opinion
4 min

What it’s like to talk to your doctor about sexual health when you’re bisexual

There’s a misconception that bi people are just going through a phase — but what if our doctors believe it too?

Credit: Indiana Joel/Daily Xtra

“Are you sexually active?”

I’d been dreading this question since losing my virginity to a female friend a few weeks earlier, not long after my 16th birthday. Somehow, the harsh fluorescent lights in my doctor’s examination room made this query seem even more menacing.

“Yes,” I said, but there was an ellipsis in my voice. A hesitation. An unspoken “but . . . ”

“You’re using condoms, right? So you don’t get pregnant?” she prompted, and I didn’t know what to say, because we weren’t. We didn’t need to. It was the wrong question.

“Uh, I’m not having sex with a guy,” I managed to stammer.

My doctor peered at me over her wire-rim glasses, “Oh,” she replied.

There are a lot of things a teenager might be nervous to disclose to their doctor — a marijuana habit, some worrying mental health symptoms, a secret relationship their parents don’t know about. While we should all feel free to tell our doctors what’s really going on with us, it’s particularly egregious that so many of them are still in the dark about something so basic as sexual orientation, making these already-difficult situations even more challenging. 

The day of my first difficult conversation about my sexual health, my doctor didn’t give me any medical advice on the sex I was having. She didn’t suggest my partner and I use dental dams or latex gloves. She didn’t suggest we get tested for sexually transmitted infections (STIs). She didn’t ask whether my partner was cis or trans. She didn’t ask what sexual orientation I identified as (bisexual, for the record). She didn’t even ask me if I had any questions for her. She just moved on to the next part of our checkup. 

I didn’t recognize these as problems at the time; I was too young and nervous to question the approach of my all-knowing doctor. Everything I later learned about safer sex — with the other cis girl I was seeing at that time, and with other partners later on — I learned from the internet. And while the internet can be a great resource for such information, doctors should be a better one.

Bisexuals are told all the time — both implicitly and explicitly — that we’re not queer enough to align ourselves with queerness, or that we’re too queer to align ourselves with straightness. I still find it hard to push back against these stereotypes today, at 25. 

These presumptions are particularly upsetting in medical situations, where many of us already feel nervous and unempowered and, for many queers, apprehensive. The medical system has oftentimes failed us and our queer foreparents: inequitable health care access due to poverty, doctors’ lack of knowledge about LGBT identities and sexuality and the pathologization of queerness are just a few examples.

Two years later, in a different relationship with a person of a different gender, I returned to my doctor. I was a girl on a mission. 

“I’m seeing someone new and I’d like to get an IUD,” I told my doc, with all the bravery and resolve I could muster as a meek 18-year-old still coming to terms with her sexuality.

“I thought you were a lesbian?” she replied coolly, barely looking up from her computer screen.

“No, I’m bisexual,” I clarified, my voice only shaking a little.

Medically speaking, it shouldn’t actually matter what word(s) I use to define my sexual orientation; my doctor should want to know, instead, what sexual activities I am participating in. I could’ve been a lesbian having sex with a man (they do exist!). I could’ve been having sex with a trans woman or a nonbinary person who had the ability to get me pregnant. There was no reason for my doctor to assume I was a lesbian in the first place, nor that a risk of pregnancy during sex meant my existing sexual orientation was being challenged.

I was reminded of a story I had read online. An American photographer I followed, Brigid Marz, wrote on Flickr that she and her girlfriend went to a hospital to get treatment for her flu symptoms. A staff member asked Brigid if there was any chance she might be pregnant, and she laughed, indicated her girlfriend, and said no. She’d dated and had sex with men before, but not recently enough that she could be pregnant. Months later, she received a $700 medical bill, $300 of which was for a pregnancy test she’d neither authorized nor needed. 

“I am so sick of being treated differently just because I have boobs,” she wrote, but I would argue she was treated differently because she is non-monosexual – she is neither completely straight nor completely gay. Our medical system seems to assume everyone is one or the other, sometimes even when we’re loudly asserting otherwise. 

In the end, my doctor refused to prescribe me an IUD on the basis that I was “just casually dating” and should wait until I was “in a serious relationship” before committing to a long-term birth control method that reflected my relationship status. She prescribed me the pill instead — the hormonal content of which exacerbated my mental health conditions for years, something the non-hormonal copper IUD may not have done. 

What rankled me was that I was in a serious relationship at the time. My doctor may have assumed my relationship was casual because I was now with a man and I was previously with a woman, or she may have simply thought I was too young for the IUD — but I think it was because of negative stereotypes about bisexual people

Bi folks’ relationships and attractions are often written off as “just a phase” or “just for fun.” We’re told we don’t know what we really want or who we really like — or, worse, that we’re intentionally playing with partners’ hearts, never intending to pursue commitment or depth in our relationships. 

In my experience, this is about as true for bisexual people as it is for straight or gay people — some folks are looking for serious relationships and some just aren’t — but this assumption weighs most heavily on bisexuals. Whether or not my doctor was consciously aware of the stereotypes she was affirming that day, it’s clear to me that my relationship would not have been written off as “casual” if I identified as straight or gay.

If I could go back and talk to myself when I was a shy and shaking 16-year-old in my doctor’s office, I’d tell her to advocate for herself. I’d tell her to ask the questions she wanted answered, and double-check the answers on Scarleteen later. I’d tell her it was okay if she didn’t even know what questions to ask. 

I’d tell her to be unashamed of her burgeoning bisexual identity, because it’s nothing to feel shifty about. But mostly, I’d wish I didn’t have to tell her all these things. Her doctor shouldn’t have made her doubt all this in the first place.