Finding Kink-Aware Healthcare
If you’re kinky or engage in any form of adventurous sexuality, it’s smart to find medical and mental healthcare providers who understand kink.
None of what you read here should be construed as medical or mental health advice that you should accept without first checking with a doctor or therapist educated and experienced in this topic. But hopefully this post will give you a good place to start that process.
Ever since I partnered in the 1980s with a psychotherapist who specialized in a client population of mostly kinky people, I’ve been deeply aware of how difficult it can be for the sexually different or adventurous among us to get culturally competent healthcare.
When I say healthcare, I mean all kinds of care related to our health – physical or mental.
I recently stumbled on an article by Margot Schein for Planned Parenthood, “Kinky and in Need of Healthcare,” It was heartening to see the topic hosted by such an esteemed and respected healthcare providing organization.
The myth I heard that inspired this piece was that BDSM, even though it is consensual, is considered abuse by the medical community and therefore, must be reported. This is simply false. But the concern is clearly born from a mix of misinformation, rumors, and reality.
Two important questions should be asked:
What can kinky patients do to quell their provider’s concerns?
What can providers do to put their patients at ease and demonstrate nonjudgement?
I found an article by Melina Jackson, “Do You Need a Kink-Friendly Doctor?,” that discusses the same topic from a body modification standpoint, but the content applies to finding kink-aware care generally.
Not all doctors are open about body modifications, BDSM or unusual sex toys. Many doctors are not trained to talk about these things so they might dismiss them as dangerous and unnecessary. Finally, some doctors are so firmly against any of these activities and modifications that they refuse to give advice or help people engage in these activities.
For this reason, it is very important to find a kink-friendly doctor you can talk to.
Kinksters should ideally have kink-ware and competent medical care, but they also need kink-aware and competent mental healthcare too.
I was poking around on The Alternative Sexualities Health Research Alliance (TASHRA) website and found a great 2010 article by Keely Kolmes Psy.D. and Geri Weitzman Ph.D., “A Guide to Choosing a Kink-Aware Therapist” written for the National Coalition for Sexual Freedom (NCSF).
There are some therapists who have acquired the education necessary to work with people who practice BDSM, however, and who are accepting of their clients' BDSM lifestyles. It is useful for people who practice BDSM to be able to choose a therapist who is kink-aware, when possible. This article is about how to locate such therapists, and how to choose from among the different kink-aware therapists that one finds.
While a lot of discussion about kink-aware healthcare focuses on BDSM specifically, if you can find a therapist (or doctor) who understands BDSM, they’re more likely to be culturally competent about a wide range of kink and alternative sexualities. In the past, kink was often equated with BDSM. These days, we see kink as a much broader set of erotic practices and cultures of which BDSM is but one aspect.
Years ago, my partner at the time and a well-known psychotherapist with extensive experience with kink-aware therapy, Guy Baldwin, and I started a referral service called Kink Aware Professionals (KAP), a service dedicated to providing the community with a listing of psychotherapeutic, medical, legal, and other professionals who have stated that they are knowledgeable about and sensitive to diverse expressions of sexuality.
Guy and I turned over the KAP service to NCSF years ago and they’ve done a great job hosting and managing that referral service since. It’s a great starting point resource for finding kink-aware healthcare. But please do follow-up research. For example, if you find a local therapist claiming to provide kink-aware care, see if you can find out more about them. Perhaps local community members know about them. Much as you would try to find out more about a potential kink play partner from community members, the same is true for healthcare providers.
When you search online to find kink-aware healthcare, you’ll see far more articles and resources about finding therapists versus medical doctors. Perhaps that makes some sense since so much of the stigma around kink and adventurous sexuality generally is associated with mental health, but there are times it’s important to find a medical doctor who’s competent treating kinky patients.
In 2012, I wrote a pamphlet for NCSF titled “Finding Kink Aware Medical Care.” I don’t think the pamphlet is currently available, but I’m replicating what I wrote should it be helpful. Thank you to Susan Wright, Executive Director of NCSF, for letting me replicate what I wrote.
Here’s most of that pamphlet. It was written 12 years ago, but I think it still applies. I’ve revised it to better pertain to a wider audience than its original BDSM focus and to better fit this post’s format.
Into Kink? Need Medical Care?
So, you practice BDSM or some other form of kink and need medical care. Perhaps you're looking for a general practitioner for checkups. Or maybe you need urgent medical care. Perhaps you are concerned about discrimination. Or you fear you'll have to spend too much time educating someone about kink when they should be focused solely on your health. How do you find a provider who will be sensitive to your sexuality? And if you can't, how do you handle your sexuality when dealing with such medical care providers?
Where to Start
Use the previously mentioned Kink Aware Professionals (KAP) directory. On the KAP page you can search for kink-aware professionals in your area. You may be able to find a doctor, physician's assistant, nurse practitioner, or clinic close to where you live. If you don’t, try calling the nearest listed professionals (even non-medical professionals) and ask them if they can recommend someone local.
Another option is to ask for referrals from people in local kink-related groups and community social circles. Check in with your network of kinky friends or a social or educational group. If you are comfortable asking such questions publicly, consider using social media, your email list, and other ways of reaching out to your network. There is nothing better than a personal referral.
