The Awkward Spouse Question

Discussion in 'LGBTQ' started by starri, Sep 11, 2016.

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  1. starri

    starri 5+ Year Member

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    "So, what does your wife do?"

    I'm a fourth year medical student. While getting the question from residents, attendings and other students isn't going to be a problem much longer because I'll be rooted in one program with a stable set of coworkers, it still comes up from time to time with patients.

    I get that SSM is still a new thing, and I truly appreciate those people who are trying to be neutral who ask "spouse," but the best I'm able to muster is a meek "Um, I actually have a husband." I'm totally willing to be out, because if programs don't want an openly-gay resident, that's not a place I want to be anyway. But I HATE that I'm forced to do it that way.
     
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  3. desidoc_

    desidoc_

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    I know I'm not offering any sort of helpful information, but imo people shouldn't be asking anyways. They should learn to mind their own beeswax tbh!!
     
  4. starri

    starri 5+ Year Member

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    People seem to think the ring is an invitation to pry. Like I said, I'm out, have been out for over twenty years (I'm also an old), but I'd rather have that information given out on my terms.
     
  5. lymphocyte

    lymphocyte 2+ Year Member

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    I'm always very particular to respond, "My partner does X."

    I think you're under zero obligation to respond in a way that makes you feel uncomfortable, and you owe no explanations. But some people genuinely don't even think about the assumptions they make. "My husband does X" might be an empowered way to respond that also teaches at the same time. The shame is frankly on them for making what should be seen as a social faux-pas.
     
    Last edited: Sep 12, 2016
  6. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    I know, it's really annoying and feels really intrusive. I don't have quite the same problem, but something somewhat similar. I am a straight female and have had the same boyfriend for 8 years; we've lived together for over 4. But we're not married and so I don't wear a wedding ring. A lot of people have asked why a nice girl like me doesn't find a good man to take care of her, and several have offered to set me up with their son/nephew/cousin/neighbor. When I've explained that I'm in a long-term relationship with a nice guy, so thanks but no thanks, people then ask me why we don't get married, why is he dragging his feet, what does he do for work (i.e. "what, he can't afford to marry you?!"), etc. I've even gotten (sigh) advice on how to trap him into marrying me, or the suggestion that I should ditch him and find someone willing to get married. It never occurs to them that *I* don't want to get married either.

    I know it's really annoying, but I try to look at it as - the patients feel so comfortable with you, that they want to know more about you as a person, and not just a doctor. And you've truly developed rapport with them, in a way. At least, that's how I try to sell it to myself so I don't get so irritated.
     
  7. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    Yeah, you would hope. But the patient-provider relationship is so weird, and patients may really feel very close to you, no matter how one-sided this actually is. I had a patient once stare at me earnestly and tell me, with 100% sincerity, that I was her BEST FRIEND. My friendship was the only thing that kept her going. <gulp> Trust me, we never hung out outside of her assigned appointment time, and I'm not sure how she came to that conclusion.

    Plus, if you think about it, as physicians and nurses, we tend to know a lot about the patient, so they may want to know more about you as a way of reciprocating that. Like I said....its a weird relationship.
     
  8. desidoc_

    desidoc_

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    My only fear is that when patients ask these kinds of questions some will discriminate against their healthcare providers upon learning about their gender identity and/or sexual orientation. Obviously this already happens with physician race. And I'm positive it happens with respect to LGBTQ+ identities. So what kinds of safeguards or measures do hospitals/hospital departments/clinics have in place for physicians and other healthcare workers who face homophobia/transphobia/transmisogyny? It doesn't really matter if the workplace is supportive of LGBTQ+ employees if they don't have anything to help those employees out when the patients end up being bigots.
     
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  9. Guero

    Guero 2QT2Bcis Plaidapus SDN Moderator 7+ Year Member

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    Coming from Los Angeles, it's taken nearly a decade to even begin acclimating to the cultural intrusiveness endemic to the South and other similar conservative areas of the states. But there are definitely ways to deflect and protect.

    Should you feel uncomfortable with, or worse, fear a patient and/or family may react negatively or violently, I'd suggest deflecting back on to the patient encounter, for instance, "I'm very concerned about your X/presentation and would prefer to use our limited time on getting you better. Now, tell me again a little about X/Sx/Sign."

