Getting a Simple Answer
(Edited: Elevated to Marble Dinosaur Egg status)
Poor TBTAM. All she's trying to do is get a straight answer from her patients about whether or not they are sexually active, and everyone wants the question asked differently.
Here's my strategy:
All female patients get asked, "What do you use for birth control?"
Just about every possible answer leads naturally into clarifying questions and answers, providing useful and needed clinical information while generating rapport with a new patient.
One set of answers is simply the method: the pill, the diaphragm, condoms, etc. The natural next question is, "How is that working for you?" or some variant, to determine how satisfied the patient is with whatever method she's using, how effectively she's using it and so on.
Another answer is, "Nothing." Although there are several possibilities, in real life they divide themselves by whether or not the patient continues explaining on her own. Here's how the first set of answers usually plays out:
"Nothing; I've had my tubes tied."
Response: "Cool. Do you also use condoms to protect against STDs?" etc.
"Nothing; my husband's been fixed."
(Vasectcomy. My favorite method. I tell women whose husbands are considering it, "It's great; you won't feel a thing.")
"Nothing; I'm trying to get pregnant."
Response: "How long? Have you ever been pregnant?" etc. (fertility issues)
"Nothing; I'm not in a relationship right now."
Response: "Ok. What do you use when you do have sex?" (also presents the opportunity to find out how she feels about the lack of a relationship.)
Best answer I've ever heard:
*glaring daggers at me*
"I have a 2-year-old. I don't have sex."
(No response; if looks could kill, I would have been dead on the floor.)
Then there's the second group of women who say, "Nothing," and then fall silent. There are several options for the next question, and which way to go is a bit of a judgement call based on the woman's age, demeanor, and just a gut sense on my part. Here's what I usually say:
If the patient is a stupid teen (or 20-something) the answer is usually a disgusted, "Eeew! No."
Response: "So how do keep from getting pregnant when you have sex?"
The answer is usually something like, "He pulls out," or, "I don't know," etc.
Note: these patients are usually pregnant.
Lesbians are usually very impressed with me at that point, and answer simply, "Yes." This gives me the opportunity to go on with, "That's nice. Are you in a relationship?" etc. No shock; no surprise; just moving on to find out more about her (which can include, from a GYN standpoint, whether she has ever has sex with a man in the past.) Rather than trumpeting how tolerant and accepting I am, I have demonstrated it by matter-of-factly bringing it up as part of my routine history.
(By the way: males starting about age 14 are asked, "Do you use condoms when you have sex?" thus forcing the explicit answer, "I don't have sex." I call it the "Have you stopped beating your wife yet?" approach.)