Accessing Healthcare as a Bi+ Person | Bi+ Health Month 2022
“Are you sexually active?”
“Not with my current partner, no.”
“Do you want to be sexual with her?”
“...Them. Possibly. I enjoyed being intimate with my previous boyfriend.”
“Oh, sorry. Is your current boyfriend happy with not being intimate? How has he been with that?”
“Them. Partner, not boyfriend.”
I am a disabled mspec and transgender person who is also a survivor of sexual assault, and as a result of this, I have been on the receiving end of a multitude of very awkward, personal questions from a variety of medical and psychiatric professionals involving my romantic and sexual life.
This has taught me that the world is still very set in a binary way of thinking when it comes to so many things. When I first started going to a Gender Identity Clinic I would try to justify to myself that this methodology must have some kind of purpose, that you’re being assessed on who you are as a person so of course there will be some assumptions and some less than comfortable lines of questioning.
At one of my earliest appointments at this clinic, I explained that I was attracted to both men and women (these days I’d say “all genders”) and I remember the Doctor asking, without hesitation, “Which do you prefer?” I had no idea how to answer that question, nor could I fathom what relevance it had to my being there.
Would I be more or less masculine in his eyes if I told him that up until that point I’d only had sex with men? Did it matter if I bottomed or topped? Is there some sort of magical combination you input on your controller to unlock the “Doctor Believes You” achievement?
Since then it has been a game of “What gender will they guess my partner is today?” and, “Will they assume that I’m straight or be extra spicy and assume that I’m gay?”
Even when it comes to sexual health there are awkward limitations and assumptions. Queer women are often overlooked as though they don’t exist in the first place, whereas any man that sleeps with other men is loaded with extra precautions and an overarching sense of doom that, even in 2022, male-on-male love is a possible death sentence.
Any bisexual or mspec person tell you that it’s a constant struggle having to judge whether you should just go along with whatever someone has assumed about you that day, knowing it’s only ever a half-truth, or be committed to being your true self.
Unless it’s a matter of sexual health, should I feel the need to correct medical professionals when they make assumptions about my romantic life? Perhaps not. Perhaps I have “straight passing privilege”, as some might claim, and I should just be quiet and grateful.
But in the words of Jules Ryan, “If you have to earn privilege through self-repression, being in the closet, or having your gender/sexuality erased, then it’s not privilege.”[1]
In 2017 the UK charity Stonewall surveyed 5000 LGBTQ+ people[2], and 31% (1668) of those identified as bisexual. A huge 44% of those 1668 people also identified as disabled. That’s a huge portion of mspec people who are likely to encounter medical professionals on a regular basis for one reason or another, it’s rare for disabled people to avoid them, and that constant not knowing how you’ll be perceived is an added stress that no-one needs.
13% of bi people had experienced unwanted sexual contact, and 42% of those felt that their sexual orientation might have been a motivating factor in them experiencing unwanted sexual contact. This in itself can sometimes result in requiring either medical attention, a Rape Crisis Centre (which typically involves medical professionals), or a Sexual Assault Support Service (usually talking therapy and counselling).
The added weight of knowing what assumptions are often made about bisexuality (“promiscuous”, “slutty”, “thoughtless”, “risky”) when in a situation like that can be incredibly daunting, and it is no surprise that so many sexual assaults go unreported.
This is, of course, if they’re even out to anyone in the first place. The survey showed that whilst 74% of gay/lesbian respondents were out to their friends, only 36% of bisexual respondents were out as mspec. The survey goes on to state further that 40% of bi men and 29% of bi women are not out to anyone when seeking medical care.
The survey report states:
“21% of bi respondents to our survey said healthcare professionals didn’t understand their specific health needs.
22% of bi respondents indicated that they had experienced inappropriate curiosity from healthcare professionals when trying to access care.”
There is a fundamental failing happening when people do not feel safe to be out to the professionals who are so integral to their daily wellbeing. I am personally someone who is very out and proud, and despite the discrimination that I have faced for my sexuality I am someone who has been lucky enough to develop the strength needed to live my truth without fear. The fact of the matter is that not everyone has that privilege, and no one should be required to take a gamble with their safety every time they decide to be honest.
LGBTQ+ awareness and inclusivity training exists, for most public bodies it’s recommended e-learning, so why are we still forced into this position of uncertainty and trepidation any time we need to see a medical professional?
[1] https://radiantbutch.medium.com/why-i-dont-use-the-term-straight-passing-privilege-f7f0b06a2c49
[2] https://www.stonewall.org.uk/system/files/lgbt_in_britain_bi.pdf
Find out more about Bi+ Health Awareness Month at https://bihealthmonth.org/
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This article was written by Felix F Fern (He/They), Felix F Fern is a disabled, mspec and non-binary transgender activist and co-founder of the grassroots activism team Trans Activism UK.