Sexual Orientation Question

nurseprnRN, BSN, RN · Apr 3, 2013

I think you're very probably right. Basic health teaching is basic health teaching. Basic sexual health is basic sexual health. Although you probably wouldn't be teaching a gay male couple who were planning to adopt about pregnancy, and you probably wouldn't be teaching a lesbian couple about prostate issues, though you might be teaching them about circumcision if they had a baby boy. :)

allnurses Guide · Apr 3, 2013

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?

The positive predictive value of screening tests is increased by screening only those individuals at higher risk. What is the highest risk group for HIV (only two groups have increased in HIV dx in the past 5 years)?

hiddencatRN, BSN, RN · Apr 3, 2013

I'm not really sure I understand what you're asking. Aren't all women encouraged to get paps anyway? And as far as demographics for HIV, knowing what populations remain at higher risk and which populations have a growing incidence of infection allows for targeting of that population for education and outreach to prevent infection.

I don't think you can really provide holistic reproductive system care though without discussing sexuality, which included orientation as well as activities.

wish_me_luck, BSN, RN · Apr 3, 2013

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).

wish_me_luck, BSN, RN · Apr 3, 2013

Hidden, I am asking what everyone's (who reads this) opinion is on the whole question of "do you sleep with men, women, or both?". Is it even relevant? If so, why do you think that?

My opinion is that it should not be asked because it is irrelevant due to the fact that most diseases/education/health promotion activities are universal--does not matter sexual orientation. I cannot think of anything good coming out of asking it, only discrimination.

Now, what's your opinion?

allnurses Guide · Apr 3, 2013

Absolutely ask. The answer modifies both your assessment and screening tests.

Edit: At least in my job it matters.

Tait, MSN, RN · Apr 3, 2013

It feels to me that there is a long standing assumption that homosexuals/bisexuals are at an increased risk because of increased sexual activity, and/or unsafe practices. I have been told by family in the past that homosexuals are only that way because the root issue is who you are having sex with. It took me a long time to go cross-eyed on that one and realize that is the lamest explanation. Love is love.

I believe as well, though I really should go look for sources but this paper for my last class is staring at me, younger groups of people have this safety net feeling when it comes to having sexual contact with members of the same sex. That somehow having sex with a girl won't cause the common STDs associated with herterosexual sex. I believe there is a pretty basic lack of understanding of how to protect yourself from STDs during oral sex. I mean I didn't know what the heck a dental dam was until I was in my 20's, nor could I currently pick one out of a line-up if you asked me to show you one.

If discussing homo/bi-sexual tendencies helps increase awareness of other potential risks I am fine with it. Plus anyone has the right to refuse to answer the question.

Tait

SuzieVN · Apr 3, 2013

Other than cervical cancer (which could be called STD- after effects) caused by HPV, I can't think of one. But I have heard pregnancy called the worst STD, ever (see below). Interesting thought, wish_me.

On topic, is you want to see an ultimate chick flick? "The Pill". It's free in hulu.com What I found telling in the movie is that not once is 'STD' (other that pregancy) ever mentioned as a consequence of unprotected sex.

wish_me_luck, BSN, RN · Apr 3, 2013

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.

hiddencatRN, BSN, RN · Apr 3, 2013

Hidden, I am asking what everyone's (who reads this) opinion is on the whole question of "do you sleep with men, women, or both?". Is it even relevant? If so, why do you think that?
My opinion is that it should not be asked because it is irrelevant due to the fact that most diseases/education/health promotion activities are universal--does not matter sexual orientation. I cannot think of anything good coming out of asking it, only discrimination.
Now, what's your opinion?

What I already posted- that you can't treat the full person's sexual and reproductive health without asking about sexuality and sexual activities. In addition to having been asked about sexual partners (gender and quantity) I also have been asked about safe sex practices like condom/barrier use and other birth control.

Yes, providers can be biased, and having many friends who are LGBTQ, I know that it can be difficult for them to find providers who are non-judgmental and supportive. But I think the solution to that is not to pretend that sexuality isn't part of a person's health assessment, but to educate and encourage providers to accept that human sexuality is varied.

SuzieVN · Apr 3, 2013

I think you post is amazing, in that it forces peeps to realize that- wow- straight people are getting HIV, men are getting HPV, chlamydia is 'all over the place', and that not one type or group or subset is more at risk, or more at risk of transmitting, some pretty serious diseases. I've never seen it addressed in such a 'prescient' manner. And thanks for giving me a reason to drop that word- I love it!