131. Two OBGYNs Talk About Infidelity

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Unknown Speaker (0:36): Hey. Welcome to tell me how you're mighty, real talk about cheating. I'm Tracy Schorn, the blogger known as Chump Lady, where I implore people to leave cheaters and gain lives.

Unknown Speaker (0:46): And I'm Sarah Gorel, radio broadcaster by day, single mother of four. And thirteen years ago, my ex walked out on his family for his affair partner. And it didn't feel like it at the time, but my life is so much better without him.

Sarah Gorel (0:58): And we're here to tell you that you are mighty. We survived infidelity, and you can too. And this is our podcast. Welcome. Hey.

Sarah Gorel (1:10): Today, we're talking about women's health and infidelity with two OBGYNs, doctor Leila Musavi and doctor Diane Trankel. Leila and I went to college together, and Diane and Leila were practice partners together for many years. And they are straight shooting women who've seen it all. Welcome, Leila and Diane.

Unknown Speaker (1:29): Thank you.

Unknown Speaker (1:30): Thank you.

Sarah Gorel (1:30): I just wanted to talk with you guys because getting tested for sexually transmitted diseases is one of those awful things that you need to do when you've been cheated on. But there's a lot of magical thinking about it. Like, you have to accept that your partner was unfaithful, but you might assume that they used protection. And then, of course, cheaters also have magical thinking, and they often do not use protection. And the way you find out you've been chumped is you have a bad pap smear.

Sarah Gorel (1:59): So I was interested in talking about this from your perspective as medical professionals, what you see and what you would want people to do in this situation. You know, come to you. It's okay. You've seen everything. And I'll let you guys talk about, you know, what comes to your mind.

Leila Musavi (2:19): I'm not an active practice, of course. Now I'm retired. But one thing I recall is there would be a lot of almost wasting time talking about whether or not cheating actually happened as a kind of way to delay the reality of the testing and the reality of what was happening. So I would spend a lot of my time trying to convince the woman that even though we're not a 100% sure, testing is a good idea. Just let me do this so that we can start medically addressing any repercussions of whatever actions happen.

Leila Musavi (2:52): And if everything comes back fine, that's not proof or disproof of any behavior, but at least she's safe physically. So that was a source of frustration for me because they would wanna say, but but maybe, but maybe, but my girlfriend, but I

Unknown Speaker (3:07): don't

Unknown Speaker (3:07): know. And like, just let me do the testing. Let's get on with this part. So yeah, that's my thoughts.

Diane Trankel (3:15): Yeah. You know, obviously a very sensitive topic and you do have to keep in mind that there's a lot of guilt and shame involved in being cheated on. So you you have to be very sensitive to that when you do approach the topic and also educate them on how even having, or the thought of possibly having a sexually transmitted infection from infidelity can cause not just a emotional, mental impact on you, but also physical impact on you in your future health, as well as potential economic impact. And so it's very important for us to kind of tease out and encourage our patients in their self care basically, you know, approach it as self care because a lot of times women, we take care of everybody else and we take care of ourselves last. And I think that kind of carries over to this issue.

Diane Trankel (4:19): And that's what Layla was talking about, how they kind of dilly dally about the decision of what to do because there's a lot of shame and

Leila Musavi (4:26): Yeah. I think that's part of the denial process. And I understand that The sooner we find out if something's happening, the better overall for her. The other thing with sexually transmitted infections is the limited scope of what people understand those possibilities to be. So, you know, they think about maybe chlamydia or gonorrhea, maybe HIV, but HPD, which causes cervical cancer and head and neck cancer, is a huge problem.

Leila Musavi (4:56): And so if you've been monogamous or thought you were monogamous for twenty years, you would not have maybe gotten the vaccine or you're too old to get the vaccine when it came out. You get you thought, well, I'm I don't have to worry about that.

Sarah Gorel (5:08): Yeah. We interviewed, Eileen Fox. I I think I shared the article with you guys. She's a woman who thought she was in a monogamous marriage for thirty years, and her husband had a double life with men. And she got a very virulent strain of HPV sixteen, and she has vulval cancer, anal cancer.

Sarah Gorel (5:28): I mean and so she's out there trying to get people to get the HPV vaccine. I had no idea that it's very hard to get if you're over the age of 45, which just kind of shocks me that that's a thing.

