Family planning clinic in 'failing to understand bisexuals' shocker!

[baratron]

So, I've been wanting to get a Mirena coil fitted for a while. I like the permanence of my copper coil, but I don't like the way it aggravates my periods. I've always been extremely reluctant to use a hormonal method of contraception because I have extremely bad PMS (premenstrual dysphoric disorder) - indeed, whether I am officially bipolar or "just" have violent reactions to fluctuations in my hormone levels is something that neither I nor my medical professionals have ever worked out. But the Mirena delivers the hormones directly into one's uterus, and as a result may be much more suitable for women with severe PMS than the Pill. More importantly, it may also offer protection against endometrial cancer, which runs in my family.

I discussed the Mirena coil with my GP a few months ago, and she went through all the pros and cons with me then. But I have "a thing" about not liking my private parts to be seen by the same doctor who I see for everything else. Y'know? I like one doctor who sees me clothed and a different one who sees me naked. So for years I've been going to the only evening Family Planning Clinic in my local area. I like it because it runs from 6.30-8.30pm, meaning I can usually manage to get there, and the doctors they have there are actual gynaecologists, meaning that all they do is look at women's private parts and mine is therefore not very exciting.

So yesterday I finally acquired enough spoons to call the Clinic and I got asked a number of questions by the nurse. What contraception I was using at the moment, the date of my last period, and when I "last had sex".

I answered these questions and was told that I couldn't get my coil switched out because there might still be sperm inside me.

I said "But we use condoms as well as the coil!" and was told that still wasn't good enough. Fair enough, they don't want women with accidental pregnancies AND a coil fitted, that can be very dangerous.

But THEN I remembered how, exactly, we'd last "had sex". I'm bisexual, Richard & I have been together 17 years, and we're pretty experimental. It was a method with absolutely zero risk of pregnancy. None whatsoever!

Except I was too embarrassed to then say, on the call, what we'd actually done. She'd said "sex" - not "intercourse" or "penis-in-vagina" or "penetrative sex", or any other phrase which specifically referred to sexual activity likely to cause pregnancy! So I went away and felt embarrassed for a while, and talked to Richard, and resolved to try again today.

Today I called back and explained the situation (helps that my period has actually shown up, rather than yesterday when I had all the cramps but no bleeding yet), but there was no doctor available. Since the Clinic only runs on Monday and Tuesday evenings, I'm going to have to wait until next Monday. Which also means no p-i-v until next Monday, which is a bit bloody annoying (pardon the expression) since I have my period and its associated pain, and the one thing that's guaranteed to sort that out (at least for a while) is orgasm.

Am I stupid for not realising that in the context of a Family Planning Clinic, "sex" means p-i-v, or are they stupid for not specifying what they meant by "sex"?

What I do know is that the majority of bi folk define "sex" a lot more broadly than penis-in-vagina, since we may be having sex with every conceivable permutation of genitalia. And if a Clinic is going to serve bisexual women in relationships with men, they need to be aware of this.

Comments

[bitty.livejournal.com]

i found the mirena to be sanity-saving. my periods are immensely better, my pms is better about half the time (which is better than none of the time), and the hormones being delivered locally has worked significantly better for me than the pill. (although we have officially established that the first few months of the mirena the hormones are strong enough to cause hair loss for me. so i do have *some* side effects of the hormones, just not nearly as many as from the pill.)

[erik]

They need to specify exactly what they mean. "Sex" is a very vague term, and even vanilla persons can define it quite differently, especially if they come from different cultures.

[bitty.livejournal.com]

it depends on what your definition of "is" is.

[sfred]

I agree that they should be more specific about what sort of sex they mean. Even "penetrative sex" - does that always mean PIV, or does it include other options of item-in-place?

[thekumquat.livejournal.com]

I'd be confused too, though I've learnt from responding 'what do you mean by sex' that the vast majority of people consider only PIV/A penetration to be 'sex' and oral sex or toy use etc as 'sexual activity' but not sex, so the questioners are used to phrasing in those terms.

The last time I went to a pure sexual health clinic (as opposed to family planning and sexual health), apparent ly I was the first asymptomatic woman they'd had for months who wasn't a sex worker - other women only go if they have symptoms. Which colours their expectations of answers somewhat.

[sfred]

Yes, they often seem very surprised to see me too.

[haggis.livejournal.com]

Last time I went, I wanted to get my implant removed b/c I will be trying get pregnant in a year or so AND get STD tests for peace of mind re multiple partners. I was quite nervous of being shamed for this combination but I had to see different people so it didn't come up.

[sfred]

*sympathy*

I sometimes worry that I'll be judged for having multiple sexual partners, and then it occurs to me that for the definitions they're using, I have way fewer sexual partners than I so for my own definitions, and then I get confusingly defensive about not being judged...

[haggis.livejournal.com]

I suspect they have to balance between being sufficiently clear to get accurate information and being so explicit that people get too embarrassed to speak. Different people have different comfort levels on that and sexual health discussions are fraught with unspoken shame and taboos :-(

[jinian.livejournal.com]

Well, since it took you a while to twig to the fact that you couldn't have sperm inside even when she said that was the problem, I think the sneaking societal assumption might be in you as well. It's certainly in me sometimes. It's frustrating, though, and she should definitely have been more specific. As for being specific back at her, I've gotten some use out of the phrase "not THAT kind of sex." If she likes coy, there's coy for her!

[baratron.livejournal.com]

Hmm, it's more that I wasn't very awake to remember exactly what we'd done immediately, and that a while ago I looked up potential risk factors of different types of sex. It turns out there is a theoretical - very low, but still possible - chance of getting pregnant from sex in which ejaculation happens over your body, and the same for anal sex. The man concerned would have to have some kind of amazing super-sperm for this to happen, but it's possible. Just not very probable.

As a person with a female reproductive system who does not want to be pregnant, I tend to rank absolutely anything where sperm comes near my vulva as potentially risky. Since this is >99% of the sex we have and I wasn't very awake, it was a while before I remembered that we'd done something different to one of our usual options.

[wandra.livejournal.com]

I went to a sexual health clinic the other week for routine testing, and was asked by the doctor when I'd last had sex. I asked "what kind of sex" and the she said "all kinds of sex" which made it much easier to explain. She didn't seem at all bothered about my multiple partners either.

One of my partners had the opposite experience somewhere else - apparently there "sex" means only PIV and presumably A.