she's
Speaker 3: seeking birth control pill. So, you know, that's the beginning
Speaker 3: of the sixties A. We all know it's a turbulent decade.
Speaker 3: And by the end of it, it becomes clear that
Speaker 3: sexual liberation isn't necessarily liberating for women. There's an expectation
Speaker 3: to be sexually available. It isn't always in their best interest.
Speaker 2: So out of that springs a lot of.
Speaker 3: Anger about what is happening in the gynecologist's office. And
Speaker 3: there's a meeting at a workshop on women's liberation in
Speaker 3: nineteen sixty nine in a college in Boston, Emmanual College,
Speaker 3: and there's a two hour meeting and the topic is
Speaker 3: women and their bodies, and it's twelve women and they're
Speaker 3: just all they want to do is come up a
Speaker 3: list of reasonable ob guns in the Boston area, and
Speaker 3: they realize they can't come up with a single name,
Speaker 3: literally a single name, and then they decide to keep meeting,
Speaker 3: and eventually that group evolves into the Boston Women's Health
Speaker 3: Book Collective That Rights Our Bodies, Ourselves, and it's really
Speaker 3: the first women's health manual written by women for women,
Speaker 3: not by medical professionals, accessible information about their own bodies
Speaker 3: that they research themselves. But part of this anger is fueled,
Speaker 3: I mean they see the gynecologists is sort of emblematic
Speaker 3: of all the problems of misogyny in American society. There's
Speaker 3: a great quote in Vaginal Politics and it opens with
Speaker 3: a description of her first visit to a gynecologist where
Speaker 3: she says, I was naked, he was clothed. I was
Speaker 3: lying down, he was standing up. I was silent, he
Speaker 3: was speaking. It just kind of captured in this tiny
Speaker 3: little narrative everything that was silencing women and basically robbing
Speaker 3: them of their identity.
Speaker 2: So you fast forward to two options.
Speaker 3: One fight against medical school quotas that are keeping women
Speaker 3: out of medical school. But secondly, many people realized that
Speaker 3: wasn't going to be good enough. Now you start having
Speaker 3: more women going to medical school, they're subjected to jokes,
Speaker 3: they're ridiculed. They've got their professors putting up Playboy cartoons
Speaker 3: kind of mocking them, sexualizing the procedure, et cetera, et cetera.
Speaker 3: And so you have other women that are creating these
Speaker 3: kind of lay feminist women's health organizations, lay, meaning they're
Speaker 3: not run by MD's. And that's where the birth of
Speaker 3: self help. That was a long winded way of me
Speaker 3: getting to self help.
Speaker 4: Oh I loved it. I loved it.
Speaker 3: So the idea is you are the expert of your
Speaker 3: own body, and you don't need someone, you know, an intermediary,
Speaker 3: a so called expert, to show you or tell you things.
Speaker 3: And the way you do it is by spreading your legs,
Speaker 3: getting a mirror in a flashlight and a plastic speculum,
Speaker 3: and suddenly, voila, you see your own cervix, your own vagina,
Speaker 3: the walls of your vagina. And for many this was
Speaker 3: incredibly revolutionary because of the fact that they could suddenly
Speaker 3: that gaze which had started with Sims right saying introducing
Speaker 3: the backhandle, this soon I saw things as no man
Speaker 3: ever seen before. They turn that on its head and
Speaker 3: basically see the speculum as a potential form of women's liberation.
Speaker 3: There's a great cartoon I have in the Book of
Speaker 3: Wonder Woman holding the speculum, this feminist tool of empowerment.
Speaker 2: We don't need these men to tell us. We can have.
Speaker 3: Access to that information ourselves. Now, some of these women
Speaker 3: didn't just look. They did things right, including perform abortions.
Speaker 3: They're the collective in Chicago, Jane taught each other how
Speaker 3: to do abortions. So it was very politically motivated at times,
Speaker 3: and very radical and empowering as well.
Speaker 1: Thinking about that period made me sort of wonder, what
Speaker 1: are the components of a good pelvic exam?
Speaker 2: Rika?
Speaker 4: What makes a good pelvic exam?
Speaker 1: I think it's easy to think of ways that a
Speaker 1: pelvic exam is bad, but what are the good components?
Speaker 2: Yeah, and in.
