It’s true. I asked them.
Well, not really. But Dr. Alan Shindel of UCSF did, in last month’s Academic Medicine. He asked more than 2,000 U.S. and Canadian medical students two questions: 1. How’s your sex life? and 2. Are you comfortable dealing with patients’ sexual issues?
A promising 81 percent said yes to question 2, but that could be an overestimate since respondents to an optional sex survey are more likely to be comfortable with sex. But what about the other 19 percent? Why can’t they talk about sex?
The biggest correlation was a lack of training. A majority of the students said that they get inadequate sexual health education. The other major correlation depended on the responses to question 1.
It turns out that med students have varying levels of sexual experience and encounter sexual dysfunction just like the rest of the world (big surprise). But, interestingly, a student with a history of fewer sexual partners, of lower sexual frequency or of sexual dysfunction was more likely to be uncomfortable discussing sex.
Hence, med students need more sex. And better sex. But until we can mandate quotas and quality control in med student sex lives, the study suggests that adequate sexual health training is still the best way to raise comfort levels.
Our med schools aren’t teaching us sexual health, and this needs to change. Sexual health is as important to a patient as physical health or mental health. In a sexual response, you use all parts of your body, not just your genitals. Your vision and brain are involved in arousal, your heart rate goes up and your hormones go crazy.
So any number of medical conditions or medications that affect the body can also affect the person’s sex life. In reverse, sexual problems can lead to depression, discourage treatment compliance and cause interpersonal conflicts.
Unfortunately, a lot of doctors simply don’t ask about sex outside of the standard STI screen. They don’t think it’s relevant or they’re uncomfortable bringing it up.
This attitude can make it even harder for the patients to bring it up themselves. And since we avoid discussing sex, we don’t realize that those of us with a sexual problem are not alone. One report says that 43 percent of women and 31 percent of men ages 18 to 59 experience sexual dysfunction.
The conversation needs to get started. Patients need to ask about their sexual problems so that they can get help. Doctors need to learn about sexual health so that they can help their patients.
In order to get there, we need more sexual health education, and we need more sexual health research. On a more basic level, we have to keep chipping away at the shame that we’ve associated with sex and with sexual problems. It’s for the sake of health and wellness. Sexual shame should not be preventing physicians from addressing sexual health.
Great strides have been made through advocacy groups and sexual health electives. Yet, until we uncover more about sexual health and teach more in the curricula, we can’t effectively train a generation of sex-savvy doctors.
So start talking about sex with your doctor. Doctors, start talking about sex with your patients. It’s important, so let’s treat it like it is.
Perry Tsai is an At-Large columnist for The Daily Tar Heel. He is a second-year medical student from New Orleans, LA. Email him at firstname.lastname@example.org
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