After feeling awkward about her sexuality with doctors, Seattle nurse practitioner Nicole Flemmer has proposed a new model for health care called “empathetic partnership” which is designed to make women of sexual minority feel safe and included.
“They struggle to feel comfortable because there is so much stigma in society in general,” Flemmer said. “And that stigma has crossed over into the medical and nursing field.”
During one of her annual exams in Seattle, Flemmer was questioned by her nurse about her sexual activity.
“You’re sexually active; you’re not on birth control; you’re not trying to get pregnant – what’s going on?” she asked.
When Flemmer said she is married to a woman, her nurse frowned and wrote down some notes.
“I have had providers make a lot of assumptions about me,” she said. A few years ago, “ego-dystonic homosexuality” was written in Flemmer’s medical records – a diagnosis that hasn’t been recognized for decades.
“It was diagnosed in 2009 by a doctor who I saw for a medication refill, who had never even talked to me about my sexuality,” she said.
Not only can doctor visits be awkward, they can be detrimental to one’s health.
“Sexuality is a big part of a person,” Flemmer said, admitting she used to act straight at appointments because she was afraid of what the doctor might say or do. “In medicine and nursing, we’re trying to treat whole people. If you make an assumption about a big part of that, you’re doing a real disservice to patients. If you have misinformation you may miss an important factor in determining the [health] risks of a person’s specific circumstance.”
In her model, Flemmer includes six elements that are “vital for health care providers to create ‘effective and therapeutic partnerships with patients.’”
“Accessing health care and being sick are incredibly vulnerable times in a person’s life,” Flemmer said. “Creating the empathetic partnership framework is one way I am trying to make it safer for people of both LGBT and other minority populations to have access to safe care and partnerships with their clinicians if they so wish.”