It’s a warm September morning, the last weekday before classes start, and Kya slowly follows the path through the west side of campus, finally locating the entrance to student health. She glances once more at the paper in her hand, confirming she is in the right place, even though she double and triple checked before she left her dorm—a long-held anxious habit. She opens the door and follows the colorful signs, leading upstairs to the reception desk.

“Good morning!” the receptionist greets warmly, reaching a hand out for Kya’s letter and handing her a clipboard in return. “We’re happy you’re here. You can have a seat here in the waiting room and work on filling out some of this paperwork while you wait for your appointment. Feel free to help yourself to some snacks and drinks while you wait as well.” Kya nods in acknowledgement, taking the clipboard and grabbing a bottle of juice before finding an open seat in the crowded waiting room.

About a week ago, on move in day, Kya paged through her new student orientation packet and noticed the student health letter. It explained that all new students would need to report to student health on the assigned date and time for a physical exam and consultation with the doctor. It didn’t go into much detail about what to expect from this appointment, only that the goals were to make sure students were healthy and equipped with the tools and knowledge needed to take charge of their healthcare as young adults. Kya had immediately started to sweat upon reading this information. Medical offices have always made her anxious, and without any frame of reference for what to expect, her thoughts had been spiraling.

Kya scans her environment tentatively, noticing that the waiting room looks to be full of first-year students, some who are casually chatting with friends or peers, and some who appear to be as nervous as Kya, sitting quietly and fidgeting. The office is decorated with signs and balloons in the school colors, no doubt trying to make this whole idea seem more inviting than it actually is. Kya tries her best to stop her thoughts from continuing to spiral and focuses instead on the paperwork in front of her. The first couple pages ask about general demographics and medical history—major surgeries, chronic conditions, vaccines, etc.. She diligently fills all this information out, thinking maybe this appointment will just be an initial health overview. Then she flips to the second half of the packet and notices some of the questions getting a little more specific and personal. When did you get your period for the first time? When was your last period? How many days do you usually bleed for? Have you ever engaged in any sexual activity with a partner? How old were you the first time you did this? When was the last time? Have you ever been tested for STIs? Kya’s face reddens at some of these questions, but she answers them quickly and sets the clipboard down next to her, face down for privacy.

“Kya?” a friendly female voice calls out. Kya’s head snaps up, and she sees a young blonde nurse standing in the doorway, looking out expectantly into the waiting room. Kya gets a flash of anxiety throughout her body, but she quickly grabs her things and heads in the nurse’s direction, not wanting to draw attention from the other students. “How are you doing today, Kya?” the nurse asks as she leads Kya down the hallway. “My name is Leah, by the way.”

“Oh, uh, I’m good,” she manages.

“Well, we’re happy to have you here on campus. I know this isn’t the most exciting day of welcome week, but we’ll get you on your way pretty quickly, I promise!” Nurse Leah stops about halfway down the hallway near the nurse’s station. “We’re just going to stop here and grab your height and weight really quick. You can set your things down on the chair and step up onto the scale. Would you prefer to look at what your weight is, or turn away?”

“I..I’m fine to see it, thanks,” Kya says, surprised at the question, but thankful that they seem to be more sensitive to student needs here. She steps onto the scale, waits a moment for Leah to record her weight, then moves her back against the wall to have her height measured.

“Perfect!” Leah says. “You can grab your stuff and follow me back to the exam room now. We’re just going to be back here in room 5,” she says, gesturing to a room on the left side of the hallway with an aqua blue door. Kya steps inside and sets her things down on one of the plastic chairs. The exam room is simple, the walls a cool blue, meant to be calming. Kya takes note of this difference and appreciates that she doesn’t have to be bombarded by the school colors while she gets her exam. “You can have a seat in one of those chairs, and I’ll take your clipboard for you.” Kya hands Leah the paperwork and settles herself down in the chair next to her stuff. Leah briefly thumbs through the packet, then sets it down on the counter behind her. “Yep, make yourself comfortable! So if it’s alright with you, I’m just going to grab some vitals real quick to start us out.” Kya nods, and Leah grabs an oral thermometer out of a drawer and gestures for Kya to place it under her tongue. After a minute, the thermometer registers, and Leah lets Kya know her temperature is normal.

