does matter if he has sex with men. Additionally, anal sex
with a man opens him up to a different type of medical
risk than anal sex with a dildo-wielding woman.
of stresses that a heterosexual-identified woman is not,
without regard to her behavior. There are social stresses
regarding partner choice ("Will my partner be allowed
to visit into the MICU? What will happen when my co-
workers meet my lover?"). There are also genuine physical
dangers rape, assault and even homicide associated
with being gay, lesbian, a sex worker, an S/M practitioner,
or transgendered, as the crime sheet in any city can
attest.
then bisexual. It can be hard to imagine, but there are
people who are not quite sure which gender they are,
people who are frustrated when no one will acknowledge
their chosen gender, and people who find any gender at
all intolerable. Is a woman who is happily married, but
secretly desires sexual contact with other women, a lesbian
or bisexual or even heterosexual? Does that orientation
change if she begins an affair with another woman, if
she leaves her husband, or even if she becomes celibate?
There are no simple answers. Just remember that because
someone identifies with one sexual orientation, it does
not necessarily define their actual behavior. Acceptance
of this fluidity is the first step in providing nonjudgmental
health care and not alienating your patient.