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Sex and the family practitioner

“Most physicians are hesitant to ask patients about sexuality,” asserts clinical psychologist Julia Strand, Ph.D., assistant director of the Sexual Behaviors Consultation Unit. “If a patient is there for a physical, with complaints of, say, fatigue, the typical doctor doesn’t feel comfortable asking, ‘How’s your sex life?’”

It’s an understandable awkwardness, but one that may not serve patients well, considering the numbers of otherwise normal men grappling with dysfunctions like premature ejaculation and women who go out of their way to avoid marital sex. Without help, such problems can become pressing quality-of-life issues.

To prepare School of Medicine students to deal with this aspect of health care, Hopkins puts them through an introduction to human sexuality that includes an intensive two-day overview by faculty specialists and a rotation through the Sexual Behaviors Unit, with a chance to observe at least two patient interviews. “We’ve searched far and wide,” says Chester Schmidt, M.D., the unit’s associate director, “and I don’t believe any other medical school has this type of program.”

With or without such a background, faculty in the sex unit suggest that family doctors can help patients raise questions about sex simply by adding an item or two to the standard list of inquiries. Questions along the lines of “Are you satisfied with your sex life?” help patients get started, they instruct.

“If you give them an opening,” Strand says, “some of them are going to take it.” That’s all a family practitioner should need to decide if a patient might benefit from treatment or a referral.