Diane Trankel (5:41): Right. And the vaccine is indicated for under 46. You can still get it, but your insurance won't cover it. But you know, if I have women who are divorced for other reasons and they're contemplating dating again, I remind them that STIs exist because they're like, oh, I haven't thought about that for so many years, you know, and I would say you you really need to protect yourself against HPV. Yeah.

Diane Trankel (6:09): That is a biggie, you know.

Leila Musavi (6:11): And the other part of that is when you see older women who once they reach menopause, let's say, that's kind of what they consider condoms for is protecting themselves from pregnancy. And then they take themselves out of play from STIs in their heads. But in reality, it's crazy prevalent. And I had an instance where I had an a widow who, you know, we live in Michigan. So people go south for the winter.

Leila Musavi (6:44): And she had gone newly widowed and gone south for the winter and, met a gentleman and, had some fun and which is great. You know, you you're great. But then bumps had appeared and she came back to me because I'm her doctor and she was freaking out. And I looked at it and I said, you know, this looks like warts. And if you are a college student from Central Michigan University, that's be my automatic response.

Leila Musavi (7:13): But because you're in your sixties, I've never seen that, you know, like that. And so I, was concerned, and I I did biopsy to make sure they were. But that's a real problem is the lack of education in that population. On the doctor's side too, you don't expect it. You know, you you have in your mind who gets STIs, and it's usually not somebody who's, you know, got silver hair.

Sarah Gorel (7:37): Yeah. It's a growing demographic of people over the age of 55 getting STIs. The bacteria doesn't know how old you are.

Leila Musavi (7:46): It doesn't care. And the other this is apart from the cheating situation, but it can be, I guess, is in that demographic, in the straight heterosexual women, there's far fewer men who are available. So all you need in one of those retirement communities is one or two gentlemen who are very active and, again, not worrying about pregnancy, and they are a loaded gun, if you will, and are just spreading it around.

Sarah Gorel (8:12): I wanted to talk about one thing you were talking about, denial when you're asking people to get tested. But one thing that I see a lot is chump lady, okay, is that a woman will start to have symptoms. You know? She'll have some discharge, something weird. And, again, she's presuming that she's in a monogamous relationship.

Sarah Gorel (8:31): Okay? And she'll talk to her doctor or something. But she's been gaslit, right, from her partner. You guys like, oh, you got that? I'm I'm not kidding.

Sarah Gorel (8:40): I have heard the toilet seat. That didn't come from me. You know?

Unknown Speaker (8:44): Yeah. We hear that too.

Sarah Gorel (8:46): Cheaters, they just mind fuck their partners that what they're experiencing in their bodies is is not real. And, of course, you don't wanna believe it because it's so horrifying to think of that. And so maybe you won't let your doctor test it, or you'll say, no. I'm good, you know, or I got this somewhere else.

Leila Musavi (9:02): Yeah. I think the symptoms start the questions in your mind. Yeah. And then if you come to the office and say, you know, doc, I've got this itchy discharge or a pump down there or whatever, then we are put in the position of saying, I think, you know, we should do some testing. And now I'm opening the door to not just suspicions, but real tangible problems in the relationship.

Leila Musavi (9:27): And then you have you're stuck as the patient probably and speaking not from personal experience, but thinking, do I really wanna say this out loud? Because that that's gonna make it real. And it's gonna shatter everything in your life. Everything that you believe about yourself and your family and just your whole public persona is gonna be destroyed. And the other thing is discharge isn't the only thing.

Leila Musavi (9:52): I would run into this with bleeding between periods or suddenly the periods have changed. I've been on the pill forever and now my periods have changed. Well, that's a symptom of an infection. And how do you say that without well, where would I get that infection from, doctor Musavi? I guess we can talk about that too, or maybe you need to go home and talk to your husband.

Leila Musavi (10:13): I don't know. And then some partners would convince her that she was cheating.

Unknown Speaker (10:18): Oh, good grief.

Diane Trankel (10:19): That happens a lot too with the projection. Right? In order to derail their suspicions is to turn it around on the Trump and say, you must be the one cheating because it's not me. And then they start questioning their own reality. You know?

Sarah Gorel (10:38): Yeah. Don't know where your body's been. When you're having medical symptoms, that's like next level mind fuckery. Right?

