Stop Relying on Us!

The mental, physical, and financial load on women¹ and people who have or have had a uterus² when it comes to intimate health

Disclaimer: This article is non-heteronormative, non-cisnormative, and also not treating monogamy as a relationship standard.

One day, my partner came home after a visit to the dermatologist telling me: “I got HPV. You need to get checked, too.” This was followed by me calling my gynaecologist for an appointment, and texting my second partner to get checked, too. The following months, I assisted one of my partners with their HPV treatment, while getting regular checks at the gynaecologist to make sure that my vaccine had been keeping me safe, so I would not pass it on to my other partner. All of us had been using condoms but here we go — you can still get HPV just on those parts that are not covered by a condom.

My appointments were taxing: Each time I lost several hours in the day for getting there, examination, getting back. I was lucky enough to work from home but ultimately, I had to work longer during those days. They also quickly started to be expensive, as I had to pay each time I got an extra check for HPV. Unfortunately, they were also very painful, each smear and cell sample caused me to bleed for at least a day, so I was not looking forward to them. But I did those to keep all of us safe.

Since both of my partners at the time were assigned male at birth, born during a time before the HPV vaccine existed, they had never been offered the vaccine. When I got my vaccine after the age of 30, I had to pay it in full — around 500 EUR. None of my partners had offered any help, and none of them got vaccinated afterwards either. So ultimately it dawned on me:

Their health depended on mine. If I had not gone through the ordeal of frequent uncomfortable testing and paid for the three shots of Gardasil 9 (each of which made me very sick for three days), both of them would have HPV.

They did not think much of it as for them, HPV in the genital area would not lead to cervical cancer since none of them was equipped with a cervix (and they did not seem to mind that HPV from unprotected oral sex can also lead to throat and tongue cancer). They also did not have to get annual pap smears for prevention, so they had no regular reminder that HPV even exists — unless you count me as one. Society made it very simple for them to ignore. As a result, none of them gave in to my asking them to get the vaccine, or compensating me for getting extra checks to make sure my vaccine saved me and all of us, let alone even offer any support to make up for the time lost in the doctor’s office, eg. by helping with getting groceries.

Why You Should Bother

The point of my story is: If you have been been dating people who are not cis men, chances are you are not aware of how much your own health relies on that of the people you have been dating (especially if you are a cis man). Your dates might have had medical procedures that were exhausting, painful, and expensive to keep themselves and you safe — and you might simply not be aware of those, or of the load this puts on their shoulders. This article aims at creating this awareness, and demand that you, from today, try to share 50% of that load.

There are so many situations where cis and trans women, as well as anyone else with a uterus (eg. trans men and many non-binary people) are doing things that you might unconsciously take for granted, and so many different ways of how this puts a higher load on their shoulders, that I think it is time we talked about that — in every little detail.

Bare with me — I am 100% convinced building more awareness can improve your relationships and make you a better partner.

REGULAR DOCTOR VISITS

Do you fancy to sit on a chair, butt naked, arse up in the air and your legs spread wide, while one to three people are in the room, using instrument to open you up and take a deep look inside? No? Take a moment and reflect on why. These visits put you in an uncomfortable and vulnerable place — and you have to trust your doctor to do the right thing and be gentle at that. Unfortunately, the bad news is that there is a massive bias against women and people with uteri in medicine. Patients often face not being taken seriously even when they suffer, having their boundaries overstepped, sexist remarks, or even assaults. As a result, many people each year die from ovarian cancer or suffer from endometriosis for decades before finally being diagnosed and getting their appropriate treatment.

CONTRACEPTION

Your partner might want or need medical intervention — either through taking hormones, hormonal or non-hormonal IUDs, other methods that require a lot of attention and planning as well as equipment — to improve their sexual health. The reasons could be issues with their menstruation, manage and treat endometriosis, or to put their mind at ease if condoms are simply not safe enough.

It is important to understand:

Anything your partner does for contraception can impact their sexual health, and often also impact yours. Most interventions for contraception come with additional risks for their health, and a considerable cost. As their partner, you should not only care — you should aim to help them with any choice they want to make, by:

• Listening when they are still going through their options
• Informing yourself about the procedures that might be considered, as well as potential side-effects or signs for serious complications
• Offering to help them find more information about their options
• Offering to pay part of the price as most options will not be paid by insurance (eg. IUD placement, regular checkups
• Offering them assistance before, during, and after appointments
• Offering them help outside of a procedure as they might not feel fit enough, eg. to get them whatever they need from the pharmacy, chores, etc.

You should, however, never attempt to persuade your partner to take an option that is more convenient to YOU. This is their body, and while it can impact you, too, this is not your call to make.

STIS AND STI PREVENTION

If your partner has been dating cis men before, they might not feel comfortable to bring up prevention or checkups by themselves as they might be used to being shamed or gaslighted. Do not wait for them to bring it up — take the initiative and bring it up yourself (Shaun Galanos gives some great advice of how to do the talk without that being awkward).
Offer a safe space to talk about whether or not any of you or your previous or current partners ever had an STI, what you would suggest to do to prevent from them, and most importantly invite your partner to suggest what they would like. They might simply never had a safe space to really ask about that. Maybe even ask them what they would need to feel safe to discuss this openly with you at the beginning of your conversation.

