Hey there, I am a nurse at a women's health clinic and birthing center. I have kind of a funky question. This has come up a couple of times where I work, and I just wanted to know how lesbian moms/women would prefer to have their doctor/health care practitioner handle their line of questioning as well as the documentation in their charts.
Whenever a woman comes in for an appointment (usually for an annual exam), we have a set list of things that we ask. First day of last menstrual period, medications, herbals and vitamins taken, whether you smoke. We also ask about birth control use. If a woman says that she does not use any sort of birth control, we ask if she is sexually active. If she says yes, then we always ask if pregnancy is not a concern. If she says, no pregnancy is not a concern, we usually explore that further...they are trying to conceive, partner has a vasectomy, they have never used birth control and have never gotten pregnant, etc. Occasionally a woman will say, because I'm gay, or because my partner is a woman.
Okay, no problem there. But one of my questions is, how to document this? Normally I simply put: No BC used, positive sexual activity, partner is female. I hesitate to put lesbian; first of all because I don't know that. Maybe sometimes a woman has male partners, sometimes female. Somehow, too, it doesn't sit well with me to put that down, I'm not sure why. Do any of you gay/bi mamas have any way you would prefer that your health care professional documents your sexual orientation?
A few of our gay patients I now recognize, since I"ve been there a while, so I just ask them if they are with the same partner as last year. Also if I see in their chart that it is previously charted that they have a female sexual partner, I again just ask if they are with the same partner as last year. But for the ones that I don't recognize, or who are new to our practice, I always feel a little uncomfortable after the fact when I have asked my questions. I feel like I have assumed they are straight (which I have, usually), but I'm not sure how to reword my questions for a more inclusive format.
So my other question is, if you were sitting in our exam room, and
I was asking you the questions that I listed, would the line of questioning or the way I worded them make you feel uncomfortable or unwelcome? Is there any other way the questions might be worded to make you feel better and more open and honest? I imagine for many gay women, especially those who are out and have been a long time, it isn't a big deal. The women I am particularly worried about alienating or making uncomfortable are the young women (high school or college) who are not yet comfortable with their sexuality, or who have not yet told anyone. I can imagine if your parents and relatives think you are straight, and you live your lifestyle rather secretly, it would be disconcerting to have to say the words "I'm gay." Or is it not that big of a deal?
Sorry, when I type this out, it all seems rather silly. But we are located in a pretty conservative town, home of Fred Phelps, and I feel like gays and lesbians have a hard enough time here as it is. I'm just trying to be sensitive about it all, and since it came up the other day again at the office, with a new patient, who blushed when she told me she was gay, I wondered if maybe there is another way of asking that might be more, oh I don't know, supportive? Nonjudgemental? Because I, and none of us where I work, give a hoot about someone's sexual orientation. I just felt bad when the woman blushed and looked away. I didn't want to make a bigger deal about it, so I just touched her hand, smiled, and said, "That's totally okay, you know." and went on with my questions.
Anyhow, some guidance in how to make office routines, questions, and documentation more accepting and supportive would be appreciated.
Thanks!
Lori
Whenever a woman comes in for an appointment (usually for an annual exam), we have a set list of things that we ask. First day of last menstrual period, medications, herbals and vitamins taken, whether you smoke. We also ask about birth control use. If a woman says that she does not use any sort of birth control, we ask if she is sexually active. If she says yes, then we always ask if pregnancy is not a concern. If she says, no pregnancy is not a concern, we usually explore that further...they are trying to conceive, partner has a vasectomy, they have never used birth control and have never gotten pregnant, etc. Occasionally a woman will say, because I'm gay, or because my partner is a woman.
Okay, no problem there. But one of my questions is, how to document this? Normally I simply put: No BC used, positive sexual activity, partner is female. I hesitate to put lesbian; first of all because I don't know that. Maybe sometimes a woman has male partners, sometimes female. Somehow, too, it doesn't sit well with me to put that down, I'm not sure why. Do any of you gay/bi mamas have any way you would prefer that your health care professional documents your sexual orientation?
A few of our gay patients I now recognize, since I"ve been there a while, so I just ask them if they are with the same partner as last year. Also if I see in their chart that it is previously charted that they have a female sexual partner, I again just ask if they are with the same partner as last year. But for the ones that I don't recognize, or who are new to our practice, I always feel a little uncomfortable after the fact when I have asked my questions. I feel like I have assumed they are straight (which I have, usually), but I'm not sure how to reword my questions for a more inclusive format.
So my other question is, if you were sitting in our exam room, and
I was asking you the questions that I listed, would the line of questioning or the way I worded them make you feel uncomfortable or unwelcome? Is there any other way the questions might be worded to make you feel better and more open and honest? I imagine for many gay women, especially those who are out and have been a long time, it isn't a big deal. The women I am particularly worried about alienating or making uncomfortable are the young women (high school or college) who are not yet comfortable with their sexuality, or who have not yet told anyone. I can imagine if your parents and relatives think you are straight, and you live your lifestyle rather secretly, it would be disconcerting to have to say the words "I'm gay." Or is it not that big of a deal?
Sorry, when I type this out, it all seems rather silly. But we are located in a pretty conservative town, home of Fred Phelps, and I feel like gays and lesbians have a hard enough time here as it is. I'm just trying to be sensitive about it all, and since it came up the other day again at the office, with a new patient, who blushed when she told me she was gay, I wondered if maybe there is another way of asking that might be more, oh I don't know, supportive? Nonjudgemental? Because I, and none of us where I work, give a hoot about someone's sexual orientation. I just felt bad when the woman blushed and looked away. I didn't want to make a bigger deal about it, so I just touched her hand, smiled, and said, "That's totally okay, you know." and went on with my questions.
Anyhow, some guidance in how to make office routines, questions, and documentation more accepting and supportive would be appreciated.
Thanks!
Lori
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