Speaker 3: Fact, a lot of what we experienced today are a
Speaker 3: result of the women's health movement kind of putting their
Speaker 3: foot down and saying here are some demands. So another group,
Speaker 3: the Women's Community Health Center, which was a feminist women's
Speaker 3: health collector in Boston, partnered remarkably with Harvard Medical School
Speaker 3: for this kind of experiment. It doesn't last long. This
Speaker 3: is in nineteen seventy four. I believe that basically some
Speaker 3: of female Harvard medical students go to the center and say,
Speaker 3: we're not comfortable with how we're.
Speaker 2: Learning how to do a public exam.
Speaker 3: In general, medical students in this time period, like in
Speaker 3: the fifties and sixties, are either learning on simulated plastic
Speaker 3: pelvisist or on anesthetized patients, or on prostitutes who are
Speaker 3: being paid to do the exam, and there's a lot
Speaker 3: of debate about, you know, is this appropriate.
Speaker 2: So suddenly you.
Speaker 3: Have the emergence of these women going to more women
Speaker 3: going to medical schools as these quotas are eliminated, and
Speaker 3: the women are not comfortable with how they're learning it,
Speaker 3: and they go to the community Health center and say,
Speaker 3: could you help us here? Could you volunteer your own bodies.
Speaker 3: If we could convince Harvard that you teach it and
Speaker 3: we learn how to do a public exam on you guys,
Speaker 3: and you instruct us, then we can have a better
Speaker 3: sense of what's appropriate. And among the things I do
Speaker 3: is they come up with a list of guidelines that
Speaker 3: they require everybody at Harvard to use, and things that
Speaker 3: now are so obvious, like warm the speculum right before
Speaker 3: you insert it.
Speaker 2: Make eye contact with your patients.
Speaker 4: Oh my gosh, that that had to be written out.
Speaker 2: Yeah.
Speaker 4: The instruction is.
Speaker 3: Introduce yourself, like just basic things to set the woman
Speaker 3: at ease so that it is slightly less traumatic. Those
Speaker 3: are the things that are now ideally commonplace and it's
Speaker 3: a result of that. But if you think about it,
Speaker 3: and I tell my students this, other than the ethical problems,
Speaker 3: but from a teaching perspective, what's the problem with teaching
Speaker 3: someone how to do an exam this sensitive on an
Speaker 3: anesthetis unconscious patient or on a plastic pelvis.
Speaker 4: There's no feedback, right right, Yeah, But the.
Speaker 3: Message is it doesn't matter if it hurts, right that,
Speaker 3: what matters is that you do the exam, You see
Speaker 3: what you need to see.
Speaker 1: Right, wh cares about the patient. It's the patient's body
Speaker 1: part that you're interested.
Speaker 2: In, exactly.
Speaker 3: And so that kind of humanistic part that had been
Speaker 3: lost that required an active, conscious body that could provide
Speaker 3: some feedback, help to kind of change some of those
Speaker 3: attitudes that there are ways to do this that are
Speaker 3: less traumatic, and we should be talking about that, not
Speaker 3: just getting an accurate paps mirror whatever else.
Speaker 1: Right, actually incorporating the patient into the goals of a
Speaker 1: pelvic exam. Speaking of using and esthetized women to train
Speaker 1: for pelvic exams, where do we stand with that today?
Speaker 4: In the US?
Speaker 3: The fortunate thing is we're talking about it, and there's
Speaker 3: been legislation. It changes regularly, but now certain states have
Speaker 3: legislation on the books preventing the training of medical students
Speaker 3: on women without their consent who are under anesthesia for
Speaker 3: a procedure in which it's unnecessary. But on top of it,
Speaker 3: now recently Health and Human Services have said that teaching
Speaker 3: hospitals that receive federal aid are required to get consent
Speaker 3: for these procedures. When that story came out, people were
Speaker 3: either totally got it and said this is how.
Speaker 2: Can this be?
Speaker 3: Like I'm horrified, I didn't even know this was happening,
Speaker 3: And others were like, oh God, one more consent for him?
Speaker 2: Can we do nothing? Can we accomplish nothing?
Speaker 3: And if you looked at the comments, there was pretty
Speaker 3: clearly a gender divide.
Speaker 2: Right, not entirely, but.
