I teach health and social care at post-16, so I am used to discussing intimate body parts and embarrassing bodily processes with teenagers, who tend to squirm in horror at the mention of poop or beg me not to get the bananas and condoms out.
There was one occasion, though, a few years ago, when I was teaching my level 2 class about health screening. An uncertain but brave voice suddenly perked up. “What’s it like to have a smear test?” Ah.
Not “what happens” during a smear test. They didn’t want the facts, they wanted to know the experience – and they had decided I was the woman to tell them.
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After taking a second to recover from the dismay that my students clearly had decided I was old enough to require a smear test, the dilemma set in. Staring back at me were a sea of anxiously agog faces. They weren’t messing about – this was a serious question.
Somehow I blundered through a response that stated the obvious – it’s not exactly dignified.
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This memory was relegated to one of “those” teaching moments, until I was recently planning for the next half-term. We are delivering the public health unit to level 3, and, feeling rather unenamoured with the contents of the specification, I decided to get some inspiration to see what upcoming health awareness weeks there are to make things more relevant. Voila! Cervical Screening Awareness Week this year is 14 to 20 June.
This got me thinking. I teach a course that is overwhelmingly subscribed with females. My teaching career has been based in FE and sixth-form colleges, which are both exempt from the government’s mandatory relationships and sex education curriculum. We address health issues as part of the course, including health screening, but this tends to be delivered in a very factual and clinical way. The emotional aspects of such intrusive procedures are barely considered. Why? It’s as though we intentionally teach students that patients do not have feelings.
NHS data published in November 2020 shows that the 25-29 age range has the lowest uptake of cervical screening, with 35 per cent of women not accepting their invitation. I imagine that emotional barriers are a key explanation in this. Let’s be honest, ladies – it’s hardly an occasion we look forward to.
Throughout school, my students have been taught about periods, sexually transmitted infections and contraception. Many of them have received the HPV vaccine and understand its importance in minimising their risk of developing cervical cancer. This is a great start – but when I look at the attendance statistics, I wonder if we are doing half a job. Not that we don’t already have enough to be doing, of course, but is there an opportunity, just for five minutes, to explore the emotions of being so exposed? Would it really be harmful to our students to do so now?
To make a conversation about “what it is like” to have a smear test requires insight, and the likelihood is I would be the only person in the room who could offer that.
My students want to explore sensitive topics and ask questions in a safe, non-judgmental and nurturing environment. So, is it crossing professional boundaries to talk about something so intimate but potentially life-saving, or is it worse to ignore the curiosity and allow those apprehensions to multiply? If I could alleviate the worries of one student now, so that in several years’ time she felt able to be tested, does that mean I could save her life? It feels like a tug-of-war between a duty of care and the need to safeguard learners.
Post-16 is surely a time when sexual health awareness is needed most. Our students want to test and enjoy their freedoms, but it comes hand in hand with responsibility.
I think a focus on cervical screening in my lessons after half-term would be a timely opportunity to address the topic. My students know I am not afraid to discuss “taboos”, so, if anything, the possibility of one of “those” questions is best prepared for. How would I answer it honestly but without compromising my boundaries? Hmm.
We teach children the importance of brushing their teeth and washing their hands. We teach older children and teenagers about personal hygiene, contraception and the dangers of smoking and alcohol. We teach young adults how to drive responsibly, stay safe on a night out and manage their own health needs. Why are we not equipping them with the reassurance and courage to take a life-saving test?
Students may head off into the big bad world years before the NHS invitation lands on their doormat, but if a discussion now can encourage them to book that appointment, it could spare them and their loved ones so much heartache.
The writer is a health and social care teacher at a college in the UK