Health care

‘It made me feel judged’: why it’s hard to get sexual health care if you’re on a monogamous agreement

Consensual non-monogamy is a strange form of relationship. Some research from North America suggests that 1 in 20 people may be in a polyamorous, trans or open relationship – and 1 in 5 say they are like to try it.

Although many people who have sex with each other can increase their exposure to sexually transmitted diseases, studies have shown that, in agreement, people who are not married have the ability to practice safe sex.

They are more likely to discuss safe sex with many of their partners. Also, they test for sexually transmitted diseases at much higher rates than monogamous people do.

Access to sexual health care is very important to consensual singles. But many continue to face barriers to accessing sexual health services, as our research has shown.

Consistent with other studies, we found stereotypes, myths and a general lack of understanding about consensual monogamy all act as potential barriers to health.

For example, when they go to their doctor or clinic for an examination, it is common for them to meet doctors and nurses who do not understand their relationship or who belittle them. About a third of our participants never, or only occasionally, disclosed their relationship style with medical professionals.

Comments may be made about their relationship, with one saying: “I wasn’t asked ‘Do you have many partners?’ but ‘do you have a boyfriend?’, which is a confusing question full of speculation.”

Or they may be treated with outright hostility, and one shares, “Another [doctor] it considered it a form of cheating and intimate partner violence”.

In the UK only 85% of medical students report having received training in working with patients with different gender and sexuality identities. To our knowledge, no medical students are being trained to work with consensual monogamous patients.

A young man looks thoughtful as the doctor writes on a new tablet.
Many patients have had confusing experiences with their doctors.
Di Studio / Shutterstock

This has serious implications, as a lack of understanding about monogamy can create barriers to patients receiving appropriate health care and building trust in their providers.

Many patients even tell us about frustrating interactions they have had because of a lack of knowledge and understanding.

I told the doctor (a woman in her 50s) that at the time I had one regular partner and we were polyamorous, so she also had other people, and sometimes I also I have other partners. He responded by saying, “Oh! A modern day! And… are you okay with that?” This was not good as it made me feel judged and he stepped in to feed his curiosity.

Sometimes, the stigma may not even result in them not getting the care they need. One participant reported that she went to her doctor for birth control but was refused: “The doctor said immediately I will do it [sexually transmitted diseases] because of my ‘life choices’ and they couldn’t provide birth control without doing an STD test.”

Not surprisingly, participants had significantly less trust in health care providers than the general population. It’s also not surprising that monogamous people often choose where they seek sexual health care, as we found in our recent study.

Most of the participants in our study reported that they felt safe and comfortable in sexual health clinics that used to serve people of different races and sexes. One participant even revealed: “It was only in LGBT places that I didn’t get judgment.”

For some, however, the lack of services means they have to make do with what’s available – sometimes lying to ensure they’re on the right track. One participant revealed: “I always say ‘my partner is stupid and cheats on me’ and I get evaluated without a problem (perhaps sympathy) instead of a judgment of being poly.”

Removing barriers

To remove these barriers, it is important that doctors and nurses have a better understanding of singletons and the unique health care needs that this group has. But this change needs to come from within the institutions. Many consensual monogamists do not wish to participate in relationship coaches – mainly because of the potential risks of stigma.

As time goes on, general awareness and exposure to true images of monogamy will continue to increase. We may one day see it being taught as standard in relationship, sex and health education (although recent trends in sex education suggest that this may not be far off. ).

But until the myths and stigma surrounding monogamy are dispelled, the onus is on organizations to make sure their services are inclusive.

This may include using general language, not making assumptions about the nature of relationships or being familiar with social terms and practices. These methods can help build and maintain trust between doctors and patients – and make it easier for patients to get the treatment they need.

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