Issue 12  •  Spring 2013

Sitting in the Waiting Room: The Dilemma of Small Town Culture and Sexual Health

Written by Matt Dineen

Living in a small town can be overwhelming. The vast anonymity of an urban metropolis does not exist here, so a walk down the street often becomes something of a social event. Familiar faces follow me everywhere I go in the town where I live. This can be comforting, but not always. Take a recent visit to the health clinic downtown.

Living in a small town can be overwhelming. The vast anonymity of an urban metropolis does not exist here, so a walk down the street often becomes something of a social event. Familiar faces follow me everywhere I go in the town where I live. This can be comforting, but not always. Take a recent visit to the health clinic downtown.

Five minutes late for my appointment, I found myself in the lobby anxiously waiting for the elevator. For the past four years, I have been among the 42.6 million Americans without health insurance and have not seen any sort of clinical setting since my college years. The elevator door finally opened and an acquaintance who I knew had been sick for the past week emerged, speaking on her cell phone. We awkwardly greeted each other as I entered the elevator, and since this particular clinic specializes in sexual health, I felt like I violated her privacy by merely running into her.

Eventually, I arrived in the office where I checked in, received a massive stack of papers to fill out, and took a seat in the waiting room. While I was filling out my health history, a college-age woman, also waiting, asked if she could borrow my pen for a second to underline something in the book she was reading. I looked up and made eye contact with another familiar face. As I returned my forms, her name was called and I realized that I had met her at a party the night before. Immersed in my paperwork, I noticed someone else walk by me multiple times. I looked up again to see yet another acquaintance settle in a seat across the room. I said hello by name, and she returned the greeting without a smile, looking surprised and uncomfortable.

Waiting rooms are foreign terrain at this point in my life. Their social mores are a murky, unspoken language that I've lost over these uninsured years. My name was called just minutes after I turned in my forms. I met the counselor who addressed any questions or concerns I had and was extremely helpful. Eventually, she made me feel more comfortable about the whole scenario, and after our session, she gave me a Dixie cup that I was to fill halfway with a sample of urine. When I returned from the bathroom, she confessed that she recognized me, well my voice, from the weekly radio show I do. She said that she appreciated the issues I address on my show. I felt simultaneously flattered and uncomfortable as she had just learned more about certain aspects of my life than most of my close friends.

While it's incredible that such a resource exists in our community, what are the implications of people avoiding its service because of the potential situations I found myself in? Sitting in the waiting room, I internalized the falsehood that my fellow visitors and I were there exclusively because of problems and not out of personal responsibility. It's a Catch-22 in a culture that pays lip service to sexual health and personal care while simultaneously demonizing those who initiate it. This double standard is more visible in a small town than in a large city like New York where a visit to such a clinic is as private and anonymous as most other aspects of urban existence.

Last year, Alex Cukan wrote in the United Press International about the stigma associated with hepatitis C, or HCV, that keeps people from getting tested (and then treated). She wrote of one UPI reader who holds an HCV support group in a small rural U.S. town. At this support group, fear was illuminated when a woman told a tale of her local doctor informing her husband of her condition before even letting her know. As if that wasn’t bad enough, the reason the doctor felt the need to inform the husband?—to let him know his wife was either using drugs or sleeping around, the supposed only ways she could have contracted this disease (maybe it was her husband who was up to something, but of course that was not suggested). Not only is this an invasion of trust and privacy, but this woman was not guilty on either account, so you can imagine the frustration that must have followed.

Another instance, in her book, The Real Truth about Teens & Sex: From Hooking Up to Friends with Benefits, Sabrina Solin Weill writes about an instance shared by Robin Stein, director of Response Center in Chicago, a teen health and education center where news of a small-town breakout in her area affected many. Almost an entire class of seventh and eighth grade students got tested for chlamydia and oral herpes, only to find out nearly forty of them wound up being infected with STD’s due to a phenomenon pretty popular in the early ‘00s called “buddy sex,” sexual encounters with friends, no strings attached. But there are apparently strings that bind you in other ways.

The backlash obviously exists, and it can be harsh, but it certainly isn’t reason enough to skip being tested. Despite the stressful nature of my personal experience, I feel fortunate to have such a great resource in this small town. Since I don't have health insurance and am low-income, all of the services were free of charge. It is one rare example in the U.S. where health care is seen as a human right accessible to all and not an industry determined by economic growth. (Btw, I recommend Michael Moore's latest film Sicko for a disturbing expose of this profit-driven system and how backward US health care (usually) is compared to the rest of the industrialized world, and yes even Cuba.)

From small rural villages and college towns to the biggest metropolis, a healthy sexual culture depends on access to education, resources, and affordable care. Beyond those necessities, we must work to further break down the taboos that lead to higher rates of diseases, teen pregnancy, and sexual assault. This begins with open and honest conversations with our friends and partners, from bedroom to the waiting room.from the bedroom to the waiting room.

 

 

Illustration by Justine Zwiebel

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