Here are a few ways I wish we could be more in agreement when it comes to sex.
1)The vast majority of your patients are having sex. And it is important to them. At least as important to many of them as their ability to play tennis or go for a jump shot or pick up their grandkids. So, since this is the reality, maybe you could include sexual health and satisfaction as a part of your wellness check? Maybe you could get comfortable talking to people about this aspect of their lives? At least don’t dismiss it or shame your patients for having concerns.
2)Most of the sex people will have in their life is not about procreation. We are having sex for many years of our lives and for many of reasons. Reproducing is a small part of only some of our sex lives. So treating reproductive health as though it is the same a sexual health is severely lacking. Issues such as long term birth control, hormone balance, sexual desire, pleasure and comfort are crucial to address.
3)Most medical concerns and their treatments have some effect on people’s sex lives. The diseases you diagnose take their toll on people’s sexual expression and can create real limitations. The drugs you prescribe can have significant sexual side effects that your patients’ may struggle with. The sexual aspects of Self are not separate from the medical concerns a person has or the journey they may need to take for healing. Please consider these aspects of your patients when you talk to us about treatment.
4)A large percentage of your patients are not heterosexual or monogamously married with children or clearly placed in some simplistic gender binary. For example, consistently statistics suggest that approximately 10% of the population is bisexual, lesbian or gay. I suspect that this number is low and reflects both a narrow categorization of sexual identity and also a long history of repression and fear of discrimination. But even if it was only 10%, denying the unique needs or rights of this group of people in our communities is discrimination plain and simple. And it is medically irresponsible. Get yourself informed.
5)You have blindspots and biases like the rest of us. We don’t expect you to be perfect so please don’t expect that of yourself. You most likely grew up with the same cultural models and mythologies as we did. You probably had very little accurate sex education. You probably have been hurt, betrayed, embarrassed, and confused about things, like the rest of us. So let’s agree that your years of medical school did not erase the limitations to your sexual perspective or understanding. That’s ok. You are allowed to not have all the answers, just acknowledge that and we can work with you from there.
6)Your job is to give us information so that we can make informed choices, not to make choices for us. No matter how much medical experience or training you have, you cannot know more than your patient does about the potential consequences and benefits of a decision in their life. Help us to understand our options, then honor that the personal factors at play on our lives are hugely relevant and frankly, outside of your scope. Respect what we know about our life.
Sincere thanks for all you do. Let’s grow in sexual health together.