Leila Musavi (10:45): Absolutely. Yeah. I had a longtime couple, and she had developed herpes symptoms. And they both came to the office, and I said, this is herpes. I mean, it's classic herpes.

Leila Musavi (10:59): And he was demanding more testing than is clinically needed. And he was waving his arms and yelling about her cheating on him. And she was just in shock, like catatonic practically, because not only am I saying that word, but she's physically uncomfortable. She's in pain. And now her husband is standing in the office yelling that everybody can hear him yelling, you must have cheated on me.

Leila Musavi (11:26): Where else could this have come from? And so it was like a horror movie from her perspe and ours too is because trying to get him to pipe down, why are you doing this? I'm not a police officer. I'm not gonna go to their house and interview everybody they know. So And then you have to deal with the fact that is she going to be safe?

Diane Trankel (11:46): Yeah. Because domestic abuse plays into this very often. And that's one thing that a lot of women don't realize that they're being abused until we actually bring it up in the office and they'll be telling me things and minimizing things. And, and it does sometimes, you know, involve cheating as well. And I have to just say point blank, do you realize that you're being abused?

Diane Trankel (12:14): I might've been the first person or only person who's ever said that to them or asked them. And there's no easy way to say that. Do

Unknown Speaker (12:23): they go over this in medical school?

Unknown Speaker (12:25): Absolutely not. Maybe they do now. I don't know. This I mean, it's a long time. They're over thirty years ago.

Leila Musavi (12:31): We exist in a patriarchal society rife with misogyny. So I don't know why I'm so surprised when looking back at how much that color, how we were taught about women's health. And to be perfectly frank and not on the subject of cheating, but just generally on women's health is that when women age, because this is a patriarchy, we lose our value to society in a certain way. We're not sexually available, and we're not viewed as sexually available. And so we become progressively more invisible.

Leila Musavi (13:05): And that happens with doctors, male doctors, female doctors. When a 60 year old comes in with a discharge, do we all think of sexually transmitted infection? Probably not because she has been removed socially from the pool of sexually interesting or available women. And I think that tends to women of color. We value white women who are young and everybody who doesn't fall into that has to fight as an individual to be viewed as sexual and then therefore get the care they need.

Leila Musavi (13:40): So I think that's a real big part of it. And the medical school criteria are written in that milieu of misogyny and patriarchy. And the research goes that way too. And so, you know, the idea that women want to be sexual later in life, it's kind of breaks the mold, and it goes back to the whole cheating thing in terms of when a partner cheats, everybody looks at how they look and makes a judgment based on that. I don't know how many times I would say to women, your partner cheating on you has nothing to do with you.

Leila Musavi (14:13): It's a 100% hip. Right? And the analogy I would use because I work in a rural community and I would say, you know, we have a farm and we have animals. And there are some animals if I left the gate to their pen open and overnight, and I would go in the morning, and they'd still be in the pen. And they'd be say, hey.

Leila Musavi (14:32): You know? Where's my breakfast? And there are other animals that wake up at dawn and spend the entire day, and I'm not kidding. This is with horses especially, pushing on the fence, seeing where's the hole? Where can I get out?

Leila Musavi (14:44): That's how they are wired. It has nothing to do with the fencing. It has nothing to do with how they live. They are not gonna be faithful and they're liars. And that is a lying behavior.

Leila Musavi (14:55): And I would explain it to patients like that because I think it kind of made some sense to them.

Diane Trankel (15:00): That was actually a big one. It is so hard to convince people that they are not the cause of their spouses or their partner's infidelity. Blame yourself first.

Sarah Gorel (15:12): That's what all the literature out there tells you. I mean, which is why I became chump lady. You know, what do you do to make them cheat? And how are you going to improve yourself to win them back? You don't control that, you know?

Sarah Gorel (15:23): That horse has left the barn.

Diane Trankel (15:25): Yeah. The horse did not care and was never intending to stay there. Exactly. No matter what they said.

Unknown Speaker (15:32): That grass is always looking good to them day and night. But what they

Diane Trankel (15:36): don't understand is that the green hair grass on the other side, they're gonna stamp all over and destroy also. So we're we're not gonna have green grass there either.

