Protecting Against STD/STIs: Abstinence/Closed Relationships

<i>Edited for typos, grammar oopsies and stigmatizing language. April 12, 2018</i>

As should be obvious by now, I am not in any way advocating for any specific relationship style — neither abstinence nor closed relationships would be a comfortable fit for me. There is certainly nothing wrong with open relationships or lots and lots of good sex. But for some people they are valid life choices, so we’re gonna talk about them.

Abstinence-only programs like to say that if you don’t have sex, you can’t get STIs. They are wrong. You can get infected with both forms of herpes, HIV and Hep B without ever touching any genitals in any fashion. These infections are considered STIs because they are often transmitted sexually, they are not only transmitted sexually.

That said, it is true that the best protection available against STIs really is to not have sex outside of sexually exclusive relationships. Really doesn’t matter how many people are in the relationship — whether you have 2 people or 10 people or even 200 people, if all of them join the relationship as virgins (by which I mean, never having touched another person’s genitals, ever), and none of them ever have sex (by which I mean touching another person’s genitals or having their genitals touched any conceivable configuration, including hand jobs, using toys, and other stuff that yes really is sex) with anyone outside the relationship, then the chance of any of them getting and STI are extremely low. The more people in the relationship, the higher the risk of something crazy happening, because statistics is like that. But it is fairly safe to say that is you have a sexually exclusive group of 5 or fewer people (none of whom are drug users), your chances of getting any STI other than (possibly) herpes is damn near incalculable.

Herpes is the real joker in the deck. The blood born stuff (HIV and Hep) you are going to be safe from unless you play with needles (either S&M play or drug use) or just get insanely unlucky. Herpes, compared to most STIs is insanely easy to spread. Partly, this is because herpes (both HSV1 and HSV2) can infect the mouth (and other areas) as well as the genitals. You can get either version of herpes by any form of skin contact with an infected area. Sometimes herpes (especially HSV1) can be spread by sharing sex toys, lipstick or drinks. This means that if your best friend goes down on someone with HSV2, they can get an oral infection of herpes, and the next time you and your friend share a soda, you can get infected. Now your closed polyam quad is exposed to herpes, even though all of you were negative and none of you had sex outside the quad.

Aside from herpes, total abstinence outside of sexually exclusive relationships has a near perfect success rate. If STIs are a real concern, and you can manage it, then establishing a closed relationship with people who have tested negative of STIs you want to be sure you won’t get can be the best way to protect yourselves.

STIs and Cheating

The down side of abstinence or closed relationships as protection against STIs is that staying abstinent or closed just doesn’t work for everyone. Most polyamorists are familiar with the high rate of cheating among monogamous couples. What you may not know is that cheating (defined by the individual) is actually pretty common in polyam relationships.

Now, here’s the kicker when it comes to STIs. A study found that people who cheat are more likely to have sex without condoms, than people who are openly non-monogamous. Now, this study was comparing monogamous cheaters to non-monogamous people, but the results may apply to polyam cheaters. If you can’t deal with a closed relationship, that’s okay. It’s better to have an open relationship and negotiate a safer sex agreement then risk your health and the health of your partners by going behind their backs.

 

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This post is part of the Safer Sex Blog Series.

Preventing STIs: Be a Smart Slut – Open Relationships, Promiscuity and STIs

I’m always happy when I only need to make minimal updates to a post. It means I did it right the first time around. Only real change is that the at-home HIV tests are now “available” instead of “coming soon”. Let’s get a big cheer for that! Updated and reposted April 12, 2018

The past few weeks, talking about ways to prevent STIs, one thing that came up repeatedly was the fewer people you have sex with, and the more closed your sexual circle, the less likely you are to be infected with an STI. Which does not mean you should restrict yourself to just a few sex partners or that closed relationships are in some mystical way ‘better’ than open ones. This is about risk assessment.

