Sexual health is a cornerstone of overall health and well-being. Yet, it’s one of the most neglected topics in medical training. For many patients, their physician is the first and sometimes only professional they feel comfortable approaching with sexual health concerns. And the numbers show just how prevalent these issues are. Research suggests that up to 43% of women and 31% of men experience sexual dysfunction at some point in their lives, with many others struggling with broader sexual health concerns like low libido, difficulty with intimacy, or challenges related to physical conditions or medications.
And here’s the kicker: 40% of patients want to ask their doctor about sexual health, but very few actually do. Why? Because the physician doesn’t ask first.
This silence is hurting patients. It’s a disservice to the population, especially when the tools to address these issues exist but aren’t being used. And the root cause of this widespread problem? Medical schools are failing their students—and, in turn, their future patients—by not integrating comprehensive sexual health care training into their curricula.
Why Don’t Physicians Ask About Sexual Health?
Doctors don’t ask about sex. Patients don’t bring it up. And so, the silence persists. But why are physicians avoiding these conversations? Here are a few of the most common reasons:
1. Fear of Opening Pandora’s Box
Physicians worry that asking about sexual health will lead to a flood of complex issues they don’t know how to address, which could extend the length of an appointment and take time away from other concerns.
2. Lack of Training
Many physicians simply don’t know what to ask or how to respond. Sexual health is a specialized area that rarely makes its way into the standard medical curriculum, leaving doctors unprepared to navigate these discussions.
3. Assumptions About Patients
Some doctors assume that if a patient has a sexual health concern, they’ll bring it up themselves. But in reality, most patients are waiting for their doctor to initiate the conversation, as they feel embarrassed or uncertain about how to bring it up.
4. Personal Discomfort
Sexual health is still a taboo topic for many people, and doctors are no exception. Personal queasiness, cultural norms, or a fear of being perceived as intrusive can prevent physicians from addressing it.
5. Belief That It’s “Not Their Job”
Many doctors view sexual health as outside the scope of their practice, especially in fields like cardiology or oncology. However, sexual health impacts—and is impacted by—virtually every area of medicine, making it relevant for all healthcare providers.
The Ripple Effect of Ignoring Sexual Health
When sexual health isn’t addressed, the consequences go far beyond the bedroom. Ignoring this critical aspect of well-being can impact a patient’s physical health, emotional health, relationships, and even adherence to medical treatments.
1. Impact on Cancer Patients
Prostate cancer and breast cancer, two of the most common cancers, often come with significant sexual side effects. Yet, sexual health concerns are rarely discussed in oncology care. Patients are left to navigate these life-altering changes alone, compounding their distress and impacting their recovery.
2. Medication Adherence
Did you know that men often stop taking heart medication because it impacts their sexual function? Similarly, people avoid or discontinue antidepressants due to their effects on libido and sexual performance. When physicians don’t address these concerns or offer alternatives, patients are less likely to stick to their prescribed treatments.
3. Mental Health and Relationships
Sexual health issues are closely tied to mental health. Depression, anxiety, and low self-esteem can result from or exacerbate sexual dysfunction. And let’s not forget the strain these issues can place on relationships, further isolating patients who may already feel like they’re struggling alone.
Where Medical Schools Are Getting It Wrong
Currently, medical schools are failing to prepare their students for the reality of patient care. Sexual health is either absent from the curriculum or given a cursory glance. This creates a gap in physicians’ ability to provide holistic care.
Contrast this with programs like the one at the University of British Columbia, where sexual health is given the attention it deserves. UBC’s two-day training on sexual health, led in part by renowned sexual medicine physician Dr. Rosemary Basson, is a shining example of what’s possible. It integrates the sexual response cycle into the training, utilizes standardized patients (including those with spinal cord injuries), and teaches medical students to address sexual health concerns comprehensively.
Programs like these prove that medical schools can do better—they just need to prioritize it.
The Research on Sexual Health Training
Studies show that sexual health training improves both physician confidence and patient outcomes. When doctors are equipped to discuss sexual health, patients are more likely to share their concerns, adhere to treatments, and feel supported in their care.
Moreover, addressing sexual health concerns doesn’t have to be a time-consuming Pandora’s box. With the right training, physicians can integrate these conversations seamlessly into their practice, asking simple, effective questions that open the door for patients to share.
The Solution: Train Physicians From the Ground Up
The best way to address this gap is to start early. Sexual health care needs to be integrated into the medical curriculum from the very beginning. This doesn’t mean turning every medical student into a sexual health expert, but it does mean giving them the tools to ask the right questions and provide appropriate referrals when needed.
Training should include:
• Basic Sexual Health Education: Covering the sexual response cycle, common dysfunctions, and their treatments.
• Communication Skills: Teaching students how to ask sensitive questions in a nonjudgmental way.
• Special Populations: Including training on sexual health in cancer patients, those with disabilities, and LGBTQ+ populations.
• Practical Applications: Using standardized patients and case studies to build real-world skills.
Why Sexual Health Is Too Important to Ignore
Sexual health isn’t just about sex. It’s about quality of life, emotional well-being, and physical health. Ignoring it means failing to provide comprehensive care.
It’s time for medical schools to step up. By integrating sexual health training into their programs, they can prepare future physicians to meet their patients’ needs, improve treatment adherence, and ultimately enhance overall health outcomes.
If medical schools continue to neglect this critical area, they’re not just failing their students—they’re failing the population as a whole.
Let’s Talk About Sex (Health)
Sexual health is an essential part of medicine, and it’s time we treat it as such. Physicians have the power to change lives by addressing these issues head-on, but only if they’re given the tools to do so.
To medical schools: Get with the program. Train your students in sexual health, and help them become the well-rounded, effective physicians their patients need.
And to patients: If your doctor isn’t asking about your sexual health, don’t be afraid to bring it up. Your well-being matters, and there are solutions out there for whatever you’re facing.
Let’s make sexual health a priority—for everyone.