January 5, 2023 – Angie Ebba, 42, of Portland, Oregon, has two local girlfriends, a long-distance relationship and a platonic life partner.
Ebba is polyamorousto have multiple intimate love relationships at the identical time. Their partners learn about one another and have agreed to the arrangement, she says.
Polyamory is becoming increasingly common within the United States. In 2021, one in nine Americans reported being in a polyamorous relationship, and one in six said they desired to try it. according to a study by researchers on the Kinsey Institute.
Although a high level of transparency is required for polyamory to work, practitioners don’t all the time feel comfortable sharing their relationship status with medical professionals. The fear of disclosure isn’t unfounded. Of the people within the Kinsey study who said they weren’t fascinated by polyamory and had never done it, lower than 15% said they’d respect for individuals who practiced it.
“I constantly hear from patients who have sexual questions and problems but feel uncomfortable talking to their doctors or even other therapists,” says Dr. Ian Kerner, a psychotherapist and sex therapist in New York City. “Because polyamorous systems are still on the fringes of the mainstream, some doctors may have implicit biases or explicit judgments, especially if they lack experience.”
Obstacles to care
People who practice polyamory face unique health concerns, including a potentially higher risk of sexually transmitted infections (STIs) by having multiple sexual partners and by anxiety or depression as a result of having multiple relationships.
“In gynecology and obstetrics, this is especially important because of the risk of sexually transmitted disease and its consequences, such as infertility, vaginal discharge and systemic disease,” says Dr. Cheruba Prabakar, CEO of Lamorinda Gynecology and Surgery in Lafayette, Calif. “Disclosure of information allows the physician to think more holistically about the patient.”
Ebba doesn't tell her doctors about her private life. She knows other people in these relationships who’ve felt judged in clinical encounters, and she or he avoids revealing such things unless it's absolutely needed.
“First and foremost, I don’t tell my providers about it because I have experienced discrimination and inconvenience in the past. for being queer“I don't want to do that because I'm poly too,” she says. “If I can avoid it, I will.”
A 2019 study with 20 people A study of patients in consensual, non-monogamous relationships—which can include polyamory—found that most of them had difficulties meeting their health needs due to a lack of provider knowledge, inadequate screening, and stigma that affected their health and trust in the medical system.
“Polyamorous people often struggle to seek medical care because they fear being judged by their doctor or other medical professionals who don't understand or respect their lifestyle,” says Akos Antwi, a psychiatric nurse practitioner and co-owner of Revive Therapeutic Services in Rhode Island and Massachusetts. “They may also be hesitant to share information about their relationship with doctors who aren't familiar with the complexities of polyamory.”
Sharon Flicker, PhD, a clinical psychologist and assistant professor of psychology at California State University-Sacramento, says she understands why people are hesitant about discussing the topic of multiple relationships with their doctor.
“The interaction of healthcare providers with patients is often shaped by their mononormative assumptionsThe Monogamy is ideal and deviations from this ideal are pathological,” she says. “Secrecy represents an obstacle to sensitive treatment that meets the individual needs of the patient.”
Flicker says health professionals can attend training courses to reduce their biases and better understand and respond to the unique needs of people in consensual non-monogamous relationships. In addition, Offering to answer any questions a doctor might have after disclosure can open the door to dialogue, according to Prabakar.
“Maybe they’re just embarrassed to ask because many aren’t familiar with polyamory,” Prabakar says.
People in polyamorous relationships also can search for affirming language on healthcare providers' web sites, which can mention that patients of all sexual orientations or gender identities are welcome. An initial appointment can function an interview to seek out out what type of terms a provider uses when talking about nonmonogamy.
Safely navigating sexy time with multiple partners
Prabakar says sexual health and safety is a priority for her patients in polyamorous relationships because they’re with multiple partners.
She recommends that anyone who has multiple partners use condoms and dental dams to stop sexually transmitted diseases resembling herpes and gonorrhea, and in addition undergo regular screening for these diseases.
Tikva Wolf of Asheville, North Carolina, says she has been in polyamorous relationships for 20 years. She says she has strict boundaries with recent romantic relationships to guard her sexual health: She only has sex with individuals who know her current STI status, communicate clearly and use protection.
“If the conversation feels uncomfortable or they don't seem to know what they've been tested for, I don't have sex with them,” she says. “I don't enter into romantic partnerships with people if they're not on the same wavelength as far as relationships go, and I don't have casual sex.”
Wolf says their transparency measures reflect the larger community of individuals in polyamorous relationships.
“monogamy is the default, so there's a tendency to be more transparent about certain preferences from the start in relationships that don't quite fit that standard pattern,” she says.
Some studies support Wolf's hypothesis. A 2015 study in The Journal of Sexual Medicine found that polyamorous people had more sexual partners of their lifetime than people in monogamous relationships, but were more prone to report using condoms and getting tested for sexually transmitted diseases. About 1 / 4 of monogamous partners reported having sex outside of their primary relationship without telling their primary partner.
Kerner explains that every partner in a polyamorous relationship could have different ideas about sexual intercourse; some partners could also be fascinated by casual sex, while others could also be fascinated by maintaining stable primary and secondary relationships.
“These systems are always different, and without clear boundaries, honesty and communication – for example, regarding contraceptive use – the risk of catching a sexually transmitted disease within the system increases,” and the likelihood that the polyamorous relationship is not going to work also increases, he says.
Pay attention to mental health
A polyamorous lifestyle requires not only talking about sexual health and romantic boundaries, but in addition being open about emerging feelings.
“Couples in a polyamorous relationship cannot fully anticipate their potential emotional response to the fact that their partner is with someone else,” says David Helfand, PsyD, a therapist in St. Johnsbury, Vermont, who has worked with many polyamorous couples.
People may experience feelings of insecurity or jealousy, which may result in anxiety in coping with the complexities of multiple relationships.
“When your partner goes out with someone else for the first time or you hear them in the bedroom with someone else, it can trigger intense emotions that you may not know how to handle or be prepared for,” says Helfand.
Seeing a therapist might help process the sentiments that come from dating multiple people. Ebba says she sees a therapist often, partly to set boundaries about how much time she will spend with different partners.
“Poly relationships can be great because you have more people in your life who support you,” she says. “But you also give more of your time and energy.”