Doctors Talking About Sexuality: What Are the Patients’ Feelings?

Abstract

Introduction Many medical practitioners avoid discussing the subject of sexuality with their patients because they are afraid of invading their privacy. Aim This study was carried out to discover what patients feel when asked about their sexuality by their GP. Methods A qualitative study was carried out that involved 96 patients aged 18 to 86. The patients were recruited from 4 medical offices in the South of France. A substitute general practitioner asked the patients, “How is your sexuality these days?” during routine consultations. The patients were then asked how they felt about that question in semi-structured interviews. Main Outcome Measures This study highlights the existence of a discrepancy between physicians’ beliefs and patients’ expectations. Indeed, physicians fear that they would embarrass their patients if they address the subject of sexual intimacy. As it turns out, 93% of the patients would have welcomed that question. Results 34 patients (35%) were surprised by the question. 7 patients (7%) found the question unwelcome. 89 patients (93%) had a neutral or positive feeling. 78 patients (81%) deemed that sexual history should form an integral part of GP consultations (50% were in favor of systematic screenings for sexual dysfunctions, while 31% preferred targeted screenings). 2 patients (2%) found that the question had boosted their confidence and strengthened the doctor-patient relationship. Conclusion Most patients do not deem that their GP is invading their privacy if the GP touches upon the subject of sexuality, even if the patient’s visit was for a different reason. Before addressing the issue, the GP must ensure that an appropriate framework of trust, care, and empathy is in place. If this framework is present, the patient will be able to overcome his/her feelings of surprise and know that there is a safe space to talk freely about this topic. Zéler A, Troadec C. Doctors Talking About Sexuality: What Are the Patients’ Feelings?. Sex Med 2020;8:599–607.

Competence and Attitude of Family Physicians towards Sexuality Regarding Their Sexual Orientation, Age, or Having a Partner—Survey Study and Validation

“…Elements such as longitudinally in time allow an approach based on greater confidence [ 2 , 7 , 8 ]. In addition, they have patients in consultation who associate various types of pathologies, from diabetes to cardiovascular diseases, which affect the sexual sphere to a different extent, making difficulties in this matter more prevalent [ 9 , 10 , 11 ]. They generally have a good predisposition to attend to the sexuality of their patients, but there are several clear barriers to overcome [ 5 ].…”

“…They generally have a good predisposition to attend to the sexuality of their patients, but there are several clear barriers to overcome [ 5 ]. Physicians’ attitudes are influenced by various factors, such as patients’ age, health status, or socioeconomic status, as well as their usual focus on family planning and sexually transmitted infections [ 5 , 6 , 11 ].…”

“…Family doctors tend not to ask about sexuality and focus on the biological rather than psychological aspects of their patients’ sexuality [ 10 , 11 , 17 ]. However, despite the modesty of doctors, most patients do not feel invaded when asked about sexual aspects, even when the reason for consultation is another [ 11 ]. These barriers could be overcome by improving the training of professionals, something the professionals have demanded [ 12 , 14 , 16 , 18 ].…”

“…Evidence suggests that patients feel comfortable with physicians asking about their sexuality when it is appropriately approached, building stronger relationships with them. However, asking about sexuality exposes underlying concerns that patients would not consult otherwise [ 11 ].…”

“…There have been studies that present a nonstandardized method in their analyses [ 5 ], with a qualitative approach [ 10 , 11 ] or focused on patients [ 19 ]. However, no standardized questionnaires have been found to assess family physicians’ work regarding sexuality quantitatively.…”