Sarah Gorel (15:48): Okay. So getting to the other end of the age perspective, I cannot tell you I mean, it's honestly it's like a subsection of my community. How many people have discovered they were chumps while they were pregnant?

Unknown Speaker (16:01): Oh, yeah. Thousand percent.

Sarah Gorel (16:03): I interviewed a woman in our community who was pregnant with twins. Okay? She had two preschoolers at home, pregnant with twins, in her second trimester when she found out her husband was cheating, and she left him.

Unknown Speaker (16:16): For her.

Sarah Gorel (16:17): During her second trimester, she got divorced from him and, and didn't want him in the delivery room for the twins, and now she's single parenting four children on her own.

Unknown Speaker (16:25): Oh, boy.

Sarah Gorel (16:26): But that story and I don't know what the screening but my understanding are are that there's these prenatal screenings that you go through, and that's when it turns up something like chlamydia or whatever. And they had no freaking idea. And I have heard that story so many times over the years. And I wanted to know if that tracks with your experience.

Diane Trankel (16:47): Yeah. In the first prenatal visit, we check for chlamydia and gonorrhea. Everybody gets a chlamydia and gonorrhea culture. We'd also check for syphilis, hepatitis C, hepatitis B. Like our office checks for hepatitis C.

Diane Trankel (17:01): It's not in the standard labs, but we do because we do seem to see a lot of hepatitis C regionally, but also hepatitis B and HIV. Most of the time it's chlamydia that, and that's the most common, like besides HPV, that's the most common thing that will, bacterial infection that we'll find. And that's when they find out that they have a partner who's been non monogamous with them and it's absolutely devastating. And some of them do stay together and work it out. And some of them part ways during the pregnancy.

Diane Trankel (17:37): And then, you know, the unfortunate thing is that the woman is the one who's going to be carrying the baby and she's gonna be the primary parent anyway. And one of the things that I talk to them about is like, if he's gonna do that during your pregnancy, you don't want him involved in parenting anyway. You know, you're gonna be a single parent anyway, probably even if you were still married or within that relationship.

Leila Musavi (18:01): I've seen cases where I've delivered multiples of their babies. So their first, second, third baby. And between one and the other, they come in for testing, and they'll say, I don't need to get tested, do I? Because I'm still with the same husband. And that's awkward.

Leila Musavi (18:16): And I say, you know what? Those are just the rules. So we're gonna do it. And what I'm thinking is the fact that you're asking me is kind of scaring me a little bit. Like, I'm thinking what's going on in your head?

Leila Musavi (18:27): Why do you care that much? But also, I caught stuff. It's gonna affect the baby. So and I've had cases where the partner was deployed between babies. Boom.

Leila Musavi (18:38): We've got gonorrhea all of a sudden, which is much more rare. And I've had chlamydia. And I will say this. That is probably the one of the hardest conversations besides diagnosing somebody with a loss or cancer, especially if she brings the husband in. Yeah.

Leila Musavi (18:53): And so we just very flatly say, your test results are back, and you're going need to take some antibiotics for the chlamydia that we found. I don't say where it comes from because, again, I'm not the police for this. And I've had cases where the women have stayed mostly because economically they cannot feed and house their children Mhmm. Without his help. And the other thing that's expressed to me is if I leave him and he gets custody partial custody, physical custody, I don't know who's gonna be around my baby.

Leila Musavi (19:26): And so she's making a very hard choice to be the solo mother in the home with the husband present rather than release her baby to the man who's gonna bring whoever around the baby. And so being able to divorce and like the example you gave, that's an amazing privilege economically. But most of the patients that I took care of stayed because they couldn't afford anything else.

Sarah Gorel (19:53): What is being risked? I mean, if you weren't running those tests and given those antibiotics, what happens if you have chlamydia in the womb?

Leila Musavi (20:01): Stillbirth, blindness. So infection in the uterus of any kind can kill the baby. Yeah. And it can kill the baby at any point in the pregnancy. So you might have a woman who develops a fever and tenderness, what we call chorioamnionitis, an infection going up from the vagina.

Leila Musavi (20:20): And that can cause the baby to die or be born too early. And then also, and I've seen this, where the infection gets in her blood very quickly, and she can become septic, and she can die from a blood infection, basically. So because the placenta is such a rich blood interface between mother and baby, anything that goes, goes quickly and dangerously. So if the baby is born through the birth canal naturally through the vagina and there's chlamydia present, the baby can be blind. I had one that she kept getting turning positive in the pregnancy, and it was her, I don't know, fifth baby.

