We all have that friend.

No, not the friend that keeps hooking up with your exes and seems surprised when you aren’t thrilled with all of you going on vacation together.

Or keep hooking up with a number of your exes, all at once.

Or the friend who lectures you about kale consumption when mercury is in retrograde when all you want to talk about is professional baseball.

Nope, we’re talking about the friend who won’t get the medical care—even the preventative care– that they need. Or maybe you don’t have just one friend like that. According to the Center for American Progress, lesbian and bisexual women are less likely to receive age-appropriate mammograms than our heterosexual counterparts (57 versus 62 per cent) and LGB people, in general, are much more likely (29 versus 17 per cent)  than straight folks to delay getting medical care.

In recent columns, I’ve talked about how to make a pelvic exam a better experience and how to work through your own trauma to get health care, but there’s another side to this: helping a friend get care.

It’s sometimes challenging to figure out what works, but we do know what doesn’t work:

SHAMING

Being ashamed of an action or lack of action doesn’t lead to change or none of us would spend the weekend after a break-up eating boxed mac and cheese directly from the pan. It doesn’t work any better with health care. If your friend hasn’t gotten a pap exam in ten years, they are probably already feeling shame in addition to worrying.

Adding your shame to their shame probably won’t move them into action, but it might cause them to quickly talk to you about it.

ULTIMATUMS

Ultimatums might work the short term “get a mammogram or I’m breaking up with you” but most healthcare requires to follow up and you can’t really use an ultimatum every time. Ultimatums can also backfire, and then you’re in the middle of a break-up and you’re soon to be ex still hasn’t gotten the mammogram.

What works?

THE BUDDY SYSTEM

You’d buy someone a drink after a break-up and sit with them while they cried, right? So why not buy them a drink and go to the office together? Of course, just going along for a support person is awesome, but if you need the same procedure (I am thinking specifically of a mammogram or pap) why not schedule your appointments at the same time? It can give you both courage you might not have otherwise, and you can also advocate if one of you needs some backup.

DEMYSTIFY THE EXPERIENCE

In a very strange activist meets healthcare advocacy action, a few years ago I teamed up with another comic, a nurse practitioner and two community leaders and we all had pelvic exams. On stage, at a well known New York bar.  As part of an organized show of course. But we did it so that folks could see what happens during a pelvic exam and realize “oh maybe I could do that.”

Perhaps you can’t put on a healthcare involved stage show for your friend, but scout out some youtube videos or cartoons or narrative descriptions of the kind of care they need. Making the unknown a little better known can help resolve many fears.

APPEAL TO THEIR HIGHER SELF

Ultimatums, guilt and shame don’t work as long-term motivators, but you can appeal to your friend’s nobler intentions. Explain that a certain amount of reasonable self-care is a part of activism: it keeps you going to serve the world and the community longer. And it’s good role-modelling for the queerlings coming after.

CELEBRATE SMALL VICTORIES

Every step your friend makes towards getting the care they need is big. Maybe they can’t go into the clinic and get that STI test. But if they went to the parking lot of the clinic and sat in their car, that’s still a step forward. Celebrate that and hold their hand for the next step and eventually, they’ll be in the clinic, getting the care they need.