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do, particularly if you live in a small community. On the
other hand, you're not planning on marrying this person
all you want is to get healthy and stay that way. Do you
really need approval from your health care practitioner,
or do you need competent and professional care?

Sometimes I refer patients to a specialist who I know

is uncomfortable with alternative sexualities. I warn the
patient, but I also explain that it's important to get the
best medical opinion possible. I also take the situation as
an opportunity to educate the specialist, preparing him
by explaining the kink before he sees the patient and
educating him afterwards. Knowing and interacting with
a real person who engages in an alternative sexual lifestyle
or behavior is very different than relating to a psychiatric
diagnosis about which he's only read. The experience has
made a noticeable difference in many of these specialists'
acceptance levels.

Then there's the practitioner who may not have

worked a lot with sexual minorities in the past, but is
open-minded and willing to learn about alternative sexual
behaviors. If someone is willing to admit what he doesn't
know, that's always a good sign as long as he's willing to
spend some time learning.

Do not infer that just because Doctor X is personally

involved in a particular alternative sexual behavior, he is
knowledgeable about that behavior or about other types
of sexual behaviors. Maintaining that level of expertise
represents a major effort in terms of time and energy
spent in research, in addition to the huge amount of
time required simply to keep up with one's own specialty.
Relatively few practitioners make the additional effort.
Busy practitioners probably don't have the time to research