Leila Musavi (21:04): And I kept testing her, and she was positive for chlamydia. And I keep treating her every, like, month. And I was like, what is happening? And can you just please use condoms? And she said, okay.

Leila Musavi (21:14): And I checked her again at thirty six weeks, and she was negative. And she delivered at thirty eight weeks, and I thought we were okay. And then the baby came back with chlamydia and pneumonia. And I I said in the office, how did you get chlamydia again? I thought you were using condoms.

Leila Musavi (21:31): And she said with everybody but my baby daddy. Oh, okay. So this kind of behavior, I didn't I was naive to this behavior. And so babies can

Diane Trankel (21:40): get pneumonia. And chlamydia is the main reason why we, after babies are born, they get the antibiotic eye ointment to prevent blindness. And I'll have patients say, well, I don't need that because I'm married. And so my baby doesn't need that. And I'm just thinking, oh,

Unknown Speaker (21:57): what if? Like,

Unknown Speaker (22:00): you don't know where he's been. In our minds is what's

Unknown Speaker (22:03): the big deal? Put some antibiotics in your baby's eyes.

Diane Trankel (22:07): The risk of not doing it is so high. And that's where the denial comes in as well with people. Well, that's never gonna happen to me.

Sarah Gorel (22:16): When you're trying to denial, I'm thinking, why don't we talk about this shit? I remember going back to Leila's point about the patriarchy and the systemic craziness of all of this. Like, I talk about it on my blog or I write about it. You know, getting cheated on while pregnant, and it just seems to be, like, one of these last taboos or something. Or just like, don't have a wandering dick and bring that home.

Sarah Gorel (22:40): Like, men seem to be completely ignorant of perhaps what they're doing. Like, if you thought that the stakes were as high as you could kill your partner, you could kill your baby if you do this.

Unknown Speaker (22:52): I truly don't think they care. I don't think

Leila Musavi (22:54): they care at all. I think they really don't care beyond their erection. And they have a whole list of excuses. She let herself go. She doesn't want to have sex.

Leila Musavi (23:04): She does not fun. She doesn't understand me.

Diane Trankel (23:06): Yeah. She's changed. And, yeah, I've changed because I am parenting and things change, you know, and you grow as you get older too. You mature. You never stop maturing, like emotionally maturing.

Diane Trankel (23:19): And I'll just let you know that my ex husband did cheat on me. I found out he was having an affair with our babysitter. So cliche. And speaking from personal experience as well, And Layla was my OB who took care of me during the proceed, the process and checked me for all infections. She was my two o'clock in the morning friend.

Diane Trankel (23:43): And I heard all those excuses. Well, you're not fun anymore. You're not interesting anymore. And I'm like, well, I'm raising five children. You know?

Diane Trankel (23:51): Yeah. And news flash, he's not interesting or fun either. No. He's an asshole who is leaving you high and dry to take care of every last thing and then expects you to throw your legs up in

Leila Musavi (24:03): the air and go, yeah, let's do it when you're exhausted and full of resentment. I don't know why these men are are surprised. It's really funny. Now my father-in-law was a family physician who delivered babies for forty years, and he

Unknown Speaker (24:15): was a

Leila Musavi (24:15): psychiatrist. And he would tell men, foreplay is everything you do all day long. If you don't do that, do not expect anything at nighttime. But, also, Tracy, the point of talking about infidelity in pregnancy, again, going back to the patriarchy, women, when they get married or find a long term partner, are told they've accomplished what they were supposed to accomplish, and then the peak is to have a biological child. I don't agree with any of that, but that is really what's out there.

Leila Musavi (24:47): And women don't get married with the intention of divorce. You become the bad guy if you say, you know, could he be cheating on you if she's not ready to hear that? Because everything else in her world, most likely her parents, her friends, the television, social media, is telling her, what are you complaining about? Everything is fantastic. He's got a job.

Leila Musavi (25:09): He takes care of you financially. You've got kids. You've got a big rock on your hand. Welcome to success. And then I'm in there going, you know, he could be wandering and give you diseases.

