I'm going to be doing some cultural competency training for my work about how to talk to trans* individuals. What will make things complex is we do hiv & std testing as well as sex counseling. While I feel very good about my knowledge of word choice and how things should be asked for trans* women, I wanted to get all of your opinions on how you would want someone to ask you questions about your sex habits without being offensive.

I also wanted to add there will be a trans* man there as well, but I don't know how open they are about themselves. Further this training was requested by an employee because they did testing and counseling for a trans* man. There is a question about receptive sex and what body parts are used. The question as written is more detailed on language and would be offensive if read word for word.

Personally I'm someone who goes very clinical when talking about myself because it helps me to stay detached. I do understand that is not the way for everyone though. This is an extremely uncomfortable topic that can be triggering for a lot of us.

Lastly assume since you would be getting tested, that you are sexually active.

Maybe a good way to approach it would be something like... "Can you describe to me, in a way that you are comfortable with, what types of sexual activity you've been involved in?" Now personally, if it comes to my health - I'm clinical because I don't want any misunderstandings. I use the clinical terms, or "genitals" if I don't have to be overly specific. But I know some people may not be so comfortable with that, so I think leaving it in their hands is the best. If you find that it seems vague or very unclear, you could ask for clarification. When it comes to stuff like oral sex or anal sex, those are gender neutral so I don't imagine most people are going to dance around those issues.

Could you give examples of the kinds of questions, or information you might want to know about a person?

Quote from: Nygeel on March 07, 2014, 09:14:40 PM
Could you give examples of the kinds of questions, or information you might want to know about a person?

^ This.

Maybe just post the actual question with the offensive words as **** or _____ and we can then give specific examples of how we may fee comfortable with re-wording it.

Hi,

For my self a bit late in the day for that plus im non sexual and no sexual organs, though if asked id say married once 35 years  only ever one partner and only ever sex with one .

i have been tested for hiv though never needed to i just went in and asked what was best for some one who wonted to do escort work how they went about tests and other detail and was allso involved with the AIDS dept, gays and  and other group women in work in the sex industry, i have met many people and to find out about thier lifes and understand them,   

Iv meet many gays and women lesbian  you can ask any ? of me as iv been interviewed many times so im open up front and not embarrised  , what i have found people are more embarrised in asking me and i tell them dont ever be embarrised the only way you learn is to ask.

If i were asking people about thier background , id say up front this is going to be very personal and may bring up issues you really dont wont to talk about so ether tell me or write down what you are able to talk about,

when i was haveing interviews For Two TV stations i knew i would be asked very personal ?  that involved Jos and  our family, i was prepared for that and to have that aired nation wide,

Plus what ever is discused with you be carefull where its aired, or writen and get the consent of those people, because the ramifications could impact on them with bad results,

...noeleena...

Quote from: Kreuzfidel on March 07, 2014, 09:29:56 PM
^ This.

Maybe just post the actual question with the offensive words as **** or _____ and we can then give specific examples of how we may fee comfortable with re-wording it.

My head was thinking more along the lines of what questions are currently asked for (assumed?) cis people.

I just wish when I went to the doctor and told them I haven't had sex they would just take my word for it instead of trying to force a pregnancy test on me.

I may be a little weird, but with medical issues, I'd rather the doctors just ask me. I like to go to the doctor and have just it be business. I like my doctor, but she has a gruff bedside manner and frankly I prefer that. I don't like BS.

Then again, I have been told that I'm in the minority.

Quote from: Alexthecat on March 07, 2014, 10:05:02 PM
I just wish when I went to the doctor and told them I haven't had sex they would just take my word for it instead of trying to force a pregnancy test on me.

Exactly! I have gotten into arguments with so many nurses about that. I usually eventually talk them into letting me sign a waiver saying they can't be sued if I lied .

Quote from: Alexis Paige on March 08, 2014, 12:03:21 AM
Thanks for the responses everyone
The current questions as written and the way they are supposed to be asked are for cis people. The question that the employee was concerned about reads:
"For women: in the past twelve months have you had vaginal or anal sex with a man who has sex with men?"

There are other questions as well that are similarly worded and reference vaginal intercourse.

I told that employee that in the future, first remove the last part because trans* men are men. If they have sex with a guy then obviously that guy has sex with men. I also said if someone checks that they are trans*, then you should start by saying, "I need to ask you some questions that may be uncomfortable to you, and I'm sorry if I offend you. That is not my intent. I will be using clinical terminology to refer to your genitalia. If there is any language or word choices you would prefer let me know and I will try to remember to use those instead."

I also said it would be best to not read the questions as written, but instead ask, "have you been the receptive partner in penetrative sex in the last 12 months? If so can you tell me what body parts or orifices you used?"

I've also been bringing up my opinion that the intake sheet amd questionnaire needs to be rewritten. The intake sheet I'm going to recommend that they add a preferred gender pronoun question to. Since the questionnaire is read to them, I'm goimg to try to get people to understand that they should be reworded when you ask them as needed. It is not actually a requirement to read word for word, but the way people are trained it tends to be perceived as one or used as a crutch when the employee is uncomfortable.  Getting the proper information is more important.

I find the current way offensive for multiple reasons, but I really like the way you've recommended they word it. Plus, I think that if the question is worded the way you recommend, then you can skip the whole thing about how would the patient prefer you to call certain areas because the original question's answer will give you that information.

