How do I get doctors to stop accusing me of lying?

September 26, 2024 5:09 AM

On the few occasions I manage to force myself to see them, doctors accuse me of lying about my sexual history. Why does this happen, and how do I stop it?

Something about me makes doctors assume I'm having way more sex than I'm having (or have had). The first time this happened I was 13, still very much a puriteen (had my period, but hadn't kissed anyone or used tampons yet). It's continued to happen throughout my life - a doctor will ask me about my sexual history and when I give them an honest answer they will announce that I am lying. (One, a cis woman, also accused me of lying about knowing that I was ovulating.) I am in a long-term monogamous relationship, and my partner is the last name on a short list.

Being accused of lying when I'm telling the truth is a big trauma button for me, as are doctor visits. And I've seen tons of essays by folks who came out of purity culture, so I don't think my sexual history (or lack thereof) is that unusual. So: What makes doctors believe people? Is there a way to inflect my voice or carry myself or dress that will make me more believable? I'm probably autistic, so feel free to give super granular advice ("sit up straight, but not too straight, hold your hands like so, and maintain eye contact for 2-3 seconds as you speak") because clearly I have been doing something wrong my whole life and I still cannot figure out what it is and this is one of (many, many, many) sources of medical trauma and anxiety.

(Please don't tell me to lie and give them an answer they would consider plausible. I'm a terrible liar plus I doubt I have enough sexual experience to do it convincingly, although since I can't tell the truth convincingly either who knows.)

posted by anonymous to Society & Culture (27 answers total)

I feel you on this. I wish I had a good answer because doctors just… don’t believe some people. my partner has this problem too. one thing that has helped is having me go along. could your partner go along with you? or a friend? sometimes when doctors ask questions like that and brush off my answers, i’ve had someone else in the room that I can look at and silently be like “help”. and have my partner say “no really, i’ve seen this happen X times over Y years” then (the usually man) doctor will be like “oh, the man who brought you to the doctor’s office thinks you are correct! okay! I believe you”. I hate it. it’s gotten worse after disclosing that i’m autistic to certain providers, which I thought would be helpful, but no. that’s just another reason to question a person I guess? i’m so sorry you’re dealing with this. ❤️
posted by one-half-ole at 5:32 AM on September 26 [5 favorites]

Doctors are trained to ask multiple times about sex to try and get honesty from people. This is because there are things that can't be perscribed ( like PreP) and testing that might not be done if someone isn't honest about their history. It's not really an us vs them but a doctor wants to be able to be as thorough as possible and have been told over and over that people lie about this stuff because they do. It is likely these tactics are hitting the I think they are lying radar for you.

The best thing to do is be firm in your previous answer. You can be a little jokey about it if you want but just affirm what it is and they will move on. I promise doctors don't take this personally, it's a normal part of the job.
posted by AlexiaSky at 5:37 AM on September 26 [6 favorites]

I'm a 39 year old woman and a doctor has never outright accused me of lying about this - the closest would be saying something along the lines of "are you sure you don't want to get an STD test?" despite an answer of having only one sexual partner. Personally, a doctor who accused me of lying would not be a doctor I returned to - there are doctors with better communication skills out there.
posted by coffeecat at 5:43 AM on September 26 [2 favorites]

Can you tell us the specific words that you and the doctors have used in these conversations? (You can contact a mod to give them text for a comment to post in the thread, to protect your anonymity.)

Some of this may depend on what specific question they're asking and what particular words you're using in your answer to them, and what phrases they use when they respond.
posted by brainwane at 6:29 AM on September 26 [8 favorites]

the closest would be saying something along the lines of "are you sure you don't want to get an STD test?"

They do this because there's no guarantee your partner isn't having sex with other people without your knowledge.

I've never run into issues with doctors seemingly not believing my lack of sexual activity, but it took a while for me to figure out that the easiest answer to questions about alcohol consumption was being precise ("let's say one beer a month, if that") because saying "rarely" just resulted in needing to clarify just how rarely I drink alcohol. Likewise, if you don't have PIV sex, it's easiest to say exactly that (as someone with ovaries, that's probably what they're assuming you're doing). If they're obnoxious about it, it's new doctor time (yes, easier said than done, I know).
posted by hoyland at 6:32 AM on September 26 [2 favorites]

clearly I have been doing something wrong my whole life

No, a lot of doctors are just very bad at their work.

