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Medical friend asked me about medical exams and Aces, LGBT, add your perspective?


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WheelCuddle

Posting the question as asked to me:

But do you know if there are any resources for physicians about how to work with asexual patients? I mean, obviously, we still need to take a sexual history and talk about precautions against disease/pregnancy, but I wouldn't want to alienate a patient by assuming they are interested in sex. Also, I know that pelvic or genital exams can be traumatic for transgender patients because if they feel like they are in the wrong body they may want to completely ignore the male or female specific body parts, but we still have to check them for cancer and other things. Do you know if asexuals would have similar feelings regarding pelvic/genital exams?

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I felt very uncomfortable during such examinations, but I am one person out of a very diverse population of lovely asexuals. I think it would depend on the person. As long as the Dr. explains what is going on and asks the patient to voice any concerns (and is sensitive to those concerns), it should be okay. I'd rather undergo something uncomfortable like that than die of cancer that could have been treated if caught early enough.

As for the concern about addressing sexual activity, "Are you or do you plan on becoming sexually active" is a completely fine question. It doesn't automatically assume anything. Or, if you have a pre-questionnaire to fill out (my Dr. does), maybe make asexual an option.

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flesh-pocket

there have definitely been threads around here with female folks expressing fears about exams, you could probably dig around to find a few. i dont know of any specific reasources that teach how to best help asexuals/other lgbt groups, but my best advice would be to believe a patient that says they are asexual when they say they are not sexually active. and then make decisions to not ask for specific tests if its known that the patient doesnt have a family history of the disease, or if the things to look for would most likely have sexual activity be the cause?

and for trans folks maybe just being very respectful and calling them by the pronouns they want,

for anyone really, you could have the option of keeping a person they know in the room with them during the procedure, if thats not a thing already

i think no matter what group of sexuality theres going to be people that dread those sorts of tests. just got to be very sensitive and work through it case by case probably

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Yes, Asexuals can react badly to genital exams.

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AdaAimee923

(This was before I started identifying as asexual, but) I have always felt uncomfortable whenever doctors had to touch me during an exam.

Also, I had to get my brain scanned a few months ago, and the nurse who was preparing me told me that I needed to take a pregnancy test. So I told her that I was a virgin and that there was no way I could be pregnant. She then went to speak to the doctor and they told her that I had to take the test anyway. Which of course made me extremely uncomfortable, mainly because I saw it as they just assumed that I was lying because surely if I'm a young female, I had to be having sex.

Either way, I was able to get out of taking it by signing a form that more or less said "I swear I'm not pregnant." The whole situation just made me uncomfortable.

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ObsessedWithAnime

Hmmm... interesting question...

I just recently went to get a physical, while there my doctor made the assumption that if I don't get the shot that helps prevent the spread of HPV now that it'll be too late because (I'm going off to college and apparently it is just assumed that I'm going to have start having sex all of a sudden because I'm in college or something.)

I think having a button or posters that have facts about asexuality on them or something of the like would let the patient know that their doctor knows about asexuality so it is a little less awkward telling your doctor you are asexual... This way the asexual patient can make the effort to tell the doctor that they perhaps "aren't interested in sex" as you mentioned without feeling like they might be misunderstood for saying so.

I feel uncomfortable with such physical exams- but I am genderqueer so I probably can't respond to this aspect of the question from a solely asexual perspective

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(This was before I started identifying as asexual, but) I have always felt uncomfortable whenever doctors had to touch me during an exam.

Also, I had to get my brain scanned a few months ago, and the nurse who was preparing me told me that I needed to take a pregnancy test. So I told her that I was a virgin and that there was no way I could be pregnant. She then went to speak to the doctor and they told her that I had to take the test anyway. Which of course made me extremely uncomfortable, mainly because I saw it as they just assumed that I was lying because surely if I'm a young female, I had to be having sex.

Either way, I was able to get out of taking it by signing a form that more or less said "I swear I'm not pregnant." The whole situation just made me uncomfortable.

That sounds horrible!

When I was a teenager I had to get physicals in order to run high school track, and when I said I was not sexually active, the Doctor got the sassiest look on her face, the brow raised and lips pursed and everything. "You can be honest. Your parents won't hear". I wanted to bash my head against a wall--and this was long before I even realized what asexuality even WAS.

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Ricecream-man

I think the main thing would be an openness to the existence of asexuality.

You can mention HPV vaccines and the like, and then explain why it's important if you're planning on being sexually active. Make a post college timeline as well such as 5 to 10 years. If they still don't want it or insist that they won't have sex just respecting that should be enough.

