Damaged Goods? Learning about (Mis)information about Sexuality in the Clinic

My humanities moment connects to a book, titled Damaged Goods: Women Living With Incurable Sexually Transmitted Diseases written by Adina Nack, a sociologist and women’s and gender studies (WGS) scholar writing about health, sexuality, and society. This book is about women’s experiences living with HPV. I read this book in my undergrad in a WGS course about medicine, right around the time I was starting to learn more about WGS and before I decided to double major in this discipline. In particular, one of the book’s themes focuses on provider-patient interactions and the misinformation that spreads surrounding women’s sexuality and who can be affected by HPV, which really stood out to me at the time. Women reported being told inaccurate information about their risk of contracting the disease based on their sexuality.

Flash forward to the end of my first year of graduate school, where I was at the gynecologist for an annual pap smear. In the back of my head, I was always curious about the themes from this book and about how providers might share inaccurate information with their patients. Unfortunately, as it turns out, I was not disappointed. I don’t remember how the conversation started per se, but I know that I initiated a line of questioning about STIs and the risks of contracting HPV as a queer woman and that my gynecologist did not. In response to my inquiries, my gynecologist responded saying that women who have sex with women are not as at risk as others, saying something along of the lines of “it doesn’t go in as far” — whatever that means.

This moment was important to me for two reasons: 1) in the moment, I remembered from Nack’s book that this type of (mis)information contributed to women’s misunderstandings of their risk of getting HPV and subsequently their contraction of this STI; and 2) later, I would reflect on and unpack whatever “it doesn’t go in as far” means and the types of ideologies about gender and sexuality circulating there. This provider held a lot of assumptions about gender and sexuality that informed this response: assumptions about the types of sex people are having; about how sexual identity and behavior relate to one another; and about binary sex/gender. These assumptions contributed to inferior care and did not take into account people’s lived experiences of their gender and sexuality.

Nack highlighted women’s perspectives on their health and sexual selves in her book to capture a more complex understanding of women’s sexuality. As demonstrated by my provider, the complexity of people’s lived experiences of their gender and sexuality are incompatible at times with a biomedical framework or understanding of gender and sexuality, and misinformation about health, sexuality, and gender can flourish in this space. These types of themes of this incompatibility between biomedical and WGS informed understandings of sexuality and gender and the stakes for patients have turned into questions that guide my research. With my research, I am interested in how gender and sexuality get transformed in the clinical encounter and how doctors teach and learn about gender and sexuality. Within the classroom, how is a patient’s gender/sexuality, and the complexity inherent in these lived experiences, understood? Physicians, in some ways, elided the sexualities and gender identities of women in Nack’s book, and my own. To me WGS perspectives on gender and sexuality make room for possibilities to transcend gender and sexuality binaries. These understandings of gender and sexuality from the two sources — biomedical and WGS — do not necessarily map onto one another, and I want to know why and how WGS perspectives can impact medical education to be able to provide care for LGBTQ identities in a nuanced way.