I had a doctor once who asked me very pointedly if I was taking drugs and refused to believe me when I said that I wasn't. Not only was I not taking any drugs at the time, I have to this day never even tried any drugs at all, including the legal ones. Except for that one time I tried a CBD salve. I am very, very boring! Why she thought that insisting I was using drugs and telling me she didn't believe me was a good idea, and why it didn't seem to occur to her that maybe having and expressing this distrust would impair her ability to be an actual good doctor to me, I don't know.

I think some doctors are just not as bright as they think they are.


Is there a way to inflect my voice or carry myself or dress that will make me more believable?

Who knows (do you know how to look like a very wealthy person with multiple lawyers on retainer?) But I wish I had told that doctor, calmly but seriously, that it is important to me to work with a doctor that listens to me and believes me, and that if she didn't feel able to do that then I did not feel comfortable continuing to be her patient.
posted by trig at 6:40 AM on September 26 [15 favorites]

The only thing that has worked for me is getting older. For example, I vividly remember getting some viral thing with a rash when I was about 22. A doctor and nurse examining me were concerned that it might be German measles and that I might be pregnant. "I can't be pregnant," I told them several times. It was physically impossible, but they clearly did not believe me – they may even have had a policy of not taking such claims seriously – and had me take a test.

I just realized on thinking about this that it always slightly amazes me even now that when I tell something to a healthcare professional, they take it as fact. There was always an air of distrust when I was under 40 or so.
posted by zadcat at 6:44 AM on September 26 [1 favorite]

Lots of people experience shame about having more (or more different) sex than they think people expect. This means that some of them lie about sex to doctors. On top of that, many people have an imperfect understanding of aspects of sex and their bodies. This means that some of their statements are unreliable, even though they are not deliberately lying. This probably isn't the only cause of the problem you're experiencing but it sounds like a factor.
posted by plonkee at 6:48 AM on September 26 [4 favorites]

I have had to get technical. I’ll say stuff like “I haven’t had vaginally penetrative sex involving a real penis in [approximate large number of years]”, and “I regularly achieve orgasm and don’t have any issue with my sex drive.” After a certain amount of time, if you’ve had the same monogamous partner for the whole time, or none, your previous experience or lack thereof really does not and should not matter, unless it’s trauma that you’re working through. A doctor might try to nudge a patient into a discussion about stuff like sex drive changing over time, fertility, sti testing and vaccines, and also very subtly probing about possible abuse; I’ve found it best to just bring all that up right away and push through any feelings of taboo. Then any statements I make about my lifestyle gets taken at face value, for the most part.

But sometimes doctors are just shitty. As a profession it is deeply steeped in misogyny and a lot of the training doctors go through squeezes the empathy out of them. I have had much better relationships with nurse practitioners and specialists than GP MD people. If you can see a different doctor and have an office appointment to start, that can establish a professional relationship that’s a lot more grounded and you can emphasize the importance of trust from the beginning.
posted by Mizu at 6:55 AM on September 26 [1 favorite]

This happened with my first GYN (male, and I was...maybe 15?). He didn't believe I wasn't sexually active because I was there for what turned out to be a yeast infection (yay, swim practice 4 hrs a day). Absolutely refused to believe the infection was not from sex.

The next doctor who told me I was lying, and then admitted maybe I was just ignorant, was my female OB, when I was in my late 30s. She told me my last name meant that I was Jewish. I said no, the name was Nordic. She corrected me, saying it's a Jewish name that I just thought was Nordic. I corrected her, referencing the Swedish word root and etymology, and said that I had records of the towns where my ancestors had been born. She said I was lying, or if not, I just didn't know what I was talking about.

Anyway, for getting doctors to believe you (ugh), I agree on preview with Mizu. Getting technical helps. I also think it helps to say something like, "I want the best health care for me, and to get that I need to be honest with you about my health and activities. I am being honest with you about my health and activities."

If you have the luxury of switching to another doctor or another practice, you might add, " If for some reason you are unable to believe me, let me know. I will need to find another doctor."
posted by cocoagirl at 7:04 AM on September 26 [9 favorites]

People lie about sex to doctors A LOT, like, constantly. I know a handful of doctors and apparently Miracles Are Real given how often they have had to treat pregnant "virgins." People lie both because they do not want to be judged and because they are sometimes in denial to themselves.

So, it's maybe actually not you; doctors are just very very very used to patients who lie to make themselves sound more "respectable," and if you're giving a very low amount of activity, they just...don't believe it. There's probably not much you can do to make them believe it.