As for the exams. Most women I know are uncomfortable with them. The only way I can see you helping out aces is perhaps before/while conducting them give non sexual reasons for it.

Trans, I'm sorry. I doubt there's much you can do. Unless you don't conduct the test or they get surgery it's going to be rough.

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ObsessedWithAnime

I felt very uncomfortable during such examinations, but I am one person out of a very diverse population of lovely asexuals. I think it would depend on the person. As long as the Dr. explains what is going on and asks the patient to voice any concerns (and is sensitive to those concerns), it should be okay. I'd rather undergo something uncomfortable like that than die of cancer that could have been treated if caught early enough.

As for the concern about addressing sexual activity, "Are you or do you plan on becoming sexually active" is a completely fine question. It doesn't automatically assume anything. Or, if you have a pre-questionnaire to fill out (my Dr. does), maybe make asexual an option.

I thought of this approach too, but I'm wondering would you include all other sexualities as an option? I fell like many people would have a problem with this because they feel it isn't their doctors bushiness what their orientation is or that they are afraid of being singled out, etc. Or would it be just an allosexual vs asexual box? Then we also have the problem of people not understanding what either of those terms are and just leaving it blank hah.

there have definitely been threads around here with female folks expressing fears about exams, you could probably dig around to find a few. i dont know of any specific reasources that teach how to best help asexuals/other lgbt groups, but my best advice would be to believe a patient that says they are asexual when they say they are not sexually active. and then make decisions to not ask for specific tests if its known that the patient doesnt have a family history of the disease, or if the things to look for would most likely have sexual activity be the cause?

and for trans folks maybe just being very respectful and calling them by the pronouns they want,

for anyone really, you could have the option of keeping a person they know in the room with them during the procedure, if thats not a thing already

i think no matter what group of sexuality theres going to be people that dread those sorts of tests. just got to be very sensitive and work through it case by case probably

What do you mean? Are you saying to believe that someone who says they aren't sexual active is automatically asexual? (incorrect) Or are you saying to believe someone who says they are both asexual and not sexually active and don't need the additional tests? In that case I ask you if you have come out as asexual to your doctor? I personally find that to be an intimidating experience and haven't done so.

(This was before I started identifying as asexual, but) I have always felt uncomfortable whenever doctors had to touch me during an exam.

Also, I had to get my brain scanned a few months ago, and the nurse who was preparing me told me that I needed to take a pregnancy test. So I told her that I was a virgin and that there was no way I could be pregnant. She then went to speak to the doctor and they told her that I had to take the test anyway. Which of course made me extremely uncomfortable, mainly because I saw it as they just assumed that I was lying because surely if I'm a young female, I had to be having sex.

Either way, I was able to get out of taking it by signing a form that more or less said "I swear I'm not pregnant." The whole situation just made me uncomfortable.

ugh that's awkward. I hate how it feels assumed that all young females are lying about being sexual active! Like when they don't want your parents to go in with you because they think you'll lie about it in front of them.... ugh it's so stupid and frustrating! I'm glad you were able to get out of it

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AdaAimee923

ObessedWithAnime - I had the same issue throughout the entirety of high school. I still haven't taken the HPV vaccine. I see no reason to take it if I'm not having sex.

afflitto - It was horrible!! The appointment was supposed to only be an hour, but I was there for two and a half just because of that. And I heard the "you can be honest" thing too.

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Careful with this question, WheelCuddle, there are a lot of people on AVEN who like to police what other people choose to do medically with their bodies.

My immediate reaction is to avoid doctors at all costs, but there are other causes for this, such as that I was sexually assaulted by a pediatrician when I was 6.

Failing that, I do have a therapist who knows my situation, and she knows a doctor who is accepting of LGBTQIA people, and she said that if I wanted to go for a check-up or anything that I could sign a release and she would call the doctor and explain my asexuality and genderqueer identity to them, so that they have a head's up. What doctor's could actually do, I think, is just ask something like "Do you want/need STD/pregnancy tests, procedures that check for venereal diseases, etc.?" and then if the answer is "NO" that no should be respect then and there. That way there are no assumptions made. Same thing with being transgender. I experience extreme distress when I go to the doctor and they're all like "WHEN you have babies" - wow, excuse me, not only is it offensive to women who don't want kids, but it's extremely offensive to someone who doesn't identify as a woman and doesn't fucking want kids, ever. Doctors assume a lot of shit, and they usually don't give a rat's ass about the patient's feelings. Maybe if doctors were more sensitive and treated each patient as an individual instead of a product going by on a conveyer belt on which they can make a profit, things would be better and easier for all parties involved.

