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Ask the question June 3, 2009

Filed under: Uncategorized — lesbonurse @ 1:35 am

Today I performed a physical exam on a new patient. He appeared to be an average man in his 60’s. We went through the Review of Systems, then moved on to Social History. In addition to the smoking and drinking questions, I try to ask all of my patients about their sexual history. I don’t need to know the exact number of partners that you’ve had in your life, nor do I need to know your favorite sexual position. I do need to know whether or not you sleep with men or women, whether you are sexually active now (or in the recent past), whether you’ve had multiple partners and what kind of pregnancy or STD prevention you use.

I was going through my usual routine when I said, “I ask everyone this question: do you sleep with men, women or both?” My patient, looking a little taken aback, said “Men.” I’ll admit, even I–Lesbonurse!–was a little surprised. He just didn’t look gay (whatever that means). But I forged ahead with my next question: “How often do you use condoms when you have sex? Some of the time? All the time? Barely ever?” My patient stopped me by looking me in the eyes and saying “No one has ever asked me that before.” “Oh,” I said, preparing to move on. “No,” he said, “I mean, no doctor has ever asked me that before.” I dropped the social history questions for a little while, and we talked about his experience as an older, closeted gay man. The experience was a good reminder that even me, a super-gay healthcare provider, makes assumptions. And even me, super-gay healthcare provider, needs to ask the question every time. You never know.


3 Responses to “Ask the question”

  1. Beth Says:

    you know…i’m glad you touched on this subject. I always make sure to ask whether a patient is sexually active with “men women or both” and most patients snicker at this question….but when the occasional patient is given the opportunity to not be discriminated against by prior medical heterosexual assumptions…I feel proud to have made them feel comfortable and accepted without stereotype, and continue to ask EVERYONE the same question. Also, when patients do snicker, I take the opportunity to tell them that everyone should feel welcome, and if they were gay or bi, they would want to not have any assumptions as well….and MOST understand that (and hopefully translate it into their lives too).

    You rock!

  2. starlinglove Says:

    Since you are lesbonurse, you yourself must be familiar with the way that every health professional I have ever dealt with has handled this. It goes like this:

    Health Prof: OK are you sexually active?
    Me: yes.
    HP: OK are you using any birth control or protection?
    Me: no.
    HP: OK are you trying to get pregnant?
    Me: no.
    (and so on until I decide to let them off the hook)
    Me (in a blurty kind of way): I’m gay!!!! I’m a lesbian! My partner is a woman!

    I had a dr once who I really liked, who when I said I wasn’t happy with my posture spent like 20 mins trying to find a good physcial therapist who she thought would be most helpful, who always asked me about any upcoming vacation plans I had every time she gave me a breast exam, who after I said I was gay, she responded “I’m sorry!” But I knew she meant she was sorry that she was insensitive to the possibility that I might be gay, not that she was sorry I was gay. I laughed, it is good to have a sense of humor about these things.

    But thanks for being out there and being sensitive, and thanks to Beth too and everyone else who tries– it means something!

    • lesbonurse Says:

      Yes, that situation has happened to me as a patient, too. Usually if a patient says they’re sexually active and not using birth control but they’re not forthcoming with more information, my next question is “Is your partner male?” I get a lot of surprised looks from my heterosexual patients with that one.

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