We’ve all been there; that awkward moment at the doctor’s office when the white lab coat asks, “Are you sexually active?” For some of us it’s a resounding “Yes.” For others, it’s a string of ums and uhs.
Some might assume their provider is only concerned about heterosexual relationships. This is not the case. As women who partner with women, we may or may not also have male sexual partners at some time in our lives. When doctors ask questions about sexual activity they are mainly concerned about your risk of sexually transmitted infections and other related health issues, such as genital herpes, yeast, bacterial vaginosis, or human papillomavirus (HPV), which if left untreated can lead to certain types of cervical cancer.
Contrary to common misconceptions, women who have sex with women are considered sexually active and they are also at risk for STIs – transmitting STIs to each other through skin-to-skin contact, contact with moist tissues (mucosa) such as in oral sex, vaginal fluids and (a big no-no) sharing sex toys. BYOT ladies, please.
It can be uncomfortable for queer women to disclose to their physicians who their partners are and what sexual activities they engage in due to fear of discrimination or perceived stigma. Some women may have had negative experiences with doctors in the past and refuse to expose themselves to the potential discomfort or embarrassment again, either by not disclosing their orientation and behaviors or by not visiting the doctor at all. This is no good.
Coming out can be a simultaneously nerve-racking and liberating task. But one of the keys to good health and healthcare is being open, straightforward (no pun intended) and honest with your healthcare providers. Studies show that people are less likely to be out to their medical provider regarding their sexuality than in other areas of their lives. In addition, studies have shown a direct correlation between being out and experiencing lower levels of depression. Coming out can help queer women feel more self-empowered, and make them more likely to advocate for their health in other ways.
Coming out can also allow their providers to know who their support system is, and be able to use information about their out lives to make the most accurate diagnosis and treatment plans. Being out can increase LGBTQ visibility within the healthcare system.
Understand that your doctor works for you. You choose them and pay them to provide you with competent and respectful care. This is your human right. If at any time you feel uncomfortable with a doctor or the service they provide, say something to fix the issue or choose a different practitioner with whom you are more comfortable.
Ask for referrals to LGBTQ-friendly practitioners or health centers in your area. Ask friends or family for recommendations or contact your local LGBTQ health organization for referrals. Mautner Project: The National Lesbian Health Organization can help you find health clinics and various types of providers who have experience working with the LGBTQ community and understand the issues faced by queer women.
Call first and inquire. Call up the doctor you’re considering and simply ask, “Do you consider yourself an LGBTQ-friendly practice?” or “Do you have experience working with lesbian or bisexual women?” It’s completely anonymous and if you don’t like the person’s response, no harm done, just don’t make an appointment.
Bring a friend or your partner. It is always your right to have another person present throughout any doctor’s visit. So bring your partner or close friend as moral support, to help you explain things to the doctor, or to take notes of what was recommended.
Plan what you want to ask. Knowing ahead of time what you want to get from the visit can help you feel empowered and confident. There are no stupid questions. Also, think about how you plan to most accurately answer the doctor’s questions in order to get the most complete care.
Communicate any concerns regarding confidentiality with your provider. For women under the age of 18 or those covered by a family member’s insurance policy, it may be important to be assured that any and everything you share with your doctor is kept confidential. Unless the doctor suspects child or elder abuse, risk of suicide, or direct threat of another person, they are required by law to maintain strict confidentiality.
Be clear. A clear knowledge of your sexual practices will enable a provider to best work with you in assessing possible risks or providing appropriate screenings. If your sexual behaviors differ from your orientation, make sure to tell your provider about the sexual activities you have engaged in. (For example, you identify as a lesbian, but have occasionally had sexual contact with men.)
