Sexual Orientation Question

allnurses Guide · Apr 4, 2013

please explain why it needs to be asked?
Sex is sex. Fluids are fluids. Orifices are orifices. You can teach anyone sex education without knowing if they are gay/ straight/ bisexual, or a top or a bottom or this or that.

It has been explained. If you can respond to the example I provided previously with a rationale that does not involve inclusion of sexual preference I would love to see it.

Sex is sex. Fluid is fluid. Risks are different.

Stigma is unfortunate and I wish wholeheartedly it didn't exist.

SuzieVN · Apr 4, 2013

I have explained. One, everyone is getting everything, from any and everybody. Two, lots of people aren't about to tell you they are gay. Three, is doesn't matter, since STDs have officially become a 'universal' situation thay have crossed every conceivable border. I see a real, continued, urgent, forward, strange justification to ask a patient is he's gay...

Gonorrhea is gonorrhea.

HIV is HIV.

I'd like some 'clear' rationale to explain why it matters if you have contracted those, or anything else, rectally, orally, lady partslly, or even by sharing needles. What does it affect the outcome, if you are attempting to do your best to give your patients current health information, so they can decide what risks to take, for themselves?

Thanks.

SuzieVN · Apr 4, 2013

Aside from closeted gays that aren't about to tell you their 'secret', are straight females that like unprotected receptive anal sex going to admit that to you? Point made.

Is unprotected anal sex a risk for HIV, and everything else? You betcha.

Inform them of such, as part of your overall sex educaion lecture. "If you engage in anal sex you are at risk for:......". Sexuality has nothing to do with this education. And it does NOT belong a in chart, that it probably digital- and therefore at risk of being made available online. My opinion.

CountryMomma, ASN, RN · Apr 4, 2013

You ask, because they may need a safe place to explore their fears, their questions, and their feelings. We are the safe, neutral place they can go to. Teens know about confidentiality and protection. Why is it dangerous for them to admit to their medical profession that they may or are GLBQT? What on earth do hate crimes have to do with it? I hope like hell nurses aren't wagging their tongues at the local lynching tree about Johnny being gay. ?!

There is a stigma. Yes. Which is why teens need to be screened for increased suicide, self-harm, and domestic/peer abuse. How are you going to know that a teen needs a more indepth assessment regarding substance abuse, suicide, domestic abuse, and peer abuse, without knowing what places them at risk?

And who cares if it is in their chart? Being made available online? To whom? Where? Do you understand confidentiality?

I don't get what your issue is, but you seem very passionate, and misguided, about this topic. You very neatly sidestepped the rest of my argument, and falsely deconstructed one point.

Also, one very simple and clear point to your question "What does it affect the outcome, if you are attempting to do your best to give your patients current health information, so they can decide what risks to take, for themselves?" --

If you do not know what their risks are, and how they are contracting it, and what they are doing, or not doing, to mitigate those risks, you cannot fully inform and educate your client.

SuzieVN · Apr 4, 2013

Off kilter analogy, of sorts: I smoked 'heavily' for 25 years, 2-3 packs a day. Marlboro, Reds, Box, only (I still miss them 10 years later!). Every time I got bronchitis and went to the Doc, he'd naturally ask: "Do you smoke?" I always said: "No way, never- are you kidding me? I'm a nurse- my patients infected me!" So, not only was he naive and lacking basic assessment skills, but also- I lied to his face, so he wouldn't think I was a 'bad person'. . .who smoked.

SuzieVN · Apr 4, 2013

You ask, because they may need a safe place to explore their fears, their questions, and their feelings. We are the safe, neutral place they can go to. Teens know about confidentiality and protection. Why is it dangerous for them to admit to their medical profession that they may or are GLBQT? What on earth do hate crimes have to do with it? I hope like hell nurses aren't wagging their tongues at the local lynching tree about Johnny being gay. ?!
There is a stigma. Yes. Which is why teens need to be screened for increased suicide, self-harm, and domestic/peer abuse. How are you going to know that a teen needs a more indepth assessment regarding substance abuse, suicide, domestic abuse, and peer abuse, without knowing what places them at risk?
And who cares if it is in their chart? Being made available online? To whom? Where? Do you understand confidentiality?
I don't get what your issue is, but you seem very passionate, and misguided, about this topic. You very neatly sidestepped the rest of my argument, and falsely deconstructed one point.
Also, one very simple and clear point to your question "What does it affect the outcome, if you are attempting to do your best to give your patients current health information, so they can decide what risks to take, for themselves?" --
If you do not know what their risks are, and how they are contracting it, and what they are doing, or not doing, to mitigate those risks, you cannot fully inform and educate your client.