And most importantly:

Inform yourself how the products your partner would like to use work best, and make sure they are available. It happens all too often that they had been the one to remember to get new condoms, search the web for internal condoms or dental dams as they are usually not available in pharmacies, and are also usually more expensive than classic condoms, or to get more lube. Oh, btw — lube does make the use of condoms safer, while removing the pressure of your partner to get and stay wet enough at all times. Which means you should inform yourself which type of lube works best with your protective product of choice, as well

Are Condoms not Working for You?

If you are equipped with a penis and find condoms are not working for you, chances are you simply haven’t found the correct size yet. Again, do not have your partner do all the research, please do it for yourself but this can be helped and should by no means be a reason to put any pressure on your partner in an attempt to make them choose another or no contraceptive method for your comfort. If you really feel like you would prefer another option, do your research and make suggestions but be careful to not persuade them to do something that might not feel safe enough for them.

SEXUAL WELLBEING

So you want your partner to have fun in bed? This requires them being healthy and well; but also, it might require some extra bits to prevent from them getting a bladder infection after intercourse, or having some discomfort during their menstruation. So yes, you should care about those things that do not make YOU sick, too.

Sex Toys (yes, you read that right)

Your partner’s intimate well-being is as much your concern as it is theirs; if you feel they cannot get an orgasm during intercourse with you, and they wish to add a toy to the mix to achieve their satisfaction, they should not carry the financial load all by themselves — YES, they can and might use it also when they’re only by themselves, but they might also use it together with you, so I suggest you offer them to help financially AND timewise by doing your own research for suitable products.

Lube

A lot of lubes are actually not suitable for a vaginal pH; the result is that folks with vaginas using unsuitable lube can suffer from irritation on their mucosa (which can make sex uncomfortable or painful and that discomfort can last for days after intercourse), or in the worst case bacterial or yeast infections which need doctor visits, treatment, and bring their own kind of discomfort and pain. To avoid this from happening, assist your partner with finding what works best for them, by dedicating some time for research, taking the initiative in trying new brands out, and by sharing the financial load.

Bed sheets or other special equipment

Is your partner a squirter? Or are they just in general bothered that whatever products you may use, they could stain the sheets and be difficult to remove? Are they menstruating and enjoy intimacy during their cycle? Help them out, eg. if they wanted to use special bed sheets for sex, share the time for research and the financial load. Also do remember to wash and dry them on time; do not have this task on your partner’s mind only.

Cycle-tracking devices

These often come at a certain price, and they might require some discipline (such as remembering to wear the device every night and update some stats at specifics times in the day). These also help figure out early if something is wrong — reminder: as a cis man dating non-cis men, your health partly depends on your partner’s health, too, so you’ll benefit from this as well. Not a bad idea to help them out if they wanted to use such a device. Get yourself familiar with how it works and support them.

Menstrual products

Some folks might prefer to use products to make sex less messy during menstruation, eg. soft tampons. Please keep in mind that it does not matter if YOU think these are necessary or not; it matters what your partner feels better with, as this is their body.

BTW, even outside of what you’re doing in the sheets, menstrual hygiene comes at a cost for menstruating folks. There is both a gender pay gap AND taxes on menstrual products, read: they might earn less than you or other men in their area of expertise, AND pay more for what they need as a basic hygiene product. This needs, undoubtedly, to be solved systematically (read: by the government), but we all know this is not happening any time soon. In the meantime, it is your duty to help close that gap a little by paying part of their menstrual products, even if they do not use them during intimacy. Please keep in mind though that THEY make the choice what they want to use, not YOU. Try to avoid suggesting what you think is more comfortable or less expensive. You’re not the one using those things in or on your body, so the choice is never yours.

Medication

Some menstruating folks need pain medication or devices to help with menstrual cramps. These come at an extra cost, too, and require planning to be available when needed. Support your partner(s) whenever you can, both financially as well as by sharing the mental load (remembering to check if things they might need are available).

Medication vs. orgasms

Is your partner on medication that inhibits their ability to have orgasms (some painkillers, anti-convulsants, and anti-depressants can have this as a side-effect)? This can be very frustrating for them. Take the initiative to help them find other pleasurable things to do, or if they wanted to have orgasms, help them prepare for doctor visits to get better care. Unfortunately, in our society, men might be offered sildenafil to help — women and people with uteri are told to just live with it. (Sildenafil, however, has also been reported to help for people equipped with a clitoris but your partner will most likely never get to convince a doctor to give them a prescription.)

Now that we have covered all the situations and ways of how you could and should be helping your partner — let’s talk about what it does to your partner if you did not take as much part as we suggested here:

The load on women and people who have or have had a uterus

Every time they have to see a gynecologist, every time they have to remind you to use lube or discuss who is getting the next pack of condoms, there is a specific load on your partner’s shoulders. You might have heard about mental load³ before — this is however not the only load your partner has to manage. Getting familiar with the types of load that come with being a woman or other person who has or has had a uterus in society will help you to support them even better.