“Alright, blood pressure next…” she narrates, slipping a cuff around Kya’s left arm. Kya feels a few squeezes, then the cuff is removed, Leah giving a thumbs up as she moves to place materials back in their drawers. “Okay Kya, do you think you can give me a urine sample before we continue?” Kya glances over at Leah and notices she has retrieved a plastic specimen cup and small square package from one of the cabinets.

“Um, well…if I have to?”

“It’s part of the routine new student physical. We use it to check for infections and other issues, and we can add on STI and pregnancy testing if you’d like,” Leah replies, giving Kya an encouraging smile.

“Um, alright then, I can try to give one.”

“Perfect, I’ll walk you down the hall to the bathroom!” Kya follows her, wordlessly, to the end of the hallway. Leah opens the bathroom door and hands her the specimen container. “So first you’ll open up the package and use the wipe to clean your vulva, then you can go ahead and pee into the cup as best as you can—we only need a little bit for testing. When you’re done, screw the lid to the container on tight and hand it to me. I’ll be waiting right outside the door.” Kya nods, taking the cup and closing the bathroom door behind her. She sets the supplies down on the back of the toilet, then takes a deep breath as she lowers her pants and underwear. She tears open the wipe package, using one hand to gently spread her labia and the other to give a few swipes down her folds with the wipe. She’s given plenty of urine samples before, but it never stops feeling a little awkward, especially with nurse Leah standing just on the other side of the door. She quickly discards the wipe, then takes a seat on the toilet, knees wide open. She unscrews the lid to the container, positions it under herself, and starts to pee, catching as much as she can inside the cup. Once she’s done, she hurries to clean herself up and exit the bathroom. Opening the door, she shyly hands nurse Leah her sample, cheeks burning a little.

“Thanks Kya! Don’t worry, I’m going to drop it off right here at the nurse’s station. I know it can feel a little weird for someone to be looking at your pee.” Kya nods again, grateful that Leah understands the awkwardness. “Alright, well let’s head back to the exam room now so we can continue our visit.”

Once the two are back in the exam room, Leah motions for Kya to sit back in the plastic chair and walks over with a dixie cup containing a couple of items that Kya can’t see very well. “Okay Kya, so next I just need to poke your finger to get a blood sample. It will feel like a tiny pinch, but I promise it will be super quick, alright?” Kya starts to feel fidgety again. She tends to get really anxious when it comes to needles, but she doesn’t want to seem like a baby now that she’s at college. Besides, it’s only a finger poke, not an actual shot or blood draw. She swallows hard, then nods her head in acknowledgement and holds out her hand. Kya watches as Leah chooses a finger, wipes it with an alcohol swab, then takes a small lancet out of the cup. “Okay, little pinch now…” she says as she pricks Kya’s finger and squeezes a little to get some blood onto a slide. “There you go, all done…nice job,” she remarks, applying a purple bandage to Kya’s finger.

“Alright now Kya, that takes care of all the preliminary stuff for today. So, to get ready for the exam, I’ll step out and talk to Dr. Taylor, and you’ll go ahead and get completely undressed—bra and underwear come off as well. Then you can put on the exam gown, open to the front, and have a seat on the exam table. Then in a few minutes, both Dr. Taylor and I will be back to see you. Do you have any questions for me?” Kya looks nervously over at the folded pink gown Leah set on the exam table for her and crosses her arms tightly over her chest.

“Um, I’ve never had a checkup…like this before. Why do I have to take off…everything?” Kya asks, her voice shaky.

“Oh honey, it’s totally okay to be nervous for a first exam like this, but I don’t want you to worry. We just have you take off everything so we can evaluate your body better, but the gown will be covering everything that’s not currently being examined. Now that you’re in college, it will be more important to evaluate things like your reproductive and sexual health, that’s all. When Dr. Taylor comes in, I’ll make sure we explain and walk you through everything before it happens, okay?”

