So as some of you MSP readers who know me in real life may know, I have a broken foot. Well, really it’s not that bad, just a stress fracture. But it still means 4-6 weeks of healing time, walking with a limp in a silly Air Cast, and a trip to the podiatrist. When it happened, I decided to pick a new podiatrist that is closer to the apartment I’m living in this summer (my old podiatrist was closer to my family home), and didn’t know much about the guy before going to the appointment. He diagnosed me quickly, and though he had a pompous attitude, nothing really stuck out to me until it came time to X-Ray me.
Let me set the scene first. I was in the exam room with my partner, Liv. Though on my own I am not that obviously queer to the untrained eye, when Liv and I are together, it’s pretty clear that we are a queer couple. He has piercings and tattoos up the wazoo, and pretty much looks like a little gay boy.
So, here comes the problematic stuff. We were exchanging regular doctor-patient witty banter, and in the midst of all the joking conversation, he checked off the little box that stated there was no way I could be pregnant- without even asking me.
Now, he’s right. But that’s kind of irrelevant- first of all, he knew nothing about my sex life or sexual preferences/practices, had no idea if Liv was my partner, or if he was my only/primary partner, and had none of my sexual history. As far as he was concerned, he had no evidence to base that assumption on, other than what he thought he saw. This incident came at a perfect time for me, though, because just three weeks earlier I had helped to edit a friend’s capstone project on the LGBT healthcare experience, entitled Words Left Unsaid:The Healthcare Experiences of Simmons Female Students Who Have Sex With Women. Mary Ann Lee, the author of the capstone, has allowed me to quote parts of her thesis in this post.
As Mary Ann writes in her abstract, her study was a survey of the healthcare experiences of women who have sex with women, and how they “are directly connected to their decision to disclose their sexual preferences to their healthcare providers. Eleven female Simmons undergraduate students wererecruited through flyers, the internet, and word of mouth. They were interviewedseparately about their decision to disclose their sexual activities to theirproviders. The data were analyzed using grounded theory. The participants identified three factors that influenced this decision: lack of communityacceptance (within the larger community and within their high schools), theassumption of heterosexuality by their providers, and the lack of knowledge within the healthcare community. These factors impacted the patient-provider relationship and changed the trust patients had with their providers. If patientsdid not trust their provider, they were less likely to disclose their experiences to them. Therefore, providers must ask their patients directly about their sexual preferences and consider the cultural and historical implications of the discussion.”
Mary Ann also wrote about discussions between women who have sex with women and their healthcare providers. “Elizabeth and Jessica explicitly used the term “the game” to describe the conversation where their providers questioned their ability to be pregnant. “The game” included a series of questions that signified their providers’ assumption ofheterosexual sex. The game usually began with the provider asking if the patientcould be pregnant, to which the patient replied with “no”. Then, the providerasked if the patient was sexually active. The patient replied with “yes” because they were engaging in sex, just not sex with men. Next, the provider asked if the patient was using birth control or any other type of contraception, and the answer was “no.” As the game progressed (providers typically asked thesequestions multiple times), the patients realized that their providers were confused because they were assuming that the patient only engaged in sex with men. This continued until the patient corrected their provider.”
When one of Mary Ann’s subjects was approached by a nurse wanting to do a pregnancy test, she purposely messed with her head. “So she comes over and she’s like, “Honey, we want to do a pregnancy test for you” and I’m like, “I’m not pregnant” and she said, “Well, how do you know that?” I said “because I’m not,” and she said, “Nurse such and such asked if you were sexually active and you responded that you were.” “Right, because I am.” “Well, do you use any form of birth control or a contraceptive of any kind? Like condoms, anything like that?” And I was like, “…No.” And she said, “Oh! We need to do a pregnancy test on you!” And I said “No,you don’t!” By this time Andrea had recognized the game and began to play into it. “And I didn’t say anything, yet. I was waiting to see how long. I’m a mindfuck. Just because I can. Because I was so mad and so offended.”
It’s clearly an issue that healthcare providers so frequently assume a heterosexual lifestyle. Obviously there are places that train their employees to be more inclusive, clinics like Planned Parenthood, or the Sidney Borum, Jr. Health Center in Boston, but this needs to be an ongoing and open conversation.