The more often you cross a street, the more likely you are to get hit by a car. The more often you have sex, the more chances your birth control will fail. The more you eat, the greater your risk of getting food poisoning. If anyone suggests you restrict yourself to a starvation diet to reduce your risk of getting food poisoning I hope you tell them to take a long walk off a short pier. Seriously.

But the same way you know not to eat food that smells off, if you are going to have a large number of sex partners, and frequently enough that STI testing is becoming increasingly fallible as a method of self protection, then be a smart slut. Learn the signs and symptoms of those STIs that have obvious signs and symptoms. Check with your local health department about what STIs are common in your area, and which barrier method provides the best protection. Invest in a few of the over-the-counter HIV test kits.

If you want to have an open relationship, be a slut, pick up one night stands, whatever makes you happy, there is nothing wrong with that. But do it knowing your risks. Only you can choose the level of risk you are comfortable with. So educate yourself, make your choice for you, and don’t let any of the sex-negative slut shaming idiots tell you otherwise.

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This post is part of the Safer Sex Blog Series.

Preventing STIs: Testing Agreements

This is one of the few posts so far to need significant updates. I removed a lot of stuff that reinforced stigma against STIs. Facts are the same, presentation is different. Updated March 29, 2018.

Just going to skim this one, cause I’ll be delving into STI testing in some depth later. But since regular testing is one of the main ways polyam folk tend to protect themselves, it deserves a mention here.

The idea behind using STI testing to preventing getting infected, is that if you never have sex with anyone who has STIs you don’t want to risk getting, you are safe. So if you show a STI test to everyone you have sex with, and everyone you have sex with shows STI tests to you, and you don’t have (unprotected) sex with someone who has an STI test you don’t want to get, you’re both safe right? Maybe.

STI tests are good ways to stop the spread of STIs. And they do provide some protection again getting infected. Over all, if you are going to have multiple sex partners in a non-exclusive relationship, getting regular STI tests is a damn good idea. But, it isn’t perfect. (I should make that the theme of this section – “Preventing STIs: Nothing’s Perfect”) There are no hard and fast numbers on what kind of protection getting tested gives you. This is partly because everyone has different testing practices, and partly because every clinic tests for different STIs. That last is another way of saying that STI tests almost never test for every STI. In fact, I have never heard of any clinic or lab testing for every possible STI outside of the rare research study trying to learn about how prevalent STIs are.

Which is one of the big reasons that STI testing doesn’t provide perfect protection against getting ANY STI. If the tests don’t cover every STI, then you can’t know for sure if you or your partners are STI free. Which means you may well be passing around STIs and not know it.

This is one reason why it’s important to learn about STIs yourself and decide which ones you really want to protect yourself against.

The good news is STIs most people want to protect against, like HIV and Hep B do get tested for pretty much everywhere The other hole in the protection STI protection gives you is dormancy. It takes time for an infection to show up on a test. You have probably heard that HIV can take anywhere from 2 weeks to 6 months to show up in a test. (Semi-good news: sexual transmission almost always shows up within a month, 3 months max. It’s actually the method of transmission that shows up the fastest.) However, the dormancy can still leave you unprotected.

Say you get together with partner X for the first time. Partner X has an STI test they got two weeks ago showing they are STI negative. Partner X hasn’t had sex with anyone since the test. But partner X did have sex with someone a week before getting tested. Partner X may have gotten an infection and it would not have shown up in their STI test. But they can pass it on to you.

In general, STI tests provide more protection when you have fewer partners, and your partners have fewer partners, and etc. If you get involved with someone new every month, and they get involved with someone new every month, the protection testing provides drops significantly. If you get involved with one or two new people a year, and they get involved with one or two new people a year, STI testing gives a fair of protection. However there is a flip side, and a very important one. STI testing isn’t just about protecting yourself. STI testing is also about protecting others. Regular STI testing is the best way to find out about an infection before it gets passed on to someone else. So testing actually provides two layers of protection. It gives you some protection against infections and if you get infected, it gives you a chance to prevent the infection from being passed to anyone else.

