Sexual Orientation Question

Nurses Relations

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I have been thinking about this lately...and I am being serious when I ask this; but, with all the advancements in knowing about risk factors for various diseases (especially STIs), what does sexual orientation have to do with anything?

What I mean is this--like HIV/AIDs, it was first thought to be a gay man's disease; now we know that it can be transmitted whether you are gay or straight. Another example would be all women getting pap smears whether they are a homosexual, bisexual, or heterosexual--what's wrong with just teaching all females to get pap smears as long as they have a cervix?...leaving it at a statement rather than asking their sexual preferences.

I just can't think of one disease or educational need that only applies to people who are homosexual or bisexual. All the ones I can think of are pretty universal diseases/health promotion exams/teachings. I just think it can lead to discrimination rather than anything good.

Thoughts?

Do only gays needs screened for rectal cancer?

They're at a higher risk due to HPV which can be transmitted even with condom use.

I'm aware of the Westboro Baptist Church, as well as other forms and styles of homophobia in the world. I'm also agog that you consider a holistic approach that considers a person's lifestyle and how their activities affect their health to be somehow related to homophobia and discrimination. Sexuality matters to a person's health.

Unsafe sex is what matters, and everybody and their duck is doing it...The STD numbers don't lie. I brought up WBC just tongue in cheek- they're so insane, you have to laugh. Don't nurses NEED a good laught?

But I agree with your point, totally, about HPV. Syphillis, also. But in my world, people all think that HIV is the only beast to be aware of, everything else just needs...a pill? Welcome to Wallyworld!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Grn, I mean mainly as it relates to your sex (biological), not gender--you wouldn't be discussing prostate issues with women, or cervical cancer or pregnancy with men. Birth issues are different. I mean, like when they ask if you sleep with men, women, or both. Why does it matter who I (or anyone else) sleep with? I don't see any good coming from it, just discrimination on the part of the healthcare provider (people are biased/have their own opinions on the issue whether they admit it or not and most times, their opinions dictate their actions).

It might.....if a man is on the "downlow" in a hetero relationship they may be engaging in unsafe practices that place them and their partners at a higher risk and the same goes for females with multiple partners engaging in high risk behaviors. I don't think the question indicates that sexual orientation precipitates disease.....but it opens the door to sexual behavior discussions that do lead to an increased incidence of STD's

The question do you sleep with men women or both might be indicative of a behavior of unprotected sex with multiple partners....that precipitates disease.

Specializes in Adult Internal Medicine.
Boston, how does it affect your job and screenings/assessments? I mean, if I went to you, and you asked me that question and I answered I sleep with women or both, what are you going to do assessment/screening/educational wise that is different than if I answered men? Either way, you would still do a pap smear, STI screenings (yes, HIV can still be passed female to female; although, the risk is much lower than female/male or male/male sex), and other routine assessments.

However, if you think being homosexual or bisexual is wrong (I am not accusing, just explaining), you might be apt to treat me differently (in a discriminatory way) than a patient who is heterosexual.

Age, gender, race/ethnicity, psychosocial factors, and even sexual orientation are important factors in caring for individuals, not because of racism or ageism ornate like, but because they have a profound effect on the differential.

Lets, for a minute, consider age, race, gender, and sexual preference.

Read this:

http://www.cdc.gov/hiv/topics/aa/

Then consider nursing's role in primary prevention. Can you identify a high risk group for intervention? Does age, gender, race, or sexual preference play a role in identifying that group?

Specializes in Adult Internal Medicine.

In the 1990's maybe, it would have been relevant to ask a man if he had sex with men. Since, like it says, STDs are all over the place and no longer confined to gays, straights, etc.- I don't see the point in questioning sexuality- other than maybe, 'do you have sex outside of your relationship, and if yes- are you taking precautions to protect that person from your indiscretions', and use it as a teaching opportunity. In fact, I find it rather ...lewd. All it can do is label him/her, with no benefit. But with a lot of potential harm.

See above.

