Jan. 5, 2023 — Angie Ebba, 42, of Portland, Ore., has two local girlfriends, a long-distance partner and a platonic life partner.
eba is Polygonal, having multiple close romantic relationships at the same time. Her partners knew each other and agreed to the arrangement, she said.
Polyamory is becoming more and more common in the United States. In 2021, one in nine Americans say they are in a polyamorous relationship, one in six say they want to try it, according to a study by researchers at the Kinsey Institute.
While a great deal of transparency is needed for polyamory to work, people who practice polyamory aren’t always willing to share their relationship status with healthcare professionals. The fear of disclosure is not unfounded. Fewer than 15 percent of those in the Kinsey study who said they were not and never interested in polyamorous relationships said they respected people involved in polyamorous relationships.
“I hear all the time that patients have sexual questions and issues but are reluctant to talk to their doctors or even other therapists,” says Ian Kerner, Ph.D., a psychotherapist and sex therapist in New York City. “Because the multivariate system remains outside the mainstream, some physicians may have implicit bias or explicit judgment, especially if they are inexperienced.”
Barriers to care
People who practice polyamorous relationships face unique health concerns.These include potentially higher risk Sexually Transmitted Infections (STIs) Having multiple sexual partners, and anxiety or depression from dealing with multiple relationships.
“This is especially important in obstetrics and gynecology given the risk of STI transmission and its consequences, such as infertility, vaginal discharge, and systemic disease,” said Cheruba Prabakar, chief executive officer of Lamorinda Gynecology and Surgery in Lafayette, Calif. Dr. said. “Disclosure will allow providers to consider patients more holistically.”
Ebba did not tell her doctors about her personal life. She knew others in these relationships who felt judged in clinical encounters, and she avoided disclosure unless absolutely necessary.
“First, I will not let my provider know because I have faced discrimination and embarrassment in the past because it’s weird; I don’t want it because it’s a polygon,” she said. “If I can avoid it, I will. “
A study of 20 people in 2019 In consensual non-monogamous relationships – which may include polygamous relationships – most of them were found to report challenges in addressing their health care needs that were linked to a lack of provider knowledge, Inadequate preventive screening is associated with stigma affecting their health and trust in the healthcare system.
“People who are polygamous often have difficulty seeking health care because they fear being judged by their doctors or other clinicians who don’t understand or respect their lifestyle choices,” says Akos Antwi, a psychiatric mental health nurse, Also a co-owner of Revive Therapeutic with services in Rhode Island and Massachusetts. “They may also be reluctant to share information about their relationship with providers who are not familiar with the complexities of polyamory.”
Dr. Sharon Flicker, a clinical psychologist and assistant professor of psychology at Cal State University Sacramento, said she understands why people worry about discussing the topic of multiple relationships with their healthcare providers.
“Healthcare provider interactions with patients are often influenced by their single norm assumptionThat Monogamy is ideal Deviation from this ideal is pathological,” she said. “Confidentiality creates barriers to sensitive care that meets the individual needs of patients. ”
Health care professionals can seek training to reduce their biases and better understand and address the unique needs of people involved in consensual nonmonogamous relationships, Flicker said. also, According to Prabakar, proactively answering any questions a physician may have following a disclosure can open the door for a conversation.
“They may just be embarrassed to ask because many people may not be familiar with” polygamy, Prabhakar said.
People in polyamorous relationships can also look for affirmative language on a healthcare provider’s website, which may mention that patients of all sexual orientations or gender identities are welcome. The first date can serve as an interview to find out what terms the provider is using when referring to non-monogamous.
Safely Sexy Time With Multiple Partners
Sexual health and safety is paramount for patients in polyamorous relationships because they have multiple partners, Prabakar said.
She recommends that anyone with multiple partners use condoms and dental barriers to protect against STIs such as herpes and gonorrhea, in addition to regular disease screening.
Tikva Wolf, of Asheville, North Carolina, said she has been in a polyamorous relationship for 20 years. She said that in order to protect her sexual health, she has strict restrictions on starting new relationships: She only has sex with people who understand her current STI status, communicate well, and take protective measures.
“If the conversation feels awkward, or if they don’t seem to know which tests they’ve had, I don’t have sex with them,” she said. “I don’t enter into romantic partnerships with people unless they agree on the relationship, and I don’t have casual sex.”
Wolfe said her actions to increase transparency mirror the larger group engaged in polyamorous relationships.
“Monogamy is the default, so in any relationship that doesn’t quite fit that standard box, there’s a tendency to be more transparent about pre-stating specific preferences,” she said.
Several studies support Wolf’s hypothesis. A 2015 study Journal of Sexual Medicine People who were found to be polygamous reported having more lifetime sexual partners than those who were monogamous, but were more likely to report using condoms and being tested for STIs. About a quarter of monogamous couples report having sex outside of their primary relationship without informing their primary partner.
Each partner in a polyamorous relationship may have a different perspective on sexual activity, Kerner explained; some partners may be interested in casual sex, while others are interested in maintaining a stable primary and secondary relationship.
“These systems are always different, and without clear boundaries, honesty, and communication — such as around the use of protection — the likelihood of STI infection within the system increases,” and the likelihood of polyamorous relationships failing, he says.
taking care of mental health
A polygamous lifestyle requires not only talking about sexual health and romantic boundaries, but also being open when feelings arise.
“Couples in polyamorous relationships don’t fully anticipate the emotional reactions they might have to their partner being with another person,” says David Helfand, PhD, a psychologist in St. A therapist in Johnsbury who has worked with many polyamorous couples.
People may experience feelings of insecurity or jealousy, which can lead to anxiety in navigating the complexities of multiple relationships.
“The first time your spouse is going on a date with another person, or you hear in the bedroom that they’re dating someone else, it can create strong emotions that you may not know how to handle or be ready for,” Helfand says.
Seeing a therapist can help deal with the emotions triggered by dating multiple people. Ebba says she sees a therapist regularly, in part to help set time boundaries with different partners.
“Polar relationships can be great because you have more supportive people in your life,” she says. “But you also put more time and effort into it.”