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This post is part of the Safer Sex Blog Series.

Protecting Against STIs: Barrier Method

Updates today include: updated information based on new research/resources, adding information about dental dams, and changing terms for condoms to the inclusive “external” and “internal” condoms. updated March 7, 2018.

 

Person stuff: I want to say thanks again to everyone who donated to help me fund my visit with my kids and to those who sent prayers/good wishes/thoughts our way. A very great time was had by all, including visiting family, hiking trips, museum trips, and catching a carnival.
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Okay, back to our regular programming.

As I mentioned in my last post, the well-known refrain in STI prevention is ‘barrier method’. Barrier method usually means a condom (external or internal), which prevents direct contact between the genitals. For all their problems, condoms are the only effective method for actually stopping several STIs jumping from one person to another. What many people do not realize is that a cervical cap can also be an effective barrier method against certain STIs. Every other method for preventing STIs is basically about making sure no one you are having sex with has currently-infectious STIs. (Exception: PrEP, which is specific to HIV/AIDS and will be covered in another post.)

CONDOMS

Condoms do not protect against all STIs. They do not protect 100% against the STIs they are effective against. However, they are probably the best thing going. External condoms and internal condoms offer different levels of protection against different STIs. The protection offered by external condoms has been more thoroughly studied, so consider the information on internal condoms incomplete pending further research.

External Condoms

External condoms (commonly called ‘male condoms’ or just ‘condoms’) are usually made of latex, though there are non-latex varieties for people with latex allergies. They go on over the penis and trap semen. They also prevent direct contact between the penis or sex toy and the vagina, anus or mouth during intercourse. (Yes, condoms can be used during oral sex as well if there is any chance one of you has an STI. They can also be used on shared sex toys to prevent STI transfer.) Here is a decent step-by-step guide to putting on an external condom.

External condoms provide protection against STIs transmitted through genital fluids, including:

  • HIV
  • chlamydia
  • gonorrhea
  • trichomoniasis
  • HPV

Depending on where the infection is, external condoms may provide protection against:

  • genital herpes
  • syphilis
  • chancroid

The CDC has the following advice for using external condoms:

  • Use a new condom with each sex act (i.e., oral, vaginal, and anal).
  • Carefully handle the condom to avoid damaging it with fingernails, teeth, or other sharp objects.
  • Put the condom on after the penis is erect and before any genital, oral, or anal contact with the partner.
  • Use only water-based lubricants (e.g., K-Y Jelly, Astroglide, AquaLube, and glycerin) with latex condoms. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) can weaken latex and should not be used.
  • Ensure adequate lubrication during vaginal and anal sex, which might require the use of exogenous water-based lubricants.
  • To prevent the condom from slipping off, hold the condom firmly against the base of the penis (or sex toy) during withdrawal, and withdraw while the penis is still erect.

Note – natural condoms (those made from natural membranes) are not effective in preventing STIs).

Internal Condoms

Internal condoms (commonly knows as “female condoms”) are made of nitrile and are inserted into the vagina or anus. A ring at the base of the condom is intended to it in place by the cervix. When using internal condoms for anal sex, care needs to taken to keep the condom in place. internal condoms flare at the top, covering part or all of the labia/butt. The best guide I’ve been able to find to using internal condoms is here. If you know of a better one, please let me know. Internal condoms should be used in the same circumstances as external condoms, but internal and external condoms should never be used together – the friction will cause one or both to break.

All the research I have found on internal condoms has been on vaginal use. They are probably just as effective for anal use, but we don’t know for sure.

Current research suggests that internal condoms offer protection against the same STIs that external condoms do. Research into how effective they are is ongoing.

Internal condoms cover a wider area than external condoms, and so may provide better protection against:

  • genital herpes
  • syphilis
  • chancroid

Except for the bit about removing the condom, the guidelines from the CDC above apply equally to internal condoms.

