How and When to Tell Him about Medical Issues


how to explain medical issues
I am very grateful for all the kind, sweet, thoughtful, and responsible women who ask me this question: “I have this issue that I feel I need to be upfront with him about before our relationship goes too far.  Should I tell him about it on the first date?”

I appreciate these women, but they go too far in their efforts to avoid deceiving a potential partner.  Some women seem to feel they are being deceitful or irresponsible if they do not reveal all of their physical or mental health flaws on the first date.  I disagree.

My personal opinion is that you can best answer the “when and how” question by referring to the golden rule.  I believe it’s as simple as that.  The golden rule simply extols the value of doing to others as you would have them do unto you.

I don’t know about you, but I would prefer that you allow me to get to know you before you flood my mind with a list of your hidden problems.  Problems do not define you, but many women seem to feel their problems do define them.

I’ll give you an example.  Someone once asked me if she was being irresponsible not to mention that she is living on disability income through Social Security.  She thought she needed to mention it in her online dating profile to avoid “leading men on.”

Now, I don’t know about you, but I feel a person is selling herself short if she does not make at least a small attempt to sell me on the many virtues I would encounter if I continued a relationship with her.  It’s not that you should never speak the straightforward truth about problem areas;  it’s just not appropriate to delve into deeply personal information on a first date!

That’s why I evoke the golden rule.  I don’t want to share information about my medical issues with the person I just met, so I don’t expect you to do that either.  Maybe this is the golden rule in reverse; “Tell it unto me as I would expect myself to tell it unto thee.”  =)

In all seriousness, I want to encourage any of you who struggle over this issue to take a deep breath and relax.  Real relationships unfold over time.  Don’t try to force the entire relationship into the first date.  He can learn about you and discover both your wonderful qualities and your liabilities over time.

Some people hear this advice and finally relax into the normal way of relating to people again.  Others are so brainwashed by the fast-paced style of dating, which has taken over that they still struggle with guilt.

Our culture has changed when it comes to dating.  People around the world look at potential partners as expendable options to be sorted through rapidly.

how to explain medical issuesThis change is largely because of the psychological shifts created by online dating.  Men and women feel like there are hundreds of options out there and a seemingly inexhaustible supply, so they approach a first date with the mindset of quickly filtering out all the various qualities they would find distasteful in a potential partner.

You don’t have to go along with that toxic change in the dating culture.  Treat people like real human beings, and expect them to do the same in return.

I don’t want to know about the warts on the bottom of your feet when I first meet you.  I figure I’ll see those while I am learning how beautiful and playful you can be when joining me at the beach and kicking off your socks and shoes.

In this more “organic” context, your flaws will be paired with the real-life experience of getting to know the benefits of building a relationship with you.  Does that make sense?

Some people press me for even more detail.  Each relationship is unique, and requires a different approach because of the various factors at play.  Allow me to offer a few “rule of thumb” guidelines for you to consider.

  • If the flaw is something embarrassing to you, but not something that will harm him, you can wait much longer for the topic to come up naturally throughout the course of your unfolding relationship.  If it is an issue that could cause him emotional or physical harm, you might want to bring up the subject by the time you reach the third date.
  • Do not tell him deep dark secrets just because you feel guilty.  Guilt should not be your motivation.
  • Generally speaking, you should bring up the topic as soon as you can envision a “normal” conversation about it.  By “normal,” I mean a conversation that others would not judge as forced and socially awkward.  When two people know each other, they can sense the right time for bringing up the topic even if it is a sensitive one.
  • Before you tell him a deep dark secret, ask yourself whether he would be able to fill in other details about your personal life and history easily that have an equal weight (on the neutral or positive side of things).  If he doesn’t know you well enough to understand the context and story associated with your “flaw,” then it’s too soon for that particular talk.

I hope these guidelines were helpful, but remember that the preceding principles should be your ultimate guide rather than these rule-of-thumb statements.

It is my belief that you have a responsibility to put your best foot forward when meeting people.  I say this because the fast-paced dating culture often means you only get one shot at impressing a person enough to get a second date.

Research has consistently shown that we tend to draw final conclusions about potential partners far too soon.  We put too much confidence in our first impressions.

That’s why it’s so important to get a second and third date so you can truly get to know each other.  I hope this advice will help you reach that goal.


