How to tell your provider that you’re polyamorous

I’ve been some flavor of consensually non-monogamous for over 15 years. During those years, I have had to come out as poly to psychiatrists, therapists, primary care physicians, surgeons, specialists, and nurse practitioners. I’m lucky in that I live in a relatively progressive state and care very little what people think of my personal life, but back when I was a military spouse? I would have been horrified to try to broach the topic.

Whether you’re newly poly and coming out to a health care provider you’ve had for years, you’ve been poly for a long time and have a new provider, or anything in between, discussing your relationship orientation or sexual practices with your health care provider can be daunting. That said, it can be an important conversation to have in order to make sure you receive the care you need based on your personal risk factors and behaviors.

Keep in mind that for folk in rural areas it can often be harder to find accepting and nonjudgmental care than it is for those of us who live in urban areas. Remember, though, that your health care providers are bound by HIPAA, which means that even if they react poorly, they’re still required to keep patient confidentiality. If you’re concerned about being outed, know that they can’t share your private information without putting their career on the line. So even if your town is small and you’re still in the closet, your provider can’t gossip about you with your family, friends, or neighbors.

Here are some tips for how to come out to your health care provider as polyamorous.

1. Be sure that you want and need to have this conversation

It’s important to consider why you want to come out to your provider, and if the information is relevant to your care. Do you have multiple sexual partners currently? Do you need an STI test because you have a new sexual partner, but your provider knows you’re married? Does one of your potential partners have herpes, and you’d like to know how to protect yourself and your other partners? If you identify as poly, but don’t currently have any behaviors outside of a monogamous relationship, the conversation may not be necessary (yet). Or perhaps you know it will be eventually, and just want to get it out of the way.

2. Decide whether you want to stick with your current provider or find a new one

Whether you’ve been going to the same provider or practice since you were a kid like my wife, or you’ve just established a relationship with one as an adult, coming out as poly to a current provider has both benefits and drawbacks. On the one hand, you may already have a sense of how open or judgmental your provider may be or what the best way might be to broach the conversation. On the other hand, it can be harder to have a potentially fraught conversation with someone you have a long history with, and the risk of them reacting poorly may feel higher stakes than it would with a provider you just met.

You may already know that you need or want to find a new provider, or your coming out conversation with your current provider may make it clear that you don’t want to work with them anymore. The first step in looking for a new provider is to try to find someone who is already knowledgeable about polyamory, currently has patients who are poly, or who is at least poly-friendly.

3. Describe your behaviors, not your identity

Poly or non-monogamous can mean a lot of different things in practice, and using these terms without further explanation can lead your health care provider to make assumptions that may not be accurate. Instead (or in addition), consider talking about the behaviors you engage in that may be relevant to your care. For example, you could share the number of current sexual partners you have, what genitals they have, your use of barriers and other safer sex practices, and anything else that seems relevant.

4. Prepare a script and practice it beforehand

Write yourself a short script with the information you want to cover. Not sure what to say? Here’s a sample script that I’ve used in the past that might help:

“Dr. X, I think you should know that I currently (or may in the future) have multiple sexual partners. My partners have X genitalia. I do/do not use a barrier method of birth control with these partners (or I use barriers with X partner and not Y partner). I’m telling you this because I’d like to be able to discuss any risk factors I might have with this information in mind.”

Next, practice your script. It may feel a little ridiculous, but practicing what you want to say to your provider can help you feel prepared and confident when the time comes. Whether it’s with a partner or friend or by yourself, take the time to rehearse what you want to say, just like you might do for an interview.

6. Know when to walk away

It’s an exhausting prospect, but if you go through all these steps, and your provider ends up being judgmental or negative about your choices, it’s important to know when to cut your losses and start again at step one. If your provider is simply ignorant about polyamory, it’s up to you whether you want to take on the job of educating them about it or would prefer to find a new provider who has more experience with polyamory.

It can be a long and painstaking process, but finding a health care provider that you are comfortable honestly discussing your romantic and sexual life with is well worth the effort in the long run.