Ask people at your local LGBTQ resource center. An LGBTQ-friendly practice may be an alternate choice if you are unable to find a kink-aware professional. Some cities have sex-positive organizations you might ask.
Dr. Charles Moser wrote Health Care Without Shame: A Handbook for the Sexually Diverse and Their Caregivers (paid link). It’s a great book that helps sexually diverse people get the healthcare they deserve and it can also help educate healthcare providers about caring for their kinkster patients.
Assessing Your Current Need
If you need urgent care, you don't have the luxury of time. You may need to go to a hospital emergency room or urgent care facility. Your health is what's most important at that moment, but if it’s possible that your sexuality will be of concern, you might be able to mitigate any potential concerns the emergency provider might have. Maybe you have marks or bruises on your body or some other condition related to your sexuality. When in doubt, bring it up. You want the best care you can get. The emergency provider needs as much information as possible to properly treat your condition. But if your emergency situation does not require you exposing your erotic interests, it may be best to not offer them if they are not related to your emergency situation. Sometimes not sharing this information is the prudent thing to do.
Think ahead. If you're kinky, there may come a time when you will need to have a provider who understands your situation. Be prepared and plan how you will handle it.
The Big Issues with BDSM
There are three issues that may come up if you're into BDSM specifically.
If you have marks, bruises, or scarring, a provider might be concerned they are the result of abuse versus consensual erotic play.
A provider might be predisposed to consider BDSM a manifestation of a mental disorder.
Due to a provider's ignorance or personal morality, they may consider BDSM immoral or disgusting.
Remember, when someone responds negatively, they are likely reacting to a stereotype and such judgments are not really about you but rather their own bias.
You deserve nonjudgmental medical care and should not have to censor your history or avoid an appointment. With a provider you see regularly, it may be best to bring these up early in your professional relationship. That way you have set the foundation for a better mutual understanding for your future medical needs.
What Should You Ask a Provider?
Get as many referrals as possible. Call a few to set up an appointment. Make a list of questions to ask. Here are some suggestions. Not all may apply to your situation, so adapt them as needed.
Are you familiar with alternative forms of sexual expression and kink such as BDSM?
Do you feel that people who engage in such activities present any challenges to you as a healthcare provider?
Do you consider your practice kink-friendly? How many kinky clients have you knowingly worked with?
If I were to ask you questions about health safety, medical risks of certain sexual activities, and so on, do you feel comfortable discussing them without any sense of judgment or disapproval?
I enjoy rough sex and often have bruises or marks. I do not want you misinterpreting them as abuse or assault. Can you deal with that?
Do you understand that BDSM and related kink activities can be done consensually for fun and erotic satisfaction and are not abusive activities?
Do you consider consensual kink pathological and dangerous?
Are you OK with patients who live within unique relationship configurations such as dominant/submissive, polyamorous, and so on.
I often have questions about sexually transmitted infections and sexual health. Are you familiar with the research in those areas?
Is your practice LGBTQ friendly?
What do you charge? Do you accept insurance? Can you describe your practice style? What can I expect during a typical office visit?
Planning Ahead for Emergencies
If you have to seek emergency care, it's best to be prepared to address a situation where your sexuality comes into play. If you already see a kink-friendly doctor or psychotherapist, have their contact information handy. If an emergency medical provider has concerns, you can ask them to call your doctor or therapist.
Be forthright and honest about your situation. Holding back vital information can lessen the quality of care. However, share the minimum necessary for the provider to fully understand the problem. Don't go into extra details. Don't make up overly elaborate stories. If a provider is sensitive and has a clue, they'll ask the right questions and then more information can be shared.
If your emergency situation is the result of rough or BDSM play, or if your body might indicate such recent play (marks, bruises), be honest and tell them right away that it's the result of consensual erotic play that you enjoy and know how to do safely. If you take this approach the provider is more likely to believe you. If you admit that marks or bruises are from kinky sex, many providers will understand. If you try to hide it, they may automatically assume there is abuse occurring.
I should insert here that if abuse is occurring, that is never acceptable. Consent is the cornerstone of all kink and sexual activity. The bottom line is that everyone has the right to give or retract consent at any time during play. In “Defining Consent in BDSM and Multiple-Partner Relationships,” Elisabeth A. Sheff discusses the topic.
Polyamorists and kinksters emphasize the importance of consent as it can help to ensure emotional and physical safety limits.
Plan for the unforeseeable. While having a primary healthcare provider who is knowledgeable about your kink may not always prevent emergency medical personnel from alerting law enforcement, you can minimize the possibility. Present the emergency staff with contact information for your doctor or therapist who can answer any pertinent questions. A calm and straightforward presentation is always best.
What To Look For In a Provider
What should you look for in a healthcare provider? Most of the qualities are the same you would expect from any healthcare provider under any circumstances. They should be competent, open, nonjudgmental, and willing to answer your questions. Additionally, they should be as kink-aware and knowledgeable as possible.
Finally…
I’d like to suggest people support with their donations two organizations that I feel are doing great work in regards to kink-aware medical and mental healthcare. I’ve mentioned both earlier: TASHRA and NCSF. They can always use donations to help them continue their important work.
As an Amazon Associate I earn from qualifying purchases from the book link. You can use this link to access all my writings and social media. My content is usually open and free to all to view, but for those who are able your paid subscription (click the Subscribe button) or patron support is always appreciated.