Information for childhood sexual assault survivors with vaginal/vulvar injuries

Note: This is probably triggering.It’s medical studies talking about vulva injuries in kids and how they heal. Read at your own risk. Here is a nice picture of a bunny to give you the opportunity to not read what is below if you don’t want to.

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I am doing some research to help find an appropriate specialist to treat my vulvar injuries. I have found some disturbing things out.

Apparently injuries to the vulva bleed a lot, and you can die. Some sources recommended examining injured children under anasthesia, because it’s really common for there be other internal injuries (tearing into the urethra or anus). In places in the world where young women and children are commonly raped and mutilated genitally, things like ‘fistulas’ are common, which is where the wall between the colon and the vagina has a hole in it, and fecal matter gets into the vagina. My heart goes out to those women. I sure hope I have nothing like that. Surely I would have noticed?

And generally, tears in the vulva inflicted as children usually heal well and quickly without scarring, unless they are particularly deep and severe. Lucky me. I have two really long, very evident scars.  So survivors who know you were injured, don’t feel invalidated if you haven’t got scars. Most women don’t. Reading this, I think that it’s is likely that there were other less severe tears that healed up without leaving a lot of signs. Also, the scars from tearing during rape, in adults anyhow, tend to rip backward toward the anus (if that’s how I understand posterior in this context), which is the opposite of what happened to me. Here’s the reference on that:

Here’s an excerpt from one of the few references I found that wasn’t about tearing during birthing. “Healing of Nonhymenal Genital Injuries in Prepubertal and Adolescent Girls: A Descriptive Study”:

Superficial vestibular lacerations seemed healed in 2 days, whereas deep perineal lacerations required up to 20 days. The appearance of new blood vessel formation was detected only in prepubertal girls, whereas scar tissue formation occurred only after a deep laceration in both groups.

CONCLUSIONS. The majority of these nonhymenal genital injuries healed with little or no evidence of previous trauma. The time required for resolution varied by type, location, and severity.  http://www.pediatricsdigest.mobi/content/120/5/1000.full

Here’s a list of common complication for female genital injury, along with how to treat it soon after it happened as published by the World Health Organization. This would be the treatment I didn’t get.

I’ve looked at some diagrams and there doesn’t seem to be a name for the part of my anatomy that got torn, basically between the vestibule, through the urethra to the clitoris. Although if the diagram of the child sized vulva is accurate, that space was a lot shorter when I was a child.

This is the diagram of a kids vulva. The most commonly injured places are all toward the anus from the vulva.
This is the diagram of a kids vulva. The most commonly injured places are all toward the anus from the vulva.
This, likewise is a drawing of an adult woman's vulva showing the names for all the parts and which ones usually get injured in sexual assault. Now you know what all your lady bits are are called.
This, likewise is a drawing of an adult woman’s vulva showing the names for all the parts and which ones usually get injured in sexual assault. Now you know what all your lady bits are are called.

Probably the most disturbing thing though is that looking up ‘reconstructive gynecology’ brings up listings for ‘vaginal rejuvenation’ surgery, where women get their labia cosmetically altered to make them prettier, and get their vagina ‘tightened up’. That is the most misogynist thing I’ve heard of in a long time. I need reconstructive surgery from a horrible injury. Y’all with intact vaginae and vulvae should be grateful, and not damage them with unnecessary surgery to make your vagina/vulva look better. Outrageous. Seriously. Sheesh!

How to get care for an vulva injured in childhood.

Photocredit/art credit: http://kateordie.tumblr.com
Photocredit/art credit: http://kateordie.tumblr.com

I am going to blow my own horn here. I did good.

First, some background. I had sex for the first time with a new lover recently and my vulva was really not happy afterward, directly related to my injuries. First off, my lover did not respond well to being told I had scars/injuries on my vulva (she ignored the comment. really?) and then was much rougher with me than my sensitive peach can handle. Yes, I probably shouldn’t have continued having sex with her, but you know, sometimes you make a call at the time. I changed the activity, but by then the damage was done. Now I know. Next time I’ll be more firm about what can and cannot happen up front.

The flesh tag at the mouth of my vagina got rubbed raw and my poor peach hurt for days. It was what most women would consider ordinary sexual activities, none of which would have been unusually rough treatment for an uninjured vagina/vulva.

So I put my foot down, and decided by golly I was going to find a doctor and get this sorted. I tried at first to find a family doctor with some street cred about sexual assault. This was a disaster, as the doctor I found at first was, and then was not accepting patients. The sexual assault centre didn’t have anyone to recommend, and I ended the day in tears.

I  waited a week or two to cool down and then a couple of days ago I decided to just go into the walk-in clinic and ask for a referral to a specialist there. Here’s what I did right:

  1. I asked my wife to come with me. She made me eat first so I wouldn’t be low blood sugar, kept me company in the waiting room, and also wrote down what the doctor said.
  2. I asked for support. I messaged four of my friends who know about the injuries and told them what I was doing and asked for energetic support. I said I wanted to avoid crying and find an effective referral. They sent me supportive messages back that I read in the waiting room.
  3. I dressed up. I wore business-casual clothing, did my hair, applied light makeup. Office armor.
  4. I introduced myself and my wife to the doctor with our first names, to make us real people.
  5. I brought a printout of a photo I’d taken of my vulva that clearly shows the scars. This turned out to be a brilliant idea, as I could show the doctor the scars without having to undress.
  6. Some good phrases I used: “I’m looking for a referral to a specialist to address some injuries from a sexual assault.” “I didn’t receive medical attention, but that doesn’t mean I didn’t need medical attention.”  “It healed badly and affects my sex life now.” “I have a picture of the injury.”
  7. I pulled out my printout of the photo my wife took for me. (If you take a photo of your own injury I recommend using a flash, as it shows the scars more clearly) and pointed out the two long lines of scars. Having the photo also allowed me to point out where the flesh tag is and where the vascular damage is.

The doctor said he would try and track down a suitable specialist for me and gave me a timeline for how long he thought it would take. A couple of weeks for him to find someone suitable (he gave me some internet search terms to look under if I wanted to try and find someone myself) and then 3-9 months to get in. He consulted with me about whether I should see an Ob/Gyn (who might have experience with similar injuries from birthing tears) or a reconstructive gynecologist. All in all he was very nice and I was happy about what happened. He said that removing the flesh tag would be straightforward but that there might be scarring which might be problematic. I told him I just wanted to see what I was dealing with and what could be done, surgically and non-surgically, to mitigate it. (I probably used the word mitigate. I’m like that.) Yay.