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How should doctors address asexuals?


R_1

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On one hand, you have a bunch of people lying they didn't had sex despite evidence otherwise, and it is their responsibility to make sure. On the other hand, aces are in the minority and there's the issue of needing to address. So this thread is to discuss how doctors should adress things when they are aware asexuals exist. Also, there's the thing about being asexual does not mean not sexually active.

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firewallflower

One key point that doctors (among many others) should keep in mind: Asexuality ≠ celibacy.

 

This means, yes, that one can be asexual (that is, not experiencing sexual attraction, however precisely we define that) and still be sexually active. Conversely, one can never have sex, yet still not be asexual. If a doctor is concerned about whether an individual has had sex, their a/sexual identity is probably not the most foolproof way of determining the answer.

 

I suspect I'm not quite catching your drift, but I honestly don't feel that doctors need to address asexuals in a different manner than they would the general population. As medical professionals, I believe it is vital that they be educated on asexuality as an orientation (not a dysfunction). But in terms of general medical approach, I don't quite see the overlap. I'm afraid I'd likely need a specific situation example in order to be able to weigh in on what you're getting at. 'Tis certainly an interesting question, however. :)

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My thought is that a doctor needs to take it seriously. While it's true some aces have an active sex life, it's also a valid reason why someone would not. Doctors who start to read into a patient's inactive sex life (sometimes it's a symptom of depression in allos), should be satisfied with the explanation 'I'm asexual'.

 

Also if a patient tells them they are ace, the doctor shouldn't then try to 'fix' their sexuality by investigating hormone levels or suggesting therapy (unless it's something the patient asks for).

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Why do people lie about having sex ro doctors ? 😯 Unless they are are underage....

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HonoraryJedi

I think the "sexuality or medical problem" thing is a valid issue. We don't like to have it constantly suggested we have a medical issue when we don't. But we also don't want those who *do* honestly have medical issues interfering with their feelings to fall to the cracks. I do think it is reasonable for a doctor to want to investigate hormone levels or whatever they do, if they're not sure. But then, they should also be aware that 'there is no issue, this one is ace' is a possible outcome.

 

Apart from that, I don't think asexuality would be all that relevant for doctors. Whether someone is or has been having sex is more important than why, I figure.

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Comrade F&F

I'm surprised this is even an issue. Doctors with their medical background means they know well enough about the Kinsey scale. Personally, I never had a problem with my own doctor.

 

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everywhere and nowhere
On 3/19/2019 at 8:53 AM, HonoraryJedi said:

I think the "sexuality or medical problem" thing is a valid issue. We don't like to have it constantly suggested we have a medical issue when we don't. But we also don't want those who *do* honestly have medical issues interfering with their feelings to fall to the cracks. I do think it is reasonable for a doctor to want to investigate hormone levels or whatever they do, if they're not sure.

However, they should also be prepared that "I want to be healthy, but I don't want to start experiencing sexual attraction!" is a possible and valid response. Particularly probable for the more sex-averse people: someone who is sex-averse may feel very real discomfort at the idea of beginning to desire sex, or losing their sex aversion. I certainly feel this way: even the entirely hypothetical sex I could possibly have if I wasn't sex-averse feels violating. And still there are no two identical people, the number of possible combinations of different experiences, conditions and factors is infinite, so it's entirely possible to be both sex-averse and functionally asexual for an acquired reason.

It's certainly easier to be sex-averse and not want sex anyway than to desire sex and still feel unable to have it. A person could possibly find themself in this kind of situation due to being effectively asexual for a reason which could be treated. This is a valid reason for rejecting treatment or asking if modifications to the accepted treatment are possible, which would, for example, normalise hormone levels without triggering sexual feelings.

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If the patient is not concerned about it and there are no other signs/symptoms of related illness, then it isn't an issue. It would probably just be left at like "okay, it's not a problem, moving on..."

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If ANY health specialist won't believe me when I say anything about me, it's time to find a new health specialist.  Indeed, I had to do just that once when trying to find a therapist.

 

I don't believe it's their job to "make sure", I believe it's their job to act based on the information provided (and not their personal hunches)

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On 3/21/2019 at 1:34 AM, Philip027 said:

If ANY health specialist won't believe me when I say anything about me, it's time to find a new health specialist.  Indeed, I had to do just that once when trying to find a therapist.

 

I don't believe it's their job to "make sure", I believe it's their job to act based on the information provided (and not their personal hunches)

Doctors get lied to all the time. Sometimes it's not a flat out lie, but still incorrect information (caused by lack of awareness, flawed self-perception or whatnot). It is very much their job to make sure because making sure makes sure that whatever follows this process of "making sure" has the effect you want it to have.

