When we talk about sexual assault, especially with people who haven’t themselves been assaulted, the conversation often turns accusatory: what did we survivors do, what didn’t we do, or what we, according to them, should have done differently. We are sent messages ranging from, “Well, did you report it!?” to “You ruined his life.” It doesn’t feel like survivors can ever win in the eyes of those who have never experienced the gravity and violation of sexual assault.
I have experienced this sort of dialogue from even family and friends, who I’ve since set firm boundaries with. Accusatory framing doesn’t help us move forward. It doesn’t teach autonomy, healing, or trust in our own bodies. It causes us secondary harm, and it isn’t empowering. We already had our power taken away during assault: being able to reclaim it, and being helped in that, is important.
Taking my own power back after assault looked nothing like what I expected. I didn’t enroll in a master’s degree program or register for a marathon… well, not yet at least. I did the most daunting, counterintuitive thing I could imagine: voluntarily letting someone get all up in there to place an IUD.
After experiencing sexual assault at a boyfriend’s hands, my relationship with my body fundamentally changed. I mistrusted it. Things that once felt neutral suddenly felt threatening. Even the shower became a charged space. I either had a friend sit on the bathmat or turned the lights off, afraid I might catch a glimpse of my shame-ridden bare body in the mirror. Given I couldn’t handle my dorm’s bathroom, you can imagine the loadedness of a gynecologist’s office. My body didn’t feel like a home anymore, not a home I wanted to reside in at least. It felt like something I had to protect at all costs. I did so by way of getting an IUD.
The irony isn’t lost on me. The very act meant to give me peace of mind required surrendering control in a way that mirrored my trauma. Lying back on an exam table, my feet in stirrups. On display for the world to see, or at least a provider or two. Someone else holding authority over my body while I stared and counted ceiling tiles. It felt cruel, almost absurd, that the healthcare I needed demanded something that looked so much like what had poisoned me to begin with. I almost didn’t go through with it.
What changed wasn’t my fear, it was how it was handled.
I found a provider who practiced trauma-informed care. Before the procedure, she explained each step to me.
She gave me every option she could for pain control. Even the idea of pain control felt like giving up rights to my autonomy in a way. Yes, I have always been stubborn, but this went deeper than that. The offer of laughing gas felt paralyzing. All I could imagine was how out of my body it would make me feel and how much trust I’d be placing in a near stranger. I wanted to feel fully present which felt jeopardized by some pain relief measures.
I opted to pre-game with Tylenol and Misoprostol. If Misoprostol sounds familiar to you, it is because it is often coupled with mifepristone for medical abortions. In this case, it was used, as it often is, to soften my cervical walls for ease with the IUD insertion. It isn’t a capsule or tablet to be swallowed, rather one you insert vaginally. So there I was, wildly unaroused in my shitty college apartment with one leg propped up on my bed. There was no natural lubrication to be found and so inserting each foreign pill into place felt vile. I wouldn’t have gotten through it without my roommate cheering me on. Oh, girlhood. All of this turmoil and the procedure day not here, but still one sleep away.
During the procedure, my gynecologist checked in for consent repeatedly, and I had full confidence that at any point I withdrew it, the procedure would have stopped. Feet up in stirrups, a playlist a loved one made for me in the background, I felt like an active participant instead of a passive body. That mattered more than I can put into words. The procedure itself was uncomfortable and painful, yes. But it was also finite. Predictable. Governed by my consent. And when it was over, I cried tears of triumph instead of pain. I had done something so hard on my own terms. My body had endured something intimate without being violated. That distinction felt revolutionary.
Getting an IUD didn’t “fix” my trauma.
It didn’t suddenly make sex easy or erase the fear stored in my nervous system. Healing isn’t ever that neat and tidy. My body still struggles deciphering danger and discomfort, whether the bear is attacking or just nearby. However, it did give me a new and steady sense of agency, even in the face of persistent flashbacks.
I don’t tell this story to encourage everyone to get an IUD. It was an option best suited for me, for right now. And if I wake up tomorrow wanting it out, I know who to call. Trauma-informed choices look different for everyone. It means taking control of your reproductive health in whatever way feels safest. There is no universal choice that creates or demonstrates strength, only choices that align with the needs of you and your body.
It is my hope that all folks get to make those choices in a healthcare setting free of judgment, and alongside a team of providers that understand consent is an ongoing conversation, rather than just an item to check off a list. When the time comes for my routine pap smears and eventually mammograms, I feel assured that I won’t be forced to retraumatize myself in an effort to access what should be considered basic care.
I want all of us to stop judging survivors for how they cope, heal, or protect themselves. Telling them to move on or how to move forward, to atop talking about it, to keep it inside. No more of that. I’ll share with whom I deem appropriate because trauma shaped this chapter of my life. Trauma shapes our decisions, our boundaries, our relationship to risk — even our relationships with contraception and preventative healthcare. Having not initially chosen to report my assault and collect evidence, I know that someone out there thinks I did it all wrong. But, I’ll tell you what, I am here to take my power back, step by step and making it out of the gynecologist’s office in one piece was one of many.
For me, healing looked like choosing discomfort over fear, like reclaiming a part of my body I once avoided, like trusting myself enough to decide what protection meant, both physically and emotionally. Trauma inclined me to make this medical decision, but autonomy is what made it mine.
