It's tempting to assume that people know everything there is to know about each other before they even embark on a first date these days, what with hourly tweets and tell-all Facebook posts.
But your likes and dislikes (plus a class photo from fourth grade) only tell a fraction of your life story. And when your life is punctuated by a sensitive ordeal — infertility, sexually transmitted disease, genetic predisposition for a terminal illness — revealing your entire story can be daunting.
"People are afraid of being judged," says Katharine O'Connell White, assistant professor of obstetrics and gynecology at Tufts University School of Medicine. "They're afraid of how their partner will think the news reflects on them as a person, and they're afraid of what it will do to the relationship."
But withholding information about your health can jeopardize the relationship and, in some cases, your partner's health.
Sharing the information "is a really hard thing to do, but at the same time it's a really important thing to do," says White. "It's like going to the dentist. No one wants to do it, but it has to be done."
Here's a guide to walk you through the process.
"This isn't something you bring up on the first date," says Roshini Rajapaksa, assistant professor of medicine at New York University Medical Center and co-author of What the Yuck? The Freaky and Fabulous Truth About Your Body (Oxmoor House). "I recommend waiting until you feel like you have real long-term potential with the person, and you feel like you can trust them with this information."
If your news could affect your partner's health, of course, the conversation should be fast-tracked.
"I have a fairly hard-and-fast rule that any STD conversation has to happen before you get naked," says White. "But if you have a genetic disease or something that doesn't affect your partner's health, you can wait until you've agreed to be monogamous and you're talking about the future."
But don't wait too long.
"You want to talk about it before things have progressed too far," White cautions. "Before you've moved in together, before you're engaged. You don't want your partner to feel tricked. It's like springing a prenup on someone the day before the wedding. You're so far down the path, that to say no at that point is almost impossible."
"Obviously you want a place where you've got some privacy, not only for you, but so the other person can react in a comfortable way," says Rajapaksa.
You'll also want the ability to linger, if necessary.
"Not when you're on your way out the door, not on your way to bed and not when someone (else) is about to come over for dinner," suggests White. "You don't want to have other distractions. You want the focus just on the two of you and what you're talking about.
"I'm a big fan of car conversations," she adds. "You don't have to look at each other, but you're in close proximity and no one can get out of the situation fast. It's how I tell parents to talk to their kids about sex."
Remember that you're setting the tone for this conversation, so stay positive.
"Start off by telling the person, 'The reason I'm telling you this is I really trust you, and I feel like you're not a judgmental person,' " says Rajapaksa. "You don't want to become too emotional about it."
Have some information on hand about your particular issue.
"Maybe it's a book you've gotten about the topic, reputable websites they can go to," White says. "Depending on the situation, patient associations have fact sheets that you can print out — herpes facts from the CDC, cystic fibrosis information from the foundation."
If they're game, says Rajapaksa, offer to bring them to one of your doctor's appointments.
Above all, give your partner room for optimism.
"Don't assume it's a deal-breaker," adds White. "Unless you're sharing news that you have a terminal illness, there's usually something you can do about the condition that makes it less than completely devastating. If it's herpes, there are ways of decreasing transmission. If it's a genetic disorder, you can have prepregnancy testing. There's a way around most of these things."
Give your partner some time to process the information.
"It's important to let the other person talk and ask questions," says Rajapaksa. "Don't expect a reaction right away. It may take a couple days for them to react at all, or to react in the way you may have wanted."
"People very often react from a place of fear of the unknown," cautions White. "Fear and confusion can masquerade as anger and aggressiveness. Some people will just need time and space to process."
If your partner decides not to stick around after your news, try to accept the response as a signal that you weren't meant for each other.
"Never regret telling them," says Rajapaksa. "Your health is part of you just like your hair color and height. In a long-term relationship you need to be accepted for everything you are."