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The real reason why women aren’t attending their cervical smear tests

22 January 2018

2:50 PM

22 January 2018

2:50 PM

Are young women stupid? Apparently, 15 per cent of them would miss a cervical smear appointment for a gym class or waxing appointment. These strange upside-down priorities are outlined in a study of 2,017 women published by charity Jo’s Cervical Cancer Trust, which also found that two thirds of those surveyed weren’t aware they were most at risk of the illness.

The charity also found a third of women were too embarrassed to get on with having the test, with 35 per cent saying they were anxious about their body shape, 34 per cent worrying about the appearance of their genitals, and 38 per cent worrying about smell. Sure, cervical smear tests aren’t anyone’s ideal way of spending five minutes, but they also aren’t very difficult to book. Similarly, waxing appointments aren’t very difficult to move, or not double book with a smear test in the first place. Both involve a woman in a state of undress with a stranger tending to their most intimate areas, but only one could save a life.

So why do these waxing addicts have such skewed priorities? Well, the charity did point out that the women most at risk of developing cervical cancer often aren’t aware of that, which explains why someone might put the test off, thinking it doesn’t really apply. There’s also the immortality complex of the young, which doesn’t just drive them to miss medical appointments because while they conceptually accept that they are going to die, it still feels a long way off, but also leads to people driving too fast and taking drugs. This complex seems less prevalent among Millennials, who have a preoccupation with safety, as outlined recently in the Spectator. Yet not enough of a preoccupation to get them to attend their smear tests.

The tension between being fine about a waxing appointment but not about a smear test does suggest that there is a profound anxiety about body image. The trend among young women is for the ‘Hollywood’ wax, which removes all pubic hair. This is, anecdotally, what their boyfriends expect to see when they undress, presumably as a result of learning about sex and women’s bodies through online porn.


Why women feel they have to conform to the demands of a young chap who hasn’t quite got to grips with femininity is another interesting question. It feeds into the wider debate about the pressure that social media places on young people. They are preoccupied with how many likes they receive for posts in which they try to showcase a perfect life. They are racked with envy and insecurity about their friends’ posts. Pubic regions don’t tend to turn up on Instagram (or perhaps I’m just following the wrong feeds), but that general sense that your body must conform or you cannot be happy does.

I’m from a generation that went through adolescence without social media. Facebook only appeared at the end of my second year of university. Some of us still had film cameras when we pitched up in Fresher’s Week. And yet my friends and I managed to have the same anxieties about how we looked and whether this meant we were happy. There was no Facebook, for instance, when a boy I dated briefly in sixth form told me that if he was honest, he preferred ‘semi-anorexic’ girls. I was resilient enough to believe that a large bowl of pasta was infinitely preferable to this fellow’s perspective on life, but I do remember comparing my limbs, muscly from a childhood of riding horses, sprinting over hurdles and doing ballet, to the rather bonier ones belonging to the girl he then moved onto. My envy wasn’t online: it was in the flesh.

I recently reviewed Johann Hari’s book about depression, and was amused to see that one of his suggestions for tackling mental illness was ‘a tough advertising regulator who wouldn’t permit ads designed to make us feel bad in any way’. What on earth would that cover? I’m capable of feeling bad about whether I’ve bought the best fabric conditioner, let alone whether my moisturiser is really going to stop me from looking any older than 30 or whether my car means I’m living my best life. People can see advertising as a company trying to get their attention with various claims, or as an authority in how you should look, dress, eat and live. Resilient people don’t fall for the latter approach.

Similarly, the Smug Married dinner parties that Bridget Jones finds herself invited to took place before anyone knew what #blessed meant. Yes, people brag about their perfect lives online, but they were pretty darn good at doing it in person before Mark Zuckerberg was even born. We used to twitch our curtains: now we poke our noses into people’s lives through our phone screens as we try to work out how we can one up them.

The good thing about social media is that one can choose to turn it off. It’s much harder to leave a tiresome dinner party early. But in both instances, a healthy sense of irony and a good sense of self means you can survive inadvertent exposure to bragging. And this is what might help solve the cervical smear conundrum and perhaps also wider mental health problems associated with the internet. If you aren’t insecure, then you’re less likely to seek out these accounts that make you feel miserable about your life. You may even find that there’s a whole world of social media that doesn’t involve fretting about yourself but instead delighting in the world around you. I have an additional Twitter feed to my work account, and use it to follow people who tweet about the natural world, especially botany. It’s a personal interest of mine and has very little to do with me or my apparent failings to measure up to other people. It’s not so much an escape from the real world as an attempt to focus on the truly real world more closely: that real world contains plants so clever that they impersonate the sight, smell and texture of a bee, for instance, or animals that can work together to flush out their prey. The real world isn’t actually the one inside our heads that involves us all fretting about someone else’s thighs or, as you get older, their exciting kitchen makeover.

The problem isn’t so much social media as it is a lack of resilience. Resilient people might choose to switch off their notifications so that they don’t have to read the unpleasant comments of someone who may well be a paid Russian troll.

Resilient people, by the way, are also able to cope with the existence of opinions different to their own. It is those who are brittle who wish to shut down other speakers, rather than engage with them. And this is why we should worry about how resilient young people are growing up to be. Safe spaces, social media envy and fear that the state of one’s personal topiary might be too much for a nurse hunting for cancerous cells are not problems in themselves but symptoms of a generation that isn’t confident enough in itself to tell those men who want hairless girlfriends to jog on, to smile wryly at the boastful antics of an old classmate or to listen to someone who holds a minority view. Only when young people learn to feel comfortable in their own skin will those problems start to fade.


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