Speaker 3: It just it speaks to this idea comes out of
Speaker 3: the history of medicine and how we train doctors that
Speaker 3: apprenticeship model or this idea you have to you have
Speaker 3: to learn, you have to practice.
Speaker 2: How are you going to do it?
Speaker 3: Do you need permission every time you look inside a
Speaker 3: mouth or an ear? But of course the vagina is
Speaker 3: a very different type of orifice. Right The boundaries between
Speaker 3: what's sex and what's medicine become very easily blurred when
Speaker 3: you're talking about penetrating vagina. And we know that because
Speaker 3: of cases like Larry Nasar and others. I talk about
Speaker 3: them in the book as white coat predators. These are
Speaker 3: people that have basically learned to take advantage of the
Speaker 3: system to violate women for their own sexual desire rather
Speaker 3: than in the interest of the patient. And the problem is,
Speaker 3: even though most kindecologists aren't doing this, but we've created
Speaker 3: an environment.
Speaker 2: Where it's the potential is there.
Speaker 3: And it goes back to that silencing and the fact
Speaker 3: that we don't talk about what goes on in the exam,
Speaker 3: or what should go on the exam, or any of that,
Speaker 3: because we just don't talk about it.
Speaker 1: And shame is such a huge part of this silencing,
Speaker 1: because we're taught to feel ashamed about our bodies. We're
Speaker 1: taught that it's not polite to talk about, and I
Speaker 1: want to sort of ask about, like how this shame
Speaker 1: then has played such a huge role in making it
Speaker 1: difficult to recognize when something is an abuse, when something
Speaker 1: is crossing a line.
Speaker 3: It's a huge problem. It's a huge problem, and it's
Speaker 3: such a double standard, right, I mean, if we go
Speaker 3: all the way back to pre James, Mary and Sims
Speaker 3: of the fact that these women's body parts were secret
Speaker 3: because they were hidden, and medieval Christian laws prevented looking.
Speaker 2: At talking about these things.
Speaker 3: So it's I mean, it's got a very long history,
Speaker 3: but in contemporary society it's still the case.
Speaker 2: I mean, studies show, for.
Speaker 3: Example, there was a study done in twenty fourteen in
Speaker 3: the UK.
Speaker 2: That showed that a majority of women.
Speaker 3: In the UK between the ages of sixteen and twenty
Speaker 3: five have a problem with using the term vagina or volpa.
Speaker 2: They just they don't want to say it.
Speaker 3: And this, of course leads to a basic lack of
Speaker 3: anatomical knowledge. It's not just that they're uncomfortable, they don't know.
Speaker 3: Only half of women between the ages twenty five and
Speaker 3: thirty six surveyed in the same study could accurately identify
Speaker 3: parts of the vagina on a simple diagram, and then
Speaker 3: nearly one third of the younger women admitted they avoided
Speaker 3: going to the gynecologists altogether due to shame and embarrassment.
Speaker 3: So there's a direct link this discomfort because we're encouraged
Speaker 3: from basically the day we're born not to not to
Speaker 3: talk about these body parts and to be ashamed of them,
Speaker 3: and et cetera, et cetera, and sometimes for protective reasons, right,
Speaker 3: but it's still the same problem that we don't talk
Speaker 3: about it, and this literally costs women's lives when they
Speaker 3: don't see a gain of call just and they develop
Speaker 3: cancer and that was preventable, but they're just so uncomfortable.
Speaker 3: So that shame is very much still with us, and
Speaker 3: it's political as well. I write about how this twenty
Speaker 3: twelve Michigan state representative was banned. This is Lisa Brown,
Speaker 3: banned from speaking in the House for using the term
Speaker 3: vagina in a debate over an anti abortion bill because
Speaker 3: her Republican colleague found it offensive to use the term vagina.
Speaker 2: So what does she do.
Speaker 3: She and other fellow female congresswomen speak outside the steps
Speaker 3: of the on the steps of the state capital, they
Speaker 3: read the vagina model right as just a way of.
Speaker 2: Like, what else do you want me to call it right?
Speaker 2: So it's become politicized and that adds to that kind
Speaker 2: of discomfort, which again translates to a silencing around the
Speaker 2: procedure itself and how it's supposed to happen. Who is
Speaker 2: supposed to be in the room, how are you supposed
Speaker 2: to be touched, the fact that gloves should be used,
Speaker 2: all of these things that when the abuse occurs, it's
Speaker 2: often with young women who have no idea because they
Speaker 2: haven't been told, and they're you know, it's through these
Speaker 2: duplicitous men that.
