In 2016, when I was 40 freaking years old and a divorced mother of three, I had a doctor tell me I should not consent to having barrier-free sex with anyone who didn’t have to pay to get rid of me [cringe]. She said this to me as we were wrapping up my annual exam and my semiannual STI panel, during which I’d mentioned having made the decision to stop using barriers with a sexual partner of mine. I spent about five seconds in a state of speechlessness and then asked her if she was open to some feedback on that opinion. She indicated she was, which was fortunate, because she was going to hear what I had to say regardless of her willingness.
I reminded my doctor that this particular partner already had someone he’d have to pay to get rid of, (this means “married to” in case you’re not following), and that I didn’t think I’d ever be in that position again with anyone. I told her that I saw her bit of unsolicited advice as incredibly mononormative and as such, it didn’t apply to me. Additionally, I wasn’t simply consenting to this: I wanted it. Oh wonder of wonders . . . it’s not always some guy pressuring some gal into ditching condoms *eye roll.* I went on to inform her I intended to continue to decide whether or not to use barriers with folks based on my comfort level with their sexual practices and that I may do so with more than one person at a time.
I wanted the ability to be transparent about that with her so I could receive the best medical care for my situation.
To her credit, she was quick to reconsider what she’d said and apologize. She also thanked me for calling her out on it. Her acceptance of my assertions and validation of my concerns meant I retained her as my primary care physician for as long as she practiced at my clinic. Had she not, I would have found someone else to provide my medical care.
After all, doctors are service providers, and if I don’t like how they treat me I will find someone who is a better fit.
When I started seeing a therapist a couple years ago, I told him I was non-monogamous, queer, and identified as non-binary in terms of gender. I also told him I needed a therapist who was not only tolerant of those things, but supportive and encouraging. I didn’t see a productive future in therapy with anyone I’d have to talk into accepting me. He, too, thanked me for that direct assertion. This was important to me because it empowered me to hold him accountable for anything that did not feel supportive in that regard. Therapists, too, are service providers.
In the greater non-monogamous community, I witness a lot of fear around being “out” in society. Some of this is a fear of rejection by family, friends, or social communities. Others risk losing their children in adversarial custody battles, or their jobs under morality clauses. But I see this fear leading to remaining closeted with medical providers, and that means folks aren’t receiving the best care for their lifestyles.
It’s important to remember your doctor cannot report any details of your care to your employer or ex-spouse, they can’t gossip about you around town, and it’s in your best interest to be completely honest with them about all aspects of your life.
I recently read a post from a woman who asked her primary care doctor several times about birth control options after her IUD was removed. Her doctor dismissed the questions because her husband had had a vasectomy! It was that post that inspired me to write this blog. Non-monogamous folks sometimes resist being transparent even in safe spaces because the judgement of mononormative folks can feel so very defeating. But I’ve got news for you about your board certified care providers: they aren’t better than you just because they have a certain degree. Nothing about their certifications qualify them to levy moral judgement against you and let it affect their treatment of you. They probably have more education in certain areas, sure . . . but you’re the expert on you.
You wouldn’t take your car in for routine maintenance but withhold that it’s been making a funny sound when you get over 50mph. You wouldn’t hire a nanny to watch your children and keep it a secret that one of them is allergic to bees. You can’t expect anyone to provide services to the best of their ability when they’re missing pertinent information.
A good doctor will listen to you when you tell them about you, and then they’ll treat you based on the information you give them without shame of any kind. But remember: in the absence of information, all they have are assumptions, so you need to do your part and be forthcoming.
So how do you go about moving from a fear of stigma to advocating for yourself with medical professionals?
- Interview your medical professionals prior to enlisting their services; this could be a phone call, an email, or a quick chat before your exam. I like to keep my clothes on with new doctors until we’ve had a chance to meet fully clothed; I don’t find meeting new people in a paper gown to be a best practice. I have yet to meet a doctor who did not respect me for this practice.
- Familiarize yourself with privacy laws in your country, (HIPAA in the US, PIPEDA in Canada, etc.). In the US, I haven’t been able to legally access the medical records of my children since they reached the age of 12, and that is exactly as it should be.
- Develop a sense of entitlement when it comes to the quality of your care. You are a consumer whose money is just as valuable whether it comes from an employer funded health insurance company or a government funded one. Your socioeconomic status does not mean you deserve substandard care or consideration of your situation.
- If necessary, fake it ‘til you make it. There is no greater boost to confidence than a positive lived experience. If you cannot summon a feeling of entitlement to good medical care, act like you do and see what happens.
Your medical staff rely on your trust in them to provide you with the best possible care – if they betray that trust, they deserve to hear about it from you. It might feel intimidating to bring something to their attention that made you feel invalidated, unsafe, or not listened to, but a good provider will be grateful for the education and correct course.
And if your doctor (or therapist, or nurse, or anyone in your chain of medical care) intentionally attempts to make you feel bad for sharing pertinent information with them? Get mad about it! Report them to whatever board is responsible for overseeing their license and find someone else to take care of you, because you’re worth that.
Look, the thing I want you to most take away from this blog is this: you deserve the best possible care for your life. You’re also the only one who can seek out the right people for the job . . . so that means you’re in charge. You are. So act like it.
**Caveat: this blog is written from the perspective of a US citizen and some of the information is specific to that locale.