After publishing the article Coming Out To Your Doctor my husband and I felt it was time to go have ourselves tested for STD’s and HIV.
Instead of setting up appointments with our primary care physicians and possibly waiting weeks to have the testing done we decided to go with a local public health resource.
We called in, did our preregistration over the phone then headed down to the testing clinic.
There were a few things about our visit that really brought home the Bi stigma.
Over the past almost year I’ve had the pleasure of working with an organization that focuses on the health needs and rights of those in the Sex Trades/Adult Entertainment Industry.
A part of my work with this organization was to give lectures/presentations to health care providers and social service providers regarding etiquette when dealing with lines of questioning regarding sex work and sexual partner history.
In other words, the doc had no idea she would be seeing a very well educated patient on protocol and politics of her field.
The nurse and the doctor both made offensive mistakes that are common in health care settings when dealing with sexuality and health.
Our visit yesterday was an example of the exact reason why I became so involved in the organization I was working with. Regardless of sexual identity, sexual practices/tendencies or gender identity, selling sex as a business or survival, all people deserve courteous respectful health care. All humans. Period.
We came to the clinic together, registered together and saw the nurse as well as doctor together. When going through the screening process we were approached with the assumption we were straight and monogamous because we are married and presenting together for testing.
The nurse did screen us both individually but at the same time in the same room.
I knew what questions were coming and I wanted to see how my husband would answer. He’s not the talkative type, doesn’t like going to the doctor much and he’s somewhat still somewhat shy about his sexuality. I knew he’d be flustered by the screening questions but instead of answering for him (which is usually his preference) I just waited to see how he’d deal with them.
After a few basic questions THE question came:
“You’re married, you’re here with your wife… so you only have sex with women…or men and women?” The question was posed with the assumption of the answer but asked anyway.
She looked at me, he looked at me, I looked at him…and waited for his reply.
He tried to figure out the right way to say it and finally said: “Men and women.”
She looked at me, then back to him.
She asked what kind of specific sexual acts does he indulge in with men. He looked at me again. Again, I didn’t say a word. I really wanted to see how this would play out.
He answered her questions (those q’s and a’s are personal, thank you 😉 )
She asked: “What about protection? Do you use protection?”
He explained to her NEVER has he done ANYTHING sexual with a male without a condom. Ever. She looked at me, I confirmed what he said, condoms always.
The next question is one that really irks me in so many ways for so many reasons as a Health Care professional.
She asked him: “How many sexual partners have you had in the last 6 months?”
Again, he looked at me, I looked at him.
He said: “Babe, can you answer this one, I mean I can but I can’t. You’re better at this kind of stuff. You tell her.”
I said: “No, come up with an answer on your own, this is your screening process.”
I explained to the nurse what I’d been doing over the past year and my education. I also explained to her it was very, very interesting to me to observe a patient actually experiencing the screening process. As an advocate I’m not in the room with the patient, I’m on the front lines educating and fighting these policies to be changed.
ought about our recent trysts and ultimately said “Babe, I don’t know what to say.”
I reminded him he did not have to say anything. He could elect to not answer any questions during the screening process and that is one question I personally refuse to answer.
It has no medical bearing whatsoever. It’s used as a tool for the medical provider to get an idea of your sexual life and possible risks you may be facing that you may not know about as a patient.
The question is not pertinent even if the patient is symptomatic of an STD or HIV at the time of the visit.
The answer is not a factor that can be used in urgent or immediate treatment of symptoms or disease.
It’s not relevant to the testing process in and of itself.
It’s not relevant to treatment for any health issues.
The ONLY TIME this question is pertinent is when it is necessary to provide partner notification in case of infectious disease.
Other than that it’s a useless question that can create bias and preconceived judgement in the mind of the health care provider potentially creating a hostile environment for the patient.
I choose not to indulge and have taken that stance since my first STD screening test as a teenager although I get scientifically why the question is a part of the standard screening process. If I did test positive for an infectious disease I’d disclose whatever info needed for partner notification instantly. No arguments from me there.
But in reality, who ever tells the truth on that question anyway?
Any scientific data collected from whatever clinic(s) from that question would be really questionable. The data is not verifiable and it’s not solid information to base research off of.
Anyway, I was screened by the nurse after he was.
Again the question regarding do I sleep with men only or men and women. I answered I engaged in sexual activity with both males and females.
She looked from him to me and back to him.
We explained we’re both bisexual and we do a lot of speaking, educating, etc on bisexuality in marriages and long term relationships. She was visibly shocked.
