Prism Blog, Sex & Relationships

How to Talk to Your Doctor About Polyamory

 

Bringing up alternative relationships styles with a doctor can be intimidating, especially when you don’t know for sure what their experience is with these topics. However, to get the care you need, it can be important for your doctor to know your relationship status. HSDP‘s most recent workshop focused on working with polyamorous patients in clinic: how we can create a safe space for patients to talk about their relationships without being judged. This is a followup post to Talking to Your Doctor About BDSM.

For Poly Patients:

  • You may first want to decide what you want your doctor to know about your personal life based on what is necessary for your care.
    • For example, perhaps it is relevant to tell your doctor that you are in multiple relationships when you have a questions about safer sex practices, but not when you are going in for a flu shot.
    • You may decide that you personally feel more comfortable when you can be open about your identity or relationship status with every doctor, regardless of the reason for visit.
  • The most important thing to remember when talking to your doctor about topics that may be new to them, is that they are primarily looking out for your safety. This means that it’s especially important to remain confident when talking about issues like poly and kink that could be seen as related to partner abuse.
    • Let your provider know that you are happy and feel empowered by polyamory, if that is true for you, so that they don’t have reason to suspect that you are in a dangerous situation.
    • However, if you are actually in a dangerous or uncomfortable situation and want to discuss this with your provider, it is okay to bring that up as well. Many poly people feel that they need to constantly “prove” to monogamous people that being poly is healthy and makes everyone happy, and because of this they may feel reluctant to bring up issues that they actually want to talk about.
    • Remember to take care of yourself, your doctor is there to support you and you have the right to get the help you want. If you feel judged by your doctor for seeking help, or you feel you are not getting the care you want because they are not educated about your lifestyle, consider getting a recommendation from a friend for a new doctor!

For Poly Healthcare Practitioners:

  • The number one thing to keep in mind, with this and any other topic you may be unfamiliar with, is simply to maintain a professional, nonjudgmental attitude when talking to your patients.
    • Though actually knowing about and understanding topics like polyamory is helpful, you can still be an effective practitioner simply by keeping an open mind and paying attention to what your patients are asking of you.
  • Related to this, keep your assumptions at bay. Don’t automatically assume that your poly patient is more likely to get an STI. In fact, most polyamorous people are much more STI aware and are more likely to have safer sex than monogamous people, partly because they have more people to be accountable to.
    • This applies to all aspects of a patients life: don’t assume they’re straight, don’t assume their gender, don’t assume they can afford to pay for the prescription you give them, etc.
    • You can ask more broad questions, like “What safe sex practices do you use?”, “Are you currently dating?/What is your current relationship status?”, and “What genders do you usually date?”. These questions are great because they don’t assume that the patient is having sex, that they use or need birth control, nor do they assume anything about their sexual identity or relationship status.
  • If you are truly concerned for a patient’s mental health or physical safety (and not just because you have not educated yourself about poly relationships), you can ask questions like “Do you feel safe at home?” or “Do you have a support system or someone to talk to?” to decide whether you need to take further steps.

More Helpful Resources:

What Psychologists Should Know About Polyamory

Kinkopedia: Solo Polyamory

Solopoly.net

What Health Professionals Need to Know

A Poly Metaphor


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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For Providers, Prism Blog, Transgender Wellness

3 Ways for Healthcare Providers to Respect Diversity

  • Avoid making harmful assumptions about your patient. Whether you’re assuming they’re straight, cisgender, uneducated, dealing with addiction, or any number of things, any time you’re assuming rather than asking and listening to your patient you aren’t giving them the care they deserve. (For example, don’t ask a patient about her boyfriend when she hasn’t told you her sexuality or relationship status. In fact, personal questions like this are really only relevant if your patient brings them up first.)
  • Listen to your patient’s primary symptom and make sure to address it, regardless of other things you’ve learned (or assumed) about their health during the interview. Regardless of drug use, body size, relationship style, gender identity, mental illness, or any other issue, your patient won’t come back if you treat what you’ve decided is most pertinent to their health rather than what’s most important to them. This may seem obvious, but these kind of mistakes happen a lot. (For example, don’t treat a patient for weight loss who has come to see you for headaches!)
  • First and foremost we are here for our patients’ health and well-being. Never ask a patient about changing their lifestyle or identity. Furthermore, make sure you are not using up their valuable appointment time by trying to educate yourself. Look things up online on your own time if you need to learn more and save appointment time for your patient.
  • Provide gender neutral bathrooms. 
    • Who can benefit from gender neutral bathrooms? Parents with children of a different gender, people with an attendant of a different gender, trans* people, and individuals with non-normative gender presentations.
    • Why are gender neutral bathrooms important for trans* people? When a bathroom is gender neutral, trans* people can use it without risking harassment or violence from people who think they are in the “wrong” restroom. Access to gender neutral bathrooms also prevents UTIs and other health issues caused by “holding it” until a safer restroom is available.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Prism Blog, Transgender Wellness

Chest Binding Safely: Save Your Back!

