Why is it important to discuss sexual health and sexual wellness?
- Discussing sexual health is necessary to understanding an individual’s overall wellness.
- Sexual health is connected to happiness, well-being, and longevity.
- Taking a sexual history can help open up a conversation about:
- Self-identified sexual wellness concerns
- Need for primary prevention (e.g., contraception, PEP, PrEP, etc.)
- Sexually transmitted infections, including testing, diagnosis, and increased risk for HIV acquisition through lesions, ulcers or inflammation
Download Printable Handout
Key Points
Ensure a Positive Sexual Health Conversation
- Assess your own comfort discussing sex with various patient groups and identify any biases that you may have. If you are uncomfortable talking about sex and sexuality, your patient will be too.
- Make your patient feel comfortable and establish rapport before asking sensitive questions.
- Use neutral and inclusive terms (e.g., “partner”) and pose your questions in a non-judgmental manner.
- Avoid making assumptions about your patient based on age, appearance, marital status, or any other factor. Unless you ask, you cannot know a person’s sexual orientation, behaviors, or gender identity.
- Try not to react overtly, even if you feel uncomfortable or embarrassed. Pay attention to your body language and posture.
- Ask patients/clients for their pronouns. Use the pronouns that they prefer and support that patient’s gender identity, even if their anatomy does not match that identity. It may be best to introduce yourself first with your name and pronoun to set the tone for the safe environment.
- Rephrase your question or briefly explain why you are asking a question if a patient seems offended or reluctant to answer.
- Use ubiquity statements to strive to neutralize the conversation. These statements help patients understand that sexual concerns are common.
- Ensure that you and your patient share an understanding of the terms being used to avoid confusion. If you are not familiar with a term your patient used, ask for an explanation
Non-Gendered Language
Acknowledge Differences in Identity, Language Use, and Sexual Practices
The 8 P’s: Sample Questions
Preferences
Do you have a preferred language that you use to refer to your body?
What kinds of sex do you engage in?
Partners
Have you had sex in the last three months? If so, what kind(s) of sex have you engaged in?
How would your partners identify themselves in terms of gender?
Practices
Do you have any other types of sex that hasn’t been asked about?
Do you use toys inside your [insert preferred language for genitals] or anus, or on your partner(s)?
Pleasure
Do you have any pain or discomfort during or after an orgasm?
Are you having sex for pleasure or are there other reasons (survival sex/transactional sex)?
Past History of STI’s
Have you ever had a sexually transmitted infection in the past?
If yes, do you remember the part of the body that tested positive?
Protections From STI’s
Are there some kinds of sex where you do not use barriers?
Partner Abuse
Has anyone ever forced or compelled you to do anything sexually that you did not want to do?
Is there any violence in any of your relationships?
Pregnancy Plans
Have you thought about having your own biological children, or carrying a pregnancy?
When you are having sex, is there any exposure to sperm or chance of pregnancy?
Questions To Avoid
And Suggested Alternatives When Taking A Sexual History
FOR MORE HELP, CALL THE HEALTH INFORMATION HELPLINE AT 215-985-2437
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