Tell the nurse/doc whoever you see first that you are a CSA survivor. This is their profession & they've dealt with many times before. There is even a protocol for it. If you know what you need, tell them. I need to know what's going to happen next. Some docs incorporate the protocol into every first time appointment especially if an older first timer. That may include a shorter exam, the presence of a nurse who will even hand hold if you like. Prefer a running conversation or silence...just tell them. They want to make it as comfortable as possible as this is an important part of physical health. If you want to take a friend with you, do so. Don't need to explain. Just plan a lunch or shopping afterwards. Take care of yourself.