Interested in binding, or already binding? Here are some very important health tips that you need to know!:

  • Do NOT use an ace bandage or similar homemade device for binding. Wrapping around your chest several times can result in dangerously tight binding that cuts off circulation, breathing, tissue damage, and skin irritation. If you want to make a binder, cut off the top of some control top pantyhose and sew on some straps. This is much safer and still just as cheap!
  • NEVER sleep in a binder (unless you are in a place where it is unsafe for you to sleep without it). Don’t leave your binder on for more than 8 hours at a time. Your body needs time to stretch and breathe. Think about those pictures of women who wore corsets daily and how it changed the shape of their abdominal organs permanently. This can happen so a lesser extent with binding too and tissue damage caused by constant binding can make top surgery more difficult!
  • Wear the right size binder. Don’t wear a smaller size thinking it will be more effective, it won’t flatten your chest more effectively, it’ll just cause more damage to your ribs and make breathing more difficult.
  • If you wear a binder frequently, make sure its made of breathable fabric (not neoprene), or wear a tank top or apply cornstarch underneath it to prevent chafing and breaking out.
  • If possible, take a “day off” at least once a week. Wearing even a tight sports bra once a week instead of a binder can help take some of the pressure off of your ribs.
  • Go braless or wear a loose bra as much as possible. Actually bouncing your chest can help restore circulation and prevent tissue damage. Take your binder off as soon as you can, and spend a few minutes either jumping or just manually moving your chest. This can help prevent issues like breast cancer and tissue damage (and is even recommended for people who wear underwire bras regularly).
  • Binding can change breast tissue, potentially increasing chances of breast cancer. It is important to do regular self exams so you recognize any changes in your body right away. The most important thing is to notice what lumps are normal for you and which are abnormal, immovable, and/or don’t go away.
  • Give yourself chest massages (or get a loved one to do it for you!) to work out any tightness that wearing a binder causes. Pay special attention to the sides of your ribs, collar bone area, shoulders, and use a tennis ball (or two tennis balls taped together) on a wall or the floor to get the knots out of your back and between your scapula.
  • Buy at least two binders so that you can alternate between them. If you give them a day off to regain their shape they’ll last longer! Wash them in special detergent that keeps them stretchy too: you can find soaps for medical braces, swimsuits, or nylons that all work well for this.
  • If you are younger than 20, your body is still growing and changing and this makes binder safety even more important. Don’t wear a binder more than 3-4 times  a week. At younger ages you are more likely to cause dangerous changes to your ribcage and chest tissue by binding more frequently.

Resources for Buying a Binder:
This site has information on fitting, buying, and wearing binders
Low cost binders
T Kingdom
Underworks
Underworks swim binder
Binder reviews

Binder Alternatives:
Frog Bra Substitutes
Qwear sports bras


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Prism Blog, Sex & Relationships

How to Talk to a Doctor about BDSM


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When practicing BDSM/kink it’s important to know how to talk to your health provider about marks and bruises. Knowing how to talk about it can save you a lot of uncomfortable explanations (and potential investigations into your domestic/sex life if your doctor suspects you are being abused). If questioned, a good tactic is to simply smile and tell your doctor that the marks were consensual.
Check out this article on talking to healthcare providers about poly and kink.
And this article about going to your doctor with bruises and marks.

For any healthcare providers out there, a great way to ask a patient about marks is simply to ask “were these marks consensual or accidental?” Asking how they got them opens up the conversation for a lot of excuses because the patient may not feel comfortable telling you the truth. If they know that you understand marks can be consensual, they will be much more likely to tell you if this is the case. If they don’t say they were consensual, you can evaluate further whether abuse is involved.

You can now find my profile on NCSF’s Directory. Check out their site to find other kink friendly practitioners.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

hair loss, Menopause and Beyond, PCOS, Prism Blog, Transgender Wellness

How Does Saw Palmetto Decrease Baldness?

Normally, hair follicles remain active for up to a decade, producing a long strand of 10 year old hair. In alopecia, however, follicles stop producing hair before the hair is long enough to even emerge from the skin. Male pattern baldness, or Androgenic Alopecia, is both genetically determined and influenced by hormones.

Genetics cause some people’s hair follicles to be more susceptible to DHT (dihidrotestosterone), which changes the growth phase of hair follicles. This gene can be present in any sex, but is only expressed when DHT, a form of testosterone, is present. Hence the name “male-pattern” baldness. This is the reason why many trans men develop this pattern of baldness while on T, and why this process of balding stops in most trans women once they start taking anti-androgens (like spironolactone).

