When moving to a new city, and after having found an apartment and located all the essentials, an arduous search begins. You must look for a doctor, dentist, a hairdresser, and, in the case of people with a uterus, a gynecologist.
My wandering Jewish complex has led me to change countries three times, and with that, I have added about five gynecologists to my list.
The experience is almost always the same: managing to make an appointment, not getting lost with Google Maps and, in my current case, looking up on the bus how to say the key words in the new language.
However, there is a situation that always repeats itself.
I have to explain to each of my gynecologists why, at thirty-two years old, I have never used contraception.
The astonished face, the raised eyebrow, and the obvious surprise are only a preamble to what follows.
As a gay woman I have had to explain many times that I haven’t had the need because I don’t have intimate relations with men, and that my hormones have not needed to be readjusted either.
“Do you plan to have children?” is the question that always follows, as if the absence of a maternity project simply renders their job or my presence in their office useless.
“No,” I answer, always trying to conceal my fright at the idea.
The doctor-patient relationship brings with it a significant burden of vulnerability and trust, and when that vulnerability is centered from the waist down, the need for trust increases proportionally.
Especially when the sex education available to LGBTQ people is so scarce.
Famine and pandemics like HIV/AIDS transformed condom awareness campaigns, and even today I am faced with empty eyes from specialists who don’t know what to recommend to protect my sexual health and that of my partner.
A couple of years ago, the Human Rights Campaign denounced the absence of sexual education programs for the LGBTQ community, especially inclusive programs that did not limit themselves to emphasizing the risk of sexually transmitted diseases among couples with a penis.
The GLSEN 2013 National School Climate Survey found that less than five percent of LGBTQ students had health classes that included positive representations of issues related to their sexual preference. Two years later, that number had only increased by a couple of percentage points.
In qualitative research conducted by the Planned Parenthood Federation of America (PPFA) and the HRC, LGBTQ youth reported having limited or no sex education in their schools; these programs focused primarily or exclusively on heterosexual relationships between cisgender people (people whose gender identity coincides with their assigned sex at birth), and the prevention of pregnancy within those relationships.
Not surprisingly, when the first cases of HIV infection among monogamous lesbian women through the use of sex toys were reported, many were left with their mouths open.
In my personal case, and having a history of dermatological diseases, the appearance of lesions on my pubic area made me run from office to office for more than six months, fearing that I had been infected with some serotype of the Human Papilloma Virus, HPV, despite not having had sexual partners for more than eight months.
Three dermatologists and two gynecologists could not agree on a diagnosis. And the weariness of my insistence was evident.
“You really wouldn’t have anything to worry about,” one said. “HPV is only spread through direct contact with fluids, and that’s not your case.” He was, in fact, wrong, and it seemed ridiculous for me to have to give a class in homosexual sexology to a supposed specialist who was counting the minutes so he could tell me, “You can get dressed now.”
It was as if they were telling me, “There’s nothing to do here.”
Meanwhile, my concern was mixed with another feeling: that of guilt; that idea rooted in the collective unconscious that, by breaking the rules, you are not entitled to a solution or medical attention with a dose of empathy.
Finally I got a gynecologist who, in the midst of the neurosis caused by the coronavirus, was able to answer my questions.
When talking about risk factors among homosexual women, depression and anxiety predominate, as well as — with a lapidary insistence, I must say — lack of education or economic instability.
However, little is said about our risk factors for contamination by sexually transmitted diseases such as HPV, a virus that does not respect condoms, and which is frequently transmitted by skin-to-skin contact.
Bacterial vaginosis, for example, often happens to homosexual women when there is a change in the pH in the vagina, and the presence of harmful bacteria that outgrow the natural mucous membrane flora is altered. Irritation and itching are often mistaken for mycosis, and inadequate treatment — a product of embarrassment when facing the pharmacist’s counter — can make the situation even worse.
Some cases lead to chlamydia, whose aggressiveness can cause severe damage to the uterus, ovaries, and fallopian tubes.
In the case of genital herpes, (especially HSV-1 and 2) it can be dormant in the body, not manifest, and easily spread through oral sex.
When I’ve talked to friends or former partners about these types of diseases, the ignorance is almost absolute, and at best it’s confused with HPV, and one immediately thinks of cervical cancer.
However, we are all exposed to high rates of transmission of these diseases. The only ones that are less likely are gonorrhea, HIV/AIDS, hepatitis, and syphilis, and this is not exactly encouraging.
Similarly, to protect ourselves, there are few mechanisms, including the latex barrier — also called the female condom — which is not widely marketed, and is very unlikely to be found in a pharmacy.
Several gynecologists I have consulted often have vague memories of it, and no idea how to obtain it, and to tell you the truth, they seem to care very little about it.
In my fourteen years out of the closet, and having grown up in Latin America, I can say accurately that no homophobic gesture has made me feel more vulnerable than the one I have felt sitting in a gynecological office, and that, worse yet, it comes from women whose supposed professionalism suggests the irony of having to perform an ovary examination with a gesture that transforms my sexual identity into a pornographic commodity.