In Engle’s article “Taking a sexual history is an essential part of good health care” the compulsory notion that “sex is vital to human life” kicks off the argument that taking patient sexual histories as clinicians is a necessity for the betterment of wellbeing and sexual health (2020). From the notion that “sex is a normal part of human existence” comes the conversation on barriers to discussing sexual history. While specifically looking at patients and clinicians, the general population including providers fall short of proficiency in sexual health, are embarrassed by the thought of discussing it, and a fear of offending the patient or others as a reason for not asking about someone’s sexual history in clinical settings. With practitioners also failing to do these in settings where it should be routine, Engles (2020) details that comprehensive sexual histories are an “important first step in providing the necessary advice and treatments a patient may need” by helping to “assess risk, prevent, diagnose, treat STIs, assess medication side effects”and “assess emotional and mental health” – all to encompass who is the client in front of them (Engles 2020).
While the need for sexual histories gathered from adult populations is pivotal to research, prevention, and treatment, adolescents and seniors “are having sex and parenting they aren't isn’t going to change” this sentiment (Engles 2020). Kids have “growing brains that are doing what they are supposed to doing” making it important to “try new things” – risky or not (Engles 2020). Seniors are “not sexless beings” and “education is crucial regardless of age (Engles 2020). Taking a sexual history of a client has the capacity to help practitioners understand what knowledge a client has about sex and sexuality. This leads to more insights about a clients set and setting–past, present, and future.
In closing, Engles (2020) provides a more digestible approach to considering sexual histories as a practice in clinical or social work settings. They remind that every agent is different and sexual histories might look different depending on who one is talking to, but “patients are sensitive and the more comfortable” a practitioner is, “the more comfortable they’ll be.”
- How can medical education and training programs better prepare clinicians to comfortably and effectively discuss sexual history with patients across different age groups?
- What role does cultural background and societal norms play in shaping a patient's willingness to disclose their sexual history, and how can clinicians adapt their approach to be more inclusive?
- How can the public, organizations, or governments work to normalize conversations about sexual health beyond clinical settings, reducing stigma and improving overall sexual wellbeing in communities?