Though we cannot change the gene, we can prevent testosterone from converting to DHT to stop this balding process. Testosterone converts to DHT via the enzyme 5-alpha-reductase. Research has shown that saw palmetto inhibits 5-alpha-reductase, preventing this pattern of baldness.


Saw palmetto is very effective for hair growthSaw palmetto together with the supplement beta-sitosterol has been shown to have a 60% effectiveness rate for hair loss reversal. In my experience this does not increase facial hair growth, however studies have shown inconclusive results about its effect on overall testosterone levels. It likely blocks aromatase, an enzyme which converts testosterone to estradiol, a major hormone involved in breast development. If you’re concerned about saw palmetto supplements increasing your testosterone levels, a good alternative is to use it topically. It has been used topically with similar effectiveness.

Saw palmetto also prevents the accumulation of DHT in the prostate, lowering the risk of prostate cancer. It acts on estrogen and progesterone receptors to lower the risk of breast cancer. It’s helpful for colds and coughs, sore throats, asthma, chronic bronchitis, chronic pelvic pain syndrome, and migraine headaches. It is also a diuretic (makes you pee more), a sedative, and an aphrodisiac, so be cautious if those are effect you do not want.

DO NOT take saw palmetto with spironolactone because they are both diuretics and could significantly lower your blood pressure or cause dehydration. People with bleeding disorders or who are taking anticoagulant or antiplatelet medications (“blood-thinners”) such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix) should avoid taking saw palmetto unless under medical supervision. It should also be avoided at least two weeks before or after surgery. Saw palmetto may interact with other medicines, including anti-inflammatory drugs, blood pressure medications, birth control pills and antibiotics.


Another great herb for hair loss is Shou Wu. Shou Wu Pian (aka Fu Ti) is an ancient Chinese herb that increases hair growth. It is generally used for scalp hair growth, but in my experience it increases mustache growth as well. If increased facial hair would be a problem for you, you may not want to take this formula. It’s also important not to take this formula if you are already taking synthetic hormones or other medications as it can increase the strain on your liver.


More hair loss prevention
Massage daily with Rosemary hair oil
Topical borage seed oil works like Propecia to block androgen receptors in hair follicles
Teas of silica rich herbs like horsetail, oats, or nettles
Nourish your kidneys with asparagus, artichoke, celery, aduki beans, parsley
Using a plum blossom needle to stimulate hair growth.

Finally, to support your overall constitution and get treatments tailored specficially to your goals, come in for a treatment!


Where to find:

Shou Wu Pian (aka Fu Ti)

Saw Palmetto with Beta-Sitosterol

Topical Saw Palmetto

Read more


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Prism Blog, Transgender Wellness

Herbs for Transitioning: The Basics

Herbs can be used for many aspects of transitioning: transitioning with herbs alone, switching from synthetic hormones to herbs to maintain secondary sex characteristics, and supporting the body with herbs and nutrition to counteract side effects of synthetic hormones.

The Basics:

It’s first important to take care of your body with proper nutrition so that you can handle the changes  and stress that will accompany transitioning. All hormones are made of fat, so it’s important to eat good fats (raw oils & omega 3s especially) to help your body form and transform those hormones, and also to coat your nerve cells (their myelin sheaths are also made of fat) to help you cope with stress and stay emotionally healthy. Fats form the boundaries of our cells–they keep out and let in what we want to–we need good fats in our bodies to have good boundaries physically and emotionally!

We ALL have the same hormones, just in different amounts and we USE different amounts of them too. Furthermore, we can change how our bodies use the hormones we already have. Every body makes progesterone from cholesterol, and that progesterone can turn into estrogen OR testosterone. The estrogen and testosterone in our bodies can also convert back and forth (estrogen to testosterone and vice versa). This is the reason you want to get your hormone dosages right: if you take too much, your body is just going to convert it into another hormone to maintain balance in your system. This could actually counter the desired effects of the hormone you are taking: too much estrogen in your system and your body will start converting it to testosterone, counteracting the changes you want to make.

Coming up with a plan for your body:

There are many different options for transitioning, even when just using synthetic hormones. Progesterone itself helps to build tissue and can often be useful for developing breasts (taken externally) or muscle tissue (taken internally). Aromatase is what turns testosterone into estrogen, so you can take extra aromatase instead of (or in addition to) taking estrogen. Likewise, you can take aromatase inhibitor to prevent that testosterone from turning into estrogen, instead of taking testosterone. There are many options for prescription hormones; it’s important to talk to your doctor about what will work best for your body.
For most people, herbs aren’t going to change your hormones drastically alone, so you might choose to start out taking synthetic hormones and, once you’ve achieved the effect you want, use herbs to lower your dose of synthetic hormones or switch to herbs entirely. Herbs can maintain the hormone levels and characteristics you’ve built up with synthetic hormones. This is a good alternative to the sometimes health damaging side effects of long-term synthetic hormone use.


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References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.