Did you know…
90% of HPV infections clear on their own within 2 years, but that HPV can lead to cervical cancer?
80-90% of sexually active people will have HPV at some point?
Males are almost never tested for HPV?
Despite HPV being very common across all sexes, women and those with female anatomy carry the burden of HPV for everyone. Males don’t get routinely tested. Only women get pap smears and followup procedures for abnormal paps. This means that compared with men, women spend extra time and money managing the potential consequences of HPV despite being equally likely to have the virus.
It’s so normal that it’s easy to miss. Women take time off from work and life to go to doctor’s visits for paps. If results are abnormal, they may need additional visits and sometimes painful procedures. At the same time, men have exactly zero medical visits, procedures, or expenses related to HPV.
And these are not just any doctor’s visits, but visits in which someone who is essentially a stranger looks at and touches your vagina. These visits are emotionally burdensome for many people. The vulnerability inherent to gynecological care is enough to keep many women from going at all.
Beyond the emotional burden of the doctor’s visit itself, women are also the only ones confronted with the ethical quandary of whether to disclose to future partners that they have HPV. Since men aren’t expected to get tested, they never have to feel worry, shame or guilt about having HPV. Because even when they have it, they don’t know they have it. They get to be blissfully ignorant even as they may be putting partners at risk.
It should be said that we’ve arrived at this moment in history partly because we’re taking better care of women. Paps began to be widely performed in the 1940s, less than a hundred years ago. In the decades since we’ve incorporated them into routine care, cervical cancer rates have dropped dramatically. It’s now extremely rare to die from cervical cancer in the United States.
Also, since HPV poses a higher health risk for women than men, it makes sense that testing and prevention is mainly aimed at women. I’m glad that we have ways to protect women from cervical cancer, and we’re doing a much better job at that than we used to.
But there’s still room for improvement here. I can’t help but see the spectre of patriarchy in all of this. And it touches upon something that’s widely misunderstood about what feminism really is.
Many people understand feminism to mean “women are equal to men.” As in, women can have the same jobs as men and earn as much money as men. Sure, that’s an important first step. But it’s somewhat surface-level and rudimentary. As I see it, feminism is a deeper and more expansive thing.
To me feminism involves honoring the feminine, which is very different from simple equality. In my view the transformation required to free ourselves from patriarchy is not linear. It’s not just about replacing men with women in the C-suite. It’s about re-making our systems entirely, allowing the power and intelligence of the feminine to thread its way through all of society, transforming and evolving it.
What do I mean by “the feminine?” The feminine is many things. I associate it with a culture of care, slowing down and tending to the heart and body. I also associate it with eroticism and Goddess energy and Shakti. And as I write this I realize that what I really mean by the feminine is the divine feminine. I believe the divine feminine, in her many forms, is what we need most right now to create a better world.
When it comes to healthcare, honoring the feminine involves owning the needs of our hearts and bodies, and demanding they be met. It’s not just “nice” to know and like your doctor. It’s not just “nice” to have enough time to ask all your questions, even new ones that you didn’t write down beforehand. It’s not just “nice” to be your whole self at the doctor, including your spiritual side. It’s not just “nice” to see the same doctor for every visit, so that your relationship and their understanding of your health evolves over years. From the feminine point of view, these are not fluffy niceties. They are requirements. And we’ve lost them all in healthcare as we know it.
We desperately need to bring the feminine back into healthcare of all kinds, and women’s health in particular. As my midwifery teacher used to say, “when you touch a woman’s vagina, you touch everything that’s ever happened to her there.” And you also create a new thing that’s happening to her there. It matters who your gynecologist is. Most of us already know this, but it’s easy to disregard it out of necessity or because we don’t know what to do about it. But if we’re feminists in the way I am a feminist, we should be angry. Very, very angry.
Given that framing of feminism, what do we do about the HPV burden? Even if we did everything we can think of to involve men in cervical cancer prevention, the reality is that women will still need more frequent and more invasive HPV-related care than men.
The answer is not to somehow make the quantity of medical visits equal between men and women, but rather to make the quality of visits better. And to provide care in a way that listens to the feminine call for slowing down, relating, honoring the spiritual. This is what I’m doing at Wise Body, one patient at a time.
For the angry feminists and Goddess-worshippers (as well as the divine feminine-curious) who would like to go deeper on this topic, I’m starting a series of circles called Healthcare and the Divine Feminine. The first one will be online in December, on HPV and cervical health. You can find more details on that below.
In the mean time, a few ideas for how to level the playing field when it comes to HPV:
Make sure your kids get the HPV vaccine, including boys.
Remember HPV risk even when your partner has gotten tested for STIs (HPV won’t be part of an STI panel).
Honor your wish to know and like the person from whom you receive gynecological care.
Attend my December event to learn more about holistic care for HPV and abnormal paps.
Upcoming Events
Healthcare and the Divine Feminine: A Feminist, Spiritual Approach to HPV and Abnormal Paps
Join Jane Riccobono, NP, CNM of Wise Body Women’s Health for a Goddess Circle on cervical health and HPV. Free, registration required. Register here.
About Wise Body Women’s Health
Wise Body Women’s Health is an integrative gynecology practice in New York City founded by Jane Riccobono, CNM, WHNP. A former midwife with over ten years of experience, Jane founded Wise Body for women who want healthcare that sees all of them—body, heart, mind and spirit.
Jane’s approach to women’s health is feminist and spiritual. She provides integrated care that blends evidence-based treatment, nutrition and lifestyle counseling, and intuitive wisdom.
Whether you’re navigating perimenopause, painful periods, or simply want a provider who sees the whole picture, Wise Body offers unhurried, whole-person care. Learn more here.