As a sexologist I often see patients who have visited two levels of providers before getting to me for help with sexual concerns. Often they have seen a physician or nurse practitioner, and then a marriage or relationship therapist. Sometimes, they have not been asked, nor do they bring up their sexual concerns.
For one thing, few patients feel comfortable initiating the conversation. In one survey of 500 adults over 25, 68% feared that raising concerns about sexual problems would embarrass their physician, and 71% believed their physician might dismiss their concerns (Marwick, 1999).
Clinicians, whether providing medical or counseling services are hesitant to ask about patient’s sexual functioning due to lack of comfort, lack of training or education, concerns about patient perception of intrusiveness or inappropriateness, time pressures, lack of familiarity with resources, and underestimation of the prevalence of sexual difficulties.
We know from studies that at least 40% of people will be affected by sexual difficulties (Laumann, 1999; Bancroft, 2003) and that figure rises to between 52-60 % for individuals who have been diagnosed with cancer (Fobair, 2006; Schover, 2018).
First: Let the patient know it’s not taboo.
One of the easiest ways to communicate this is to ask 3 questions on your Intake form:
Second: Have a list of capable providers handy or refer the patient to the American Association of Sex Educators, Counselors and Therapists website (AASECT.org). The website lists certified sexuality professionals by state.
Third: Decide to gain some information and comfort by seeking out additional training in sexual medicine or sexuality education through several organizations or individuals who provide it.
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