Physician involvement in sexuality education began in 1904, when dermatologist Prince Morrow, MD published Social Disease and Marriage. His goal was to protect women whose husbands were bringing home sexually transmitted infections (then called venereal disease) from prostitutes.
Sexuality education and medicine became more enmeshed when other physicians and the American Purity Alliance joined Morrow’s work to reduce STIs disease as a way to promote sexual morality. Today, healthcare providers don’t usually discuss sexual morality with patients, but you are an important source of information about sexuality.
Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs, and values about identity, relationships, and intimacy. Sexual health and decision making are critical aspects of sexuality education, and you may have more opportunities to educate patients than you may realize.
The Breadth of Patient Sexuality
If you limit your exam room consultation to discussions of the function and health of sexual organs only, you risk missing out on information that could have an impact on a patient’s sexual health and overall wellness. There are five categories of sexuality that comprise every person’s sexual being:
- Sensuality = awareness, acceptance and enjoyment of our own or others’ bodies.
- Intimacy = the degree to which we express and have a need for closeness with another person.
- Sexual identity = how we perceive ourselves as sexual beings in terms of sex, gender, orientation, expression.
- Sexual health and reproduction = attitudes and behaviors toward our health and the potential consequences of vaginal, oral, and anal intercourse.
- Sexualization = using sex or sexuality to influence, manipulate, or control others.
The area of sexuality healthcare providers address most often is sexual health and reproduction for two reasons: it is where most acute medical issues fall, and there are fewer gray areas that can be time-consuming to discuss. However, the other areas of sexuality are less concrete but equally important to discuss, as these examples illustrate:
- Patients may avoid sexual intercourse or masturbation because they believe genitals are ugly or shameful
- Patients may not experience sexual pleasure because they don’t understand their sexual anatomy or the sexual response cycle
- A partner’s turn-ons may hurt your patient emotionally or physically
- A patient may be struggling with gender identity or sexual sexual identity
- A patient may be too embarrassed to disclose sexual coercion/abuse
Research shows that patients often fear being judged by their providers or being embarrassed, so they may not bring up their concerns. Be sure to open the door to conversations about sexuality — One quick way to begin is to ask, “If there were anything you would change about your sex life?”
Contact me if you’re interested in learning more about essential, yet easy educational conversations you can have with patients about sexuality.