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Barriers to Presenting Sexuality

Barriers to Presenting Sexuality

Sexual problems are common in men and women all over the world, with its identified major risk factors and associated comorbidities. Primary care physicians are considered by many people the first health care providers who encounter sexual health issues. Even though the primary care setting is an excellent one to address sexual dysfunction problems in the general population, it is felt that primary care physicians tend to address sexual health issues less than their patients anticipate. Attempts to rectify this deficiency were sought by WHO, and a widely accepted guideline is currently in process, focusing on addressing sexuality related issues.

Patients have difficulty discussing their problems with a physician due to a sense of frustration, confusion, embarrassment or distress; moreover, patients often feel that physicians are reluctant, disinterested, or unskilled in sexual problem management. Physicians have identified ‘lack of time’ or belief that the, ‘patient will initiate discussions’, were reasons not to ask about sexual problems. Also, lack of training may mean that the clinical utility of taking sexual history may not be apparent to the physician and the uncertainty about ethical or legal issues; gender differences; and language barriers were blamed for not obtaining sexual history when deemed necessary.

One of the main barriers found to inhibit discussion of sexual health issues in primary care is the sensitivity.  Physicians may be embarrassed, or concerned about being intrusive. Another commonly cited barrier is their complexity, this perception might originate because there are psychosocial issues around it, and because the language is difficult. Additionally, treatment is not well standardised. Indeed, these barriers may help to explain the low rates of sexual history recording, certainly all these barriers need to be addressed.

In-Charge Al Hoora Health Center, Consultant Family Physician and Clinical Sexologist, Arad Health Center, Ministry of Health (MOH) Primary and Public Health Directorate. Member of WHO “Revision of ICD-10” Working Group on the Classification of Sexual Disorders and Sexual Health Member of WHO Working Group on “Sexuality counselling guidelines for health care providers”. 

Areas of Interest / Categories: Pregnancy, Sexual Health Care, WAS 2013

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