Speaker 3: Know how to get away with it, you know, if
Speaker 3: it doesn't help. But another survey, twenty seventeen study asking
Speaker 3: hundreds of women just after getting a pelvic exam, the
Speaker 3: question do you know why this examination is performed? Half
Speaker 3: of them couldn't answer that question. There's a lot of
Speaker 3: confusion about what it.
Speaker 2: Is, why it's done. There's debates.
Speaker 3: The American College of Physicians in twenty fourteen determined that
Speaker 3: it should the procedures shouldn't even be done anymore under
Speaker 3: for healthy asymptomatic non pregnant women. But the American College
Speaker 3: of obstractions, and ganecologists still promotes it, So there's I
Speaker 3: think that confusion has filtered down to more more general
Speaker 3: popular you know, why do I need it?
Speaker 2: What should I do? What is it? And why do
Speaker 2: I do it? And I don't understand my own body part.
Speaker 3: And one of the things I hope people get out
Speaker 3: of my book is how important it is to have
Speaker 3: those conversations to talk about it and talk about it
Speaker 3: with your gynecologists when you go in, what your expectations
Speaker 3: are and if you're afraid and pain and all.
Speaker 2: Of these other things that were sort of discouraged for
Speaker 2: advocating for ourselves.
Speaker 1: And I feel like that's such a huge part of
Speaker 1: this is advocacy, word of mouth, raising awareness, just sort
Speaker 1: of making this knowledge and information accessible. And that's, you know,
Speaker 1: something that you your book is doing, and it's also
Speaker 1: something that you highlight in your book the work of
Speaker 1: some advocacy groups like Survivor that really have done so
Speaker 1: much to provide this information, this baseline in a way
Speaker 1: that's not so you know, fraught with all of the
Speaker 1: problems of walking into an exam room for the very
Speaker 1: first time knowing what to expect, and so I'd love
Speaker 1: for you to just talk about some of these advocacy
Speaker 1: groups and the work that they're doing.
Speaker 2: Sure.
Speaker 3: Yeah, And actually I was just speaking at the Survivor's
Speaker 3: Annual Cervical Cancer Summit in Washington, d C.
Speaker 2: About three weeks ago.
Speaker 3: Survivor for those listening is spelled ceer vivo R right.
Speaker 3: So Survivors of Cervical Cancer an organization created by Tamika Felder,
Speaker 3: who is amazing, very powerful, brilliant woman and a.
Speaker 2: Survivor herself, of course, But.
Speaker 3: At this summit, which was sort of equally informational but
Speaker 3: also about creating a sense of community, enabling survivors to
Speaker 3: come together and tell their stories, talk about spreading the word,
Speaker 3: but Shane kept coming up over and over again.
Speaker 2: I was really struck by this.
Speaker 3: So many of the people that got up to speak
Speaker 3: said that when they found out they were diagnosed with
Speaker 3: cervical cancer, first of all, many of them wouldn't use
Speaker 3: the term. They were shamed because it's a female reproductive part.
Speaker 3: But second because it's HPV. It's caused by a sexually
Speaker 3: transmitted disease, so there's this shame around. You know, how
Speaker 3: one gets the virus that can lead to cervical cancer,
Speaker 3: So that that deep level of shame, even when it's
Speaker 3: about something that you're a victim of, Right, you didn't
Speaker 3: cause it. Anyone can get HPV, you know, all it
Speaker 3: takes is one sexual encounter.
Speaker 2: But that level of shame, you know.
Speaker 3: And so when I got up and did my reading,
Speaker 3: I said, let's let's go back even further.
Speaker 2: You know, it's not just cervical cancer, but shame more
Speaker 2: general about reproductive parts that we need to be talking about,
Speaker 2: and we need to be sharing stories.
Speaker 3: They're very much about sharing stories, and I saw my
Speaker 3: role as the only historian in the room of saying
Speaker 3: the stories that matter are absolutely the people in the room,
Speaker 3: but also historically, how can we breathe life into you know,
Speaker 3: generations of women who have encountered this. So they're doing
Speaker 3: amazing work and recognizing that we need funding, we need
Speaker 3: federal funding, and we need studies done.
