How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!
Every Thursday night, the crew responds to a bonus question in chat form.
Dear How to Do It,
I am a 29-year-old gay man. I have been searching forever for a primary care provider that would listen to me and actually care about my health. I finally found one in Dr. Cee. Dr. Cee is gay, a little older than me, and a total babe! I thought that I would just crush on him, and that would be that. But recently, at an appointment, he hugged me at the end. I didn’t think anything of it until later that week, I saw him on Grindr. I didn’t look at his profile, but he had a face pic and I could tell from the thumbnail that it was him. I was surprised when he messaged me first and things got hot and heavy via chat. Now I want to hook up with him, but I also don’t want to lose my AMAZING PCP. Can I sleep with my doctor and still have him be my doctor? Or have things already been ruined in a professional sense, and now I should just see him outside the office?
Stoya: A good primary care doctor is hard to find, especially for LGBT people and sex workers.
Rich: It took me years.
Stoya: I use my psychiatrist.
Rich: Is that advantageous?
Stoya: Well, I’m already in his office. And he is an M.D. Sometimes I go to the health insurance company’s clinic. (I still feel lucky to have health insurance.)
Rich: I also feel lucky to have it. When I read this, I thought, “Don’t shit where you eat,” which I think you may be getting at in a more elegant way?
Stoya: I think that is my point. It’s hard to find a good PCP. You’ve found one. Don’t jeopardize it.
Rich: So, I have experience here. I don’t really want to detail it because it probably sounds like a letter to Penthouse, but I’ve hooked up with a doctor. Not my PCP, but a specialist I saw years ago. In his office. I don’t want to present a scenario that underplays the damage this behavior could cause in another scenario, but it was hot, I initiated, I’m FINE … and I never saw him again. He was a good doctor, but I couldn’t do it. It just felt too weird after that. I shat where I ate, and I lost my appetite. It sucks. I could have used such a specialist in my rotation.
Stoya: I’m a bit worried about the doctor approaching his patient on an app.
“Code of Medical Ethics Opinion 9.1.1
Romantic or sexual interactions between physicians and patients that occur concurrently with the patient physician relationship are unethical. Such interactions detract from the goals of the patient-physician relationship and may exploit the vulnerability of the patient, compromise the physician’s ability to make objective judgments about the patient’s health care, and ultimately be detrimental to the patient’s well-being.”
Stoya: So maybe this PCP isn’t as amazing as he seems. “A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient”—which this guy has not done.
Rich: No, he has not. That said, I do think this is potentially less worrisome in a gay arrangement, if only because the power dynamic isn’t quite as severe in a patriarchical society as man-woman. Generally speaking, men aren’t targeted like women are in a predatory way, so I do think it’s possible to emerge from this situation unscathed. But I’m not endorsing it.
Stoya: To be direct: Please don’t do this.
Rich: Right. Not necessarily a catastrophe in the making, but unwise and worrisome on the part of the doctor.
Stoya: Exactly. And do you really want a boyfriend who violates his profession’s ethical code?
Rich: Especially a profession as important to quality of life as medicine?
Stoya: This is a significant red flag (the more I think about it).
Rich: It is. If attraction is just too much to ignore reason, I think the clearest path to OK is to find a new PCP and just see Dr. Cee as a romantic partner.
Stoya: Either way, I think he needs new primary care.
Rich: Yes, there’s basically no looking back. A line has been crossed. I should add that while the consensus would be that this doctor has behaved in a way that is unethical, I don’t think this scenario is illegal, per se. Usually when this has been prosecuted, other stuff (age, mental illness) is in play.
Stoya: So it doesn’t sound like the most drastic line has been crossed, but our writer should still find a new doctor and try to move on romantically.
Rich: Yes. And if one must be picked, I’d say pursue romance. But one is the max here—can’t do both.
More How to Do It
I live with my partner of 10 years in a happy, committed relationship. My partner is a fantastic person and very considerate and giving in bed. So what’s the problem? I desperately want to have sex with other people. Every time we have sex or I masturbate I think only of other people. Everywhere I go I get crushes: subway passengers, my bank teller, co-workers, the gamut. I can’t imagine a better partner in life for myself, and I really don’t want to break up over this, but I also know that suggesting we open up the relationship would be devastating. How do I manage this? It’s not going away, and it feels like I’m cheating.