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?

Specializes in Public Health.

And heterosexual people that have anal sex are at risk as well. The receptive partner is always at higher risk.

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Specializes in Pedi.
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?

I agree. I think not asking conveys a sort of unspoken judgment. You may be judging the patient as heterosexual and making all kinds of assumptions. Other posters already gave examples but I'll share another one that I remember from college.

In my community health class, the instructor was discussing GLBT issues and sensitivity when interviewing patients. She shared a story that a student shared with her at one point. The student identified as gay and went to the student health center with some sexual related health concerns. The nurse/nurse practitioner/doctor/whomever automatically asked her "well are you having sex with your boyfriend?" and she said she immediately shut down and felt like she couldn't actually discuss her issues with them at all.

I work in pediatrics so I rarely have to ask about such things though occasionally it comes up with a teenager. HOWEVER, I have had many patients over the years with two moms or two dads. Living in Massachusetts, it's not rare in the least. If I were to ever admit a patient- either in the hospital or now to my home care agency and only one parent is present/I have no information on the other parent, I always simply ask "Is there another parent or guardian involved?" I do not automatically say to a patient's mother "is the child's father involved?" because the child may very well not have a father but may have a second mother. So the answer to question #1 would be yes but if I asked question #2, the answer would be no and it would also be awkward because the mother may assume that I would judge her if she told me that her partner was another woman.

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Specializes in Med Surg.

I'll bet I've seen more physicians/nurses and assorted medical professionals then a lot of people on this board and NEVER have I had anyone ask me my sexual orientation. EVER.

I have had many people at ERs ask the are you safe at home question, I'm asked about my "cycle," etc. but never my sexual orientation. In what context are we asking these questions?

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Specializes in Adult Internal Medicine.
I'll bet I've seen more physicians/nurses and assorted medical professionals then a lot of people on this board and NEVER have I had anyone ask me my sexual orientation. EVER.

I have had many people at ERs ask the are you safe at home question, I'm asked about my "cycle," etc. but never my sexual orientation. In what context are we asking these questions?

I ask new patients in primary care.

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Specializes in Med Surg.
I ask new patients in primary care.

I live in the southeast. That may explain a lot. If you asked every primary care patient here that question it would go over like a pregnant polevaulter.

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Nobody that I saw mentioned this but....Male homosexuals are more at risk because of the type of sex they have. The anal and rectal tissue itself is more delicate and has nore of a tendency to tear and bleed even at the microscopic level therefore increasing the risk if transmission immensely.

gay men are not the only demographic that has anal sex. ;)

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Specializes in Pedi.
I'll bet I've seen more physicians/nurses and assorted medical professionals then a lot of people on this board and NEVER have I had anyone ask me my sexual orientation. EVER.

I have had many people at ERs ask the are you safe at home question, I'm asked about my "cycle," etc. but never my sexual orientation. In what context are we asking these questions?

My pediatrician asked me this when I was a teenager and I've been asked it by all PCPs that I've had since then- they don't ask it annually, just the first time they meet me because they assume it hasn't changed. I've never been asked it by my oncologist, neurologist, nephrologist, endocrinologist or ophthalmologist because it's not something that's relevant to them. They're specialists and seeing me for specific reasons.

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Specializes in Medical Surgical/Addiction/Mental Health.
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.

From where did you receive this information?

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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?

Yes, the query about which gender a pt has relations with is very relevant.

If you frame questions based upon sexuality "are you gay or straight?" for instance will illicit various responses at least from males based upon factors such as race, demographics, and several other factors.

In the Latino/Hispanic, African American, Arab and Muslim, Latin (French, Italian, etc..) male populations there is a stigma attached to being "gay" or "homosexual" which is often defined by living a certain lifestyle. OTHO hooking up and or otherwise simply having relations with a man or boy often is either given a pass or kept quiet about (aka: on the Down Low).

There is also not a small population of males who are attracted to and or at least have relations with MTF transgender women. Because what they are having relations with looks like or in theory is supposed to be female many of these men do not consider such relations homosexual in nature.

Therefore if you ask many of these males only if they are "gay" they will respond "no", and in their minds there is no question about their sexuality. However from a public and personal health point of view *any* male same sex relations raises the possibilty of not only HIV but several other sexually transmitted diseases as well.

Finally there are former inmates correctional institutions who society has long given a pass (due to the absence of women) for homosexual relations. However again whatever such a man's true sexual preferences are if he engaged in those acts during his time again from a health point if view certain questions must be asked.

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Specializes in Adult Internal Medicine.

gay men are not the only demographic that has anal sex. ;)

True.

I don't have the statistics on-hand, but I am willing to make a fairly educated guess that they are the largest population that does. Correct me if wrong?

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Specializes in Adult Internal Medicine.

I live in the southeast. That may explain a lot. If you asked every primary care patient here that question it would go over like a pregnant polevaulter.

It doesn't have to go over well, if often doesn't here either. In the past few years I have had two patients that have looked at me like I was crazy and, after our relationship developed, have admitted to sexual actions with a different gender. The point is that by asking the question it established a base to build on as our patient-provider relationship developed.

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