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66 thoughts on “How and When to Tell Him about Medical Issues

  1. Dana Lynn Papai said:

    Dear James,
    I enjoy the common sense, directness of your column. In regards to the medical issue discussion, some medical problems are going to be evident from the beginning.
    I am a 67 year old woman whose dating profile photos are often messaged ” Hello beautiful” or “Hi gorgeous” which frankly I find annoying but that is a completely separate issue. So I am an attractive lady who looks good for her age. The downside, I have lived with severe osteo-arthritis, since my early fifties . It has resulted in both hips being replaced, cervical and lumbar spinal surgeries, one ankle surgery and discussions about additional surgeries for knees, ankles and shoulders which I have not done since they do not “cure” the root cause of the problem. (I began to feel a bit like bride of Frankenstein without the hair.) As a result of what has been surgical corrected I can walk but since one leg is 3/4 of an inch shorter that the other, I use a cane for support and balance and I walk with a pronounced limp. This is a big improvement over the rollator/walker I was reduced to using when I was 56, so I’m not complaining. It does mean that I have a mobility problem and it is blatantly obvious. I am not going to be the 1st choice of Mr Uber fitness, and even the quiet walks (no sandy beaches, please) have limitations. This is a challenge in spite of the fact the I do chair Yoga, aqua-cise and floor exercise 5 to 6 days a week. I can do gentle biking, some canoeing or kayaking but I will not find an evening of line dancing or dancing of any type a pleasurable experience anymore. I am still intellectually and culturally active participating in book clubs, concerts, plays and movies. Activities are carefully considered. A few hours at a craft fair is usually doable, all day at a county fair would be too much time on my feet and too much walking 🙁 How do I best approach this situation? Shock therapy at the met and greet (Hi, yes, I walk with a limp and a cane.) or break it to them gently as we discuss activities we enjoy online or in phone conversation? Your ideas would be appreciated. Thanks, Dana P.

    • James Bauer said:

      Hi Dana, that’s a good question. In essence, you’re pointing out the fact that in certain circumstances a medical issue reveals itself as soon as you meet in person. And because of that, it changes the dynamics a bit. Should you proactively soften the realization since it’s going to be revealed anyway? Or should you just let him discover it and give him a chance to prove his ability to focus on what’s beautiful about you instead of the things that might hold you back from fully participating in some activities?

      I think in this case the wisdom of, “do unto others as you’d have them do unto you” applies. Here’s what I’m thinking…

      If I was talking to you online and then we arranged an in-person meeting, I would be embarrassed if the shock showed on my face upon meeting you in person. I would want to know in advance so I could show you my best side, focusing on what’s beautiful about all the things we have in common and all of the stories we could build together. I would want to be given the opportunity to adjust slowly instead of all at once in a single in-person meeting.

      So I think in situations where there will be a sudden revelation, it’s better to allow it to gradually emerge in your natural conversation before you meet in person.

  2. Vanessa said:

    Hi, there is this guy that I have known all my life. However he lives in a different country. We recently reconnected via whatsapp and over a couple of months I told him I was always attracted to him. I’m not sure if I should pursue this. Whats your advise? Distance is an issue for me.

    • James Bauer said:

      Hey Vanessa. It’s just my opinion, but I believe most people are not happy in a relationship unless it is progressing toward the eventual plan to live near enough to spend meaningful time in each other’s physical presence. With long-distance relationships, the tricky part is that you often have to sacrifice a lot to move closer to each other before you are 100% sure that the relationship is going to be something you want to commit to.

      Still, there are ways around that. Which I discuss in a short report I wrote about building intimacy in long-distance relationships. You can access that report here.

      If you’re not willing to consider relocating, and he isn’t either, then you’ll want to decide if a long-distance romantic partnership is something you’ll be satisfied with for life. I hope that helps you to gain clarity in this situation.

  3. Anonymous said:

    I love you James for your kind and thoughtful advice. We all need a voice of clarity within us.

  4. Jesse said:

    Hi James,
    In my mid twenties I was emotionally unwell as a result of low self esteem and prior abuse I suffered. This led me to commit a very serious crime. I received a felony conviction and 10 years of probation, but no jail time. I chose to undergo 5 years of psychotherapy to heal from past trauma and better understand myself and my behaviors. I earned a masters degree and established a successful career. I have a life full of friends and family (not all of whom are aware of my criminal background). I am still ashamed of my past and the social stigma associated with my particular conviction. How and when should I tell a prospective partner about my past?

