By Matthew Ng
Marriage is, by and large, a contract between two consenting individuals. People marry for legal, social, emotional, financial, or religious reasons. Increasingly, the marrying individuals may be of different ethnic groups or different nationalities. The contract can be an arranged one. Most marriages are monogamous although some cultures and religions permit polygamy.
Up until recently, legal frameworks ensured that marriage occurred between a man and a woman. Of course, this is changing. As of January 2019, over twenty countries recognize and allow same-sex marriages.
Tempest
Madam K was in her sixties, just one of the many patients waiting to see the doctor. She had diabetes, hypertension, and dyslipaedemia. She lived with her three adult daughters in a five-room flat. Her husband had died years ago from nasopharyngeal cancer. Things were stable at home.
Three years ago, her oldest daughter brought her female partner home to live. Seeing this, her youngest daughter brought her partner home as well. This partner also turned out to be female. Madam K was horrified and devastated. The tensions eventually lessened when she realized that her daughters’ partners treated her respectfully and well. Her middle daughter married and had a baby, whom Madam K helped look after. Things improved at home.
These days, Madam K has found some peace. She treats her daughters’ partners as two additional daughters in the home. Her daughter continues to drive her to her clinic appointments. Things appear to be at a new stable.
Commentary
Same-sex relationships are frowned upon in our society. Famously, homosexual sex between consenting men is criminal, although the law is not enforced. Same-sex marriage is not recognized. That said, many same-sex couples are living together openly as spouses in a committed relationship.
One such male homosexual couple made the news recently. One of the partners was trying to legally adopt his biological child, born overseas of a surrogate mother. In a landmark ruling, the High Court allowed the adoption to proceed.
As physicians we may need to deal with these new family units sooner than many other people. Members of non-traditional families face all the traditional health challenges that require our care. Not only that, because same-sex relationships are almost unthinkable in conservative Singapore, extended family members may face additional stresses too. The vignette describes such a family member.
Dr Matthew Ng is a family physician in a tertiary hospital who also teaches undergraduates. He is a past editor of the Singapore Family Physician and continues to be the long-serving chief examiner of the GDFM examination.
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