Leila Musavi (25:21): Not my prince. Well, okay. I guess I don't believe in princes. So bringing it up in pregnancy is is really difficult. And if you say it, and she's not ready to hear that, people get very offended.

Leila Musavi (25:34): They will change doctors. They'll be verbally abusive to the staff. Your doctor is such an asshole for saying that to me. How could you possibly say that? They get on social media, and they destroy us.

Leila Musavi (25:47): So it's really tough. You know, you work out ways to say it nicely, but it's the test that kind of is in pregnancy, especially, you know, your test is positive for chlamydia. There's no way to dispute that.

Sarah Gorel (25:59): Right. Right. I mean, like, were talking with the bacteria. It doesn't care who you are. The test result is what the test result is, and it's not like you're at fault.

Sarah Gorel (26:08): And and I would think too, if you deliver any kind of bad news, you have cancer or whatever, it was just your job as a doctor. From the perspective of somebody who writes about it, it was, like, one of the very first things that came to my mind when I was cheated on. You know? And I'm demanding he gets tested and the rest of it. But what I've learned being chump lady is that so many people, it takes them a long time to summon up the courage to go get tested.

Sarah Gorel (26:32): And they they think that their doctor's gonna judge them. And maybe some will. I mean, I've heard some dad stories, but you guys aren't those people. But it's like it makes it really real when your feet are up in those stirrups and, you know, and they cry, and it's awful. And it's really traumatic.

Sarah Gorel (26:48): And, again, for me, the disconnect is between affairs are sexy, jolly fun and, you know, naughty, naughty, wink, wink. And nobody's talking about this shit. Nobody's talking about what's in the petri dish. You know? No one's talk about how vulnerable or sick or dangerous this could be.

Sarah Gorel (27:06): Or that you could be, you know, like Eileen Fox, the woman who got the horrible HPV strain. You could be in a thirty year marriage thinking your life is one thing, and it could be something entirely different. And we don't talk about how criminal that is. Mean, this woman is, like, fighting for her life.

Leila Musavi (27:23): Well, I mean, look at Giselle Pelico. I mean Yeah. And that's the tip of the iceberg because that stuff and then that whatever site that they found CNN just revealed.

Unknown Speaker (27:32): The rape academy.

Leila Musavi (27:34): Yeah. The rape academy. Yeah. One thing I've I've experienced multiple times, and and it got like, as Diane was saying, it bleeds into the abuse, situation, is the partner comes in to discuss the results. And I've had men look at me in the face, stick their finger in my face, and say, your tests are wrong.

Leila Musavi (27:51): You're wrong. Oh, yeah. There was a mistake at the lab. And I'm like, my dude, with this, just that how we operate. We don't go every single test is wrong because I don't like the results.

Leila Musavi (28:02): So that tells you the emotional maturity of who you're dealing with and, but she's got to go home with that. And that's so scary as a physician because you're like, you don't know what he's going to do to her if you push too hard.

Diane Trankel (28:14): Cause remember that when you're pregnant, you have the highest risk of dying of domestic assault. That's the highest risk group for being killed in a domestic violence situation. And so that's another layer that we have to deal with when we are diagnosing people during pregnancy with an STI.

Sarah Gorel (28:34): Yeah. I was thinking of those guys are coming into your office in a public place with witnesses and confronting you as medical professionals about this test. If they're that bold in public

Unknown Speaker (28:47): What are they doing in private?

Leila Musavi (28:49): Oh, yeah. But I do wonder if they would be that way if we were male doctors. Yeah, there's not. If I had a beard like my husband and was six foot one, I have a feeling Mr. Tiny Dick would shut his mouth and sit down and probably wouldn't even come in the office.

Leila Musavi (29:06): You probably wouldn't have the nerve. So we as female doctors get more of that pushback, I think, from everybody, but also abusive men because they're, like, used to pushing women around. And when we say with our whole chest, the test is chlamydia, and it's positive. It really rocks their world. But, again, you have to be very prudent because you can potentially make things worse for her.

Leila Musavi (29:35): Though sometimes seeing that, some women will, like, see him being an asshole to me. Would they trust me and think to themselves, that might be the breaking point. They might say, look at that and go, who is this guy? And why am I with him?

Unknown Speaker (29:49): I hope it is. I hope that's the breaking point. Oh my god.