Speaker 2: We need to.
Speaker 3: Continue these studies in this political climate. But we also
Speaker 3: need to allow people to feel entitled to speak about
Speaker 3: it and share stories and not be dismissed more generally.
Speaker 1: Yeah, and so we are entering in a very frightening
Speaker 1: period for women's reproductive rights here in the US, and
Speaker 1: I would love to hear your perspective on what we
Speaker 1: can learn from the past to help us better navigate
Speaker 1: what might be a very dangerous present in future.
Speaker 3: Oh boy, wouldn't I like to know the secret to that?
Speaker 2: Well, here's one way I like to think about it.
Speaker 3: There are people who were not going to change everyone's minds,
Speaker 3: certainly on certain issues. This is a divided country, divided
Speaker 3: world when it comes to things like pregnancy, fertility, infertility, abortion.
Speaker 2: Et cetera. But everybody should agree that access to basic
Speaker 2: health care.
Speaker 3: Women's healthcare should be a fundamental right that should never
Speaker 3: leave the table. Women need to have access to basic
Speaker 3: health care. And if you start dismissing funds but also
Speaker 3: criminalizing to the extent that they are, it's detrimental to
Speaker 3: the field of kinnecological care right. And you're going to
Speaker 3: see not only maternity healthcare deserts where it's very difficult
Speaker 3: to find an obguin in certain areas, but more generally
Speaker 3: women's healthcare deserts where it will be harder and harder
Speaker 3: for women in particular parts of the country to find
Speaker 3: to literally just find anybody to get a passmerr or
Speaker 3: basic health care right, and that is a vomitable that
Speaker 3: is abominable.
Speaker 2: We're talking half the population, you know.
Speaker 3: I can't think of a better way to define misogyny
Speaker 3: than basically take away the ability for women to get
Speaker 3: basic healthcare.
Speaker 4: Could not have said it better.
Speaker 1: It's I think we can look at the past to
Speaker 1: think about what we might see if this is taken away.
Speaker 4: It could be a very scary time going forward.
Speaker 1: But yeah, I loved your book, and I think it's
Speaker 1: so important to provide this broader context of this thing
Speaker 1: that so many of us experience all like regularly and
Speaker 1: don't think more about it. Maybe, or we do think
Speaker 1: more about it, but we don't know about the larger
Speaker 1: history of it, right, And.
Speaker 3: We don't have the language or the opportunity to kind
Speaker 3: of talk about it or see it as that it's
Speaker 3: a valid topic of conversation, you know, because if it
Speaker 3: was about men's healthcare, it would be I even had
Speaker 3: I had an academic, male academic when he asked.
Speaker 2: Me the title of my BOOKOK, And I told him and.
Speaker 3: He said, well, that's a pretty niche topic, isn't it.
Speaker 3: I'm like, oh, yeah, spoken by someone who's never encountered this, right,
Speaker 3: I mean, hello, thank you.
Speaker 2: Sex is of one oh one. Right, So it's dismissed
Speaker 2: by people who.
Speaker 3: Can't identify with it, and they don't even recognize that
Speaker 3: that dismissal is a political act. Yeah right, and it's
Speaker 3: a way of again silencing Oh right.
Speaker 2: Oh, I'm sorry. I guess I shouldn't be talking about
Speaker 2: this because you don't find it interesting.
Speaker 3: So yeah, I mean even just to be able to
Speaker 3: talk about it, you know, read the book, share it
Speaker 3: with a friend, have a conversation.
Speaker 1: Well, I really want to thank you so much for
Speaker 1: taking the time to chat with me today.
Speaker 4: I really appreciate it my pleasures.
Speaker 2: I love talking about this stuff.
Speaker 1: A big thank you again to doctor Wendy Klin for
Speaker 1: taking the time to chat with me. This conversation felt
Speaker 1: so meaningful to me. And if you enjoyed today's episode
Speaker 1: and would like to learn more, check out our website
Speaker 1: this podcast will kill You dot Com. We're I'll post
Speaker 1: a link to where you can find exposed the hidden
Speaker 1: history of the pelvic Exam, as well as a link
Speaker 1: to doctor Klein's website where you can find her other
Speaker 1: incredible work. And don't forget you can check out our
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