Let's Talk About Sex: Sexuality And The GP

"Just keep having lots of sex with your husband!", the doctor told me in a bright voice. This was her advice when I went to see her to talk about wanting to get pregnant. What was especially irritating about her instruction - besides the obvious fact that for many women, "lots of sex" isn't enough to impregnate them - is that I have a wife, not a husband.
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"Just keep having lots of sex with your husband!", the doctor told me in a bright voice.

This was her advice when I went to see her to talk about wanting to get pregnant. What was especially irritating about her instruction - besides the obvious fact that for many women, "lots of sex" isn't enough to impregnate them - is that I have a wife, not a husband. I had seen this doctor before and had certainly mentioned it, and I couldn't understand why this bit of information wasn't in my notes, or why, if it was in my notes, she was ignoring it.

I politely reminded her that I didn't have a husband and that having "lots of sex" with my wife wasn't likely to result in a baby.

"Oh!" she said, flustered. "Um, well, I once had a single lady who wanted to get pregnant..." The doctor couldn't think of any other advice for me, and my appointment ended with her awkwardly saying she'd look into it and get in touch. She never did contact me again.

This experience is one reason why I welcome the recent suggestion for general practitioners to talk to their patients about their sexuality. It would avoid repetitive, potentially uncomfortable conversations and also help doctors provide more individualised support for their patients.

Chairman Dr Peter Swinyard of the Family Doctor Association was quoted as saying that it was "potentially intrusive and offensive" to ask people about their sexuality. But of course there are more polite and respectful ways of going about it rather than simply demanding to know how people identify. A doctor can ask about a patient's partner or about sexual practices, rather than asking for a specific label; many people are uncomfortable with labels but are happy to refer to their same-sex partner or to acknowledge that they sleep with people from across the gender spectrum. And if doctors seem accepting and interested, more patients will likely reveal these facts to them.

Like Swinyard, some folks who are against the idea of doctors discussing sexuality with their patients argue that most medical conditions have nothing to do with sexuality. That may be the case, but of course the context of most medical conditions does relate to sexuality because a patient's health is never just about their body but also about who cares for them and who they interact with and how they feel about themselves and their lives. For example, someone may be depressed in part due to societal and/or internalised homophobia. Or a doctor might want to ask a patient about the kind of support they are getting at home, and it could derail the conversation if the patient has to interrupt the doctor to point out, "I have a male partner, not a female one." Some people are accompanied to appointments by partners and don't want to be continually asked if they are friends or siblings. Our full identities matter, and patients deserve to be visible in all aspects.

Obviously some medical matters are in fact affected by sexual practices and doctors need to be able to advise their patients accordingly. Swinyard claims there are "relatively few" such medical issues, but even if one considers only matters such as sexually transmitted illnesses, sexual health, and fertility, those are quite large issues that affect people across large swathes of their lives, and doctors need to be informed about them.

And from the basic perspective of treating our fellow humans with dignity and respect, doctor-patient consultations could run much more smoothly if doctors tried to either employ gender-neutral terms (such as partner/spouse or they instead of husband/wife or she/he) or to keep notes on what their patients told them about their home and romantic lives. A doctor could be perceived as homophobic if they always refer to a male patient's wife or girlfriend, especially if the patient has already stated otherwise. A patient wants to just get help with health problems and not to have to come out again and again. Far from wasting time, a move to talk about sexuality will actually save time, since things will be out in the open and recorded.

Personally, I changed GP practices partially because of my experience with the doctor who couldn't remember or acknowledge my sexuality and who wasn't prepared to discuss its impact on my life. I don't want other people to go through the same thing, so doctors need to start getting comfortable talking about sexuality with their patients.

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