Unknown Speaker (29:52): It only help.

Sarah Gorel (29:53): So if you can create your own chump health guide, like someone just found out, what do you want them to do? What's the first thing they do?

Diane Trankel (30:01): Oh, if somebody just found out that their spouse or the partner was cheating on them. If it's not feasible one way or another to go to their primary care, they can always go to an urgent care for testing. They can go to a planned parenthood. There are ways to get tested more anonymously. Our local health departments do STI testing.

Diane Trankel (30:25): So a situation like, you know, this doc has been my doc for the last twenty years and I'm so embarrassed. You can go someplace else. Yeah. Obviously, the problem is access. You know, we're we're so worried about health care access and that is very true.

Diane Trankel (30:41): And that's why certain sectors of our population do have more STIs that are not treated appropriately because of lack of access to health care.

Leila Musavi (30:51): One thing that comes up along the lines of access is that in Michigan, at least, if you are pregnant, you can get Medicaid. And now you have access to health care that you can go and get tested. So they might find the chlamydia because you're pregnant because you have Medicaid because you have insurance, but that's been there for a while. So the chlamydia is just hanging around, or the gonorrhea or the hepatitis or the HIV. Or syphilis.

Leila Musavi (31:20): Yeah.

Diane Trankel (31:21): Yeah. There's actually a nationwide increase in babies born with syphilis. It's called congenital syphilis. There's an increase in congenital syphilis in The United States right now. So people are going untested and undiagnosed until they're pregnant.

Leila Musavi (31:36): Well, and when you add in vaccine denial, part of that is also then the explosion in home births, which we see in our community. Mhmm. Part of that is you don't get tested for anything. And then now there's free birth, which is terrifying.

Sarah Gorel (31:51): What the hell is free birth? I've never heard of this.

Diane Trankel (31:54): No attendant. At home, by themselves, or with family, or A husband. On a beach or in a river.

Unknown Speaker (32:03): That if everything goes well, you just need a catcher's mitch. But everything could go wrong. Oh my god.

Unknown Speaker (32:09): Right. So all of the political talk

Leila Musavi (32:12): in our country right now and the actions that have been taken on a federal and state level has all gone backwards in terms of care of women and children. And I say women, but I I mean people who give birth. Okay? So we were bad before, but it's worse now. And now I'll give you a little story.

Leila Musavi (32:33): It's not to do with cheating. I was in Henry Ford Museum yesterday with, two British men who are friends, and there was a man feeding, like, a six month old child. It was a tour that he'd been on. That's why he's feeding the child. And the man that was with me turned to me and said, where's the mother?

Leila Musavi (32:51): Like,

Unknown Speaker (32:52): okay. Yeah.

Unknown Speaker (32:53): I said, well, I don't, I don't know. How do I know? He said, why is the mother not here? Meaning why is the family not together doing this thing? And I said, you know, the mother's probably at work.

Leila Musavi (33:04): And he said, all right, we have a year of maternity leave in England. And I said, we have nada. We have zilch. Unpaid leave is the same as no leave for the vast majority of women. You can't afford it?

Leila Musavi (33:17): Yeah. So we are going backwards so fast. And the children and the women are paying the price. The people who have the babies and the babies themselves are paying the price. And that goes for you started talking about going to get testing and community services.

Leila Musavi (33:32): That goes for child abuse, sexual assault of children. When you take away those resources, people don't wanna talk about that, but it's very prevalent. And those kids are left out, and there's no adults to check on them, school nurses, Planned Parenthood, health departments. You defund those institutions. I mean, Europe has gotten rid of basically cervical cancer with blanket HPV vaccines.

Diane Trankel (34:00): Yeah. Sweden is, I think, on target to, I think, eliminate cervical cancer by 2035 or 2038. I can't remember the exact numbers. And Australia is close to that as well.

Sarah Gorel (34:15): So undercut eliminating cervical cancer, but The United States, you cannot get the HPV vaccine freely and yeah.

Diane Trankel (34:23): Yeah. Well, also, unfortunately, when the vaccine came out probably, like, twenty five years ago, I'm guessing, it was in the media that it's it's, for a sexually transmitted infection. And the pushback, it's indicated it works the best if you get it when you're an adolescent, like around And twelve years I would get people in my office saying, well, my daughter's not getting that because she's not gonna have sex till she's married. And I'd say, well, you know, you don't have control of what her husband does has done in the past. Yeah.