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Ignorance is one thing, but if I tell you something that is a fact about me and you are openly skeptical or scrutinizing about it, I'm going to find a different doctor.  If I wanted to not be listened to, I can go talk to a wall, and they don't charge me any money.

 

As far as I'm concerned, if patients lie about things and that causes them to be incorrectly treated, that's their own goddamn fault.

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4 hours ago, Homer said:

Doctors get lied to all the time. Sometimes it's not a flat out lie, but still incorrect information (caused by lack of awareness, flawed self-perception or whatnot). It is very much their job to make sure because making sure makes sure that whatever follows this process of "making sure" has the effect you want it to have.

Yeah, patients lie regularly, about things which could cause certain treatments to fail or - even worse - to be harmful.  At that point (at least in some countries) it’s going to fall back on the doctor for not making sure.

 

That said, I’m struggling to think of a case where asexuality (not celibacy) would be the determining factor in whether or not to treat something or where lying about asexuality might significantly affect care.  It tends to be more of an issue with substance use and with sexual activity,

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2 minutes ago, ryn2 said:

That said, I’m struggling to think of a case where asexuality (not celibacy) would be the determining factor in whether or not to treat something or where lying about asexuality might significantly affect care.  It tends to be more of an issue with substance use and with sexual activity,

It's not so much a case of asexuality vs celibacy, but being sexually active vs not being sexually active.

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1 minute ago, Homer said:

It's not so much a case of asexuality vs celibacy, but being sexually active vs not being sexually active.

Yep, agreed, lying about that one is common and a problem...

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2 hours ago, Philip027 said:

As far as I'm concerned, if patients lie about things and that causes them to be incorrectly treated, that's their own goddamn fault.

There are certain developing countries where it's necessary to point out that coffee may be hot, just to avoid lawsuits. If I were a doctor, I'd never rely on the "it's their own fault" line.

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Legally speaking, yes, I understand why they would have to.  I just think it's bullcrap that they do, and it still wouldn't stop me from finding another doctor or X other health professional if I felt like I wasn't being listened to.  Again, I could go talk to a wall for free.

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22 minutes ago, Philip027 said:

it still wouldn't stop me from finding another doctor or X other health professional if I felt like I wasn't being listened to. 

That’s always fair too.

 

If you feel comfortable with a care provider overall, but they seem a little too persistent/disbelieving about things like alcohol consumption and sexual activity, just keep in mind that those are care-affecting areas where patients regularly lie.

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Yes, but my belief is that "they could be lying" shouldn't be the doctor's concern.  Why the hell would you, as a patient, fork out loads of time/money (considering you often have to wait a while and possibly take time off of work just to be seen) to get cared for by a doctor only to actively inhibit their ability to properly care for you?  That's just a stupid decision on top of whatever other (probably also stupid) decision you made that caused you to need a doctor in the first place, and at that point to me, that's just Darwinism at work if some bad shit happens to you.

 

A patient getting the wrong care because they lied is the patient's fault and IMO they deserve whatever sort of ill fortune they receive as a result.  Maybe the law doesn't see it that way, but I'm not going to change how I operate just because of the way the law operates in this case.

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Possibly unfortunately - depending on your perspective - in some countries (including the US, where I live) the medical professional can be held responsible for whatever befalls the dishonest patient if it’s reasonable to suspect the patient could be lying.

 

So, if the patient is dishonest about something really unusual (you ask a random selection of X doctors about it and they all look at you like you’ve lost your mind) the responsibility may fall on the patient... but if those randomly-selected doctors all say “duh, patients lie about that all the time” it falls on the doctor.

 

There is a strong legal component to it, sure, but care providers also typically don’t want to make patients worse instead of better/miss things than need to be caught early/etc.  

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On 3/19/2019 at 1:28 AM, Wizadora said:

My thought is that a doctor needs to take it seriously. While it's true some aces have an active sex life, it's also a valid reason why someone would not. Doctors who start to read into a patient's inactive sex life (sometimes it's a symptom of depression in allos), should be satisfied with the explanation 'I'm asexual'.

 

Also if a patient tells them they are ace, the doctor shouldn't then try to 'fix' their sexuality by investigating hormone levels or suggesting therapy (unless it's something the patient asks for).

THIS. Not only was asexual missing from the orientation options, my doctor told me my anxiety could impact my libido. I told her I was not concerned with my lack of desire for sex. I was quite annoyed that asexuality was so foreign to her.

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On 3/22/2019 at 9:17 PM, Philip027 said:

Why the hell would you, as a patient, fork out loads of time/money (considering you often have to wait a while and possibly take time off of work just to be seen) to get cared for by a doctor only to actively inhibit their ability to properly care for you?

Because people are stupid.