CERVICAL DIAPHRAGMS

Cervical diaphragms are caps that are placed over the cervix, so that semen cannot enter the uterus. Unlike condoms, cervical diaphragms are reusable and can last up to two years. Most information sources will say the diaphragms do not protect against STIs. This is debatable. Diaphragms definitely do not protect against the STIs that most often discussed. Diaphragms MAY protect against some STIs. (Sources: 1, 2, 3) A cervical diaphragm, as the name suggests, can ONLY be used for vaginal intercourse.

Cervical diaphragms may provide some protection against:

  • cervical gonorrhea
  • chlamydia
  • trichomoniasis

Diaphragms may be confused with cervical caps. Cervical caps are smaller than diaphragms, and do not provide protection against STIs.

It is worth noting that diaphragms definitely do NOT provide protection against HIV.

Dental Dams

Dental dams are squares of polyurethane or latex that are placed over the vulva or anus prior to oral sex. Use of a dental dam protects against STIs that can be transmitted through oral sex, including

  • herpes
  • genital warts
  • HIV

Dental dams should only be used once. If you don’t have or don’t have access to dental dams, you can make one out a latex external condom. DO NOT make a dental dam out of a non-latex condom, including all internal condoms, which are made of nitrile. (Saliva is a digestive fluid, it requires different types of barriers than genital fluids.) The CDC has a guide for making a dental dam out of an external condom.

Do you use a barrier method for STI protection? Please leave a comment on how your polycule uses barrier methods and your thoughts/feelings.

More on Polyamory, Safe Sex, and STIs

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What are STIs?

Expanded the “what are STIs” bit to make it clearer that there are infections which aren’t considered STIs that you can still get from sex, because language is weird that way. Other than that mostly cleaned up typos and grammar. Updated October 20, 2017
If I’m going to spend the next couple months discussing STIs, it seems like a good idea to start with what exactly they are, but first let’s take a look at terminology.

STD or STI?

STD stands for sexually transmitted disease. STI for sexually transmitted infection. STD is an old term, that many doctors no longer consider accurate. Basically, in medico-speak, a disease is something that causes symptoms which affect your health and well being. If you get hit with a virus, bacteria or fungus that doesn’t cause any symptoms, it’s an infection, not a disease. A lot of sexually transmitted stuff doesn’t cause symptoms, so many doctors now use STI instead.

Since this kind of change in medical terminology doesn’t make the headlines, non-medical websites, books and pamphlets that discuss sexually transmitted infections sometimes use STD, sometimes use STI and sometimes use both.

When I first write this blog series I used the slashy version ‘STD/STI’ on this blog, so that people who come into the series in the middle and might not have come across ‘STI’ would still know what I was talking about. Now that ‘STI’ has become more familiar, I’ll be changing the series to use just ‘STI’.

What Are STIs? And Why Do We Care?

STIs are pretty much just what the name says: infections that are transmitted sexually. Some viruses and bacteria really like the genitals. They are moist and warm and perfect breeding grounds for bacteria. They have mucus membranes, making them good places for viruses to invade cells.

And unlike the inside of the nose, other warm, moist mucusy areas come into contact with our genitals, making it possible for infections to jump from one person the another.

An infection whose primary means of moving from person to person is genital contact is caused an STI. That means there are many infections (mononucleosis, for instance) which you can get from sex but are not considered STIs, becuase usually people are infected some other way. And there are some STIs that have other means of jumping from person-to-person.

It is a basic fact: a person who never lets anyone else touch their genitals will probably not get an STI. Similarly, if people (of what ever number) who have no STIs are sexually exclusive for their entire lives, it is unlikely that any of them will ever get an STI.

Please note ‘probably’ and ‘unlikely’. As mentioned above, there are several STIs that can infect a person through other avenues. Blood borne STIs are the classic example of this.

It is, however, a reality of non-monogamy that having multiple sex partners makes STI infection easier. Thankfully, openly non-monogamous folks are pretty good at taking precautions against STIs.