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Ricecream-man

Careful with this question, WheelCuddle, there are a lot of people on AVEN who like to police what other people choose to do medically with their bodies.

My immediate reaction is to avoid doctors at all costs, but there are other causes for this, such as that I was sexually assaulted by a pediatrician when I was 6.

Failing that, I do have a therapist who knows my situation, and she knows a doctor who is accepting of LGBTQIA people, and she said that if I wanted to go for a check-up or anything that I could sign a release and she would call the doctor and explain my asexuality and genderqueer identity to them, so that they have a head's up. What doctor's could actually do, I think, is just ask something like "Do you want/need STD/pregnancy tests, procedures that check for venereal diseases, etc.?" and then if the answer is "NO" that no should be respect then and there. That way there are no assumptions made. Same thing with being transgender. I experience extreme distress when I go to the doctor and they're all like "WHEN you have babies" - wow, excuse me, not only is it offensive to women who don't want kids, but it's extremely offensive to someone who doesn't identify as a woman and doesn't fucking want kids, ever. Doctors assume a lot of shit, and they usually don't give a rat's ass about the patient's feelings. Maybe if doctors were more sensitive and treated each patient as an individual instead of a product going by on a conveyer belt on which they can make a profit, things would be better and easier for all parties involved.

The only issue with that is possible malpractice suits. Perhaps if you include a sort if release form that an adult patient or guardian signs saying they don't want it then it could be viable.

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I'm not sure how is it in Poland but I believe there is much worse than in other countries. I believe we should raise awareness among doctors, especially those LGBTQ friendly. We should organize any meetings and teach how should they behave if their patient would be an ace.

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whocaresthough

No. No. No no no. If I had to do any such exam, I'd rather die. Literally. Drop dead. I'd rather get cancer. I'd rather get whatever else you can get. Especially if I were conscious.

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My suggestions would be

1) Try to believe them if they said they have not had sex. Don't scoff at it.

2) If something they feel doesn't need to be done due to not having had sex does need done, EXPLAIN THE WHY!

3) If you can, offer a sedative if they are too anxious about the exam. Also, offer to reschedule when they can bring a friend/family member around to support them, if they need.

In other words... just be supportive. The main thing that gets on aces nerves I have seen is disbelief and feeling pressured to do things they aren't comfortable with, without explanation as to even why they would need it.

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WheelCuddle

My suggestions would be

1) Try to believe them if they said they have not had sex. Don't scoff at it.

2) If something they feel doesn't need to be done due to not having had sex does need done, EXPLAIN THE WHY!

3) If you can, offer a sedative if they are too anxious about the exam. Also, offer to reschedule when they can bring a friend/family member around to support them, if they need.

In other words... just be supportive. The main thing that gets on aces nerves I have seen is disbelief and feeling pressured to do things they aren't comfortable with, without explanation as to even why they would need it.

I think this is an excellent and concise summary of what has been expressed here, thanks!

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Ms.Frankenstein

I hate gyno exams but that has nothing to do with my sexuality and everything to do with having my hoo ha pried open and my cervix poked with a stick. I grit my teeth, make the inevitable "frightened horse face" and it's over in about 10 minutes. It's always awkward and uncomfortable, but it beats dying of a preventable disease so I do it.

As for the pregnancy tests, it sucks but they almost have to fit certain procedures because people DO lie or just don't know that they could be pregnant and if the procedure hurts the pregnancy or the woman, they can get sued. Which really, really sucks. It's life (at least in America). I don't think it has anything at all to do with discrimination and everything to do with "covering our ass because we don't know you from Eve and have no way to know if you are lying to us or not, but that last girl lied and the procedure caused a miscarriage which she sued us for."

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I will not be open about my asexuality with doctors as I assume (and have been shown to be right) that they have no idea about asexuality and can be quite insensitive. So I just lie! I have had sex tho so I just bring the dates forward so it does not seem so long ago! Plus I hate having to explain my (a)sexuality over and over again!

So perhaps an option on a form that lets an individuals know that it is OK to be asexual and to say so to the doctor. That it is something will be understood.

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I am not shy but I find genital exams very uncomfortable. I have been putting off my 2nd smear test for a few months ;_;

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chicken_legs

(This was before I started identifying as asexual, but) I have always felt uncomfortable whenever doctors had to touch me during an exam.

