In the realm of female experience, few things are more dreaded than the annual visit to the gynecologist. (Followed closely by period cramps and too-tight jeans). Ask any woman what her least favorite part of the pelvic exam is, and she might talk about the cold, clinical environment or the invasive feeling of having a near stranger so close to your most intimate areas. She might describe pain, or light squeamishness. But she absolutely, without question, will mention the speculum. The speculum is widely considered one of the worst, if not the worst part of the pelvic exam for women. And it’s been that way since the 1800s.
While you would expect most medical devices from over 100 years ago to be obsolete today, the modern speculum is almost identical to the one invented by James Marion Sims in the mid-nineteenth century. Sims is known as the father of modern gynecology and a statue of him stands in Central Park, but it might not surprise you to learn that the man who invented a device so many dread, came from a long history of unscrupulous and abusive medical practices.
The cold, uncomfortable history of the modern speculum has roots in Sims’ experiments on enslaved women who, in some cases, were purchased by Sims and kept as property. Based off these experiments, and deeply rooted in these enslaved women’s suffering, Sims developed the speculum so that he could more easily see inside a woman’s body to provide treatment. The first of Sims’ speculums was, as the story goes, made from a spoon he’d bent in half. As you might imagine from a man who conducted painful medical experiments on enslaved individuals, Sims had little care for his patients or his work, even citing in his own autobiography that “If there was anything [he] hated, it was investigating the organs of the female pelvis.” Not necessarily the vote of confidence you want from a doctor, especially one who will be operating on you without anesthetic, using techniques he’d only just invented.
As you can probably imagine, Sims’ speculum was extremely controversial in its day. Doctors feared that it’s use would turn women into sex crazed maniacs, and in 19th century Paris, speculum exams were used as punishments for prostitutes and other so-called wayward women. Since that time there have, of course, been improvements. Modern designs are made of plastic, not metal. Some include a built-in light for better visibility, and there are now a variety of shapes and sizes to suit women’s varied bodies. However, the fundamentals – and the discomfort – remain the same.
This failure in speculum innovation is not for lack of trying. Many attempts to revamp the speculum have been tried and failed. This includes inflatable versions that expand gradually from the inside, mechanisms to prevent pinching, insertable megapixel cameras, and a movement for self-insertion championed by second wave feminists in the 1960s and 70s. Still, Sims’ design has endured, and so has women’s discomfort.
Right now, the most promising shot at a revamped speculum is Yona, created by a team of women at Frog Designs. Lead designers Hailey Stewart and Sahana Kumar want to change not only the speculum, but the entire pelvic exam. Their new, silicone speculum, has three leaves that open gently, and with no audible clicking sound when it gets into place. Once they’ve conquered the speculum, Yona is looking to change other uncomfortable aspects of the exam (stirrups, anyone?) to revolutionize the entire experience for women.
But don’t go scheduling your celebratory gyno visit just yet. This redesigned speculum is still a prototype. Even Yona’s own website calls itself as a “work in progress — today a concept and conversation starter, tomorrow something much more.” Hopefully, the conversation sparked by Yona between patients and doctors continues to grow and we can finally put Sims’ speculum back where it belongs: in a museum.