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Doctors should lose their license for daring to ask "are you sexually active" because discrimination and acephobia and ooooouuuuuuttttttrrrrraaaaagggggeeeee......... 

 

Okay, but seriously, people can be in very fragile or distressed states when seeking care, which might lead them to shut down and omit information. People may also be worried about others finding out what they told the doctor. These aren't always rational concerns, but they're still real in the mind of the person seeking care, and they're relevant to the care the doctor should provide. 

 

Getting mad at a doctor for asking if you're sexually active is like getting mad at one for asking if you've been having trouble sleeping. Doctors should know that some people are fine with no sexual activity just like they should know that some people are fine on six hours of sleep. Asking if there are any accompanying stress factors behind not having sex isn't an invalidation of asexuality. Respectful and relevant follow up questions are part of giving care. 

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SithAzathoth WinterDragon

As for someone who has been in the medical field from the early 2000s a doctor should respect all her/their/ his patients regardless if the said patient said she/they/he is asexual.

 We're required to respect our patients wishes if they wish not to share it. 

 

If the said patient came in and wanted results on a matter and they mentioned they're asexual, we cannot go to different topics on whether or not it should be tested, asexuality is new to some medical facilities and their staff,  I have been asked with the hospital I go to, to be added as an advocate for people under this umbrella including  if need be train new Behavior Health specialists to understand people within the LGBT+ community. 

 

Asexuality is still newish in the medical field and being looked into, and in some buildings it's not understood but over all doctors should respect their patients and their wishes on their treatment when they need or seek it.

 

 

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33 minutes ago, Snao Cone said:

Getting mad at a doctor for asking if you're sexually active is like getting mad at one for asking if you've been having trouble sleeping.

I wouldn't get mad at the question, but I would get mad if my answer was disbelieved.  Again, why even ask the question if you won't accept the answer?

 

That goes for anybody, not just doctors, but in my book doctors get less of a pass for this because 1) they're supposed to be professionals, and 2) I'm paying them, not the other way around.  Treat me like a paying consumer instead of a criminal, or I'm finding someone else who will.

 

33 minutes ago, Snao Cone said:

Asking if there are any accompanying stress factors behind not having sex isn't an invalidation of asexuality.

If it were a problem, I would be bringing it up myself.  Don't need doctors to do this for me, thanks very much.

 

Sorry, but I have gotten the runaround from a therapist before who seemed insistent I was there for relationship/sexuality issues when in reality it was nothing to do with it.  As a result my actual issues were being brushed to the wayside, and I quickly had to cut my monetary losses and find a different therapist.  I have little tolerance for this sort of thing as a result.

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3 hours ago, Philip027 said:

If it were a problem, I would be bringing it up myself.  Don't need doctors to do this for me, thanks very much.

While this is a wise approach, it makes you fairly unusual among patients.  Many people don’t realize something is a problem (they either don’t realize they have it or, more often, assume everyone their age/gender/race/etc. has the same issue and therefore it’s normal).  Still others - my dad was one of these, and it bought him a long illness and protracted, miserable death - go to the doctor and offer up minimal information under the theory that “if something’s actually wrong the doctor will find it.”

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3 hours ago, Philip027 said:

I have gotten the runaround from a therapist before who seemed insistent I was there for relationship/sexuality issues

Therapy is a little different than medical care as in theory you (the patient) enter into therapy with specific things you want to work on and are looking for help with those things.  People are a lot less likely to go to therapists for the equivalent of preventative care (routine physicals, annual exams/screening tests) or for vague “dunno, I just feel a little weird”-type complaints.

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Asexuals are very used to being told (or insinuated at) that they have problems for being the way that they are.  Thing is, I've found that "you have a problem" very often just means "you're living your life in a way I can't possibly imagine living mine, and therefore that must be a problem"

 

People get this way over the silliest shit, such as food/music preferences.  It gets very tiresome after a while.

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helana12_03

I think they should start by not misdiagnosing us with depression or whatever else they think is causing our "lack of sexual interest". Understanding that some people are simply wired this way would be a huge step for medicine. 

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My doctor has pressed me when I told him I’m not, nor have ever been sexually active by assuring me that as a doctor he would not judge me, etc. It was related to an internal issue I was dealing with, and a completely logical conclusion on his part, though not correct. For various reasons people might deny being sexually active, and not being so is definitely not common. 

 

If if I were able to check a box saying I was asexual, it might be easier for people to understand that I am not sexually active because of lack of interest, but it wouldn’t be a guarantee that I’m not sexually active. 

 

Doctors have to ask personal questions to provide adequate treatment, sometimes. To me, it’s only a real issue if they provide the answers or their opinion on my truthfulness to outside sources.

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