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Rather than spending your own and your physician's time
teaching Alternative Sexualities 101 from the exam table,
consider suggesting that she obtain and read a couple of
the excellent books on the topic; several are listed in the
Resource Guide.
Some people engage in behaviors that are technically
or actually illegal in their locale (such as sodomy or
prostitution), or jobs with questionable societal acceptance
(such as stripper, lingerie model, professional dominatrix).
While such individuals may be concerned about having
this kind of information on an official record, your
physician can't help you if he doesn't know. If you state
your concern in the beginning, your physician may be
able to record your medical issues and concerns without
specifically stating your involvement in the worrisome (to
you) behavior.
Similarly, drug users may be concerned (with some
cause) about anyone recording their admission in an
official document. Some drug users may also find that their
doctors are reluctant to prescribe certain psychoactive
drugs, such as narcotics, for fear that the patient will
abuse the medication. You can and should discuss your
concern with your doctor without telling her the specifics.
Physicians will, almost universally, tell you what they feel
compelled to record and what they will discuss "off the
record." That discussion may well lead to a frank talk
about your sexual behavior and what problems can occur
when you use substances while engaging in sex.
What are the risks? Some people are hesitant to
come out to their health care practitioners because they're
afraid they'll be "outed" to their families, employers,
insurance companies, or even the police.