Have you've been on the receptive end of penetrative sex would be a good way to word it. Does this place also have testing for cis men? It might be a good idea if forms are split into two parts. Part A being the part a client/patient fills out saying how they identify (sexual orientation, name, gender, and birth assignment). Part B would consist of questions around sex practices. This would allow them to write down basic info for you so you can word questions better. You could also have them write in their preferred language for their genitals.

I don't mind being asked about my genitals or sexual actions in a medical situation with good reason and using clinical terms.  I can see the sense in using terms that everyone understands.  However I'm not sure that I would be comfortable with using those words with myself.  All I'd ask was that the person I was talking to would understand that and work with me on that count.  So if I said that I had penetrative sex and they asked whether it was in the front or rear hole I could just say "the first one" and that would be that.  I understand that if they need to know then they need to know, and there's no point going if you're preventing them from doing their job correctly.

I think possibly it would be worth, if you were able to get it re-written, adding gender and sexuality options to the form.  It's probably a lot easier for some people just to tick a box or write a word than say it face to face with someone, especially if they're not often out.

I've been tested for HIV, etc. The way things were asked there was a checklist to go thru. Did I engage in this or that activity? I am about as low risk as could be imagined but I thought it was respectful. My doctor asks me about stuff, I don't find it offensive because I don't find any voyeurism on her part. I think I have heard voyeurism from nurses and so on, and it strikes me as very offensive. Usually it is they ask things they don't really need to know. For instance, I had a UTI. It was dxed entirely thru urine test and I was in an ENT room which signaled it was going to be all questions and so on. So this nurse came in and asked (after I already said I had a tonsilectomy-- pre top surgery, only) if I had had *the surgery*. I'm sure if I had said yes, she would have asked me all sorts of details.

--Jay

Quote from: Alexis Paige on March 08, 2014, 12:03:21 AM
I told that employee that in the future, first remove the last part because trans* men are men. If they have sex with a guy then obviously that guy has sex with men. I also said if someone checks that they are trans*, then you should start by saying, "I need to ask you some questions that may be uncomfortable to you, and I'm sorry if I offend you. That is not my intent. I will be using clinical terminology to refer to your genitalia. If there is any language or word choices you would prefer let me know and I will try to remember to use those instead.

I think rather than saying "I will be using clinical terminology to refer to your genitalia," the intake form should have a spot for the patient to put their preferred terms.  Using "clinical terminology" is making assumptions about that person's genitals, meaning they may be post-op. 

I don't think I would expect that a medical staff would refer to my "junk" , "little guy" , "front hole", etc. I think it's a bit much to expect. When they did the HIV screening, they used anatomical terms (like we do on susan's in certain areas). IF *I* talk about my "chest" and so on, then that's okay. My doctor makes allowances for my terms.

--Jay

I think my doctor (at a clinic that does a lot of hiv/std work and a lot of trans care) asked in a pretty similar way to the way you suggested below, and it was fine with me. He followed it up with a question about what was used in the case of penetrative sex (ie, penis, toys, hands) to clarify the health risks without assuming the genitalia of partners. Maybe something like that would be helpful to you as well.

My doc does a pretty non-offensive job.  He is FTM himself though.  Its been almost a year since I've been there though, so its hard for me to remember exactly how the situation goes down.  I'm not sexually active which I guess makes things simpler.  Mostly he asks if I've been with anyone... I say no.  He verifies that again and then verifies that when I was sexually active it hadn't been with anyone with a penis (which I guess has more risks)... I again say no it wasn't.  At that point the conversation is pretty much over.  He never bothers referring to anything specific.  I don't really see the need for it unless there is a problem of some sort. 

I've never had a doctor not believe me on the not having sex question though.  Thats really weird that so many of you guys have experienced that.  Maybe I was just too obviously a little lesbian =p

In my opinion, there is no way to PREDICT every possible thing that could go wrong.  You should make a questionnaire or list of guidelines and post it to a forum or take it to a group of transgender people for feedback.  We can then tell you if something is missing or non-optimal.

That being said, there is one thing that I am adamant about and I'll mention that now.  I suggest that you make a point NOT group characteristics or problems together automatically.  A pet peeve of mine is when healthcare providers inaccurately assume that ALL transgender people have GID (some don't) and ALL transgender people are depressed (some aren't) and ALL transgender people are dysphoric (some aren't) and ALL transgender people (anything).  Saying that ALL of us are anything is probably inaccurate.

I'd say its appropriate to ask if they have preferred terminology and if not super clinical is the way to go. Personally i go super clinical besides when I call things by their analogous structure names. Like my dick and sac. Calling them Clitoris and lips gross me out, it doesn't describe my crotch accurately. I don't have standard female anatomy. I'm cool with ovaries, uterus. I don't like the word vagina but I don't have a better one.

Also when confronted by female anatomy people tend to jump into female pronouns. Or when medical professionals use male pronouns, but then say "other women" which means you just called me a woman. Obviously offensive. Less offensive but still not appreciated is my anatomy being referred to as female. example; "you need to take care of and pay attention to your female anatomy."  Its not female because its on me, a male.

I don't know but I would think in a clinical setting using the proper medical terms would be fine. I know I have a penis even though I call it an outie. But you may want to make them aware that it is nothing more than clinical terms for the human anatomy.