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Sex Impacts Your Health and Well-Being: So Why Aren't More Doctors Trained to Talk About It?

Doctors lack knowledge and skills to discuss sexual health with patients due to decline in residency standards.

In a country like the United States, where comprehensive sex education is in a serious deficit, physicians are a chief point of reference for those seeking medical information about their bodies. Yet, a new report published in the American Journal of Sexuality Education claims there has been a dramatic drop in the sex health education requirements in medical residency programs across the country, impacting on the potential treatment a patient may receive and the overall quality of public health in the nation.

Sexual health, as defined by the World Health Organization, isn’t just concerned with the absence of disease or unwanted pregnancy, but rather encompasses a state of physical, emotional and social well-being in relation to sexuality as well as potential pleasure and safe sexual experiences. 

For medical students, learning about sexual health involves acquiring information and forming beliefs and values related to sex and sexuality. However, according to Megan Andelloux, a clinical sexologist who is co-author of the report, sex education in U.S. medicine is marred by a lack of conversation that is producing sexually ignorant adults.

“We find that patients want to bring up the topic of sexuality but are met with a cold silence from their providers. If they do bring up the conversation, providers often try to shut them down or put them on antidepressants. Physicians are hailed as knowing the most about the body. But from what I have seen as well as from evidence in the report, many physicians know less about sexuality than their patients,” she said.

The report reveals that a study of 500 adults showed that even though 85 percent said they would try to talk to their physician about a sexual problem, 71 percent felt their physician would dismiss their concerns and 68 percent thought their doctor would be uncomfortable discussing sexual problems. Only 9 percent of patients had been asked about their sexual health directly during a routine visit. This created barriers between doctor-patient relations and led many to search other sources like the Internet for sexual health answers, despite preferring to discuss concerns with educated professionals.

So if there is an obvious and increasing patient demand for sexual health care as a vital public health service, why are physicians hesitant to initiate this important discussion?

Research shows that the problem lies in the lack of education, training and practical skills physicians typically receive during medical school and residency, with studies showing many physicians don’t feel prepared, confident or equipped to discuss sexual health issues with patients.

“The number-one thing medical students and residents tell me is that they don't want to appear that they don't know what they’re talking about so they would rather be quiet about sexual health than mess up when talking to patients,” Andelloux said.

Such findings aren’t really a shocker when one considers that the average amount of time medical schools spend on clinical education of sexual health topics is just eight hours—and that’s only among the 55 percent of U.S. medical schools that actually have a sexual health curriculum.

Unfortunately, sexual health education at the residency-training level doesn’t fare much better. Researchers of the report claim that in the past three years, there has been a decline and variance in the sex education requirements in residency programs, particularly in pediatrics, which has removed sexual health requirements from the regulations altogether.

The key body responsible for establishing post-MD residency requirements for all specialties is the Accreditation Committee for Graduate Medical Education. Under the ACGME regulations, not all residency programs have standardized sexual health training or clinical skills experience. Only certain specialties, such as obstetrics and gynecology and family medicine, expressly set out individual components that residents must be trained in specific to sexual health.