What does good health care look like? Depending on where we are, our needs, preferences, and who is available, a good health care experience can look very differently. What makes it good is not necessarily the specific hospital, clinic or centre, the specific words used, or what posters you see on the walls. Not everyone wants the same thing, has access to the same resources, or faces the same circumstances.
Factors that might contribute to a positive experience with your health care provider(s)
feeling connected to and in tune with the people who are caring for you
feeling like you are safe
feeling like you have some say in important decisions related to your body and your health (including sexual and reproductive health)
having the information you need to make important health care decisions
What’s your relationship status?
Many health care providers and the people who support their work receive a limited amount (if any) of training in sexuality. Getting sex positive health care may be less about a perfect script, and more about being able to bring up and discuss important topics that relate to our health, including our sexual and reproductive health.
How can you tell if your health care provider is sex positive?
Sex positivity embraces sexuality with the view that when it comes to a sexual act, practice or experience, the only relevant concerns are the consent, pleasure and well-being of the people engaged in it or affected by it. Sex positivity places no moral value on different sexualities or sex acts. It helps us set aside our judgments and makes room for the diversity of human sexuality.
It’s good to pay attention to how we feel the appointment is going. When you ask a question related to sexual or reproductive health, does your health care provider handle these questions with ease? Do you feel comfortable in the process? Or do you feel uncomfortable with their answers or sense judgment or defensiveness?
At the doctor’s office, it can often become a waiting game for the other to start. Sometimes, health care providers assume that if a patient has an issue, they will bring it up, while the patient may be waiting for the health care provider to, each thinking that it’s the others’ responsibility. Keep that in mind if you have a question you’d like answered.
Our doctors/midwives/counselors/nurses can certainly mirror discomfort. When you ask them about sex – when you are embarrassed – that awkwardness can be transferred to the person you are talking to. The best way to bring up a question or issue is to ask it using plain, everyday language. Be calm: this is your body. Ask your question as if you were asking the time or ordering a cup of coffee.
Everyone makes assumptions, which at times can get in the way of good care. Treatment or diagnosis can sometimes be based on the assumptions a health care provider makes about a person or their condition. Is your health care provider asking you simple or open ended questions? Is your health care provider listening to you to create a more complete picture of why you are seeking care or what you may need?
Does your provider make assumptions about you and your sexual health? Does your provider assume you are having penetrative sex when you don’t? That you could (or could not) get pregnant? That you have a partner of the opposite sex? Or that you are having sex/not having sex?
When you talk with your health care provider about important health related topics, are they following your lead in terms of the words you use?
If you use the word ‘partner’, does your provider use that term too or do they assume who you are in a relationship with by using terms like ‘husband’ or ‘wife’?
Is your health care provider upfront when they don’t know something? Are they willing to explore the topic or research options with you?
You are wondering whether you can get pregnant now that you have started injecting testosterone. If your doctor does not know, are they willing to research this with you and call on colleagues to make sure you have the correct information you need to make a decision about birth control use? Or, if you are already linked to another health care practitioner who works specifically with the black community, is your doctor interested in exploring how care can be complementary?
Does your health care provider work with you to address what you are asking for?
If you ask for an HIV test or a full panel of STI tests, do they give you the paperwork you are asking for or do they make assumptions and question why you’d need it in the first place?
When a health care provider can’t provide you with the services you need, are they providing an effective and timely referral?
If you decide to terminate a pregnancy and you are looking to access abortion services, is your doctor assisting you in getting the care you need if they can’t offer it themselves or are they putting up road blocks?
Do you feel like you are in a safe space to explore what would be right for you, free from pressure or fear-based messaging? Are you being provided with a range of unbiased sexual and reproductive health options so that you can make informed decisions that are right for you?
You are HIV negative and your partner is HIV positive and you want to know what the safer sex methods available to you are. Are you provided with non-judgmental, evidence-based information for you to decide what you feel comfortable with or are you being told what is right and what is wrong?
Does your provider try to ensure that you feel safe, have a feeling of control over your own treatment and that you are included in your care and treatment choices?
You feel pretty nervous about getting a pelvic exam because of past trauma. Is your provider working with you to help find ways to do the examination in a more comfortable way by suggesting to raise the table, by detailing each step of the process, by stopping if you request a pause?
Do you feel like you can safely disclose important information about yourself and your sexual and reproductive health?
You are pregnant and thinking of getting an abortion, is it safe to talk about it? Or, you are a man and have sex with other men, is it safe to talk about it? Or, you would like to correct your service provider about your gender identity, is it safe to talk about it?