Diane Trankel (35:00): Maybe she may not have intercourse or sexual contact or physical contact with anybody before she's married. However, she's only one person in that couple And the same culture does not police men or boys half as much as how they police women and girls.

Leila Musavi (35:20): Yeah. So our purity culture is about locking the women up, if you will. And I took care of a lot of Mennonite patients. And in their church, they really value male purity. So if the man stays in the church, I never saw an abnormal pap ever in that community.

Leila Musavi (35:38): But I'll tell you what, every single mom would have her child her children vaccinated because in our Mennonite community, they really trusted medicine, and they wanted every vaccine possible. They thought it made sense because they would say to me, I'm not sure if she's gonna stay in the church. And so the HPV vaccine needs to be initiated before exposure. So people would come in with warts or amnolipap and ask me, can I get the vaccine now? Because my mom didn't believe in vaccines, so I didn't get vaccinated, blah blah blah.

Leila Musavi (36:08): And I'd say, you know, we could do it. We have to wait a little bit, but sorry.

Diane Trankel (36:13): No. I mean, we still give it to anybody at any age. And even people who have a history of Admiral Pap smears, I offer it to everybody.

Sarah Gorel (36:23): Irene Fox, the woman who had the terrible strain, she was saying she's trying to educate people. She got it, even though she's gotten cancer. There is a preventative aspect to it.

Leila Musavi (36:32): So, yeah, it is valuable, but vaccine denial is a huge, huge problem for OBGYN health.

Sarah Gorel (36:39): Well, thank you guys so much for talking about this with me and for keeping it real. Any advice you wanna give to anybody up there? Be nice to your doctor. Listen. And don't bring your husbands.

Leila Musavi (36:49): Well, my advice would be, again, going back to the analogy I made with the animals in the farm, that you're not responsible for other people's behavior. And the instant somebody starts the sentence that way, you're into verbal and emotional abuse. And I think if you have to get away from your partner to have a frank conversation with your doctor about stuff, that's already a huge red flag. I'm very suspicious of men who wanna come to appointments. That isn't like talking about a surgery, for instance.

Leila Musavi (37:23): I would always be like, why are you here? Good. Put them on hot spot. Why are you here? Because in our society, women tend to handle their own health quite well.

Leila Musavi (37:33): Their health literacy is much higher than men's. What do you add to this situation, sir? And that goes for a lesbian couple as well. But knowing the reality that for a lot of women, once they have a child with a partner, they are tied a lot of times financially, and that works to the benefit of the partner because then they have control. And so that's delaying pregnancy.

Leila Musavi (37:57): Controlling your fertility is so important for women's autonomy and agency. And back to politics, when you remove that ability, people still don't have sex. I mean, sex is a natural part of life for a lot of people. It's fun, and there are some secondary gains from it for women who are impoverished. So understanding that if we take away their ability to control their fertility, then they become so vulnerable to abuse, infections, and then being trapped in bad relationships.

Diane Trankel (38:31): I think what I would say that I focus a lot on self love basically with all of my patients, but especially those who have been in a situation of infidelity and I try to build them up because the more that they get built up, the more courage they'll have to actually do something that is good for themselves instead of thinking about what everybody else is going to think and building up their sense of self worth is invaluable. And I start that even with my young patients, adolescents, I try to build them up and make them feel good about themselves because I feel that if, if you feel good about yourself, you're going to advocate for yourself. And in the situation where somebody cheats on you, self advocation is all you've got. And if you don't love yourself, you know, and baseline, and that's what these, these abusive partners, a lot of times they basically make you hate yourself because they have convinced you that you had a problem. And with that self love is power.

Diane Trankel (39:38): And I try to bring power back into their lives, basically. Empowerment.

Unknown Speaker (39:44): Your patients are so lucky to have you guys. And Leila, I know you're retired. But Diane, you you guys are gifts to Central Michigan. Thank you.

Unknown Speaker (39:54): Thank you.

Sarah Gorel (40:02): Reach out to us. You can check us out at tellmehowyou'remighty.com or check out the blog at chumplady.com. I'm always open to your suggestions there.

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