For kink identified people, finding judgment free healthcare can be tricky. It is one of the reason’s why the National Coalition for Sexual Freedom has compiled a directory of kink aware professionals. For those who are sexual masochists, submissives, and the like, deciding whether to explain bruising or power dynamics to a medical provider is not easy. Most assessment tools used to screen for domestic violence are not really designed to differentiate between consensual and non consensual violence.

There are usually questions to the effect of:
In the past 12 months, has your partner ever hit, slapped, or kicked you?
In the past 12 months, have you ever hit, slapped, or kicked your partner?
Have you ever yelled at, insulted or swore at your partner?
Has your partner ever yelled, insulted, or swore at you?

These questions may pose a dilemma to someone in a kinky relationship. Do you answer honestly and risk being seen as a perpetrator or recipient of domestic violence? Do you skip the questions or answer in the negative? Without some item or statement clarifying whether this was in the context of consensual kink, the person filling out the form could be faced with some hard choices.

Granted, there are usually questions that can mitigate these questions, which ask if the person has ever been worried for their safety or feel like they are “walking on eggshells” around their partner.

As I was pondering these issues, this article popped up on my Facebook feed. It is written by a medical student in New York and her exposure to NYC’s BDSM culture.

When it comes to conversing about sex, medical professionals are often uncomfortable. I can’t count the number of times that my peers and I have been chastised for failing to elicit a sexual history. When we think a medical issue is unrelated to sex, it can feel awkward and like a waste of time to bring it up. But it’s usually the medical professional who feels uncomfortable—not the patient.

This sentiment has been reflected in conversations I’ve had with many a colleague. My current job and my recently completed certificate program put me in close contact with medical providers, which has helped me understand the perspective of medical providers. I don’t think it really occurred to me just how difficult it can be for providers to broach the topic of sex at all, let alone kinky sex. Even at clinics that specialize in LGBT clients, providers can really struggle when it comes to taking a sexual history inventory.

The article goes on to raise a very important point:

Kink-oriented patients have the same right to medical advice about their sexual practices as anyone else and healthcare providers can help with that.

I could not agree more, and I’m glad to see providers like this author and my former cohort members advocating for cultural competency.

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