The 5 types of load

1. Mental load
2. Physical load
3. Temportal load
4. Financial load
5. Emotional load

Mental load

If they are the one in your relationship who mostly remembers to get new condoms, lube, their new prescription for contraception, informing themselves about the HPV vaccine and where to get it — even if in some cases they ask you to get whatever is needed, they have been carrying the mental load of managing your relationship’s intimate health.

Physical load

Every time your partner has a physical exam at their gynecologist’s, every time they take hormonal contraception, or when they get a vaccine for HPV — they are carrying the physical load of your relationship’s intimate health:
Some exams can come with a lot of discomfort, hormonal contraception has side effects and puts them at a higher risk for blood clotting and strokes, and so on. If they get an IUD, the procedure can be indredibly painful as well as lead to serious complications later on, such as perforation of the uterus or ectopian pregnancies.

Temporal load

This is the load related to the time your partner is spending with gathering and processing information for their sexual wellbeing and health, as well as the time they spend to find a doctor and go to an appointment. In many cases, they have to see their gynecologist regularily — which costs time they might otherwise have spent at work, so they will have to work longer, or which costs time that will be missing out of their day for other things such as chores, studying, or simply: relaxing. While you might not be able to take all temporal load off them, you can try to make up for the time they lost by offering them help anywhere else to safe time. You could, for instance, encourage them to relax after their appointment and ask them if there was anything you can help with, eg. chores, getting something from the supermarket, etc.

Financial load

While this one might seem straight-forward, it is surprisingly often ignored by anyone who is not a woman or person who has or has had a uterus:

Every time your partner is getting their prescription for hormonal contraception or painkillers for menstrual pain, menstrual products, dental dams, regular checkups such as PAP smears and ultrasound — they are paying for this and as such carrying the financial load of your relationship’s intimate health. They might not be used to anyone offering them to carry part of that burden, or might have made bad experiences when trying to ask for help with previous partners, so you should not expect them to remind or ask you for help (see also: mental load).

Make yourself aware of the cost they have to ensure their and your sexual health and wellbeing, and offer them to take part of that load. Encourage them to tell you after an appointment what their financial load has been so you can offer your help.

Emotional load

How is this one different from mental load, you may ask?
Mental load did not cover how your partners will feel about any of the above — but being the one who is carrying most of the discomfort, risks, and financial burden of your relationship’s intimate health can cause a lot of emotions and this can in itself be quite exhausting. Especially if they do not have a safe space to talk about how this makes them feel. Here are some examples:

• Having had an appointment and you are not asking about it at all — gynecologist appointments can be very taxing by themselves but feeling as if their partner did not even care can lead to disappointment and loneliness.
• Not feeling safe during their appointment — you might not be aware but a lot of people have experiences doctors overstepping their boundaries in a very intimate setting, as well as their needs or pain not being taken seriously. This comes with extra stress and is something that they usually have to deal with alone.
• Having to remind you about something they have asked you before, eg. getting or using lube when having sex — aka mental load — can be making them uncomfortable, as it might seem you do not care enough about their safety and pleasure, and frustrating.
• Managing your feelings. Do you express frustration or justify yourself when they ask you for support with any of the above, or when they express their frustration about carrying all the load by themselves? You’re making your partner manage your feelings on top of their own and your relationship’s intimate health. This can be very exhausting and is, frankly speaking, not their job.
• Having your very sensitive intimate organs being examined by a doctor can be taxing by itself; have you ever thought about whether or not this might actually be safe for them? You would be surprised how many people have made inappropriate experiences with their gynecologists. Their doctors could make flirty remarks, shame them, gaslight them when they seek help for their symptoms, and much more. Your partner might have to manage being upset about it, or being anxious before each appointment.
• Natural cycles can have a massive impact on your partner’s feelings about anything. Yet people with a menstrual cycle might be used to being gaslighted and expected to function even when they are suffering from PMS or other symptoms. They might simply be way more vulnerable in the second half of their cycle. Have you ever talked to your partner about that and asked them what needs they might have? It could for instance help a lot to me more attentive and careful when they are PMSing, and offering them help wherever possible.
• Hormonal contraception can have a massive impact on all of their feelings as well, some good, some bad.

This list is not complete; emotions are highly individual.

What you can do:

In a nutshell: Find out what their load could possibly be — then offer them to help out.

They might be surprised, or not want you to come with them to the doc’s — please accept that and to not pressure them! — but at the very least, you should show emotional support by telling them that you care, that you appreciate what they are doing for their, and thereby, YOUR health, and that you know of the possible issues they are facing. Encourage them to speak up and offer them the space to listen to what they say without judging. This is the very least you can do.

Footnotes

¹ women: unless stated otherwise, “women” is the umbrella term for all women, cis and trans — keep in mind that not all women might have a uterus

² “people who have or have had a uterus” can refer to some non-binary people and trans men — I understand this is not an ideal choice of words and has limitations; if you have a better idea for phrasing, please reach out!

³ Mental Load: “preparing, organising and anticipating everything, emotional and practical, that needs to get done to make life flow”, BBC 2021