In a classic “one step forward, two steps back” kind of situation, every stride made in the medical field only seems to uncover more ways in which women have been not-so-subtly undermined and underserved. Women’s health is finally beginning to be taken as seriously as it should be, and the latest casualty of this is sexual health and STD testing.

According to a new report published by Quest Diagnostics, women are being severely underserved and under-tested when it comes to their sexual health. The study included 4,742 participants: 3,414 women between the ages of 15 and 24; 1,016 mothers of young women in that age group; and 312 doctors, gynecologists, and other health experts involved in sexual health. Participants were asked a number of questions to gauge safe-sex behaviors as well as attitudes and prejudices.

Only 56 percent of the sexually active women in the study have ever been tested for an STD.

According to the findings, only 56 percent of sexually active women have ever been tested for an STD: Of the sexually active women who were untested, to explain why they hadn’t been tested, 62 percent said they didn’t think they were at risk, and 55 percent said they don’t exhibit symptoms, Teen Vogue reported. Especially since many STDs are asymptomatic, this is obviously an unhealthy problem, but it also points to a far-reaching systemic issue.

The study found that 51 percent of respondents said they don’t want to discuss sex or STDs with their doctors, which could be a result of a culture of shame. But the large number of untested women can also be attributed to the fact that many MDs aren’t monitoring their patients’ sexual health: Just 51 percent of women said their doctor had asked them about STD testing, and, more frighteningly, 24 percent of primary-care physicians were reportedly uncomfortable talking to their female patients about it. Despite knowing that patients with STDs might not exhibit symptoms, some medical health experts (one in three!) ignore screening guidelines in the absence of symptoms.

The study only further demonstrates that women have to look out for themselves: If you feel uncomfortable talking to your doctor about STD screenings, remember that knowledge is power: It’s important that you find a health-care provider you can talk to.

Going to the doctor can be daunting, so here’s how often you should actually be going and answers to some of your most embarrassing questions for your OB/GYN.