“Okay…I guess.”

With that, nurse Leah steps out of the room and shuts the door behind her, leaving Kya alone. For a moment, Kya just stares at the table and the gown, but then she slowly gets up from her chair to start undressing. She tugs off her new college t-shirt and slides off her track shorts, placing them on one of the plastic chairs beside her. Then she hesitantly reaches back, unclipping her bra and letting it slide forward off her chest. It already feels weird to be standing so bare in this room. Kya sucks in another sharp breath, then lowers her fingers to the waistband of her soft pink bikini underwear. Before she can overthink it too much, she slowly slips them down and steps out of them, tucking them discreetly in the middle of her clothing pile. She then quickly walks over to the exam table, grabs the gown, and slips it on like a robe, pulling the front tight around her. She lifts herself onto the table, hearing that familiar crinkling of the paper as she settles onto it.

A few minutes later, there is a soft knock at the door, and nurse Leah re-enters the room with Dr. Taylor. Kya’s body starts to get prickly immediately when she realizes that Dr. Taylor is a man. He is tall, with light brown hair, blue eyes, and an inviting smile. He is wearing khakis and a fitted blue polo underneath is white lab coat. He walks over immediately and shakes Kya’s hand, giving it a squeeze. “Hi Kya, I’m Dr. Taylor, one of the student health physicians here. Nurse Leah tells me it’s your first time having this style of a physical, and I want you to know I’m going to do everything I can to make you feel comfortable. After all, I do want to make a good first impression so you’ll come back if you need care while you’re here on campus. We’re just here to make sure you’re healthy and taken care of, alright?”

“Hi, Dr. Taylor, it’s nice to meet you. Thank you.” Kya answers shyly, arms still crossed over her chest. She softens a little at his friendly introductions, but is still unsure about the whole situation. Dr. Taylor walks over to the counter and takes a seat on the rolling stool, Leah standing next to him by the computer.

“I’m going to start by asking some questions so I can get to know you and your history a little better. Some of the questions might feel a little personal, but just try to be as honest as you can. Everything you say in here is private.” Dr. Taylor pauses for Kya’s acknowledgement, then continues. “So you marked on your intake paperwork that you don’t currently have any health problems, is that right? And nothing is bothering you today?”

“Yes, that’s right. And no, I feel fine.”

“I’m glad to hear that. Are you having regular periods?”

“Yes, usually.”

“Ok, great. Now Kya, do you remember how old you were when you started puberty? Like when you started noticing some pubic hair and developing breast buds?”

Kya pulls her gown tighter against herself as the conversation shifts toward her body and its development. “Um, I’m not sure exactly. Maybe 11 or 12?”

“Ok, no need to be exact. That sounds about average.” Dr. Taylor continues scanning down the paperwork with his eyes, and Leah types Kya’s answers into the computer. “Alright Kya, so have you been sexually active at all yet?”

Kya blushes and squeezes her legs together, feeling awkward about the question. “Uh, well I did…it… once over the summer, maybe a couple months ago.”

“Ok, thanks for being honest Kya, I know it can feel weird to talk about sex, but it’s important for me to know as your doctor. When this happened, was it penis in vagina intercourse?

“Um, yes.”

“Ok, did you use a condom or other protection when you had intercourse?”

“Yes, a condom.”

“Perfect. And, have you engaged in any oral sex before?”

Kya blushes even harder and shifts on the table. “Yeah, we, um, both did it on each other.”

“Great, that’s perfectly normal and healthy Kya. I think I’ve got a good sexual history to start us off, thank you. Is it ok if we move on to the physical exam portion now?” Dr. Taylor says. Kya nods, feeling nerves bubble up inside her, but knowing this is something she has to do. Dr. Taylor smiles at her and pulls the stethoscope down from around his neck.

