Here are some alternatives. Slightly raising the head of the table may provide a better angle to allow use of the stirrups. Most examining tables have a covered tray at the end that can pull out. By resting the feet there and dropping the knees to the sides, an exam can often be accomplished without stirrups. A nurse or assistant can support each leg for the few minutes required to complete an exam.
Many little women require the use of a pediatric speculum.
Some little women have no trouble with an average size speculum, but having the smaller one available, just in case, is important. If the positioning is adequate and the speculum is right, the exam can go as smoothly as they ever do. Keep in mind, almost NO women actually LIKE having a gyn exam, so if it is tolerable, that's pretty good. This does not allow for screening for cervical cancer, which is the reason for the Pap smear, but is better than no evaluation at all, when necessary.