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9
sexual practices and to garner suggestions about how to
do them more safely.
If you find it hard to say the words, write a few notes
to yourself before you go in, so you don't forget important
information in the embarrassment of the moment. Some
patients give me a letter to read in their presence, send
me an e-mail, or just blush their way through a face-to-
face conversation.
Just because you have an accepting physician does
not mean you necessarily have to come out immediately
with every detail of your sexual behavior. It is quite
appropriate to start by simply giving your doctor enough
information to begin discussing the health risks, if any,
of your activities. Later, as the doctor/patient relationship
strengthens, then you may feel more comfortable sharing
more details.
When to come out. You will get better care if you
come out to your physician during a regular appointment.
If you wait until you're in some kind of crisis (a stuck butt
plug, a bleeding laceration, a badly infected piercing,
whatever), you are putting your doctor into a difficult
position. For one thing, there's no guarantee that your
doctor will be the one on call when the fecal matter hits
the ventilation device, and the physician who is on call
may or may not be open-minded ­ the result will be your
physician hearing the events from his uptight associate.
Also, it's only fair to give your health care practitioner
a chance to learn more about your sexual practices ­ and to
voice objections, if he has any ­ before a serious problem
arises. A calm discussion when no problem exists is more
likely to be successful than confronting your physician with