If you’ve ever felt let down by a healthcare provider’s lack of attention to your sexual health, you’re not alone. Research shows that people want to have more comprehensive discussions about sexual health during their doctor visits, however, many providers rarely broach the subject without being prompted. In this article, Hello Alpha Chief Medical Officer and trained OB/GYN Dr. Mary Jacobson will explore the importance of building relationships with sex-positive healthcare providers, and how to start and have candid conversations about sexual health with your medical team.

When was the last time you had a conversation with your healthcare provider about your sexual health? When was the last time they asked you about your sexual health? If you’re like many, it’s possible that you’ve never had this conversation or perhaps they’ve never tried having this conversation with you either. But, why? Talking about sexual health can be uncomfortable, but it’s a crucial component of overall wellness.

According to a recent study, healthcare professionals don’t ask about sexual health because they worry about a myriad of things: opening an uncomfortable conversation, offending someone, not knowing how to sensitively and directly ask, not knowing what to do with the responses, feeling ashamed or embarrassed, not understanding the symptoms/concerns, and lack of time.

At the same time, another study found that patients were worried that their provider would not handle their concerns well:

71% of patients believe they will be dismissed on this topic
68% believe they will make their provider uncomfortable by bringing up sexual health
76% believe there is no effective treatment for their concern
More than 90% believe it is the provider’s responsibility to address sexual health issues

Both patients and healthcare providers alike can find it difficult to open the conversation about sexual health.

As an obstetrician/gynecologist with over 25 years of clinical experience, I can confirm the importance of a relationship with a sex-positive healthcare provider and of sexuality in maintaining well-being. I transitioned from a career in Wall Street to healthcare in the late 80s. I was deeply inspired by the people with AIDs with whom I worked, in particular a gay man named Bill who was a physical therapist and who shared a lot of sage advice with me as he lay dying. From Bill, I learned about compassion, empathy, and meeting others where they are. By acknowledging that there is a wide range of sexual orientations and practices, which may differ from their own, a sex-positive provider believes their patients have the right to receive thorough health education and compassionate, non-judgmental care. Sexual health isn’t limited to preventive measures or STI care, but also other aspects like libido, pleasure, and even mental health.

Unfortunately, due to the personal sexual biases, whether explicitly expressed or conveyed through their tone and nonverbal cues, sometimes people feel shamed by their doctor about their sexual health. It is important to recognize that cultural factors, including attitudes towards sexuality, play a significant role as social determinants of health. This is true for everyone, but particularly important if you are a member of the LGBTQ+ community or if you identify as a sexual or gender minority.

In my view, a sex-positive healthcare provider possesses comprehensive knowledge about appropriate language to describe sexuality and gender, recognizes the impact of sex on health, and consistently demonstrates respect towards all patients. They don’t make assumptions about you and partner with you on treatment that works best for an individual’s needs.

Here are four tips from the clinical team at Hello Alpha for addressing sexual health issues:

Plan ahead. Before your appointment, take some time to consider the specific details of the sexual health issue you want to discuss. It can be helpful to keep a symptom diary, documenting factors such as frequency, duration, and any mitigating or exacerbating factors.

Prepare questions. Jot down your questions in advance and be specific about the information you’re looking for. Whether it’s medical advice, solutions, or simply someone to listen empathetically, clearly express your needs. Your relationship with your provider needs to work for you, otherwise it doesn’t work at all. For example, if you’re having pain during intercourse, you might want to prepare questions like why this might be happening, what are potential treatments, and what your provider might recommend as additional resources.

Be direct. This can be difficult to do since talking about sex can make you feel vulnerable or uncomfortable, but first, take a deep breath. Candidly let your provider know that you have a sexual health matter at the start of your appointment. Tell them you have specific questions or concerns related to your sexual health and ask about the best way to get answers. By openly addressing the topic, you can gauge your provider’s reaction and ensure they save time for the discussion.

It’s about your normal, not what’s normal. You know your body best, and a sex-positive healthcare provider will recognize that. If you’re noticing changes in your sexual health that might be dismissed as “normal” but aren’t for you, it’s worth bringing up with a provider you trust.

Taking an active role in addressing your sexual health with your medical provider is crucial for receiving the care and support you deserve. By employing these strategies and advocating for yourself, you can improve the quality of conversations around sexual health and ensure that your concerns are properly addressed. Remember, open communication is key to fostering a productive and inclusive healthcare experience.