This is bad, by the way! A lot of doctors are bad at being doctors and shouldn't be that. A good doctor may not believe self-reporting but will find circumspect and polite ways to work with that possibility.

Your best bet is as people say above, specifically saying that you do not appreciate being told you are lying and if they will not take your statements as fact then you will be getting care elsewhere.

Or, she said grumpily, just start self-reporting that long-term relationship as a marriage, wear a ring, and doctors will assume you are never ever having sex again.
posted by We put our faith in Blast Hardcheese at 8:29 AM on September 26 [11 favorites]

I have specifically been told that women lie about their sexual well, anything, and thus they can't trust your answers. Which is why I've been forced to take pregnancy tests when there's literally no way I could be pregnant. I don't think there's anything you can do about "lying culture" and how doctors are schooled not to believe your answers, though. I don't even have conversations with gynos about how I don't have the opportunity to get laid because they're not gonna believe it, and they're there to treat people who ARE sexually active, and it kind of breaks their brains if you say, "no, I haven't in a billion years but I'd still like that HPV vaccine just in case." I got told that for my next gyno appointment I should emphasize that I really want my checkup and Pap smear rather than "I'm just here to get my period-eliminating birth control renewed, there's seriously NO NEED for that Pap smear." If I have to vaguely pretend to be sexually active to get services, then that's what I have to do.
posted by jenfullmoon at 9:09 AM on September 26

An NP actively giving me a pelvic exam once very excitedly popped her head under my thigh to inform me that we don't actually pee out of our clitoris. And I was like, "...I know?" And she said something like "I didn't! Not until my rotation last year!"

Anyway, women's healthcare is in shambles and people suck.

If I were in your position getting grilled about lying I would level back a polite "um what the fuck?" at them and ask them to explain what they mean. As polite as I would personally manage to get, in the circumstances.
posted by phunniemee at 9:36 AM on September 26 [3 favorites]

Because people lie to doctors all the time. Out of fear or embarrassment I would guess. I've had great doctors, and am always honest with them
posted by Czjewel at 9:42 AM on September 26

A doctor and nurse examining me were concerned that it might be German measles and that I might be pregnant. "I can't be pregnant," I told them several times. It was physically impossible, but they clearly did not believe me – they may even have had a policy of not taking such claims seriously – and had me take a test.

for something like german measles it's probably more important to be absolutely certain about pregnancy rather than have doctors either take people at their word or try and evaluate the trustworthiness of everyone who might be pregnant, because people do sometimes lie about this even if you definitely wouldn't; policies like this are designed for populations, not people

(doctors being weird and accusatory about your sexual history though, is just pointless and intrusive; if you wanted to lie about your quite-long-ago sexual history it's not like you're hurting anyone but yourself anyway)
posted by BungaDunga at 10:08 AM on September 26 [7 favorites]

I would try to reframe this if possible. The doctor has no way of knowing whether or not you are lying. And you, in turn, have no way of knowing whether the doctor believes you are telling the truth. Interiority is a black box. You can only know two things:

1. Am I receiving the best possible medical care?
2. Am I being treated respectfully by the medical professional in front of me?

As people have mentioned above, there may be times when giving people the best possible medical care might involve not taking a patient's word about something. From the doctor's perspective, the reasoning might be something like: "Lots of people are unreliable narrators when it comes to X, so if the symptoms suggest X, it's safer to treat X, regardless of what the patient says about it." I think the example of an STD screen given above is perfect. If a patient shows up with symptoms of an STD, and you ask them, "Is it possible that your partner is cheating on you?" most people are going to say, "What?!!? No way! That's impossible!" And for most of them, that's true, but obviously, for some small unlucky percentage of people, their partners are cheating...and there's no way for the doctor to know which patients those are. So the doctor treats everyone with those symptoms as though they have an STD - not because they think any patient in particular is lying, but because they - rightly - see that they have no way of knowing which patients are telling the truth.

In that case, there's nothing you are doing wrong to make the doctors disbelieve you -- there is nothing personal about it at all. It's not that they're picking out you as essentially unreliable; it's that they just bring a certain amount of baseline skepticism to bear around this stuff, and you're taking it personally when it's really just an acknowledgement that they don't know you, as a person, at all. You can adjust your whole personality and temperament and change your tone of voice and bring twelve male supporters to every appointment so they never, ever doubt you...or you could be like, whatever, they don't know me, this has nothing to do with me. And if you are otherwise satisfied with your medical care, and the doctor otherwise treats you respectfully and doesn't act like an asshole, you can let it roll of your back. And if you're not, if this is part of a larger pattern of the doctor being rude and dismissive...you can get a new doctor.