    As for colleagues, staff, and superiors, I agree that being forthright, *especially* on the interview trail, is paramount. Answer as comfortably as you can, ensuring you're able to gauge their reaction and make it known that you're you and want to have colleagues and superiors that accept you for your true self and innate talents rather than fitting an intolerant view of gender and sexuality. Try being confident, "Oh, he does X," or "My hubby does Y," or "Thanks for asking! My hubby is so excited about possibly moving here and is looking into Z." Positivity goes a long way in diffusing potential awkwardness and setting things in a better light, letting them know they need not be embarrassed if making the innocent and common mistake they may not have even realized they made.

    I hope this helps. Humblest and best wishes!
    -Guero


    Sent from my iPhone using SDN mobile
     
  10. lymphocyte

    lymphocyte 2+ Year Member

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    There was a great NEJM Perspective article that raised this very question in the context of race.

    Patients have the right to be bigots and refuse treatment for whatever reason. Doctors have rights too (though it's still unclear if Title VII covers sexual orientation), as well as a duty of care. The balance is tricky. Deflection or even lying is always a fair way to stay safe. And not every bigoted request should be granted.

    What was most helpful to read: you're allowed to hurt--hurt enough that you simply can't care for a non-emergent, hateful patient.

    For many minority health care workers, expressions of patients’ racial preferences are painful and degrading indignities, which cumulatively contribute to moral distress and burnout. Physicians must balance several ethical obligations. They should respect patients’ informed refusals of medical interventions. They should also subordinate their self-interest to a patient’s best interests and overcome any aversions they may have toward patients. Still, no ethical duty is absolute, and reasonable limits may be placed on unacceptable patient conduct. Institutions can track and collect data on these physician–patient encounters, including their effects on physicians and their ultimate resolution, with the goal of supporting staff and improving the handling of these situations.​

    http://www.nejm.org/doi/full/10.1056/NEJMp1514939
     
    Last edited: Sep 15, 2016
  11. Guero

    Guero 2QT2Bcis Plaidapus SDN Moderator 7+ Year Member

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    Very well elaborated and subsantiated, thank you! I've seen these very situations take place on the wards as a clinical researcher before med school and was taught the ethics during medical school. I probably should've cited something; thankfully, you beat me to bringing it full circle. ;)
     
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  12. starri

    starri 5+ Year Member

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    I don't know, I get enough crap just for being a student from some patients, getting crap for being gay would be novel.

    There was a psych patient brought into the ED on one of my night shifts who was ranting and raving and managed to accurately slur the entire care team. It was impressive.
     
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  13. sb247

    sb247 wait...you mean I got in? 2+ Year Member

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    "I'd really prefer to focus on your care today, for instance the labs came back and they say........"

    You don't owe anyone details. If it bothers you that the assumption is your partner would match the gender of 90% of the population, you'll just need to unfortunately deal with it for awhile because teaching all of society to use gender neutral terms isn't happening in your lifetime.
     
  14. pulmoblast

    pulmoblast 2+ Year Member

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    Your self resilience and patience can be renewed from time to time by reminding yourself that in just a few years you will be in the top 1%.

    It's amazing how little you will care about these things when you pay more tax than most people's annual income


    Sent from my iPhone using SDN mobile app
     
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  15. starri

    starri 5+ Year Member

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    The assumption doesn't bother me. Like I said originally, I know this is a new thing. What I was asking was advice on how to answer.

    Also: He's not my partner. He's my spouse or my husband, at least in US parlance.
     
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  16. sb247

    sb247 wait...you mean I got in? 2+ Year Member

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    You used 'hate' in all caps

    If you wear a ring, you'll have to constantly correct people or avoid talki g about it.

    "i actually have a husband and he's really supportive of my efforts to be a good doc....speaking of which....these labs say....
     
