How Do We Minimize Stigma In Health Care?

The Health Care Setting: A Starting Point for Stigma

The health care setting is definitely one of the core starting points of stigma. I see it this way because, oftentimes, it’s where people’s internalized stigma first gets activated. When someone gets a herpes diagnosis, that’s usually the moment they receive their first external confirmation. Of course, they may have noticed a symptom earlier, started Googling, and let their mind race. But the health care professional is the one who either validates their concerns or reassures them that it’s not what they think.

The Challenges Health Care Professionals Face

Health care professionals deal with a tough set of challenges. I spent three years as a simulated patient for different medical school programs while simultaneously educating public health and mental health professionals on herpes stigma from the patient perspective. In all that time, I only encountered one case per year that focused on sexual health symptoms.

For those who don’t know what a simulated patient is, think of it like an actor for health professionals who see patients. The simulation involves a patient presenting a concern, and the professional has about 15 minutes to identify and treat it. But here’s the twist—it’s not just about treatment and diagnosis. They’re also graded on how they make the patient feel. The patient gives feedback, and that becomes the learning experience.

The Complexity of Patient Interactions

These interactions can get REALLY complex. A patient might come in with no symptoms or a variety of them. They might come in for one issue, and the provider could uncover something completely unexpected.

What makes the simulated patient experience so valuable as a training tool is that it allows providers to hear directly from the patient about what it was like having them as their provider. The things a patient values can be completely different from what a health professional was trained to prioritize. I can’t count how many times providers thought they did a great job based on their training, only for the patient to bring up concerns their training hadn’t prepared them for.

Words Matter: Challenging Stigmatizing Language

One of the few scenarios I was involved in that actually brought up sex was about whether or not I used “protection” with my sexual partners. Me being my silly, stigma-free self, I loved challenging the learners by asking, “Oh, what do you mean? Do I carry my gun on me during sex?” They always caught it, realized that “protection” was a stigmatizing word, and changed it to something more accurate like “condoms” or “barriers.”

In feedback sessions, this moment always stood out to them. Many said they would never call condoms or barriers “protection” again. That made me happy!

Alongside these lessons, I also gained a better understanding of what health care professionals diagnosing herpes are actually working with when it comes to STI education, sexual health, herpes, and stigma. This gave me more empathy for providers and helped me integrate their perspective into my herpes and stigma education for the general population.

Where Health Care Falls Short in Emotional Support

At Something Positive for Positive People, I support people navigating herpes stigma through herpes support calls and Yoga Therapy. People generally get the treatment and diagnosis for herpes, but when it comes to the emotional support and communication they need? Let’s just say that, overall, clinicians haven’t scored well in this area.

I talked about this in an episode of my podcast on The Prejudice of Stigma. A critical point came up:

Imagine someone notices a bump on their genitals and, in a panic, goes to the nearest urgent care at 1 a.m. They see a nurse, go through the formalities, show the bump, and the provider says, “Oh, it’s not that big of a deal. It just looks like herpes.”

You probably cringed reading that, right? You’re seeing this from the patient’s side, so you should cringe—because this is a big deal. Nobody wants herpes. There’s no cure, and it spreads through physical contact—AKA sex in this case—so in the patient’s mind, their sex life is “over.” That’s a huge deal for them.

Now let’s switch perspectives. It’s 1 a.m. at an urgent care. Let’s say it’s summer, a time when crime and violence tend to spike. This nurse usually deals with life-threatening cases—gunshot wounds, stabbings, and other emergencies. Not all of their patients will survive.

So when you read, “Oh, it’s just herpes. It’s not that big of a deal,” does your perspective change? Did you still cringe? Or was there some relief in knowing that this patient will live?

Perspective Is Everything

What I learned from this is that perspective is everything. We need to be empathetic to both the patient and the provider while also taking accountability for our own word choices and where we seek testing and treatment. I’m not excusing the language by any means, but I am acknowledging where it comes from. Intent doesn’t negate impact, and regardless of whether harm was intended, harm was still done to the patient.