“Ok, I’m going to move the top of your gown just a tiny bit to press the bell of the stethoscope against your chest. Don’t worry, you’ll stay covered…” Dr. Taylor shifts the pink fabric slightly, moving the bell across a few different spots on Kya’s chest to evaluate her heart. “Great, nice strong heartbeat, nothing out of the ordinary,” Dr. Taylor remarks as he removes the stethoscope from her bare skin. “Next I’m going to listen to your lungs through your gown. Sit up nice and tall for me, and I’ll have you take a few big deeps breaths…” Kya feels the stethoscope press against her back, while Dr. Taylor rests his other hand on her shoulder to steady her. The guided breaths help calm her a little, though she still has an underlying sense of anxiety, especially as she thinks about the fact that there’s only a very thin layer of fabric between her naked body and the male doctor. “Everything sounds good there!” Dr. Taylor says as he puts away his stethoscope and retrieves an otoscope from the wall. “Just going to take a peek in your ears and mouth now..” He moves to Kya’s right side and gently inserts the scope into her ear, just enough that Kya can feel a poking sensation. He looks for a moment, then switches to the other ear. Kya watches Dr. Taylor give her a thumbs up before he exchanges the otoscope for a tongue depressor and penlight. “Can you open your mouth and stick out your tongue for me now?” Kya does as she’s told, and Dr. Taylor momentarily shines a light into her mouth.

“Okay Kaya, so everything checks out really well with that portion of the exam. The next thing I need to do is a breast exam. I’ll just be doing a brief visual evaluation, and then I’ll feel the breast tissue for any lumps or other potential problems. Does that sound okay?” Dr. Taylor pauses and lets Kya digest the information. Kya’s face reddens slightly. She’s had her breasts examined before, but her pediatrician always just slipped her hand inside Kya’s shirt to quickly feel.

“Um, yeah, I guess that’s ok.”

“Ok great. It’s totally alright to feel a little awkward about the exposure. I’ll be as quick and efficient as I can, and nurse Leah is going to stay with us the whole time as a chaperone,” Dr. Taylor says, trying to be reassuring. “When you’re ready, sit up straight and open up the top of your gown just enough to expose your chest for me, and then place your arms down at your sides.” Kya swallows hard, then slowly opens her gown, letting the fabric slide a little past her shoulders. She adjusts her posture slightly and moves her hands down to touch the paper next to her on the table. Dr. Taylor takes a small step backward and visually examines Kya’s bare chest, taking note of the size and round shape of her breasts and the appearance of her light brown nipples, which are starting to respond to the cold air in the room.

“Thanks Kya. You can pull your gown closed, and then I want you to lay all the way back on the table. Nurse Leah is going to stand by your head and help you adjust your position for this next part.” Kya quickly tugs her gown back over her shoulders and swings her legs up onto the table, slowly lowering herself all the way down. Nurse Leah walks up and gives her a comforting rub on the shoulder.

“So, I’m going to take your left arm and raise it up to tuck it behind your head. Then I’ll uncover just your left breast for Dr. Taylor to examine. Then we’ll switch sides.” Nurse Leah explains. Kya nods her head, and Leah moves her into position as Dr. Taylor moves in closer to the table.

“Alright Kya, so you’ll feel my touch on your breast now. I’m going to be feeling gently in a circular motion, moving in toward your nipple. The pressure should be pretty light, but definitely let me know if anything feels uncomfortable to you,” Dr. Taylor says as he touches the finger pads of his ungloved hand to Kya’s skin and starts to palpate. Kya stares up at the ceiling as this happens, feeling embarrassed at the exposure, but trying to be compliant. She feels him start to move in closer to her nipple, and then he applies some firm pressure to her areola to check for discharge from the nipple. “Looks good Kya. Now I’ll move to the other breast and then we’ll be done with this part.” Kya continues trying to focus on breathing as her right breast is uncovered and touched. A minute later, Dr. Taylor pulls her gown closed. “Your breasts look nice and healthy today Kya. A doctor should examine them at least once a year, and you can examine them at home in between to make sure there aren’t any changes. Do you have any questions for me about that?” Kya shakes her head, glad she’s no longer exposed.