Next week I’ll be taking a look at ways you can protect yourself and your partners against STD/STI infection.

STIs

Biggest change here is removing references to “safer sex” where ever possible. As I discussed Sunday, I’ve recently come to the realization that by equating “protecting against STIs” with “safer sex” we’re missing a big part of the safer sex discussion. So I am no long referring to discussing STIs as discussing safer sex, etc etc. Probably when I’m done with the Finances blog series I’ll start writing about the wider aspects of the safer sex discussion that are usually forgotten or ignored. YOu may notice that I’ve also stopped doing “STD/STI”. When I started this blog series “STI” was a relatively new and unknown term and I felt I needed to use both to be everyone understood. These days STI is well known and the most used term in the polyam communities I am part of. So I can stop using STD and just go with STI, which is the term I prefer. I’ll note here that the medical community is not in agreement about which term to use and both terms are perfectly acceptable. Updated oct 20, 2018.

If you’ve been involved in polyamory for any length of time, participated on any forums, read any blogs or books, eventually you will have come across topic of STIs. It is a medical fact that by having more than one sexual partner, you increase your risk of getting a sexually transmitted infection. If by some chance you haven’t already run across a good discussion of the hows and whys of discussing STIs, I suggest you take a brief detour to More Than Two’s Negotiating Safe Sex. It’s on the short side, but hits the basics of discussing STIs very well. You might also find some other good info there on dealing with jealousy and other relationship-related polyam stuff (as opposed to practical-type stuff I try to focus on here).

Still, even most polyam folk who know and follow standard s and staying healthy. Just as a for instance, I had a first meeting with a potential partner once, who when we discussed safer sex said he had no objection to getting regular STI testing if I could pay for it – since it cost over $100 a person. What he didn’t know, and I turned up in a 5 minute web search, is that the local health department offers STI testing for $10 a person.

I’ve also run across a frightful amount of misinformation over the years on polyam forums about STIs, how they are prevented, how common they are, and, oh, lots of stuff.

So, next week I’m beginning a new series on STIs. I’ll be covering what STIs are, finding places to get tested in your area, and brief introduction to the various STIs, how they are treated, and just how much of a concern they are. Along with some other semi-random stuff.

In the meantime, if you want to do some research of your own, the American Sexual Health Association is a decent place to start.

Polyamory and Pregnancy: Contraception and Fertility

I removed gendered language from this post, cleaned up my phrasing and fixed a few typos. On a personal note, I gave up on abstinance eventually, and my fourth child is now a year old. I have plans to get an IUD this month, fingers crossed it works as advertised. After some debate I decided not to add detailed info on different contraceptive methods. This post is meant as a general overview of issues that can crop up in polyam relationships, and I think it does that well. Revised Feb 8, 2017.

Oops–one last thing. Please excuse all the ‘yelling’. I was apparently feeling very strongly about these issues when I wrote this post.

I touched on this one briefly in my discussion of unexpected pregnancies, but it probably deserves some special attention.

To start, I am not an expert on contraceptive methods, because once it was established that the most common methods don’t work for me, I pretty much stopped bothering, aside from using condoms. So I’m not going to be throwing around statistic this and study that. (If you are interested in what is more or less effective, WebMD has a comparison chart. In comparison, you are considered to have fertility problems if are trying to get pregnant for a year and can’t.)

Instead of going into those details, I’m going to be looking at some fundamentals of how contraceptives work, and how this can impact your polyamorous relationships. (Oh, and why is this under pregnancy? Because if you aren’t careful with your contraceptives, you are probably going to end up needing the rest of the pregnancy stuff sooner of later.)

Contraceptives

So . . . first off, the open secret of contraceptives that no one talks about: the person with internal genitalia is in control. Yup. It sucks, but it is true. Except for the most failure prone contraceptives (withdrawal and condoms), all contraceptive medication and devices are designed for people with internal genitalia. Which I’m sure many of us don’t see a problem with – it’s our bodies if we get pregnant. Kind of a foolish and one-sided view, but hey people are people. However, if you espouse that view, and you are polyam, stop and think for a minute how you feel about the fact that your partner with external genitalia has no access to effective contraceptives when with their other partners. Yup, it sucks.