Specializes in Med-Surg.

Here is what I am thinking:

If we do ask or talk about it, we come across as possibly judgmental. If we don't ask, it becomes a 'don't ask, don't tell' kind of thing.

I see absolutely nothing wrong with who you choose to sleep with, so long as they consent, and are of age. It won't make me treat you differently to know if you are heterosexual or homosexual.

Not asking, to me, makes it seem like a hush-hush topic, shameful maybe. And if there is to be no shame, if we want people to get over prejudices, then there needs to be MORE openness, not less.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Were men asked if they were homosexual before HIV came on the scene..?

No, because there was no HIV.

I have lived through the AIDS, ARC, HTLV3 as HIV development/discovery as a fatal disease. My first encounter with someone who was actually "diagnosed" was a hetero female that was having an affair with a bisexual male.....I learned a lot on that "case"

It was prevalent in the gay community not because they were gay but because unsafe sexual practices with multiple partners was common place in this community at the time. Education has offered multiple populations including IV drug users some knowledge to avoid this disease but to pretend that it isn't still necessary to keep asking those hard questions to try to futher control the spread of this disease is naive.

Teenagers need educating that oral sex is still sex.....and condoms should be made available for pretending that teaching abstinence amongst hormone ridden teen is sufficient on this day and age to keep these teens free of disease it just not thinking at all.

I don't think the way to promoting healthy life styles and screening for diseased is avoiding the hard questions. Asking the thought provoking questions about habits.....smoking, drinking etc screens for health risks to focus your treatment/care of patients is the prudent thing to do.

Specializes in LTC & home care.

A few posters have touched on this, but here's my thoughts. "Heterosexual" and "homosexual" no longer matter. There are plenty of men who identify themselves as straight, but have experimented with other men - maybe once, maybe regularly, maybe ongoing - and lady partsl sex isn't his only potentially risky behavior. If you only focus on the label "straight", you're not getting the full picture. Along those same lines, gay people aren't the only group at risk of disease transmission via anal intercourse. Sexual health is fluid (no pun intended) - people push sexual boundaries all the time. It's most important to identify the actual behaviors instead of focusing on the gender of their partner, or assuming that their partners are always of one gender or the other.

In my opinion, both men and women should be taught how and when to use a condom - even telling "gay" men that condoms can prevent pregnancy. Some gay men may laugh, but others may be having sex with women, trusting her to take birth control, and may be unpleasantly surprised to find out his one-night-stand is pregnant with an unplanned child. All women should be educated on pap smears (and men as well, if only so they can encourage their female partner(s) to maintain their health). Both genders should be educated on all STIs - let's face it, sometimes a man may see a lesion or discharge from his female partner that she hasn't noticed or can't see herself, and he needs to recognize it and feel comfortable bringing it to her attention so they can both be tested/treated.

My short answer to the OP's question is that no, sexual orientation shouldn't matter anymore. The only gender-specific teaching should happen during puberty when bodies are changing - after that, both men and women need to be equally informed and prepared for whatever sexual health issue they may be faced with.

studies have shown that sexual preference affects risk analysis directly. the questions are valid.

and yes, you can get HIV through normal lady partsl intercourse, but this is not anywhere near as likely as through receptive anal intercourse. the only circumstance in which the lady partsl intercourse risk is clinically significant is in populations that have an endemic exposure to a modifying factor. the classic modifier is malarial exposure, hence the widespread AIDS in Sub Saharan Central Africa.

in short, despite the whitewashing to the contrary, in the USA HIV is very much a male homosexual or IV drug user disease.

In school we're taught that there are risk factors for everything. Anyone can develop DM but that doesnt mean certain individuals arent at higher risk than others. Same thing with HIV. Yes, anybody can contract it but some are at higher risk than others. As nurses, we collect evidence to help identify high risk factors. I'm sorry but sexual lifestyle is a part of that evidence.

Specializes in Adult Internal Medicine.

WML, FYI I tried to respond to your msg but your PM box was full :)

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