My Healthcare Manifesto

What To Look For In a Sexual Health Specialist

One of my friends recently had an issue with some vaginal discomfort she needed to get checked out. She got a semi-urgent visit booked with her women’s health office, but when she got there was surprised to find that she wouldn’t be seeing the provider she thought she had scheduled with, and instead was told the male medical intern was the only one available. While she wasn’t jazzed about seeing a male provider, she decided she’d rather see him than not get this issue taken care of. The exam wasn’t physically painful, but she felt awkward and uncomfortable.
Fast forward a couple of weeks. She's headed back for follow-up, which she

scheduled at the last appointment specifically with a female provider, a request she confirmed again when she confirmed her appointment. Shockingly, she was told the same guy would be seeing her again, which she, understandably, declined, and insisted on seeing the original woman she was scheduled with (who was apologetic and empathized that the situation should not have happened).
When I heard her story I was aghast, and pissed off. My mouth literally fell open. To hear that a practice had tried to place her with a male provider specifically after she requested not to be was unconscionable. Bodily autonomy and individual consent is a cornerstone of appropriate medical care; no one gets to touch your body without your say-so. Ever.
It was painfully clear that she hadn’t been listened to, her preferences hadn’t been acknowledged, and that no one was advocating on her behalf. She said that the worst part about the whole experience was feeling like she was making a big deal and inconveniencing the office. I would be horrified if I found out that one of my clients ever felt this powerless in my practice.
Here are some key things you should look for when selecting a reproductive healthcare provider. Or any healthcare provider, really. These values are deeply personal to me, so I have used a lot of examples from my own experience to illustrate what good care should look like.
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1. They Listen. In school I learned that you can narrow down a diagnosis or figure out what might be going on with someone mostly by listening to them. A physical exam helps to confirm findings that are consistent with the story, or identify areas that need more investigation, but the story is the most important part. Sometimes it’s the only part; I’ve lost count of how many times talking to someone about the story or history of their issue elicits an “ah-ha!” moment for them and a better understanding of what’s going on for both of us. It’s a good feeling when you have your voice, questions, and concerns heard and understood. If your healthcare provider doesn’t make you feel this way, it’s time to look for one who does.
   
   
   
2. They Ask Questions. Questions help me personalize the care I provide. We all know what happens when we assume things. Yeah, not everyone has sex with multiple partners, engages in anal intercourse, or has a history of physical abuse. But if one of those things is true for you, it’s important for me to know that so I can provide the most appropriate healthcare for your unique situation. All of the times I have discovered something a colleague didn’t, or vice versa, is because we asked a question the other didn’t. Simple as that. From your perspective as a client, you should expect appropriate questions from a healthcare provider in a non-judgemental way.
   
   
   
3. They Provide Support. I love my dental hygienist. We both have small children we exchange stories about and pass on our latest parenting tips and tricks. Also, she doesn’t berate me for not flossing. She encourages me to floss, she tells me about the latest tools that will help me be better about flossing, but she never makes me feel bad or guilty about not doing it. Humans tend to be self-critical by nature. We all know we should eat better, exercise more, stop smoking, and floss daily. We don’t need a guilt-trip about these things, we need a cheerleader who we feel is in our corner, motivating and helping us to be better to ourselves.
   
   
   
4. They Advocate. When I was in graduate school, I spent two months one summer learning Spanish in Guatemala. It was an immersion language program where I learned to speak Spanish in Spanish. My teachers didn’t speak English, and my living arrangements were with a local family who also didn’t speak English. It was a great way to learn a lot, quickly, but it was exhausting. My brain worked so hard at figuring out a new language, translating, a new city, and new culture that I was mentally taxed to my limit. A couple weeks into my stay, when I had only a grasp on basic language, I came down with digestive issues. Not too uncommon when traveling in Central America, but it necessitated navigating the healthcare system, in a language I barely understood. Thankfully, my teacher came with me to the local clinic and did all of the navigating and some translating for me. I wouldn’t have known where to go or what to do otherwise, and on top of that, I felt really awful.
   
   I draw on that experience a lot now that I take care of people for a living. For people whose first language isn’t English, I always offer and recommend interpreter services, because I personally know what it’s like to be sick, in pain, and worried that you don’t know what’s happening around you. But even for people for whom language isn’t a barrier to healthcare, I do my best to look out for other barriers, because our healthcare system is convoluted and inefficient. Yes, Tylenol is available over the counter without a prescription. But it might be easier (and sometimes cheaper) for me to provide a prescription. Your insurance requires prior authorization for something; yes, it’s annoying. Yes, it’s time consuming. If we agree, though, that this is something important for your health, it’s my job to help you jump through the insurance hoops. It’s also my job to advocate for a better system with fewer hoops to jump through. You deserve a provider who will advocate for you and go hoop-jumping.
   
   
   
5. They Empower. Do you know who has the answers about what’s best for your health? You. My job is to give you the information you need to figure out which answers are right for you and to make your own decisions. Sometimes that involves teaching you about how your body works. Sometimes that involves explaining what a test shows or what a treatment does. Sometimes that involves explaining the risks associated with doing something. Almost always it involves helping people clarify for themselves what their priorities and preferences are. When you have the knowledge you need to make informed decisions for yourself, you feel good about those decisions. A healthcare provider should make you feel empowered in this way, so that you feel informed and confident about your decision about how to best take care of you.

Providing this model of healthcare requires time and a personalized approach of getting to know people. One of the reasons I became a Nurse Practitioner instead of another type of provider is that I wanted to be able to have this relationship-building approach with people. I also wanted to focus on health promotion and health education, and Nurse Practitioners are especially skilled in these areas of care; it’s a major part of our training and we take the time to put it into practice.
Providers of all types exist who embody this holistic approach to healthcare. If your current provider isn’t listening to you, asking questions, supporting, advocating, or empowering you, it’s time to find one that does.


Need a sexual health cheerleader? That’s totally my job! Come see me, I really like helping people get happy about taking care of their genitals and all parts of their whole selves.
©2017 Chelsea Gould