Now, I am not saying that people with external genitalia are excused from responsibility for doing everything they can to protect against unplanned pregnancies. They damn well should be using condoms and doing everything possible to reduce the likelihood of pregnancy. But, reality is .  . .

However, if you have external genitalia you can still be involved in contraception. Ask the people you are involved with what kind of contraceptives they are using, be aware of their schedule, stay informed, if you know a person you are with is forgetful, bad with schedules, whatever, then offer to help them remember the next pill/shot/ring/whatever. Hell, if they are using the ring, make putting it in and taking it out a part of your sex play! Whatever it takes STAY THE FRICK INVOLVED.

And for those of us with internal genitalia, our externally-equipped partners have every fricking reason to want to be involved and aware of what we’re using and how effective it is. For the love of chocolate, do not tell them it is none of their business – if we get pregnant, it’s their kid too! Keep them aware, keep them informed, keep the communication going!

Fertility

Next up: fertility. Personally, I think if it’s affordable (which it isn’t for me or most people) everyone who can, should get their fertility levels checked at least once. Why? Because knowing how fertile you are has a big impact on what contraceptives you should consider and how much you need to worry. Me? I am walking fertility drug. I kid you not, my partner was told his sperm count was so low he was infertile, and I got pregnant. Same thing happened to two of my aunts. And my mother has had 11 pregnancies (6 full term) half of them on various kinds of birth control. I’m told that I am too fertile to get my frigging tubes tied! (I’d end up with ectopic pregnancies – not good.)

A friend of mine had to jump through hoops like a circus dog to get pregnant. If she’d known that years ago, she could have fretted a lot less about the possibility of becoming pregnant before she was ready.

Since fertility testing is so expensive, at the very least, do what you can to check the family history. That can give you some clue as to what you might be able to expect out of your little swimmers or floaters.

Tubal

Number 3: Getting your tubes tied is not a guarantee!!!! A female friend of my had her tubes cut and tied, and a uterine ablation (her UTERUS cauterized) and still got pregnant. A male friend of my mother’s? Had his tubes tied, got his wife pregnant – it turned out that he had THREE tubes, and they missed one. Again, if it’s possible, get your fertility checked after your tubes are tied if you want to be sure.

Plan B

Fourth and ten – three words MORNING AFTER PILL!!!!! If you have any reason to believe that your birth control may be off, may have failed or may just be fricking useless, stock up on this little gem. If you have it you can always choose not to use it. The reverse is entirely not true.

 

Now, folks with internal genitalia jumped on the pill with cries of ‘hallelujah!’ for a reason – overall, the thing works. Since its introduction, there have been thousands, if not millions of people who have happily made like rabbits for years without getting pregnant. My point here is not to be crying sexual Armageddon, and if you are one of those lucky stiffs who can take the pill regularly, have your fun for as long as you want, and then get pregnant as soon as you decide you are ready? My hat’s off to you (and as a side note, I hate you). But please be aware of the facts, options, and what not to make educated decisions about what you and your partners do.

As for me? I am fricking paranoid for a reason (see above), and I am abstaining until further notice. (Michael, the blessed saint, is willing to put up with it too!)

Educating Polyamory Friendly Professionals

Minor edits and updates. In the years since I first wrote this my family spent some time living in Tennessee. Still not problems from doctors and such about being polyamorous. Though it helped that we could pass as monogamous as the time. Polyamory is well known these days, so you are more likely to find random professionals who are familiar with it. Revised Dec 20, 2016

It comes up with near predictable regularity in polyam forums:

How do I find a polyamory friendly professional?

The polyamory friendly professionals list is always referenced, but there is an assumption we need to find professionals who are already polyam friendly. Which kind of bothers me. If we keep going to the same polyam friendly professionals, where will new polyam friendly professionals come from?