She then went on to ask the rest of the same questions of me she asked him. I answered what was pertinent to care only. She knew from his screening process don’t ask me clinically useless questions and she didn’t, she skipped right over them. 🙂
My husband and I both elected to take the OraQuick Rapid HIV test.
We were given an applicator with a swab on the end, instructed to swab our gums on each side top and bottom. Then all we had to do was wait 20 minutes for the results…
She was friendly enough, really kind face, soothing voice, relaxed appearance despite her traditional businesslike black slacks and white shirt. She would be doing my husband’s screening, exam and testing I would be seeing another provider for the same. She didn’t mind my sitting in.
The doc wanted to go over the screening questions again.
We explained we’re a both bisexual couple who has sex with other men and women, together using protection always. We’ve never done anything without a condom ever just to bring her up to speed and avoid the same questions again.
She asked a few specific screening questions one more time to get more of an idea of our sex life. We reiterated we use protection always with other men when asked yet another time in a differently phrased question.
After she’d finished her inquiry the doctor then began to tell us both the dangers of men who sleep with men.
She went on and on about how men who kiss other men can get diseases they wouldn’t get if they weren’t kissing other men, she explained how men who get or give men oral without condoms can get diseases other people don’t get and of course all the many dangers of anything anal between two men.
Then the doctor told me and my husband that there is a disease called Nisseria Meningitis that is spreading in our town of Brooklyn among men who come in ” very close proximity with, but not necessarily intimacy or physical touching with other men and it’s “VERY deadly, fast acting and easily spread”.
(click the above link to read ALL about the “outbreak”, I encourage you to do so for your own understanding.)
She felt we should be vaccinated against this disease because we were at risk since my husband is bisexual and we live in Brooklyn.
Needless to say I pulled out my phone and researched right away while declining the vaccination until I knew more.
I’d interrupted her a few times during her explanation of the risks of my husband’s sexuality to explain to her I wasn’t a laymen but a colleague, another experienced HIV/AIDS Educator, a current student of Health Care Management and I’ve been working on and around legislative advocacy surrounding Health Care rights in NYC for about a year now!
She explained she was an HIV specialist and she knew what she was talking about despite my background.
How could she know I just spoke at the End AIDS Conference in Philly only a couple months ago on several panels? One of my passions in life is HIV transmission prevention and education and I’ve been volunteering for speaking engagements and teaching opportunities since my early teens. I lost almost all my teenage friends to the disease in the 90’s. I volunteer my education, time and experience on the topic wherever possible.
I was beyond upset.
I was really pissed and ready to call the Director of the facility to offer training to his staff, at no cost! They needed it dearly!
In my mind all I could think was what she’s describing is a public health concern not a bisexual male or Men who Sleep with Men (MSM) health concern.
If this disease is transmitted by close proximity only then someone should alert the Department of Health and notify the public of this new soon to be epidemic was my thinking.
I’m sure bisexual men take public transportation, go to work daily, eat out, attend recreational activities in public. If MSM have this special disease that’s airborne and spreads easily THIS WHOLE CITY would be infected by now!
What about family members of MSM who are near each other often?
How about the people MSM’s live with, can they get it too?
Can they spread it too?
It’s this kind of medical misinformation that could have a less informed patient shaking in his boots after a visit with the doctor. (The link to the medical research on the meningitis outbreak in Bklyn is highlighted above. No need to panic NY’kers, it’s nowhere near as serious as she implied. We won’t be taking the vaccine.)
The doc then examined my husband’s penis for any lesions, discharge, etc. During the exam despite him informing her he’d used protection always she insisted on swabbing the back of his throat to test for diseases because “Men who have sex with other men can get infections in their throats much easier, even if you have used a condom and there has been no exposure.”
Huh? What? Can we say Bi stigma again?
Remind you of something?
HIV in the 80’s much?
I was sent steaming into the next exam room to wait for the other physician who had my chart to examine me.
When my doctor came I explained my husband and I were in for testing together. He didn’t go over my screening and I’d given urine already.
We’d been there about 4 hours. We had a meeting at 5:30pm and it took about an hour commute to get to our location- it was 4:30pm.
By the time “my” doctor was available I had no more time or patience for the process any longer and I wasn’t willing to be late to my 5:30 meeting.
We had to leave, I wouldn’t be able to stay for a full exam.
It was explained to me by “my” doctor if our test results came back abnormal we’d be contacted via email or phone.
If we didn’t hear back in 3-5 days everything is normal but we could inquire about our results if we’d like confirmation. I had no symptoms or complaints so a full exam wasn’t necessary.
I intend to schedule an annual GYN with my regular health care provider for a full exam this coming week.
(originally written 9/7/2015)
-Jay Dee, Founder