Also, I had to get my brain scanned a few months ago, and the nurse who was preparing me told me that I needed to take a pregnancy test. So I told her that I was a virgin and that there was no way I could be pregnant. She then went to speak to the doctor and they told her that I had to take the test anyway. Which of course made me extremely uncomfortable, mainly because I saw it as they just assumed that I was lying because surely if I'm a young female, I had to be having sex.

Either way, I was able to get out of taking it by signing a form that more or less said "I swear I'm not pregnant." The whole situation just made me uncomfortable.

That sounds horrible!

When I was a teenager I had to get physicals in order to run high school track, and when I said I was not sexually active, the Doctor got the sassiest look on her face, the brow raised and lips pursed and everything. "You can be honest. Your parents won't hear". I wanted to bash my head against a wall--and this was long before I even realized what asexuality even WAS.

same happened to me years ago. I still can't forget the doctor's "there must be something wrong with this girl" face

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I will not be open about my asexuality with doctors as I assume (and have been shown to be right) that they have no idea about asexuality and can be quite insensitive. So I just lie! I have had sex tho so I just bring the dates forward so it does not seem so long ago! Plus I hate having to explain my (a)sexuality over and over again!

So perhaps an option on a form that lets an individuals know that it is OK to be asexual and to say so to the doctor. That it is something will be understood.

Asexual being listed on the patient information form with the rest of the orientations would be nice :)

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I am completely uncomfortable with the concept of having anyone touching or looking at my genitalia.

I'm 29, agender (anatomically female) and asexual (never been sexually active). I used to get literature telling me I needed to have a smear test which would make me very anxious. I would argue with doctors (all of whom were male, I'm sorry to say) regarding my not having a smear test as there is no history of it in my family and my chances of getting cervical cancer are very small. Eventually I went to see my doctor about something completely different and she happened to ask if I would sign a form asking for all literature to be stopped. I was happy to do so and explained why I didn't want it and she was completely adamant that it would be an absolute violation given my personal circumstances.

I am now hoping to get a hysterectomy. My doctor seemed quite positive about it and has referred me to the gynaecologist who I see on Thursday. I am just hoping that he can see things the same way.

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I am completely uncomfortable with the concept of having anyone touching or looking at my genitalia.

I'm 29, agender (anatomically female) and asexual (never been sexually active). I used to get literature telling me I needed to have a smear test which would make me very anxious. I would argue with doctors (all of whom were male, I'm sorry to say) regarding my not having a smear test as there is no history of it in my family and my chances of getting cervical cancer are very small. Eventually I went to see my doctor about something completely different and she happened to ask if I would sign a form asking for all literature to be stopped. I was happy to do so and explained why I didn't want it and she was completely adamant that it would be an absolute violation given my personal circumstances.

I am now hoping to get a hysterectomy. My doctor seemed quite positive about it and has referred me to the gynaecologist who I see on Thursday. I am just hoping that he can see things the same way.

My sibling kept getting letters, too. Our mother was very naggy and eventually went to her own Doctor to ask about it. Turns out, if you haven't had sex, your risk is ridiculously low, so my sibling doesn't have to go now :)

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Ms.Frankenstein

I go because they won't give me a scrip for my birth control pills if I don't. I started on the pill for contraception when I was in a relationship. I stay on them for the lighter pain free periods.

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SwimmyFins

This is an interesting question to me both as an ace and as someone who's thinking about med school. I understand the need for going to the gyno (or whoever) regularly, but the thought does make me nervous, especially since I haven't been yet. It sounds rather awkward having someone poking around up in there, but they're professionals, so I guess I'll grin and bear it when the time comes.

It does freak me out that my options as far as being open with my healthcare providers are (a) say I'm not sexually active but get funny looks if/when I don't explain why, or (b) come out and risk being treated as if asexuality were a medical condition.

If I were a doctor, I'd maybe have literature geared toward health issues common in or specific to various GSM groups in my office. I'd also verbally tell my patients that I'm supportive of whatever concerns they might have surrounding their gender and sexual identities. (Of course, this is all in my imaginary world where doctors aren't crunched for time and can actually get to know their patients. :unsure: )

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Anthracite_Impreza

I am completely uncomfortable with the concept of having anyone touching or looking at my genitalia.

I'm 29, agender (anatomically female) and asexual (never been sexually active). I used to get literature telling me I needed to have a smear test which would make me very anxious. I would argue with doctors (all of whom were male, I'm sorry to say) regarding my not having a smear test as there is no history of it in my family and my chances of getting cervical cancer are very small. Eventually I went to see my doctor about something completely different and she happened to ask if I would sign a form asking for all literature to be stopped. I was happy to do so and explained why I didn't want it and she was completely adamant that it would be an absolute violation given my personal circumstances.

