Coming Out to Your Doctor
Tips from Dr Cam Castle
It’s pretty normal to be worried about coming out to your doctor – but in most cases they’ll have heard it all before, and just need to get all the info so they can make sure you’re as healthy as you can be.
I know talking to your doctor about who you have sex with might not be high on your priority list, but it is really important to be open and honest with your doctor to ensure you stay as healthy as possible. If you’re feeling nervous, we’ve put some tips together to help.
For most, questions about sexual activity might generally make you feel awkward or uncomfortable. For others, especially among trans and non-binary people, the nature and language of the questions and assumptions that can occur provoke stress and anxiety.
Many people in our communities also worry that disclosing their sexual orientation or gender identity will be met with judgment and unkindness.
If it helps with the anxiety, remember that doctors are acting in their professional capacity when you see them and are required to keep the information you provide them private and confidential.
The reality is that your sexual activity and gender identity can have an impact on your health needs. There are certain health risks that are more prevalent in wider rainbow communities, for example, gay, bisexual and other men who have sex with men are at a higher risk of HIV and other sexually transmitted infections.
Sharing your pronouns, identity and sexual activity with your doctor also takes any assumptions out of the situation and means you’ll get better support. For example, if you’re a guy who is having condomless sex with other guys, but you don’t make this clear to your doctor, they are pretty unlikely to talk to you about things like getting on PrEP.
When talking to your doctor, it can be helpful to remember that they see many people every day who all have very different concerns. Their job involves things like looking at infected wounds, giving injections to crying children, and talking to people about their cancer care; just to name a few.
So, talking about sex is just another part of the job and not something out of the ordinary that you need to feel awkward about bringing up.
Also, doctors are finally now being taught about the unique healthcare needs of queer people and many doctors specialise in sexual health and have an interest in the health of our communities.
Ultimately the decision to discuss sex with your doctor is yours. But if you do decide to, here are some tips:
It can be helpful to ask friends or community support services for recommendations on queer-friendly doctors. There are a few online directories of doctors on google. Burnett Foundation Aotearoa also has a map of PrEP-friendly providers. Call the practice ahead of time and ask if they recommend any of their GPs in particular.
Getting the best healthcare is often about finding the right fit and the right doctor that meets your needs – you don’t have to just see one doctor for your whole life, if it’s not working, break up and see someone else (so to speak). If you do encounter homophobia or PrEP-shaming attitudes from your doctor, you have every right to find another doctor and even report that doctor to the Medical Council or Ministry of Health.
Set the agenda
Make sure when making the appointment to let them know it is for a sexual health screen, rather than bringing the topic up during a consultation. Setting the agenda helps the doctor tailor the consultation to your needs and removes the guesswork of a general consultation.
Make a list of questions you would like your doctor to answer — that way, you can leave without feeling like you didn’t bring something up. Most consultations are usually only 15 minutes, so a list helps you make the most of that time. If you tend to feel anxious at the doctors, a list will also ensure you don’t decide not to bring something up out of anxiety and regret it.
Jump right in there. You have limited time and, while it can feel awkward, there’s no better way to get the ball rolling than to get right to the topic of sexual health. Once you get started you may find your doctor will ask specific questions to drill down into what support you need. You don’t have to answer everything if you don’t feel comfortable, but remember it is confidential and the more the doctor can get the whole picture of your sexual behaviours – the better they should be able to support you.
Bring a friend
You are always welcome to bring a close friend, family member or partner with you to help support you. I’ve found that bringing your partner and introducing them can be a super easy way to come out to your doctor.
A bonus tip for any healthcare colleagues reading this:
Language is important, especially when it comes to acknowledging the person in front of you and making them feel comfortable and safe to express themselves.
A good starting point can be as simple as sharing your own pronouns and asking for your patient’s. I recently had a new patient in clinic and asked them which pronouns they use, and they told me they use ‘they/them’. From the start of that conversation, I could feel they were more at ease, and they even pointed out how much more comfortable they felt discussing things with me now they could be their true self during the consultation.
Also, when asking about sexual history and partners, don’t assume the gender of anyone’s partners or the type of sex they have.