Men, women, neither or both?

After observing me take a patient history, the medical student at the HIV clinic the other day commented, "We just finished a module on how to ask patients about their sexual practices. They taught us all these ways to be sensitive and non-judgmental. We practiced saying things like, 'Some women like to have sex with men, and some women like to have sex with women . . .'" She concluded enthusiastically, "But I like your way much better!"

My way is to simply ask, "Do you have sex with men, women, neither or both?"

I find the point-blank question much more efficient than a carefully crafted conversation of gentle prodding and suggestions. It's such a naked question that it's completely stripped of any judgment. In my opinion, the more you fret and fiddle about how to phrase the question, the more room there is to offend or make the patient uncomfortable.

No one's ever batted an eye at my question, and I've posed it countless times, to eighty-year-old professors, married women from Langley, and single men living in the West End. I ask it of everyone, however obvious their orientation might seem, because, if I still had the capacity to be surprised by people's answers, I would be.

Comments

[The Other Pete]

So what caused you to lose your capacity to be surprised?

[Martina]

Being surprised so often by people's private lives that I've learned never to make assumptions based on appearance/age/culture/profession.

Married fathers of five going to gay bathhouses, seniors having affairs, etc.

By the end of medical school I had learned to ask the important questions of everyone, regardless. Substance use is another good example.

[Sandra Ree]

Wow, you get it... you honestly get it.

"In my opinion, the more you fret and fiddle about how to phrase the question, the more room there is to offend or make the patient uncomfortable."

[Lisa G]

One of my personal favourites was a woman in her 70's 'confessing' to her current use of pot. You just never know.

[JeanMac]

Retired now after 30 years dental assisting - something I realized very quickly is that I should never guess orientation of a pt -

[James]

Thank you! I second everything you say in this post.

[red rabbit]

This is how my med school taught us to do it. And moving to a small town, EVERYBODY looks at me oddly when I say it.

But at least it's out there, and most people, even the most shocked ones, will have a good belly laugh and give an honest answer.

[Marianas Eye]

I like it. It reminds me of those multiple choice board questions -- a, b, both, neither.

[Martina]

And when in doubt, choose 'c'?

[Scott]

I like your approach much better since it's just seeking basic information in a dispassionate manner that indicates that you're just getting information, and their answer is not going to bring a judgment from you.

If you have to make a disclaimer first it will just remind them that some people think some kinds of sex are taboo and heighten the discomfort.

I guess in some places or times a reassurance of non-judgment and privacy would be appropriate. Maybe in heavily religious cultures in which taboos are strong or legally punishable. But in today's world in most places in the U.S. I don't see the point in soothing the patient first.