I am now hoping to get a hysterectomy. My doctor seemed quite positive about it and has referred me to the gynaecologist who I see on Thursday. I am just hoping that he can see things the same way.

My sibling kept getting letters, too. Our mother was very naggy and eventually went to her own Doctor to ask about it. Turns out, if you haven't had sex, your risk is ridiculously low, so my sibling doesn't have to go now :)

Is there any proof of this? I really want it to be true because I don't think I could cope with an exam down there :(

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It would depend on what for. If it's a pregnancy test or HPV vaccine, or something to check for STDs, I would refuse to do such a test/vaccine (and I have refused). I'm not sexually active, never have been, so there's no way I'd be at risk for sex related diseases/conditions.

But if it was something like a checkup, or cancer screening, or something like that, I'd probably go (although I never have, as of yet in my life) but it would be uncomfortable.

On the topic of pap smear, I've started getting letters. But I have never gone (I'm 21) and don't plan to.

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I'm really quite scared, to be frank. Im getting to the age where, whether or not im having sex, I will have to get an exam. I dont want anyone to put me in that position--literally. I dont mind nudity at all, but laying on a table like that feels wrong. I don't like people even making direct references to my sex, so giving them direct contact is unfathomable. And im not sure if its already apparent or not, but being "tight" has about 20% to do with being a virgin. You're not /suppsed/ to be tight when anything is inserted, at all. When you're relaxed and comfortable, its supposed to be lax, easy. But I know that it won't be and I know it will hurt.

An asexual I follow on another social media website just had a hysterectomy because of what was found during their exam. Im on the same boat as this person, as they were slightly happy to get a hysterectomy, but I dont want to risk dying just because its not elective. And to not prevent a disease is irresponsible, completely, but I almost... Would rather. The entire procedure feels dated, like there should be other ways that dont involve forcibly opening the vagina with equipment. I will definitely be asking for sedative to relax by body or just put me out completely. I dont want to be awake for that. It would be A+ if that choice is available, and if the doctor is just chill about it. because i get unchill very quick when others make a deal of it.

I already hate answering questions about my sexual activity, and the last time I said "I dont do that", the nurse laughed, I dont even know what her response was, it was just a laugh. Does she think...what is funny? Its confusing when people dont ask questions, because i dont know what they mean when they just make noises, but its not like i really even want to talk about it at all. So idk. That's my experience with dropping subtle hints of my asexuality in the doctor's office.

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littlepersonparadox

Everyone pretty much has the asexual thing covered in this thread.

As for trans many of us are comfortable with going to the doctor and worry about discrimination or poor care/service even if it is something not related to our gender/genitalia. That's because its been known that many doctors will either refuse service or try to "fix" what they deem to be the "Real problem" if they find out were trans rather than just letting us be and be ourselves. Perhaps make it clear that you do accept transgender patients and every transgender person experiences dysphoria in different ways if at all. So ask first before you do something that could be uncomfortable for them. If you have to do a examination that is uncomfortable make it clear that you understand their concerns and address why it needs to be done.

In general make it a open and safe LGBT+ space and environment. Don't assume what someones sexual behavior is based on their sexuality alone. Rather just ask for sexaul history in a non-interrogative way and if they say no don't push it.

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Ricecream-man

This is an interesting question to me both as an ace and as someone who's thinking about med school. I understand the need for going to the gyno (or whoever) regularly, but the thought does make me nervous, especially since I haven't been yet. It sounds rather awkward having someone poking around up in there, but they're professionals, so I guess I'll grin and bear it when the time comes.

It does freak me out that my options as far as being open with my healthcare providers are (a) say I'm not sexually active but get funny looks if/when I don't explain why, or (b) come out and risk being treated as if asexuality were a medical condition.

If I were a doctor, I'd maybe have literature geared toward health issues common in or specific to various GSM groups in my office. I'd also verbally tell my patients that I'm supportive of whatever concerns they might have surrounding their gender and sexual identities. (Of course, this is all in my imaginary world where doctors aren't crunched for time and can actually get to know their patients. :unsure: )

The reason for that is because loss of sexual appetite is indicative of a lot of mental illnesses and was previously listed in the DSM as either a major flag for a disease or an illness on it's own. I think the diagnoses of it being and issue astandalone has been revoked which would make it easier

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