Do Ask, Do Tell: Talking to your provider about being LGBT

[nogutsnoglory]

Newly released publication by the National LGBT Health Education Center on the importance of being open about your sexual/gender identity with your healthcare provider.

"Lesbian, Gay, Bisexual and Transgender (LGBT) people routinely face stigma and barriers to health care. Do Ask, Do Tell: Talking to your health care provider about being LGBT was developed to empower LGBT patients to “come out” to health care providers. Being open and honest about sexuality and gender identity is important for improving individual health and allowing providers to deliver culturally responsive, cost-effective, patient-centered care".

Brochure can be viewed at: http://www.lgbthealtheducation.org/wp-content/uploads/COM13-067_LGBTHAWbrochure_v4.pdf

 

[UnXmas]

I'm not gay, but it's often seemed obvious to me that almost all doctors assume I'm straight without ever asking me. Especially in gynecology appointments. Two different (male) ghnecologists asked me "do you have a boyfriend," when it turned out what they were wanting to know was "are you sexually active?" It struck me that if the patient wasn't straight, they were making it even more difficult for them to discuss sexual activity. I can't imagine how difficult it must be for someone who is transgender to deal with this kind of questioning.

I've felt that kind of exclusion myself too; my ovaries failed to develop properly so I'm infertile. One gynaecologist obviously hadn't bother to read my file properly because he kept going on about the difference it would make to my hormone levels "when you have children". Never mind the fact that for all he knew I might have been a lesbian and would never plan to conceive naturally, or that I might just not want children at all. It upset me a lot because I do want children, desperately, but knew I would never have any. For some reason I couldn't manage to correct him, so just sat there while he talked about how my hormone problems would make it difficult "when you try to get pregnant." He just assumed everyone was straight, and that everyone would follow some kind of certain life path, which necessarily involved every woman having children.

 

[nogutsnoglory]

I totally get what you are saying. My doctors just assume I'm straight too which is kind of odd. I had one doctor go through demographics and just said " sexual orientation heterosexual?" Im glad he was progressive enough to ask but why did he fill in the blank for me? Of course I was uncomfortable and just nodded. Others here have expressed being uncomfortable by the assumptions made. Kiltubrid said she hates that her OB/GYN just assumes she is straight and talks about her risk for pregnancy. She will only get pregnant if her and her partner deliberately decide or someone waves a magic wand!

I do feel its important to be open with doctors I know my physical and mental health would be better off if I had the guts to do so. So far I have only been able to come out to one internist and a social worker. The internist was really great because they knew about certain health concerns I was at a higher risk for and discussed them with me. Coming out to the social worker was also critical because I can openly discuss my social and romantic life. Right now there isn't much to discuss in that arena but I can talk about how I'm depressed that Crohn's holds me back from living a more fulfilling life.

 

[UnXmas]

You would think that enough people are now openly homosexual or bisexual that doctors and other professionals would no longer take it for granted that everyone's straight (or more accurately, everyone's no longer having to present as straight).

I have a friend who's Christian, and believes that she should wait until she's married to have sex. When we were at university and in our early twenties, she was upset after a doctor's appointment because the doctor had just assumed she had had sex, and was apparently very surprised that she was still a virgin. From this experience she actually said she thought it was becoming more acceptable to be gay than to still be a virgin when you're no longer in your teens, and I think that might possibly be true - or if not more acceptable it's at least more surprising. You'd think doctors could just ask rather than making any assumptions - it's not that hard to work out that that's the obvious thing to do!

 

[nogutsnoglory]

That's so weird that a doctor would make the presumption that someone is sexually active. It's not that uncommon to remain a virgin till marriage or the right person and a small group of people are asexual. Most doctors just ask if I'm sexually active but don't go further than that in terms of questioning.

I for one don't make any assumptions anymore and let people tell me about their identity and values. I respect someone who keeps their virginity till marriage. I think it's a beautiful idea. I didn't lose my virginity till my early 20's because I wanted to wait till I met the right person.

I don't think it's more acceptable to be gay than a virgin because nobody will ever discriminate against someone who is a virgin. They may find it odd or "stupid" but nobody will ever find it morally wrong or offensive. I do agree though that it might be more surprising at least in urban centers where religious sexual ethics don't play as strong of a role.

 

[Jabocs]

This is a really important issue to bring up; I guess I had never thought about potential LGBT issues in the doctor's office since I don't identify directly. Thank you for bringing this to my attention and making me (and potentially many others) more aware. However, I am not sure I have ever encountered a doctor who has naturally assumed I am sexually active (and I am 33 years old!) so it's strange to me that any doctor would just automatically assume. I really hope doctors don't do this often. Though, I guess they have a lot on their plate so sometimes tact isn't their number one thought. Either way, thanks for your thoughts, much appreciated.

 

[UnXmas]

This is a really important issue to bring up; I guess I had never thought about potential LGBT issues in the doctor's office since I don't identify directly. Thank you for bringing this to my attention and making me (and potentially many others) more aware. However, I am not sure I have ever encountered a doctor who has naturally assumed I am sexually active (and I am 33 years old!) so it's strange to me that any doctor would just automatically assume. I really hope doctors don't do this often. Though, I guess they have a lot on their plate so sometimes tact isn't their number one thought. Either way, thanks for your thoughts, much appreciated.

I expect it varies from doctor to doctor and in different countries/regions. The friend I mentioned in my post above had been to our university doctors surgery, which is on the uni. campus and only for students. So the population is hugely different from non-uni surgeries. Sexual health issues are probably one of the most common things the doctor there came across, since nearly all the students are in their late teens/early twenties and so have far less health concerns than the patients of most GP surgeries.

When I was at uni, I stayed registered with my normal GP at home and saw her when home from uni on holidays, but I once went to the university GP who I hadn't seen before because I had a minor vaginal infection. The moment I'd told her what I was there for, she said "Is the infection from Chlamydia?" That surprised me! I guess students really must be living up to the stereotype of having lots of casual sex at uni because the doctor obviously saw enough STDs to think that was the most likely cause!

So probably doctors are going to vary as to how much they consider alternatives to straight, sexually active patients.