March 9, 2020

How Doctors Can Do Better When Discussing STIs With Their Patients

If our doctors won’t even discuss STIs with us, then how can we end the stigma and shame associated with them?
Written by
S. Nicole Lane
Published on
March 9, 2020
Updated on
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I was 18 years old the first time a doctor applied silver nitrate to my cervix. “You have a few lesions,” he explained, leaning in close to my body. My legs—up in stirrups—flinched at the procedure. It happened so fast, I barely even had a moment to ask: What lesions? What the fuck is silver nitrate and is it allowed to go anywhere near my body? Nothing was explained as I stared at the ceiling. Then, my side effects set in. As I sat up I began to feel light-headed and eventually blacked out. 

Apparently, the procedure, and my sensitive cervix, were not compatible. Silver nitrate is a therapy for genital warts and cervical dysplasia. In my case, it was used to stop cellular change and prevent the spread of lesions. A nurse rushed to bring me water and abruptly slammed the door where I was alone, on the table, unable to move. I decided to crawl on the floor to yank my cell phone from my purse. I called my boyfriend to pick me up since there was no way I’d be able to drive. No one in the office ever checked on me again as I stumbled to the front door. 

There would be two more times when silver nitrate would be applied on my cervix despite my begging and exasperated explanation of horrible side effects I endured. My doctor never explained why I had these “lesions,” and never once said the words: human papillomavirus. It wouldn’t be until I was 25 that my doctor—a new, more equipped one—would explain that yes, I had contracted HPV and that, yes, I probably had HPV when silver nitrate was forcibly applied to my body. 

I know my situation is unique. It’s not every day that a medical professional hides information about their patient’s health—specifically, their STI status. Nevertheless, I speak to people—mostly women—weekly, who explain their doctors’ lack of communication about sexual health and why they feel absent from a process that involves their bodies. It’s heartbreaking, confusing, and absolutely unacceptable. 

So how can doctors create a more encouraging and supportive space for patients to discuss STIs? Because if our doctors won’t even discuss STIs, how can we end the stigma and shame associated with them? 

Dr. Corey Babb, an OB-GYN in Tulsa, Oklahoma agrees that, “The best way to discuss STIs is in an open and non-judgmental fashion; it does no good to cloud facts with personal bias.”

Since I was not aware of my status and could not be proactive, my HPV was only treated with silver nitrate and ultimately resulted in pre-cancerous cells that were removed with a LEEP procedure (this is a whole other depressing story). “If left untreated, STIs can lead to multiple [complications] in the future, including infertility, bowel obstructions, cancer, and even death. In addition, if one is unaware that they have an STI, they could unwillingly pass it along to others. This can be true even if a person is symptom free,” says Babb. 

I was young and didn’t press my doctor on why I had lesions or what those lesions meant. My doctor made a decision for me when he decided to conceal the results from my Pap test and the condition of my cervix. 

Dr. Laura McGuire, a sexologist and consultant, works as a mediator for patients and their doctors when they receive their medical results. She sees clients who describe receiving diagnoses but not understanding what that actually entails. “Doctors and nurses often don't take the time to explain exactly what a diagnosis means and to dispel misconceptions and myths, ideally, they should connect patients to an educator who can help them process this information and gather resources to further discuss all of their options with their medical providers.” In a perfect world, we can imagine sexologists and sex educators being present in the doctor’s office; they should be as normal as nurses and front desk clerks. These professionals are the ones who can talk to us and educate us instead of simply diagnosing us and leaving us with no definitive answers. When leaving a doctor’s office, so many of us wonder, Now what? Where do I go from here? 

McGuire says, “information about your body and sexual health is your right,” and explains that “doctors are there to be a bridge between your medical information and you, not to build a wall that keeps you from making the best choice for yourself, [which] can cause irreparable physical and emotional damage, and long-standing harm.” 

I felt lost and betrayed after learning my STI status had been kept from me. Not knowing what is going on with my body is alienating and violent. 

Explaining this past issue to my current doctor left her bewildered. She was shocked as I explained my lack of consent while being treated with silver nitrate for reasons never explained to me. And this happens, repeatedly, throughout the country. Though it may not specifically involve HPV or silver nitrate, medical misconduct and lack of compassion result in feelings of mistrust, animosity, and violation. 

McGuire says, “When people get a [STI] diagnosis, they then feel like they are guilty of some kind of grave offense or are dirty. We need to have far more education that removes sexual shame from the discussion and shares medically accurate information on prevention, treatment options, and ways to protect your future partners if your STI is not curable.” McGuire continues, “Bacteria and viruses are all around us. We should have no more shame about catching one that is sexually transmitted than we do about catching a common cold.”

In order to overcome these stigmas, judgment, and prejudice, medical professionals must first overcome these fears. 

Sexual education should be pushed to the forefront when doctors discuss STIs in order to eradicate any dangerous and harmful stereotypes. That way, we can all move forward with our general health and ultimately, the future of our sex lives.

Reviewed for Medical Accuracy

S. Nicole Lane is a visual artist and writer based in the South Side. Her work can be found on Playboy, Broadly, Rewire, i-D and other corners of the internet, where she discusses sexual health, wellness, and the arts. She is also an editorial associate for the Chicago Reader.

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