Last night, I was a human “book” on polyamory and BDSM for Bastyr‘s Human Library event. It’s always fun to see what questions naturopath health care providers have about alternative lifestyles, and last night was no exception.
Here are a few of the most frequently asked questions from the four groups of students I had the pleasure of chatting with last night.
What is polyamory?
The practice of having more than one long-term, loving, committed relationship with the full knowledge and consent of all parties involved.
I don’t know anything about polyamory. What do I need to know?
- Nomenclature You may hear terms like non-monogamy, polyamory, swinging, progressive swinging or open. In general, “non-monogamy” is the more encompassing term; “polyamory” is general used to describe long-term, loving relationships; “swingers” are generally couples that enjoy recreational sex. However, many people find that those definitions and categories don’t exactly fit their self-identifications. Since these words mean different things to different people, you should ask for more information. “Tell me more about what that means” or “Give me the quick tour of your relationships” work great.
- Relationship formations Relationships take many forms, so don’t assume anything. Ask, “what does that look like?” or “give me a quick tour of your relationships.” You might hear the terms triad (three people in intimate relationships with each other), vee (a relationship formation in which A and B are together and B and C are together, but A and C are just friends), W (an extension of a vee), quad (four people in an intimate relationship with varying configurations), polycule, network or tribe. Feel free to ask for more information, since no two people use these words the same way.
- Sexual orientation Polys might be heterosexual, heteroflexible, homosexual, bisexual, bicurious or anything else in between. Don’t assume that all non-monogamists are bisexual. Rather than asking “are you bisexual” (assumes a stereotype), ask “what is your sexual orientation?” I once had a gyny who casually asked, “Do you sleep with men, women or both?” I said, “both,” to which she replied, “good for you!” It was refreshing to have a health care professional that wasn’t making the assumption that everyone was straight, monogamous and vanilla.
- Sleeping arrangements People pair off or have three-or-moresomes according to preferences and lifestyle arrangements. Each relationship falls to its own level, so don’t assume that everyone in a network is sleeping with everyone else (although that may be the case), and don’t assume that all sex is group sex.
- STIs The rate of STI occurrence is actually lower in non-monogamous communities than in the general public, primarily because the issue is addressed openly and honestly. So please don’t assume that the people involved are at a higher risk for STIs (although some are).
How can I get patients to give me this information?
Design a question on your intake form that asks about the relationship structure and offers the options of monogamous, non-monogamous and polyamorous.
Orally, keep in mind that most polys won’t bring this up with a doctor because (a) unless you’re a gynecologist, it’s not really relevant or (b) there is a stigma that can lead to uncomfortable questions. So try asking, “What is your relationship configuration?” or “What is your relationship structure?” Polyamorists are used to everyone (including health care providers) assuming everyone is monogamous and are therefore more likely to see the question as a chance to open up about their non-monogamy.
What is BDSM?
Four initials represent three word pairings: bondage and discipline; dominance and submission; sadism and masochism. Participants in BDSM enjoy activities ranging from impact play such as spanking, slapping or flogging to bondage to fetishes such as medical play or age play. Power exchange dynamics in which one person consensually asserts power over another (dominance and submission) is quite common. I prefer the encompassing term “kink” to refer to everything that mainstream society sees as weird or fringe.
How do I get patients to confide their BDSM proclivities to me?
In most cases, they won’t. And I’ve never discovered a good way to ask about kink affiliations without it sounding like a come-on.
What if they have bruises? How do I distinguish between consensual play and abuse?
Most of us are taught to either make sure bruises don’t show or to make jokes about them. I usually just tell people the truth–that getting them was a lot of fun on date night!
But you can use the opener, “Were those bruises consensual?” which signifies to a patient that you’re aware of the idea of consent in BDSM activities. As you’re aware, most survivors of abuse will make excuses, whereas a kinkster will most likely smile nostalgically at the memory of the kinky play.