Not to be confused with poly prejudice, which I’ll cover in a post on my newest venture: The Poly Toolkit It’s only just getting started but it’ll soon become a place for tips and advice on getting started on the polyamorous / non-monogamous path.
Anyway: I am subscribed to the Loving More newsletter (more as a source of trad poly* info than anything else) and read this article: The Shame Game: The Reality of Testing for STIs
My first visit to a GUM clinic was after my first sexual poly experience (having been monogamous previous to that and not having to consider it) and the Nurse who saw me was wonderful. She respectfully discussed my sexual history, made no judgements whatsoever when I said I had simultaneous partners, gave me a thorough, speedy and painfree check up according to the level of unprotected sexual contact I explained I’d had, gave me a stack of free condoms (ta very much!) and that was that. However, I can easily imagine a GP failing to have such a respectful approach; indeed, I have not mentioned my relationship set-up to my GP. Partly I have had no need to, but partly I do not wish to be judged negatively. My own insecurity, perhaps, but I doubt I’m alone in feeling that way. Stories like this where a Christian GP suggested a suicidal patient find God, or where Pharmacists refuse to offer the morning after pill, hardly help to allay my fears.
The Loving More article got me thinking about healthcare providers and their judgement of poly/non monogamous set-ups. I recently had a pre-psychiatric assessment after an bout of PTSD (relating to a sexual assault ten years ago) earlier in the year. I went in there wary of mentioning my relationship status, and I’m glad I did. Part of the assessment was a data-collecting exercise: age, previous treatment, ethnic origin, sexual orientation. When asked my orientation I said bisexual, and the therapist had an instant reaction: I could almost see the cogs ticking in her head. As we went through the assessment and I explained how the PTSD often manifested (hypervigilance, fear, an extreme reaction to being touched, etc.) she kept returning to my sexuality. She was obviously trying to draw a line between my issues with being touched by my male partner (a PTSD reaction to the assault) and what she saw as a latent lesbianism that I evidently hadn’t accepted, hence my labelling myself as bisexual. I closed up at that point. I was not interested in seeking treatment from a mental health professional who evidently believed bisexuality was code for ‘sexually confused’ and thus would not be able to engage intelligently with my problem. The PTSD subsided: I believe it surfaced at the time, nearly ten years after the event, because my brain was able to deal with it and process it. Years of self analysis and some good therapy had given me the tools to cope, and the PTSD is mostly gone. However, how many people seeking treatment for sex/relationship-related issues who are poly or bi or trans or gay will hit a treatment roadblock due to the closed-mindedness of the person they seek treatment from?
In the UK the NHS is supposed to avoid judgement of your sexual lifestyle or history when offering you care. The only time they can breach patient confidentiality is when they believe not doing so will put someone else’s life at risk; for instance if you are diagnosed as HIV positive and will put your partner in danger.
I tweeted Dr Petra (who is 50 shades of awesome) and she found me several sources of information regarding the NHS and your sexual history, as well as some examples of best practice to be shared (thanks Dr P!)
The first is the BASHH guidelines -
BASHH 2006 National Guidelines – consultations requiring
sexual history-taking This document clearly outlines what healthcare providers should do when discussing the sexual history of their patients and how to deal with it sensitively. If you’ve experienced poor treatment from your GP or GUM clinic (the latter far less likely, but possible) why not offer them this as a guide? It might help them change and if it doesn’t, you should request another Doctor who will.
The second is this book (free to read): Health Care Without Shame: A handbook for the sexually diverse and their care givers by Dr Charles Moser. It’s aimed at improving the care that clinicians give and patients receive, and aims to empower both parties. Another gift for your doctor, perhaps?
And finally these guidelines from the Department of Health. Aimed at welcoming young people into health services, they actually serve as a good set of minimum standards to be expected.
As polyamory and non-monogamy become more visible I can see these issues becoming more prevalent: any community that does not follow the ‘norm’ is going to experience difficulties when interacting with mainstream institutions such as healthcare providers and the Law, just as the LGBT community has (and still does). I did not feel willing or able to explain to the therapist I saw why I did not want to see her again, even though I know I should. Have any of you tackled judgemental/insufficient/inappropriate care and achieved a positive outcome?
*See Glossary and a future post for info