This article contains words used for the female reproductive system and graphic descriptions.

I have never broken a bone, I don’t know what it feels like to get punched in the face and growing up in a bungalow means I haven’t taken a tumble down a flight of stairs. I have however taken a cricket ball to the head, been hit by a car and had a casual double mastectomy.

I’ve heard that the mind and body forgets pain, which must be true because every time I get a new tattoo I think, ‘I DON’T REMEMBER THIS PAIN.’ It also must be true because people give birth to whole new human beings, shit themselves, tear things in the process, and then decide to do it again two years later.

On a Wednesday night a few months ago I had the first smear test of my life; will I forget the pain in three years time when the next one is due?

Every Wednesday evening from 5pm onwards, trans and non-binary people can go to 56 Dean Street, London, for all their sexual health needs. CliniQ has been running since 2012 and is an inclusionary space for trans people as well as their partners and friends, founded by Graham Reed, Michelle Ross and Milo. CliniQ offers monitoring blood tests, STD tests, HIV rapid testing, PeP- emergency HIV medication, help with injections, counselling, housing support with Stonewall, assault and hate crime support with Galop. There is even yoga and acupuncture! They really do it all.  

This glorious place is where I went for my smear test. Yes, I could have gone to my GP, but I wasn’t really in the mood for being the first man-with-a-cervix that the nurse had come across. Educating as you go can be quite exhausting. Truthfully, I was petrified. This is not a part of my body that I have relationship with. Nothing is allowed up there, and hasn’t been for a long time.

The person who administered the test was a senior nurse, they were incredibly caring and friendly. This did not change the fact that it was a harrowing experience, it was extremely painful both physically and mentally. It seemed to last forever. I squirmed, sweated and screamed my way through it, squeezing the life out of another nurse’s hand.

I had been accompanied on this mission by two friends, trans siblings who stepped up, responding to my Facebook status requesting back up. One of them said it wouldn’t hurt, the other said it would hurt but wouldn’t be too bad. So then why did I have such an excruciating experience?

If you haven't already gathered, I am a trans man. If you don’t know what one of them is, give it a Google. I have been on testosterone for almost three years. About two years ago I started getting pains, every so often, that were very similar to the period pains I used to get. These new, but familiar, pains were getting worse and more frequent as time passed. I have spoken to other trans people who have the same pains, and not them, nor their GPs, had a reason for it. I spoke to one friend who has the pain pretty much constantly – what fresh hell is this!

The answer is atrophic vaginitis, or, vaginal atrophy; a name that makes me cringe and clench my thighs together. Symptoms include: dryness, inflamed vaginal walls, pain after orgasm and pain during penetration. Mostly just pain then. Hence why my smear test was so painful. This is a very common experience for people going through menopause. When I first started hormones I remember speaking to my mum and bonding over hot flushes and night sweats. This trans business can be so surreal.

What is the treatment for this awfully named condition? Apparently there is a topical hormone cream, and a hormone pill that doesn’t affect the rest of your hormone levels. Both of which you gotta shove up there, yeah right.

Another option is a hysterectomy. Gender identity clinics suggest considering a hysterectomy after two years on hormones because of the increased chance of cervical cancer. Unfortunately this routine operation is only available for trans people after a long wait, as it is seen as non-urgent. The NHS doesn’t have the funding to cater for the growing numbers of trans and non-binary people seeking medical intervention, hell, they don’t even have the funding to properly train GPs on how to talk to and treat a trans person.

I imagine we would all be better at dealing with the pain if it wasn’t so damn triggering. Before I transitioned, periods were a huge problem for me. They forced me to engage with being female, made me feel like utter shite and generally made me feel extra dysphoric (something I only understand with the power of retrospect). So now, to be experiencing pains that surpass all that I have had before, fearing that blood will trickle out of me at any moment, I am stuck. I am stuck and I am frustrated.

For the most part, transitioning is exciting, empowering and generally a relief. But it can also be really fucking hard. The onslaught of the binary never slows. The dysphoria is like being haunted. My self-awareness is off the charts. Like everything, it takes work.

So where does that leave us? In a bit of a shit position to be honest. But perhaps being able to name the pain will help. I find myself falling back on age-old period pain tricks; hot water bottle, paracetamol and forcing my sleeping partner to rub my back in the night. There is little we can do to speed up the hysto-train but instead we must practise self-care, look out for each other and keep talking about it! Don’t let it build into the monster it doesn't need to be.

If you haven’t had a smear test and know you are due one, please go to CliniQ. If you aren’t based in London then your Gender Identity Clinic may be able to help, and failing that, arm yourself with as much printed out information as you can and head to your nurse. (Top Tip: Ask them to use a smaller sized speculum and plenty of lube!) CliniQ are also able to offer links to NHS information that your GP cannot ignore.

Getting a smear test might be tough and shit, but we have to remember, it could save your life.

Elijah W Harris is an actor and writer, based in London. Photos by @heavenlytiger and @tallulah_haddon