Advice For Healthcare Professionals Treating Patients With An Interest in Kink & BDSM

Every now and then, I get the opportunity to teach basic kink concepts to a room full of healthcare professionals - doctors, nurses, EMTs, counselors, therapists, social workers, etc. These opportunities get me really excited, because I recognize that I'm not 'preaching to the choir' in these classes, but instead I have the opportunity to influence the quality of healthcare that kinky folk will receive from their providers. A provider that understands even a little bit about kink is going to be more accepting of their patients, creating a better relationship, more openness and acceptance, and leading to better care for people in my community. 

So I've asked people in my community, "What do you want your doctor to know?" I asked for some clear simple little things that would be helpful for healthcare professionals. I'll always be adding onto this list, of course. But here's a few tips:

• Don't be ashamed to talk to me about my kink. If you hesitate to ask me questions about my activities, I will be hesitant to ask you for advice or help in return.
• Let me know that you are a safe person to talk to about my kink by using correct terms and asking helpful questions, like "What do I need to know about your activities in relation to what I'm treating you for?"
• If you are uncomfortable treating a person who is into BDSM, tell me, so that I can look for another professional. This is better for you AND for me.
• When it is necessary for me to see a specialist, try to refer me to one who is also kink-friendly.
• I may have confidentiality concerns. Discuss with me how my interests may be recorded on my medical record, and the ramifications of that.
• I may use terms that aren't common for you, like 'metamour', 'top/bottom/dom/sub', or various terms for gender identities and romantic/sexual orientations. Let me know if you aren't familiar with a term I use, so that I can explain myself clearly.
• Collars - or a bracelet, necklace, or other piece of jewelry serving that purpose - are like wedding rings in significance. If you must ask me to remove it, I will. But doing so may cause emotional stress in some people. If it can be simply held out of the way, please help with this accommodation.
• BDSM marking looks different than abuse marking. Marks in 'safe zones' and marks that are symmetrical are more likely to be consensual. Please ask me about any mark that worries you.
• People participating in riskier play are likely to have done a good deal of research on how to play safely. And we are happy to talk to you about the safety precautions we take. Help me think about how we can do things more safely.
• Patients in our lifestyle may have more than one 'significant other'. We may have a spouse AND a dom, for example, that both need to be included in talking about treatments and such.
• I may have more than one regular sexual partner. This doesn't mean I am engaging in riskier behavior, but it does mean I have more than one person who is affected by my decisions and may need to be informed or consulted.
• The American Psychiatric Association depathologized kink and kinky behavior in the DSM-V as paraphilias, and kink can be integral to a person's sexuality and mental health.
• Not everything I come to you with has to do with my kink. Just because I'm kinky, that may have nothing to do with the reason I have come to see you.