“Great, so you can stay laying just like that for now. I’m going to feel your belly next. I’ll be slipping my hand inside your gown to palpate on your skin, but you’ll stay covered,” he explains. Dr. Taylor slides his hand inside the gown, just under her ribcage, and starts to apply pressure in different areas. He moves down toward her belly button, and Kya flinches a little as he continues to move lower near her hips. “It’s alright Kya, I’m just feeling around in your pelvic region. I’m not going to touch any private areas right now.” Kya relaxes a little as she hears this, but still feels a little strange as Dr. Taylor’s hand moves just above the area where her pubic hair starts. He presses around for a minute, then rests a couple fingers in her groin region to evaluate her femoral pulse before removing his hand and smoothing out her gown. “Ok Kya, you can sit up now.” Kya slowly sits up and lets her legs swing back down, somewhat unsure what will happen next. “So Kya, the next part of the visit is a pelvic exam. I know you said you’ve never had one before—most of our new students haven’t. Has a doctor ever checked you without your underwear on before?” Kya shifts on the table and presses her thighs tight against each other.

“Um, no, I’ve always had them on.” Kya responds, acutely aware that her underwear are currently off and that she’s going to be asked to expose herself.

“That’s totally alright, I just wanted to gauge what your experience or comfort level might be. Most of our patients are at least a little nervous for their first pelvic exam, but college is a really important time to be more thorough and involved in taking care of your sexual and reproductive health. I want to help you feel comfortable doing that, and I’ll talk you through everything I’m planning to do before I do it. That being said, if at any time something feels too uncomfortable or scary, all you have to do is tell me and we can pause or stop, alright?” Kya silently nods her head, conveying her understanding and trying to contain her anxiety. She watches as Dr. Taylor moves to the end of the table and pulls a couple of footrests out, clicking them into place. “Ok Kya, I’ll have you go ahead and place your feet into these stirrups here and then slide your hips all the way down to the edge of the table. Leah will help you get situated and comfortable.”

Kya hesitates, and Leah smiles at her as she gently guides each of her ankles out towards each stirrup. “You can keep sliding your body to the end of the table now Kya, there you go, now lie all the way back and let your knees relax open. I know it feels a little awkward, it’s ok,” Leah coaxes. Kya does as she’s told, cringing a little as she feels the air against her bare private area. Leah adjusts her gown so it still covers her pelvis, and then she moves to stand by Kya’s head.

Dr. Taylor slips on a pair of purple latex gloves and takes a seat on his rolling stool between Kya’s open legs. “Alright Kya, thanks for getting ready for me. I know getting into the stirrups can feel weird, especially the first time, but I promise it will be ok. I’m going to start with an external exam, so you’ll feel my fingers touching the outside of your private area now…” Kya flinches a little when she first feels Dr. Taylor’s gloved fingertips make contact with her skin, and Dr. Taylor rests a hand briefly on her inner thigh to ground her. His fingers comb through her trimmed pubic hair before pressing into her mound and palpating along her labia. “Okay, just going to open you now to get a better look at your anatomy…” Kya feels Dr. Taylor gently spread apart her labia, glancing at her clitoris and urethra before using his fingers to touch along her inner lips. She sucks a deep breath in as he moves down to her vaginal opening and spreads it wide for inspection. “Your vulva is looking really healthy and normal Kya, just as it should. Now what I need to do next is use a special tool called a speculum to get a closer look inside your vagina to make sure it’s healthy. I’ll spread some lubrication on it before I insert it into your vagina and open it up. It won’t hurt you, but it might feel a little strange or uncomfortable.”

“You have to put something inside me? Please, do we have to do that?” Kya says, alarmed. Leah rubs her shoulder reassuringly.

