22 year old WWE

I had a couple of cases that I though of presenting, but thought that this one was, by far, the most eye-brow raising. I saw a 22 year old dependent spouse with a history of hpv who was in the clinic for a wwe and pap smear. While I was reviewing her intake form, I found it significant that she was HSV positive, had a history of gonnorhea, chlamydia, and sexual abuse. Based on her overall background, one would obviously assume that there were some significant psycho-social issues in this patient's life. This suspission was confirmed when she requested STI testing, including HIV. When I inquired about why she felt it necessary to have this testing (in my history taking I asked about monogamy with her husband) she replied that she hasn't had sex with her husband for over 6 months because last November he confessed tha he wanted to be a woman, and had felt that way most of his life. The patient stated that, in light of this, she wasn't entirely confident that her husband hadn't been experimenting with sexually with other men. We ordered all of the requested tests. After the appointment, I reflected on her prior history of sexual trauma, and wondered what part that played in her choice of a man with such confusion about his sexuality.