When you bring something up with your health care provider, is that what they focus on?
If you are a sex worker, does your health care provider address your concern or assume that all health problems are linked to your work? Or, if you are overweight, does your doctor link all health problems to your weight?
Do you feel like your health care provider respects your beliefs, behaviours and values?
You are seeking care for depression and you wish to discuss the use of medication and the support you get from elders around the use of traditional medicine and practices. Is your health care provider open to learning more about how to incorporate Indigenous approaches to helping and healing?
Is your health care provider age-inclusive and knowledgeable about the sexual and reproductive health issues relevant to your age group?
Does your health care provider assume you are not sexually active because of your age? Do they have youth-friendly resources at the clinic/office/drop-in?
Does your health care provider respect your confidentiality?
In situations like sexual abuse or assault where your provider has a legal or ethical duty to report, which may require sharing your personal health information with others, does your doctor consult you first?
Questions you can ask to get a sense of how your health care provider may deal with issues of sexual or reproductive health
What are your values around sexual and/or reproductive health issues?
How do you define healthy sexuality?
Are you comfortable talking about sexual/reproductive health?
Is there anything I should know about how you work around issues of sexual or reproductive health?
Are you the person to talk to if I want to discuss my sexual and/or reproductive health issues or options?
Have you ever worked with (for example) LBG (Lesbian Bisexual Gay) or Trans* patients?
What is your policy in regards to contraception, abortion and other pregnancy options care? If you refer to other professionals, who do you refer to?
Level of knowledge on sexual and reproductive health issues specifically
If you are interested to know what kind of knowledge a provider has on sexual and reproductive health specifically, here are some good things to be on the lookout for!
Is your health care provider able to provide you with quality information on your range of contraceptive/birth control options, including emergency contraception?
Is your health care provider able to provide you with quality information on Sexually Transmitted Infections (STIs), on STI testing and on STI treatment?
Is your health care provider able to provide you with the information you need on how to have safer sex, provide you with accurate, non-judgmental information about the levels of risk associated with different types of sexual activity and discuss the factors that might put you at risk for acquiring different STIs?
Is your health care provider able to point you to reliable sources of information on contraception/STIs/testing, etc. if they don’t have it handy? (written material or online)
Are you supported in getting tested regularly for STIs?
When necessary, are you provided with information regarding a range of reproductive health options, including options related to pregnancy, including adoption and abortion?
Does your health care provider have a range of materials on diverse sexual and reproductive health issues that you can read or take home? Is the material age-inclusive and inclusive of different gender identities and sexual orientations?
Does your health care provider listen to you when discussing the sexual and reproductive health issues that are of particular importance to you?
My doc said no to what?! What is conscientious objection?
In the context of health care, conscientious objection means the refusal by a health professional to perform particular services on the grounds of moral or religious beliefs. The specific sexual and reproductive health services that are most often refused on the basis of conscientious objection are abortion, contraception and assisted reproduction.
It could be a case of conscientious objection if you find yourself in your health care provider’s office and they are either outright refusing to provide a service, refusing to refer you elsewhere to access it, creating barriers for you to access them (for example, delaying appointments, imposing time to “think it through” etc.), or shaming you for wanting to access them in the first place (sometimes, this can mean assuming the choice you’ll make and/or belittling you for asking questions about options).
This is a serious problem as it gets in the way of your ability to make choices and take charge of your own health, well-being and life in ways that work best for you/in your circumstances. Some provinces have started to work on policies to define the responsibilities of doctors and health care providers who refuse to provide services.
How to make your appointment interactive!
The experience of medical care itself isn’t always going to be fun or enjoyable but in the context of that, we should feel safe, accepted, and heard. Generally speaking, our relationships with our health care providers should be interactive.
Talking points to foster good partnerships
Can I tell you a little bit about myself? It might be helpful for you to have context
You should know this about me: (…)
One thing I’d really like to discuss with you is (…)
I wanted to make sure I wouldn’t forget anything, so I wrote a few things down
I didn’t understand that. Would you explain that to me?
Why are you asking me that question?
Could you tell me what you are doing?
Would you mind telling me about how the exam will happen?
Is there anything I, or you, can do to make this more comfortable for me?
Could you tell me why you have to do that procedure/test?
What can I do to prevent this problem in the future?
Thank you for explaining that to me.
I appreciate the extra time/care you took with me.
What is SRH Week?
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