There’s a particular kind of dread that comes with receiving your cervical screening (or “smear test”) letter. It’s the kind of envelope that quietly slips through the letterbox and settles into the pile on the kitchen counter, only to be conveniently “forgotten” about for a few days (or weeks… or months). For many women and people with a cervix, that invitation to attend a smear test is less of a helpful health reminder and more of a gut punch - a reminder of bodily discomfort, fear, embarrassment, and the enduring silence around gynaecological health.

But it doesn’t have to be this way. And we need to talk about why it still is.

The Cervix, the Silence, and the Societal Shame

The smear test is one of the most important preventative health checks offered by the NHS, designed to detect abnormal changes in cervical cells that could lead to cancer. It’s quick, free, and potentially life-saving. And yet uptake has been declining, with many people either delaying or skipping it altogether.

Why? Because the smear test exists at the intersection of multiple uncomfortable things: sex, anatomy, vulnerability, gender expectations, trauma, and medical mistrust. And for too long, society has taught us that anything involving our reproductive health is shameful, taboo, or embarrassing.

Let’s be real - how many of us were taught the correct names for our anatomy growing up? How many of us grew up believing that vaginas were “dirty” or “private” or something to be whispered about? That kind of shame doesn’t just disappear once we hit adulthood. It lingers, festers, and shows up in moments like smear test avoidance, where the idea of lying half-naked in a cold exam room with a stranger peering into our bodies feels like too much to bear.

The Real Barriers No One Talks About

When public health campaigns encourage people to “just book your test,” they often fail to address the very real, very valid reasons why someone might not. These include:

Body image and dysphoria: If you already struggle with how you feel in your body, whether due to size, disability, trauma, or gender identity, being asked to undress in a clinical setting can feel unsafe.
Past trauma: For survivors of sexual assault or medical trauma, the test can be deeply triggering. The position, power dynamic, and lack of control can all feel eerily familiar in the worst possible way.
Cultural or religious shame: In some communities, conversations around sexual health (or even just anatomy) are taboo, which makes getting screened an isolating and stigmatised act.
Healthcare mistrust: For many marginalised people, especially those from Black, Brown, disabled, LGBTQIA+ or working-class backgrounds, negative experiences with healthcare providers are all too common. If you’ve felt dismissed, disrespected or misgendered before, why would you feel safe going back?
Access issues: Whether it’s lack of time, childcare, transport, or simply not being registered with a GP, logistical barriers can quietly pile up until the test falls to the bottom of your priority list.

It’s not laziness. It’s not carelessness. It’s complexity - and we need to start treating it that way.

Destigmatising Starts with Listening

We cannot increase cervical screening rates by shaming people into attendance. Guilt is not a motivator. What is effective? Empathy. Understanding. And creating a culture where it’s OK to talk honestly about what makes smear tests so hard.

This means we need more than just pastel-coloured posters that say “Don’t Fear the Smear.” We need:

Clinicians trained in trauma-informed care, who know how to explain every step, get consent at every stage, and offer gentleness and choice.
Flexible appointments, including evenings and weekends, so people with chaotic lives, work commitments or caregiving roles can still access care.
Inclusive language and spaces for trans men, nonbinary people and anyone who feels excluded from the typical narrative around women’s health.
Representation in campaigns that show people of all sizes, backgrounds and gender expressions getting screened - because normalising visibility matters.

And, crucially, we need to talk about it. Openly. Without euphemisms or shame.

What It’s Actually Like

Here’s the thing: the test itself? It’s not exactly a party. But it’s also rarely as awful as our brains make it out to be.

It usually takes about five minutes. You’ll be asked to undress from the waist down (in private), lie on an exam table, and place your feet together with your knees apart. The nurse will use a small device called a speculum to gently open your vaginal walls and then use a soft brush to collect cells from your cervix.

Some people describe it as uncomfortable. Others barely feel it. It’s not unusual to feel nervous, vulnerable, or even emotional afterwards - and that’s OK. You’re allowed to have complex feelings about the process. But knowing what to expect, and knowing you can ask for breaks, or a chaperone, or even lie in a different position, can help you feel a bit more in control.

Reframing the Narrative

Cervical health should not be something we only discuss in hushed tones, after someone we know gets sick. It shouldn’t be something that makes us feel dirty, difficult or dramatic.

It should be a normal part of taking care of ourselves - like brushing our teeth or going to therapy. Something we do because we deserve to feel safe, respected and healthy in our bodies. Not because we’re scared, but because we’re empowered.

When we tell the truth about our fears, we create space for others to say, “Yeah, me too.” And from that solidarity, we can build a better healthcare culture - one where no one feels ashamed of needing care.

Final Thoughts: You’re Not Alone

If you’ve been putting off your smear test, please know you’re not failing at being responsible. You’re not weird or weak or wrong. Your fears are valid, and you deserve a system that treats you with kindness.

And if you do feel ready to go ahead and book that appointment - whether it’s your first time, or your first in a while - know that there are ways to make it feel safer. Bring a friend. Ask for a specific nurse. Request a longer appointment. Communicate your boundaries.

Your cervix deserves care. You deserve care.

And it all starts by breaking the silence. So let’s keep talking.

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Hana Ames is a professional content writer with hundreds of pieces of content under her belt. She is a cat and dog mama, a feminist, and a musical theatre fan, who enjoys cooking, playing board games and drinking cocktails. She has been writing professionally since 2018 and has a degree in English. Her website is www.hrawriting.com and she is always interested in discussing exciting new projects to see how she can help your business grow. Catch her on Twitter @hrawriting, Instagram @hrawriting and Facebook: www.facebook.com/hrawriting

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