Welcome back to our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois in New Mexico. Here, you can ask all the burning questions you may not want to ask your doctor.

Speaking of which, today's question is a little off the beaten path, regarding unusual sexual desires and how diabetes can make things -- umm, "more interesting" -- in the bedroom.




Karl, type 1 from California, writes:I have a question about whether a type of bedroom role play is unique to me. I participated in a “naughty endocrinologist/noncompliant patient” medical RP. It was quite enjoyable. My question is: Have you encountered another individual who acted on this fantasy before?  

Wil@Ask D’Mine answers: Nope. Never have. But the more I thought about it, it surprises me that I haven’t. From what I’ve read about bedroom role play, it’s often about exploring—and upending—power relationships.

And historically, what’s one of the most entrenched power relationships in diabetes? Right. The endo and the patient.

In all probability, among PWDs (people with diabetes) who engage in role play, your nocturnal adventure is more common than anyone realizes, but this isn’t the type of thing we discuss around the dinner table! For most people, sex happens behind closed doors with the lights off, both literally and in their minds. Just getting good data on who’s getting laid and how often is a challenge for social scientists, much less getting a handle on something like the naughty endo and the patient who needs a spanking. 

Or the other way around.

But we leave no stone unturned in our attempt to fully and truthfully answer our reader questions here at Ask D’Mine. Still, on this one, I wasn’t quite sure even where to find the first stone to unturn. This is not one of those things I can ask my (lady) endo about. So I starting by visiting Wikipedia’s entry for sexual role play to get an overview. I gotta say, you’ll love the picture that illustrates the piece. No, it’s not X-rated. It’s H-rated for hilarious. A top-hatted villain in a black cape is making away with a bound damsel in distress. Anyway, according to the article, sexual role play is basically play-acting out a sexual fantasy. It’s often a form of foreplay, it can help people overcome sexual inhibitions, and it can vary from simply pretending your spouse is a stranger you pick up in a bar, to incredibly elaborate scenarios with sets, costumes, and a script.

Now before any prudish readers jump off to another page, I gotta ask you: What were you wearing Wednesday night? Yep. We just passed the ultimate role play holiday for adults. Well, and for children, too: Halloween, a holiday which has metamorphosed into a serious role playing day -- one that lets people step out of their ordinary world and be someone (or something) else for a night. Well, so long as you stick to your race, anyway. But that’s a subject for another day and another venue.

As I noted, Wikipedia tells us that sexual role play “may involve elements of dominance and submission, passivity or obedience.” Can you see the connection between obedience and compliance? I can. It also says that, “Many of the most common sexual role plays involve a power differential.”

Interestingly, topping the list of common sexual role playing scenarios are faux medical games such as Doctor and Nurse, Doctor and Patient, and the ever-popular Nurse and Patient. Given that PWDs interface with the medical profession more often than most people, and most commonly in a traditionally somewhat adversarial way with a particular sub-specialty, your naughty endocrinologist/noncompliant patient seems a logical extension of the common doctor and patient role play. 

Wait... What’s that? You all want to know what the other common role play scenarios are? OK, I’m game. (Not in that way!) Here you go: Hooker and John, Boss and Secretary, Teacher and Student, and at the risk of causing backlash in today’s overly sensitive era: Master and Slave -- sometimes played in a more PC way as Pirate and Captive.

You’ll notice all of these role playing games are based on power relationships. Is all role play that way? Actually, no. Also on the list was Cable Guy (OK, it was really Handyman) and Housewife, and Photographer and Model. But a lot of them are power-based.

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I would imagine that these top scenarios vary from culture to culture. I wonder what’s vogue in other countries? Don’t try to Google that, you’ll only find the Porn Web. I’m already at risk of Naughty Columnist and Angry Wife when when my wife Deb checks my browsing history after today’s research.

So is all this role playing fringe stuff for pervs and losers? Experts say “no way,” and science backs them up. A 2004 ABC Primetime Live survey found that half the people in America talk to their partners about their sexual fantasies; and a 2015 internet-based study published in PLOS, a peer-reviewed open access science journal, the found that 22% of the respondents reported participating in sexual role playing.

Top that off with fact that the condom company SKYN’s annual sex survey last year showed that fully two-thirds of millennials report they role play, with scenarios involving doctors being the top choice. There’s no update on that this year, but I did learn that if you’re not getting enough, their data suggests you should die your hair red and get a tattoo. 

So, what’s up with role play and why is it so popular? Actually, in other spheres of life, role play is so common we don’t even recognize it. In Psychology Today, anthropologist and author Dr. Peter Stromberg, who has extensively researched video game role playing, writes that humans have “extraordinarily powerful imaginations” and that this “fundamental cognitive capacity” is what “makes human ways of life possible.” He points out that there’s not much difference between role play and getting “so focused on a spectator sport that we feel like we are on the field ourselves.” He also points out that the human capacity to get “caught up in fictions and games is also the basis of pretend play in children.” 

Sex educator Dr. Ian Kerner points out that the brain is actually the biggest sex organ. There’s more to sex than the physical. The website LovePanky, apparently our guide to better love and relationships, champions role play as the antidote for spicing up sex in aging relationships; and askmen quotes several sexologists as saying role play not only spices up the bedroom, but can have positive personal benefits, too, by giving people a safe space to try new things in an alter-ego. They point out, too, that engineering a role play develops a couple’s communication skills.

So, Karl, to answer your question: No. I’ve never encountered another individual who has acted on the naughty endocrinologist/noncompliant patient fantasy before, but given how common sexual role play appears to be, and the number of PWDs seeing the 7,857 practicing endocrinologists in the USA, there’s no way that you’re the only one.

But truth be told, I bet waaaaaaay more endos are playing naughty endocrinologist/noncompliant patient at night than PWDs are.

Can’t you just see it? “And now, my dear, I’ll MAKE you comply…”

