First time and "inexperienced" play patients

I have a couple of sub questions regarding play doctors examining first time patients:

- when you have someone looking to be a play patient who has no experience with medical play or fetish play in general, are your discussions or examinations different in any way than with a play patient who has a lot of experience?

- Certainly there are people who want to be in the patient role with a play doctor whom is not of the gender that that patient is sexually attracted to. Or, a patient who is maybe questioning their sexuality. Do you have specific discussions regarding this as well, or conduct the examination differently than someone who is comfortable with their sexual identity?

I am curious how others handle situations like this, or if they frequently come up.