  17. Pixiwoman

    Pixiwoman

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    This is very interesting, patients sometimes ask personal questions because of the rapport as you said but sometimes is uncomfortable if you do not want to go into details of why you are still not married, etc:rolleyes:
     
  18. act9

    act9 7+ Year Member

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    I got married this past year after a year of being engaged...I wore a ring rather intermittently because I wanted to avoid the topic with certain patients who I knew to be very religious, but as the year went on, I wore my ring more and more. I did get asked by one particularly religious couple that came in to see me on a monthly basis, and I quickly redirected ("Oh, you're wearing a ring-- did you get married?! Congratulations! Who's the lucky guy?" "Oh thank you, yes, just recently. So how is your fatigue doing now that we've changed...") They got the point. In all honesty, I only have 15 minutes with them and a lot to cover, so my social life isn't worth trying to stick in there. I actually have no problem coming out to them and leave it on them to decide if they want to stay with me or if 2+ years working with them so often has been enough for them to pause and think oh, she doesn't fit what I thought of when I think of gay people.. maybe I need think more about this. That said, some of my patients have figured it out (I think based on other provider's referral to me if a patient comes out to them, even though I work in the same clinic) and that's their whole reason for seeing me. I do cover my bases though and make sure I always have a second person in the room when doing certain physical exam components even for females (I know some female providers will do this on their own for female patients... but I'm not comfortable with that). Maybe I'm being overly cautious, others say that's common sense...

    As for other residents and attendings asking that while on rotations, yea, that happens. But it's always been out of genuine curiosity when they've asked me, just a "tell me about yourself," kind of moment that they do with everyone so they know who they are working on for the month. My intern year, I kept my cards close, but I also wasn't married then, so that was a little easier. As time has gone on, I just don't care anymore and let it be known. If people don't like what they hear, they generally just ignore the information and pretend they never heard it.
     
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  19. fantasty

    fantasty 10+ Year Member

    That sounds like an awkward way to handle it, and this opinion is coming from someone who is awkward in most forms of small talk, so that's saying something ;)

    With co-workers, any of the approaches (partner, husband, spouse) has generally worked well for me. With patients, I still play it by ear - if I know that it's unlikely that I'm ever going to see them again, I often gauge how much energy it is going to take to have *the* conversation vs. just answering with as little information that is necessary.

    I appreciate how you're trying to redirect them to the purpose of the visit, and frankly that's something I'm bad at in general. But, I'm not sure it's quite as easy as you're suggesting. I don't recall if you've talked about your marital status. But, as maybe as a thought experience, would you handle a question about "do you have children?" in the same way? (Just trying to find an equally personal but casual question that often comes up, that might be a little more universal). It's relatively easy to just say Yes, No, or Not Yet without any additional detail and redirecting back to the patient. But, do you (anyone) feel like it's their attempt to develop more of a relationship and being overly curt would be awkward?
     
  20. sb247

    sb247 wait...you mean I got in? 2+ Year Member

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    If I'm asking your most intimate personal health details, your sexual history and life story before I stab you, give you drugs, put my hands all over and occasionally in you.....you can ask if i have a wife and kids. There's the rare creeper who gets a more distant version me but I'm fine reciprocating a little transparency
     
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  21. Amygdarya

    Amygdarya 7+ Year Member

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    Unless you're in psychiatry :) You will know the most intimate details of your patient's life without giving away much of your own personal information.
     
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  22. sb247

    sb247 wait...you mean I got in? 2+ Year Member

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    #neverpsych
     
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  23. Amygdarya

    Amygdarya 7+ Year Member

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    It takes all kinds.
     
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  24. Goro

    Goro Probationary Status 7+ Year Member

    No need to be meek. Just give the answer matter of factly.

    Or, something like "My husband is a insert job title here."

    I am hoping that the people who ask you this and get your answer will take it as a teaching moment and the next time, will ask someone ""so, what does your spouse/SO do?"

    We can only dream, right? Nothing ventured, nothing gained.

     
  25. cellsaver

    cellsaver

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    tell them your husband is awesome, well hung, an amazing top and pleases you in ways most straight women wish their man would. Then show them a G rated pic of him while you beam a huge smile from ear to ear.

    That'll either shut them up or ask you if he has a straight brother who is single.

    True story! Borrowed from someone I know back home. Works like a charm, so he says.
     

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