Because that is the kind of core question people with trauma need to stop asking themselves. What can I do to make this person stop treating me badly? The answer is always the same: nothing. A rude, dismissive doctor is going to be a rude, dismissive doctor. You are not doing anything "wrong" that is making the doctor behave rudely and dismissively, any more than you are doing something to make the doctor generally skeptical about the way people talk about sex. There is nothing you can do about it, because it's their problem. It has nothing to do with you.
posted by Merricat Blackwood at 10:47 AM on September 26 [11 favorites]

I'm not trying to excuse this because I think it's a failure of care, but if you naturally speak in a "stereotypically" autistic way (sorry, trying not to spend 500 words describing it, and you may well not), that may also be being read as showing discomfort that suggests that you might be too embarrassed or ashamed to speak truthfully, which is a common enough phenomenon in the U.S. I can definitely see a (inappropriate) lack of "cultural competence" in dealing with autistic people coming into play here. Lack of eye contact, or fidgeting, shifting or stimming, may be being read incorrectly in the way I've described. Sitting up straight, yet relaxed, eye contact while answering, hands loose in your lap may help.

That said, it might help to hear examples of what they're saying, because there are different scenarios that may be in play here, as others have described, and some of them reflect genuine care concerns and may need to be tolerated as best you can, and some of them, not so much. You are also always allowed to ask why a particular question is relevant to the care you're seeking at that time. For a lot of care, your sexual history isn't relevant at all, and for much of the rest, a simple "currently having sex with one partner" is sufficient. Certainly how long your list is will rarely be relevant!

I'm sorry you're having to deal with this. As you've seen in the comments here already, this is something that happens a lot to NT women/femme-presenting people, too. Feeling that your care provider doesn't believe you is just awful (it actually makes me distrustful, even fearful). I hope the answers here can help alleviate that feeling a little.
posted by praemunire at 11:34 AM on September 26 [6 favorites]

I'm sorry that this happens to you.

Doctors can be assholes. They can make judgements based on color, gender, age, their interpretation of social-economic status, your presentation, yadda yadda. Many of the older ones are ageist with young people. Many of the younger are ageist with the old. They can be good doctors but don't have a good bedside manner. People lie to doctors. All. The. Time. About sex, drugs, alcohol, how much they exercise, what they eat... Some doctors get burnt out and have no patience.

In my fertile years I lived in a military town and the incidence of STDs was off the charts. It seems like I was always being hammered about having unprotected or extramarital sex or unknowingly being pregnant, because doctors saw that stuff continually with women my age. Most were just trying to be comprehensive; some were jerks or just plain creepy.

I like Merricat's answer and her two questions to ask yourself:
1. Am I receiving the best possible medical care?
2. Am I being treated respectfully by the medical professional in front of me?
Both questions should be yes.

If you do feel disrespected, there are two further questions you can ask to your medical person:
1. Why are you continuing to ask me about this subject?
2. Why are you implying/suggesting/telling me I am lying?

Their answer may be a valid one or it may confirm that yes, you are being disrespected, and you absolutely have the right to call them on it or tell them that you are choosing a different doctor because of it. It may also give you some ideas on how to prevent it from happening again.
posted by BlueHorse at 1:20 PM on September 26 [2 favorites]

Are you Black/African-American? If so, you've got your answer.

(I've been working in sx health/STD for 30 years, this is very much a thing. Docs notoriously often judge Black folks as hypersexual. US-based experience.)
posted by tristeza at 1:40 PM on September 26 [1 favorite]

I'm a 56-year-old cis white well-off woman and at the beginning of this year, when I went in to have my preparatory tests for a hysterectomy for endometrial cancer, I had to have a pregnancy test. I'm in menopause though I had some cancer-related bleeding (which triggered the testing) and I had my tubes tied in 2002. But I still ended up taking the test because they were just sure I might be pregnant and I'm in Texas.

What I'm saying is, you are not alone in apparently being disbelieved. And also, with reproductive care, in the current health care climate, the assumptions around pregnancy and pregnancy tests in particular may have to do with covering the asses of the doctors and clinics/hospitals involved rather than anything about you.
posted by gentlyepigrams at 3:13 PM on September 26 [1 favorite]

They're misreading the autistic body language. Here's a guide you can give to your next doctor.
posted by heatherlogan at 3:42 PM on September 26 [2 favorites]

If I wanted a costume that communicated "I have not had many sexual partners", I would choose: no makeup, hair in a ponytail, short fingernails, flat shoes, and loose clothing in dark colours that minimized my figure. (So dumb! But it might help).

