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Translated by Chloe Sautter-Léger

Some ideas seem to stick with us forever. They end up living inside and changing us in spite of ourselves.

What began as a single article on the speculum turned into a three-part series, and by mid-August, reality quickly outstriped fiction when I received the following text message: “Morning! Would you like a stainless steel speculum?” It served as a testament to how words can reach further than we imagine. 

Parts I and II of the Instruction Manual for a Subversive Usage of the Speculum covered the role of the instrument in establishing the science of the woman (Moscucci, 1990 qtd in Vuille, 2016) and the conceptualization of the gynaecological exam as performance. Both parts noted that the speculum, which makes the private public, is political.

In this final part of the Manual, two subversive usages of the speculum will be explained, in hopes of exemplifying  how to overturn the power structures that underlie the “who looks and who penetrates” dynamic (i.e. through performative arts and feminist biomedical engineering). It will analyze, in particular, the work of Annie Sprinkle, “Public Cervix Announcement” and the “Yona Project”.

Rethinking the Speculum: Public Cervix Announcement

Chicago, 1991. That is when porn star and activist Annie Sprinkle presented her last work, “Post Post Porn Modernism: Still in Search of the Ultimate Sexual Experience,” a collection of vignettes related to sex work, intimate relationships, and the liberation of the female body. Before the intermission, she explained four thoughts that led her to create “Public Cervix Announcement”: “Many of you have never seen a cervix before,” “I think mine is beautiful,” “I want to show you that there are no teeth in there,” and “there was a time that women couldn’t wear skirts above their ankles, then they wore miniskirts. This is the next step” (qtd in Kapsalis, 1997).

After douching, she self-inserts a speculum. Using a flashlight and a microphone, she invites spectators to come closer and gaze into her  vaginal cavity and see the cervix—an invitation which carries much meaning. Traditionally, only medical professionals had the necessary tool—the speculum—to explore the female body (Löwy, 2011), and only a handful of women were given the chance to operate the speculum during gynaecological examinations (Kapsalis, 1997).

“Public Cervix Announcement” worked to demystify the speculum and the fear and anxiety associated with it, as these negative effects maintained power relationships between health professionals (penetrating) and patients (penetrated).

By operating the instrument and inciting dialogue, Sprinkle made the point that the speculum “may thus no longer serve as terrifying trope (...) [and] that it is not the speculum that is inherently horrifying, but rather other aspects of the exam that cause fear and even harm” (Kapsalis, 1997, 120).

In early stages of the performance, a man (or rather a woman dressed as a man) would insert the speculum. The act was later modified so that Sprinkle would manipulate the instrument herself, in the way feminist collectives encouraged women to explore and celebrate their sexual organs with specula and mirrors in the 70s.

Redesigning the Speculum: Biomedical Engineering and Feminist Hacking

Annie Sprinkle’s performance piece emphasizes a desire to reclaim control of her body and the gynaecological  exam. In an Australian study in which 133 women were surveyed on their attitudes toward the speculum, 91% declared they would rather insert it themselves than have it done by a physician. Their reasons pertained to  discomfort and vulnerability during the insertion (Wright et al., 2005).

In an attempt to reduce the discomfort patients feel during the gynaecological exam, Mercy Asiedu, doctoral candidate in biomedical engineering, presented an alternative to the speculum. Asiedu suggested a prototype the size of a tampon carrying a 2 megapixel camera through which the cervix can be seen from the inside: “The speculum was originally designed for a physician to view the cervix from outside the body (...) but with current technology, you can easily view the cervix from inside the body” (Pardes, 2017). This prototype favours patient participation, since she can view the recorded images in real time. The 15 participants who tested the prototype said it was more comfortable than the traditional speculum (Asiedu et al., 2017).

The most promising project so far seems to be Yona, which initially set out with the objective to rethink the surgical object itself. The project  now works to rewrite the entire gynaecological examination process, promoting health for people with vaginas.

Hailey Stewart, an industrial designer and researcher, along with Sahana Kumar, an experienced designer, began working on a mission to offer a tool that does not have the same flaws as the traditional speculum—loud, cold, and uncomfortable. Their alternative is a silicone-covered speculum. Like for vibrators, the new material offers many benefits: easily sterilized, not cold, and more easily inserted (Panders, 2017). Compared to the metal speculum which contains multiple interstices, silicone helps avoid certain injuries. It is also aesthetically more pleasing.

Stewart and Kumar recognize, however, that reimagining the speculum is not enough to dispel fears related to the gynaecological examination, to which the austerity of the clinical environment contributes to the patient’s discomfort (Panders, 2017). Multiple avenues have been explored to make the experience more comfortable, such as designing an application through which the patient may ask questions and access guided meditation before the gynaecological exam, or a care package containing an anti-stress ball and socks. The ultimate goal of Yona’s creators is to transform health care, one vagina at a time.

***

A few days after receiving the text message, I was holding my very first surgical steel speculum, and I understood that this instrument was in every way, like a weapon. A weapon to be used by women to seize back their own gynaecological health. A self-defense weapon for bodies and knowledge.

Asiedu, M.N., Agudogo, J., Krieger, M.S., Miros, R., Proeschold-Bell, R.J., Schmitt, J.W. and Ramanujam, N. (2017). Design and preliminary analysis of a vaginal inserter for speculum-free cervical cancer screening. PLoS One, 12(5). DOI: 10.1371/journal.pone.0177782

Boston Women’s Health Book Collective. (2011). Our Bodies, Ourselves. Boston : Touchstone.

Kapsalis, Terri. (1997). Public privates: performing gynecology from both ends of the speculum. Durham: Duke University Press.

Löwy, Ilana. (2011). A Woman’s Disease : The History of Cervical Cancer. Oxford : Oxford University Press.

Pardes, A. (October 5, 2017).‘‘The Speculum Finally Gets a Modern Redesign’’. Wired. https://www.wired.com/story/the-speculum-finally-gets-a-modern-redesign/

Vuille, M. (2016). Gynécologie dans Encyclopédie critique du genre. Paris : Éditions La découverte, 283-292.

Wright, D., Fenwick, J., Stephenson, P. and Monterosso, L. (2005). Speculum ‘self‐insertion’: a pilot study. Journal of Clinical Nursing, 14(9), 1098-1111. https://www.ncbi.nlm.nih.gov/pubmed/16164528 

To cite this article:

Fournier, E. (2017, December 20). Instruction Manuel for a Subversive Usage of the Speculum (Part III).  Les 3 sex*. https://les3sex.com/en/news/14/article-instruction-manual-for-a-subversive-usage-of-the-speculum-part-iii-