Anoscopy can be done gently with new plastic disposable tubes that only one of 4 CRS that I saw had. All others have those metal "thingies" - brrrrrrrrrr... They are all Scrudges - trying to save on every single little thing and don't give a dam about our comfort. Female CRS are DEFINITELY more gentle and caring.
I would avoid anoscopy during acute stage of a fissure, too painful to perform.
BEST OF LUCK