To be fair, CARAS does good work and is providing more education to professionals all the time, but they aren’t miracle workers. So rather than searching the friendly professionals list in vain for someone local, how about we start educating our own polyam friendly professionals?

Over the past seven years, I’ve discussed and explained my lifestyle to obs, midwives, lawyers, shrinks, social workers and god-help-me Children and Youth Services representatives. I have never once dealt someone from the polyam friendly professionals list, and only once did I ever have a problem.

Now, living within an hour’s drive of NYC my whole life means that I’ve probably had a lot better luck than I would have if I was living in the Bible-belt. But I’ve chatted with polyam-folk in forums who lived in the Bible belt and who never had problems.

Educating a professional about polyamory is surprisingly easy. I’ve found the upfront and open approach is best. Request a consultation, and say something like ‘So-and-so recommended that I come to you, that you are the best in the area. I am in a polyamorous relationship, where I am in relationships with ___ other people. I need to know if you can be accepting and supportive of this.’

In general, I’ve found 4 common responses to this introduction:

“I’ve never heard of it before, but I’m willing to learn.” – great, answer questions, refer them to the PolyResearchers group on Yahoo!, or whatever else you can do to help them understand.

“I’m afraid I can’t be supportive of a lifestyle that is clearly (fill in reason they disapprove)” – thank them for their time and leave.

Initially say they accept, then get passive-aggressive about it – only ran into this once. I’m not sure if she honestly didn’t realize how much her bias’ were affecting her behavior, or was just an a—hole. Either way, these are the most annoying IMO b/c of the way they waste your time.

“Oh – like that show Sister Wives/Big Love. Sure, I have no problem with that.” – I just started running into this in the past year or two. In general, you can work really well with a professional who has this reaction. They are likely to be open-minded and accepting. However, you may need to deal with some misinformation on their part. Also, sometimes they want to hear how your relationship is different from the one they see on TV. Of course, sometimes it doesn’t matter either.

Resources for educating your local own polyamory friendly professionals:

Resources for educating your local own polyamory friendly professionals:

CARAS – CARAS is dedicated to the support and promotion of excellence in the study of alternative sexualities, and the dissemination of research results to the alternative sexuality communities, the public, and the research community.

What Therapists Should Know About Polyamory – article introducing what polyamory is, how it is practiced and some of the psych studies on polyamory over the past several decades. Written for therapists, but can be useful for family doctors/primary care physicians

Yahoo! PolyResearcher’s Group – this is a great place that your professional can go and ask questions. The group includes over three hundred members in varying fields of study. A great resource for anyone wanting to learn about current research in polyamory.

NCFS – the national coalition for sexual freedom should be a great resource and is the group that sponsored the article What Therapists Should Know About Polyamory, but in general while they support polyamory in theory, they are more focused on support for the BDSM community. Hard to blame them when kinksters are in danger of going to jail for their sexuality. The one area where I have found NCFS to be helpful in polyam situations is legal stuff. They may provide a lawyer with references, precedents, and research relevant to a legal case where your lifestyle is an issue. I understand that some of NCFS’ board members are moving to have more of a focus on polyamory and non-monogamy in the future.

Polyamory and Pregnancy: Prenatal Care

Another post with minor grammar edits. Nothing much has changed in prenatal care in the last five years, as my pregnancy last year demonstrated. Updated: Dec 13, 2016

Dealing with medical stuff and polyamory can be a pain in the neck when you aren’t dealing with the stress of a new pregnancy. When you are? Well, stupid rules and regulations + hormone swings can make doctors look like very good targets.

With luck, you already have an ob/gyn who is familiar with your lifestyle and is willing to include all your partners in your prenatal care. If you aren’t already seeing a poly-friendly professional, you may need to do a little searching and a little educating.

My best experience was a home birth with a nurse practitioner midwife. She accepted our relationship without a qualm, included both my partners in all our consultations. when the baby was born, one caught and the other cut the umbilical cord.

