Consultation with the CDC

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BDSM and Kink Makes the Rounds in a Grand Way!

I was honoured to speak at the Grand Rounds with the BC Center for Disease Control, along with Victor and Chase. Below is a video of the session, along with the press release that accompanied it.

I do want to say that I made a mistake in my use of language during this video. I referred to someone being “male bodied” or “female bodied” and this language is problematic when talking about people who are trans. I should have instead said “assigned female/male” at birth.

(Vancouver, BC) On January 22, the BCCDC’s ‘Grand Rounds’, a series of knowledge translation sessions with internal and external speakers and guests, took up the discussion of “BDSM and Kink in the Examination Room – What’s Your Role to Play?”

Approximately 30 people attend this lunch-time presentation that was described as: within public health and clinical practice alike, efforts to reduce barriers to accessing services have been prioritized for communities that are subject to social and health inequities, such as LGBT/2S, Indigenous, and racialized communities. In spite of this, there is still a need for healthcare providers to properly work with other sexual identities and behaviors, like people who practice BDSM and Kink. Many BDSM/Kink-identified community members report being less likely to seek medical care due to stigma, fear of provider rejection, and concerns about providers reporting consensual sexual behavior as abuse. This presentation will provide an introduction to BDSM and Kink identities to equip clinicians and other health professionals with tools to better serve members of the BDSM/Kink community.

A frame work and context was offered by Joshua Edward, Ph.D, Coordinate of the Dual Daily HIV & Syphilis (DuDHS) PrEP Study and the HPV Screening and Vaccination Evaluation in MSM (HPV-SAVE) studies and Harlan Pruden, Educator for the Chee Mamuk program. This was followed by a panel discussion of local BDSM/Kink-identified community members and leaders, Sara Blaze, Victor Salmon and Chase Hunter, from Metro Vancouver Kink Alternative Lifestyle Society (“MVK”), BC’s largest BDSM not for profit organization which focuses on promoting outreach and education.

Travis Salway, Ph.D., the moderator of this event, offered the following reflections:

(1) Consent: I was struck by Sara Blaze’s words: “Consent is paramount.” And also by the audience question that prompted Sara’s response. Indeed, we (including we in healthcare, we in public health, we in society generally) can learn a lot from BDSM and kink communities about consent. In these communities, as we heard today, consent is constantly negotiated and re-negotiated. And through this process, the conversations get “deeper and more nuanced”, in Sara’s words. By opening these conversations, many members of BDSM and kink communities then have a language and frame of reference to return to when consent is violated. For me, the work that MVK modelled and shared with us today raises numerous questions that we should be poised to answer at BCCDC and in the public health community beyond: How do we contribute to and hopefully bolster a “culture of consent” in the communities and populations we serve? How should public health practitioners themselves elicit consent from clients/patients/communities, borrowing standards established by BDSM and kink communities? E.g., understanding that consent must always be re-visited & re-negotiated; understanding that consent is a conversation, not a carte blanche.

(2) Healthcare in the context of stigma: As with other sexual minorities, members of the kink and BDSM communities may feel deterred from seeking healthcare because of stigmatizing or prejudiced attitudes they’ve encountered in the healthcare system before. There is a lot we can do about this, both short-term and long-term, and here I think we can borrow from lessons we’re learning around other stigmatized topics related to sexuality. Short-term: Victor mentioned a list of kink/BDSM-affirming providers they’ve compiled at MVK. Can we help get the word out about these providers to other British Columbians who fear a visit to a healthcare provider because of stigma? What can we learn from these providers about how they make their practice affirming of folks involved in the kink and BDSM communities? And how do we expand access to kink/BDSM-affirming providers, through our existing public health clinics (STI clinics, reproductive health clinics, sexual violence services, mental health services, etc.), or through new services, yet to be imagined? Long-term: How do we translate what we’ve learned from MVK and others about best practices in healthcare, so that we have a fully responsive healthcare system?

(3) Research: More than anything, I left the Grand Rounds today with a sense that there are large and looming research gaps that keep us from doing more/better for kink & BDSM communities. As a first step, we need a fuller picture of what types of BDSM and kink are practiced, and across multiple communities & intersecting identities. We also need to know how members of kink & BDSM communities would like to receive health services. Other sexual minorities (for example, LGBQ/2S/+ folks) experience health disparities related to issues like suicide, depression, anxiety, substance use, sexually transmitted infections, and possibly chronic health conditions (due to a chronically elevated allostatic load in response to social stressors). Do similar inequities affect members of these communities? And if so, how do we respond within public health?

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