Welcome back. Today we're going to play a game inspired by my latest trip to the gynecologist. It's called 'find all the assumptions'! It's pretty self-explanatory. I'm going to recount the major verbal interaction in the visit, and we're all going to see how many assumptions we can find 'buried' within the conversation. Ready? Okay, let's play!
Today I went to the gynecologist. After a (very) brief chat about why I was there, the doctor dug into some important basic, background questions. We were discussing sexual activity and partners, when she asked/stated: you're heterosexual, yeah?
L: No, I'm not.
Dr: Oh, then who are your sexual partners?
L: I sleep with women.
At this point, the doctor is getting ready to do a pelvic exam. She asks me if I have ever had sex with a man. This seems entirely irrelevant to my visit and, well, my life, but I responded in the affirmative.
She was relieved! The fact that I had slept with a man meant that she would be able to perform a pelvic exam on me. This seemed like strange logic to me. Luckily, she explained.
L: You know, you could use a speculum even if I had only been with females.
Dr: Many lesbians (her term) can't have a speculum inside.
L: I find that hard to believe. You know females who have sex with females also have penetration, right?
Dr: Some do. Many don't.
Our conversation went on, but that was real gist of the interaction. Let's discuss, shall we?
First, clearly, is the assumption of heterosexuality. Not only did the doctor assume that I was heterosexual, but the way she asked the question implied that it would be offensive to suggest otherwise. I present as queer. There are many reasons for this. One of the reasons is that I want to be read as queer. I am certainly not offended when someone assumes I'm queer. In North American society, you are assumed straight until proven queer. From her question, tone, and inflection, it's clear that my doctor really wanted to give me the benefit of the doubt and the 'chance' to be straight.
While not an assumption, I'm going to go ahead and say her question about my experience with men is inappropriate and, again, offensive. But oh, did it get better! Assumption: queer women can't fuck each other. This is, obviously, false. Unfortunately, my (ex)doctor still labors under the misapprehension that sex is a penis-in-the-vagina game. That's too bad for her. It's also too bad for every one of her queer patients. There are many issues with power dynamics involved in doctor-patient relationships. These can be exacerbated in a gynecological setting because of the vulnerability of the set-up. When a doctor systematically disregards or pathologizes your identity, it doesn't exactly neutralize those concerns.
Moreover, not only is it entirely offensive to suggest that I would not be able to receive a pelvic exam because I don't sleep with men, but it's also just bad medicine. I'm a 25 year old, sexually active female. You are a gynecologist. You need to find a way to give me an exam. That is your job.
I spoke to a pretty rad medical student recently. She told me about the training on GLBTQ issues they were receiving at her school. It makes me hopeful that ultimately there will be some shift in language and care. However, the basic assumptions my doctor made (of heterosexuality and that queer women don't have 'real' sex) are not just part of the medical community. Those assumptions exist everywhere. They are constantly reinforced.
Where do you see them in your life? How do they affect you?