Midwife-assisted home birth gives you control. In a hospital, you need to deal with their rules and regulations. Since midwife-assisted home birth is just as safe for low-risk pregnancies than hospital birth, it is something you may want to consider. (Actually, some studies have shown midwife assisted high-risk births in the hospital have better outcomes than obstetrician assisted, but you’re in the hospital either way.)

The biggest problem of a hospital birth from a polyam-perspective is many hospitals limit the number of people who can attend the birth. If you have a number of partners or a large poly family, this can leave you needing to choose who will be there with you, and who won’t.

That said, please, please please, put your and your baby’s safety first.

Ultrasounds and any other medical test often have the same problem—hospital or clinic limits on people who can be with you. Hard to blame them in a way—I’ve known people who would have crowded their entire extended family in to see the ultrasound! And there just isn’t that much space in the ultrasound rooms. But it can leave a polyam mom in a tough position.

The best advice I have on this one is to talk with your partners and your doctor. If your doctor understands your relationship and is willing to work with you then you shouldn’t have too many problems. And there is a good chance that if you have a big polycule, not everyone will be as interested in going to ultrasounds and what-not. Some people just don’t see the fascination in smudgy black and white pictures on a screen. Don’t feel bad if some of your partners feel that way. Include them in what they want to be a part of, and be glad that you don’t need to leave someone out who wants to be there with you.

All in all, mixing non-standard relationships and medical protocol can always be a hassle, but with prenatal care, it may be then you may fear. Which means you can focus on taking care of mommy and baby.

Originally posted July 14, 2011.

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Mental Illness and Polyamory Recap

This blog series is already one of the longest I’ve written, and I’m about to add a bunch more information. So before we dive back in I decided it would be good to do a quick recap of the key points of the series so far.

Educate Yourself

If one of your poly partners suffers from mental illness, take the time to learn about their illness and how it affects them. This includes both reading up on the general information about the illness and learning about how your partner experiences their illness.

There is No Quick Cure

Mental illness is not something people can just “get over” and there is no fast treatment or cure. Medication can help manage mental illness but is NOT a cure or fix. And just finding the right treatment approach can take months, if not years.

Mental Illness Can Mimic Relationship Problems

Mental illness can mimic jealousy, abuse, loss of interest, and a number of other relationship problems and red flags. Treating mental illness like relationship problems just compounds the problem. Treat mental illness like mental illness and relationship problems like relationship problems.

The Big Book of Poly Doesn’t Always Apply

There’s a lot of great advice for folks in poly relationships. However, some of that advice doesn’t work when combined with mental illness. Following the standard polyamory advice may not work or may even make things worse. If this happens it doesn’t mean you/your partner are bad at poly. It just means advice formulated by and for mentally healthy people doesn’t always apply when dealing with mental illness.

Sometimes Mental Illness Isn’t

Michon Neal shared a horrific experience of being misdiagnosed and having physical illness dismissed as “all in zir head” and mental illness. In Michon’s case the problem was compounded by the way doctors tend to overlook or dismiss all black women’s problems as mental illness.

For Michon this meant, ze was not only NOT getting the treatment ze needed, but was put on unnecessary medications with severe adverse effects. Nearly as harmful is when the wrong mental illness is diagnosed. Depression and bipolar may seem similar from the outside, but the respond very differently to treatment. Bipolar and schizophrenia are often mistaken for each other.

Irrational Feelings Are Still Feelings

Mental illness makes people feel things that have no basis in reality. Telling someone feeling abandoned because of depression “You are wrong to feel that way!” or “how dare you say I don’t do enough!” or anything like this doesn’t help anyone. That doesn’t mean you should try to fix problems that don’t exist. But understanding and empathy go a long way. “I’m sorry you feel that way. I hope you know that I love you and would never abandon you. Would cuddling for a bit help?”

This post is part of the Polyamory and Mental Illness blog series.

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