Sexual Health

In medicine, we are often focused on sickness and disease rather than wellness and prevention. How much time in medical school do we spend learning about HIV, syphilis, gonorrhea, and chlamydia for example, rather than the biopsychosocial and cultural aspects of sexual health? I know medical school isn’t about training anthropologists, but the social sciences are important.

Let me back up. Sexuality is about reproduction, so we must think about evolutionary biology. But it is also about culture. In a culture where violence is praised, women and LGBTQ+ people are often the victims of sexual violence.

So we must start from the beginning, from birth, modeling healthy communication in our families, and we must not tolerate sexual violence in any form.

Couples therapy and family therapy should be much more available and less stigmatized. Healthy sexual relationships throughout the lifespan should be our priority.

In the clinic, we need time to talk to patients regarding sexual health, who their partners are, and prevention of sexually transmitted infections. This can be the difference between life and death, in the case of taking PrEP to prevent HIV transmission, for example.

But time is what we don’t have in the clinic. The norm is the 15-30 minute visit. So we are rushing, and having a discussion about sexuality takes time.

We also need much people in sexual relationships to listen to each other much better. When a partner says no,, that means no. But it also brings up an important question – why is s/he saying no? What are our emotions, and why do we have them? I am not going to go too much farther there, because doing so would require a discussion of Sigmund Freud and Jacques Lacan, but these are important topics.

Health and healing is all about communication.