I don't know how to tell my doctor that I've opened my marriage

I'm married and poly. My husband and I recently opened up our relationship, and I've started seeing someone. My actual concern is that I have my yearly checkup this month, and I'm not sure how to bring it up with my doctor. I know it's really important information to share with them, but I'm honestly a little nervous about bringing it up because I don't know how they'll respond. I made a mention to one of the nurses once a couple of years ago while discussing birth control that I might have sex with someone other than my husband in the future because I'm not mono, and she looked at me like I had two heads. I have a pretty hard time articulating what I want to say when I go to the doctor already, but this is something totally new for me. Do you have any advice on how to approach the subject?

It’s not necessarily critical that your doctor have all this information - they just need to know what’s relevant to your health, especially your sexual health. If you ask for an STI screening and they say “oh, that isn’t recommended/necessary for people who are married,” you can say that your circumstances are unique and leave it at that.

If you want to tell them, it’s fine to just be blunt and matter-of-fact: “I’d like to update my ‘sexual history’ since I filled out my patient forms. My husband and I have opened our relationship, and I now have multiple sexual partners, who may themselves have multiple sexual partners. We use [protection method]. I just wanted to make sure you knew that so we can discuss my health in an accurate context.”

If you’re worried, you can print something out or write something down to bring to your appointment. You can also email your doctor or call their office ahead of time if that makes you more comfortable. Check out this article about how to talk to your doctor about polyamory for some extra resources. And if you have health concerns that you really need to address in a context of safety and knowledge around polyamory, check out the poly friendly professionals index of healthcare providers.

Do you or any of your readers have any resources you can recommend related to open relationships and STI’s? I’m sure you’re not a medical expert but I’m hoping you can point me in the right direction. I am married and currently seeing a new partner that I would like to start a sexual relationship with. He informed me that he has herpes. I can find plenty of information online regarding my risk of contracting it, but I’m wondering about the risk to my current partner & any future partners. I’m also wondering about what level of disclosure is appropriate - do I need to tell any future partners I have a partner with an STI? Does my husband need to tell his partners he has a partner that has a partner with an STI? Etc. I’d appreciate any advice you can give on this topic.

First of all, you and your partner sound like awesome people. STIs are just part of life as sexual beings, and being honest and responsible about them is hard, but hugely necessary. Being poly means having annoying conversations with our partners and our doctors, and being willing to deal with that - wanting to do the responsible thing, asking questions, considering the needs of other partners - is the absolute right thing to do, even when it’s not the most fun. So, kudos for being awesome and responsible and looking out for yourselves and each other.

The first thing is your partner needs to talk to his healthcare provider about options for him and his partners to minimize the risk of infection. Being a poly person with an STI means he might need to do some extra legwork to find the right healthcare provider for him who can understand his needs and help him make the right choices, but it’s work worth doing.

As for who has an obligation to disclose, I think honesty is the best, and ethical, policy here. You should get tested every 3 months (I believe that’s the current recommendation - talk to your healthcare provider as well), so you can say: “there’s a chance I have been exposed to herpes, though I currently test negative for it.” That lets your partners make the choice for themselves as to whether or not they want to take the (small but not non-existent) risk of exposing themselves. People may have immune conditions or other considerations that make them more or less willing to take that risk, and they deserve the chance to make an informed decision. 

I am not a medical professional, so I can’t say how minuscule the chance is that if you test negative and your husband tests negative, he might have been exposed anyway. That is something you should talk to a healthcare provider about. If I was setting the ethical standard for the universe, I would say that he should disclose as well: “I and my partner test negative, but there is a tiny chance I may have been exposed to herpes” - just because, again, his partners might have considerations that mean they don’t want to take even the tiniest risk. But on the other hand, one could argue that if the risk really is negligible, perhaps introducing something that is so stigmatized and bringing that kind of anxiety where it doesn’t need to be does more harm than good. Here is an article about the ethics of testing for herpes in asymptomatic people.

Your husband could ask: if you had a partner who had a partner who had a partner with herpes, would you want to know? But that’s the kind of “hypothetical” that sets off alarm bells and if their answer is “nah, not really, it would stress me out without any real risk” you’ve still basically informed them, which defeats the point of asking. 

One could also make the argument that nearly anyone who is sexually active - even people who are generally monogamous but not currently monogamously dating and therefore having multiple partners - has almost definitely been in a situation where they slept with someone who had slept with someone who had slept with someone who had an STI. It’s worth considering how far back into your network you have a right to know and a need to disclose, as long as you’re getting regularly tested and know and disclose your own status. This is, ultimately, a personal decision to be made with your healthcare provider and partner network. 

If you want to get more thoughts, you could talk to someone at Planned Parenthood for more advice, or talk to someone at Scarleteen (not just for teens!). Many health insurance providers also give you the number of a nurse hotline you can call to ask a medical professional questions, and a sexual health clinic in your area can also be a great resource!

Also, this doesn’t have any real relevance to your question, but I absolutely love Erika Moen, so here is her Oh Joy Sex Toy comic about herpes.