“It’s ok sweetheart, it sounds scarier than it is, I promise. Dr. Taylor just needs to get a quick look inside your body, that’s all. You can squeeze my hand if you’re nervous, but it’s nothing to worry about!” Kya isn’t so sure, but she lays back and lets Leah take hold of her hand. Dr. Taylor tears open a package of lube and begins to apply it to a small speculum the nurse had laid out prior to the exam. “Ok honey, I want you to spread your legs out wide for me and take a nice big breath. You’ll feel the tip of the speculum with the cold jelly on it at your vaginal opening, and then some pressure…there you go, you’re doing so well. The speculum is inside you now, just keep taking those breaths into your belly while I open it up and take a look with my little penlight.” Kya whimpers a little as the hard speculum pushes into her and stretches her uncomfortably wide. Dr. Taylor pulls his penlight from is lab coat pocket and aims it between her legs to visualize her cervix and vaginal walls.

“Good Kya, now I’ll take a quick swab in here and then the speculum will come out.” Kya hears another package tear open as Dr. Taylor retrieves a long cotton swab and slides it into the speculum opening. “There…just a little tickle…and that’s all done.” Dr. Taylor slowly removes the speculum from Kya’s vagina, leaving her feeling a little weird and slippery. “Everything looks good inside your vagina, Kya. Now I just need to feel inside with two of my fingers and push on your lower belly a little. Is that ok?”

For some reason Kya notices her face reddening at the thought of the doctor’s fingers going inside her, even after he’s looked at her completely exposed. “Um, yeah, ok.” She feels Leah squeeze her hand to comfort her.

“Ok honey, I’ve got some more of that cold jelly on my fingers. Relax your thighs for me and you’ll feel me pushing in.. good girl, I know it’s uncomfortable. This will only take a second,” Dr. Taylor says reassuringly as he slides two fingers into Kya and starts to press on the area around her hips, moving across to feel her ovaries and uterus. Kya scrunches her face a little at the discomfort, but tries not to react too obviously. Dr. Taylor continues to feel around, pushing against her vaginal walls with his finger tips. “Almost done here, I want you to go ahead and squeeze around my fingers…yep, just like that. Very good Kya!” After squeezing her vaginal muscles for the doctor, she feels him slowly withdraw his fingers before he turns and discards his gloves. She breathes a sigh of relief as it seems like the exam must be coming to an end. However, Kya then sees Dr. Taylor pull on a fresh pair of gloves and wheel his stool back into place.

“You’re doing such a good job for your first exam, Kya. I promise we’re just about done here, only one more thing.” She feels Dr. Taylor’s gloved hands touch her inner thighs and then slide down a little, past her opening. “I need you to take a deep breath and unclench your bottom for me now. I need to take a peek back here.” Kya starts to feel prickly with embarrassment, but finds herself relaxing her butt cheeks as the doctor’s hands come to rest on either side. A moment later, she feels him spread her wide, her most private area coming into view. “Just relax now honey, I’m going to press around near your bottom hole and make sure everything feels ok. Alright, now give me a nice strong cough.” Kya coughs and then squeezes her eyes shut, knowing Dr. Taylor is watching her anus pucker as she does so. “I know, it feels weird to be open like this back here, almost done sweetie. I just need to grab a swab—won’t hurt a bit.” The doctor tears open another long cotton swab, urging Kya to breathe as he pokes the tip into her bottom a few inches and twirls it around.

“And that’s it! You made it through your first adult physical Kya!” Dr. Taylor says encouragingly. Leah takes the cue and gently guides Kya up to a seated position as Dr. Taylor helps her feet out of the stirrups. “We’ll step out so you can get dressed. There’s some wipes on the counter if you’d like to clean off some of the lubrication. We didn’t do a pap today, so you shouldn’t experience any bleeding, but there are some pads and liners over here as well if you’d be more comfortable using one. When you’re all dressed, we’ll come back in and talk about any follow-ups you might want to schedule—birth control consults, mental health, flu shots, any of that kind of stuff.”

“Okay, thanks doctor.” Kya says, easing herself off the table to grab her clothes. She takes a deep breath with a long exhale, feeling weird between her legs, but happy she doesn’t have to feel anxious about the physical anymore. And of course, it’s a relief to know her body is healthy.