For the whole visit: Take off your coat, put your coat and purse in another chair or hang them (so you don't appear to be anxiously clutching your belongings). When the doctor enters, smile and ask how they are, and comment maybe 1-3 minutes on something generic, with smiles (How are you holding up in this hot weather, Isn't the weather lovely, How's your family, This must be such a busy time of year for you).

Sit up fairly straight, with your hands folded in your lap. I would suggest you try to sit still, and make eye contact when the doctor is talking, but not overly fixed eye contact, it's ok and good to glance away too. When you talk, you can look upwards as you think or recount something. Look at the doctor at least 1-2 seconds during every thought, maybe at the end of the thought, to see if they understand.

When asked "what's your sexual history," And give a specific answer with some numbers sprinkled in, such as, "I first had sex at age 20. I've had sex with 4 people in total. The fourth person is my husband; we've been together for 10 years. I'd say we have sex about once a week." Smile verrrry slightly - not enough to communicate "happy". Just enough to communicate "not sad".
posted by nouvelle-personne at 4:01 PM on September 26 [1 favorite]

Of course it's possible that you've just had a series of asshole doctors, but since it seems like a pattern I'm wondering if your bad experiences or your autism are coming out in the way you're responding to the questions such that they seem hesitant to the docs or like you want to expand.

e.g.
Doctor: Are you sexually active?
Patient:....no? Um....mmm....(more firmly) no.

In that scenario, "you" are probably thinking "ugh, here we go again" or "exactly what does he mean by "sexually active?". As a doc, if I had someone answer me in that way, I might ask a bit more because sometimes you get folks who aren't sure if what they're doing counts as "sexually active" or who have questions or concerns but aren't entirely comfortable voicing them. I really don't care if you're sexually active or not--my patients run the gamut from folks who are lifelong celibates to folks who have more partners in a month than I've had my whole life, and my goal is just to take care of them in the way they need.

That said, I know the "is it possible you're pregnant?...can we do a test?" thing is SUPER ANNOYING to 99% of people who know very well whether it's possible they're pregnant, but I've had many patient visits where women were very surprised to find out they were pregnant. This includes an experience where the patient insisted to me that not only was it completely impossible that they were pregnant but that they only had female partners. I very apologetically asked if I could add on a pregnancy test along with some other blood work because their symptoms sure sounded like pregnancy, and the patient turned out to be not only pregnant, but in their second trimester. That was an awkward follow up phone call. To be clear, I am 100% sure that they were not lying to me and truly believed that they could not be pregnant. So...we ask and test because it happens, and it's not even rare.
posted by The Elusive Architeuthis at 5:17 PM on September 26 [4 favorites]

If they are accusing you of lying (rather than just repeatedly asking 'are you sure' sort of stuff that they do as a 'cover your ass' sort of measure), it might be instructive to ask them why they think you'd lie about that. If nothing else, it puts them on the defensive, and the answer might inform whether you'd want to stick with them or find a new doctor that respects you.
posted by Aleyn at 7:48 PM on September 26

I didn't read all the comments so sorry if this has been said but I'm extremely curious why a dr would ever ask this or need to know this? If you're getting a physical exam w a pap, they will see if you have any abnormal cells on the cervix, which could be caused by condomless sex, but again, so many people are asymptomatic anyway...
I'm in my 40s and have seen a handful of gynecologists, have had issues that needed clearing up etc...I've ONLY ever been asked about my current situation, like if I sleep w men without birth control or some such.

Very odd and I hope you can find an empathetic dr who does not do this!
posted by bookworm4125 at 8:04 PM on September 26

Get copies of all your medical records and go through them very carefully.

I did so recently and found some wildly untrue stuff about drug use in an ER visit, and suddenly the way I'd been treated by subsequent doctors in that system made a lot more sense.
posted by Jacqueline at 2:23 AM on September 27 [5 favorites]

I have moved past a lot of this with my current round of practitioners, but have leveled with people via-“this is the answer to your question, it’s not changing, let’s move on as a best use of our time.”

Depending on how difficult they are, you can add “I know as a professional you are trained to press for the best answer, this is it, whether you believe it or not, moving on maintains some dignity for both of us here.”
posted by childofTethys at 11:52 AM on September 28 [3 favorites]