  5. Corah said:

    Congratulations for sticking with him. I always had eyes for a tall well groomed man then absolutely out of context and choice I have just met the most amazing caring, kind spoil me good all the way gentleman not height but heart is so right for me. The externals matter but sure take a back sit when it comes to a true cavallier good old fahshioned well mannered man.. By the way the tall, handsome well groomed man was none other than my daddy himself.

  6. Terri said:

    I totally agree but what do you do when you have a disability that requires the use of a walker, wheelchair or scooter – which is what I use. I feel that most men just see as far as the scooter and the limitations not the possibilities. Would love to hear what men have to say about this from their point of view. This doesn’t seem to be addressed by any relationship programs and is mostly overlooked in all dating possibility advice.

  7. Vicky Latronica said:

    After a while, when you think it’s about time to get intimate, you might say to her something like “You’re a beautiful woman and any man would love to get intimate with you. I’m a little uncomfortable to have to tell you this but I need to use a catheter or protection.” Mention you’d love to give her oral sex, (if you would.) And that she can satisfy you with her hands, (at least at first.)
    If you’re both cool with that, than God Bless you both.

  8. Andrew said:

    Great article and good advice.

    I’ve had two dates with a wonderful woman but I live with urinary incontinence and have to wear protection for it. We’ve had a ton of fun so far and It doesn’t really affect us yet but at some point I know that I will have to bring it up, especially if we spend more time together or I have to stay in town overnight (nothing intimate). It’s just embarrassing to talk about and I’m not sure of the best way to broach the subject. When do you think is a good time and am I overthinking this? For the women out there, how would you want a man to share something like that with you? What questions would you have for him? I’m comfortable in how I deal with my challenges, just not in having the first conversation as I’ve got a bit of a fear that it could be a turn off. I realize that I wouldn’t feel that way myself since love isn’t based primarily on that sort of stuff but yet I still fear that she might feel differently. Any advice or insight?

    • Divaani said:

      Hi Andrew, I think you should get to know someone well first. Not intimately, but spend time getting to know them. Listen to them carefully when they speak, then when you feel comfortable speaking to them bring it up. If she is a quality woman she is not going to run. If she does, then she isn’t for you.

      I personally would want to spend some time getting to know you before you tell me. I want to know you as a person, not your issues, first. I was dating a guy for a few weeks when he told me he had been to prison for 7 years for selling drugs. It did not bother me one bit, because I had got to know him as a person I really like. When he told me I didn’t even flinch, but he was so worried about how I would react.

      However, we further got to know each other, but then I found out from his roommate they both attend NA and AA, when he was told me he was attending church a couple times a week. He had a substance abuse problem in the past, which he did not tell me about. That I was angry about, because we were past a certain point and had become intimate. My trust was broken. He should have told me that when he told me about prison and not lied about it. And that was ultimately the undoing of the relationship. So timing is everything. I would ask you to tell me more about your incontinence, if you feel comfortable talking about it. And how has it affected your life, what are your limitations. Is there anything i can to do to help you feel more comfortable being around me etc.

      If I know you well enough and like you, that wouldn’t change anything. I personally have fibromyalgia, and it’s not something I’m gonna discuss on the first dates. I have to get to know you and see if I want to invest in the relationship before disclosing I have fibromyalgia. I wanna make sure you get to know me as a person and not a person with fibromyalgia if that makes sense. I don’t want my condition to define who I am.

  9. Vicki said:

    Hi James, I’ve been going out with 6years widower, not dating, who also goes out with other women as friends. We’re both middle-aged. He seems so interested but says all he wants is food wine and travel. I feel like I keep getting mixed signals. He wants to know if I’ve been seeing anyone etc. He compliments me lots and is such a gentleman. I’m keen to take it further but don’t want to mess up good friendship. Frustrated!

    • James Bauer said:

      Hi Vicki. Be very cautious about investing your heart (and time) in a man who openly tells you he will not make a relationship a priority. Mixed signals come from his natural desire to “add on” the benefits of companionship with someone like you, but that doesn’t mean he wants to commit to you or be involved beyond the relationship elements that yield immediate gratification.

      James

      • Vicki said:

        James, Thank you for being a straight shooter!
        I appreciate your advice as I now know it was probably wishful thinking.

  10. marenvrinda said:

    This point is so true. We dismiss too quickly. I recently met a man who I at first thought didn’t seem too into me because he didn’t ask me that much about myself. I was ready to write him off, but ended up going on a second and third date with him. We are now in a relationship, and he is the most attentive person who is very interested in myself, my life, my problems, etc. I just didn’t see it at first. So glad I stuck with him!

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