I understand confidentiality, you bet I do. I've been taking HIT classes full time for the past two years- so I can assure you that confidentiality is a thing of the past, that it no longer exists. Read some of my posts, if you will, about 'background testing', etc.

On the flipside- good point you brought up, that IF teens want to talk, and if THEY want to bring up the point of sexuality, they should be able to, in a safe place. Good counterpoint.

AnonRNC · Apr 4, 2013

I just want to say thanks... Because of this thread, I had yet ANOTHER conversation with my kids about safe sex...and found out that one thought the Pill protected against STIs. I will continue to have these conversations w/my kids.

Altra, BSN, RN · Apr 4, 2013

Off kilter analogy, of sorts: I smoked 'heavily' for 25 years, 2-3 packs a day. Marlboro, Reds, Box, only (I still miss them 10 years later!). Every time I got bronchitis and went to the Doc, he'd naturally ask: "Do you smoke?" I always said: "No way, never- are you kidding me? I'm a nurse- my patients infected me!" So, not only was he naive and lacking basic assessment skills, but also- I lied to his face, so he wouldn't think I was a 'bad person'. . .who smoked.

Unless you have reviewed your entire medical record from this provider, you do not know whether or not his "assessment skills" were lacking and he accepted as factual your insistence that you did not smoke.

If you are currently a practicing nurse ... I find this comment naïve ... that clinicians accept at face value all answers to questions.

rn/writer, RN · Apr 4, 2013

NOT asking about sexual orientation makes it seem like "that which shall not be discussed." It's the elephant in the room. Young people especially might be hesitant to initiate conversation but would respond if someone else brought it up.

If a healthcare provider can ask such questions in an honest and matter-of-fact manner, this could be a message to the patient that this is a safe environment in which to confide and seek assistance with whatever they need.

If a healthcare provider is not able to ask in a non-emotional, non-judgmental way, they might want to work on that.

theatredork · Apr 4, 2013

In 2010, men who sleep with men (MSM) accounted for 63% of new infections and 78% of new infections among males. This is still a predominantly disease affecting gay men. Even scarier, this represented a 12% uptick in the estimated number new infetions from 2008 to 2010 among MSM. So, absolutely, it still matters.

To also comment on the unsafe sex practices during the beginning of the AIDS crisis: heterosexuals also had unsafe sex practices as well. Oral contraceptives became available to women in the United States in the early 70s. The fact that it wasn't seen among the heterosexual population is because, as someone said earlier, it was easier to get via anal intercourse. Bareback sex is not limited to just gay people, but the risks are different.

You can say HIV is HIV, but you're at greater risk if you're a man that sleeps with men, and even more so if you're unsafe.

Jory, MSN, APRN, CNM · Apr 4, 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?

You are partially correct. The problem with that thought process, is some groups are at a higher risk than others.

IV drug use and Hep C...go hand in hand. If someone has Hep C I am also going to ask if they have ever been an IV drug user...survey is about 50% of ones that contracted it through drugs versus sex.

If I have a woman that says she has a variety of sexual partners (though few admit) then it's shocking how a long list of STD's usually fall with it.

While the POPULATION of heterosexuals that have HIV are higher than gays, the CONCENTRATION percentage of HIV infections is HIGHER in gay men than the general population. So yes, if someone is a gay male, then that is going to be of concern.

In healthcare, you cannot disregard high risk groups...it is not a stereotype, it is based on FACT.

uRNmyway, ASN, RN · Apr 4, 2013

You know what I noticed on here? You have one person who identifies as bisexual come on here and say she PREFERS TO BE ASKED about orientation. And a few straight people who say 'No no, it doesn't matter, it shouldn't be asked.' Who is really encouraging the stigma and hush-hush mentality here?