Has your doctor ever talked to you about sex? If you answered “yes,” consider yourself lucky. Despite the fact that a healthcare professional is usually a person’s first point of contact for sexual problems, the vast majority of these providers are uncomfortable talking about sex.
And it shows. Health practitioners with a lack of sexuality training often project their anxiety onto the patient, shutting down the process of information gathering and sharing.
So what’s a patient to do? Become your own sex advocate!
Sexual History
Many who train doctors about sex matters will tell you that the most difficult issue in their work is developing learner comfort and one’s ability to discuss sexuality with their patients. Research has found that practitioners fail to take adequate sexual histories for three major reasons:
1. They are embarrassed.
2. They believe that a sexual history isn’t relevant to the client’s chief complaint.
3. They have not been adequately trained.
While all of these factors are alarming, number two warrants the most concern by far. When it comes to medical consultations involving physical disability, the last thing on your physician’s mind is how your medical condition is going to affect your sex life.
An unfair assumption many practitioners make is: in being “disabled,” you’re “asexual.” So you need to take matters into your own hands. And this can be done in a plethora of ways, on any number of fronts. Your key action items:
Sexual Health: Determine Where You Think You Can Be the Most Effective
Being a sex advocate takes a lot of chi, so consider well where your passions in sexuality and sexual health lie and where you might be the most influential and effective. You may want to advocate for standardized sex education for medical students.
You may want to rally organizations, like the American Medical Association, asking them to make sex and disability in sexual and reproductive health services a top priority. You may want to mold tomorrow’s physician, cultivating healthy sexuality early by lobbying for comprehensive sex education in your local school district. The possibilities are practically endless.
Initiate the Sexual Discussion
Sure, it’s not easy to bring up sex issues with your doctor. But if you don’t go to bat for yourself, no one else will. This includes asking about “basic” sexual health topics like birth control, if pregnancy prevention is of concern. Men with spinal cord injury (SCI), for example, are able to produce sperm viable for pregnancy, even if they do not experience feelings of orgasm. Most women who are paralyzed from the shoulders down can get pregnant despite their disability. Yet this most important topic can get easily dismissed if a patient doesn’t speak up!
Challenge the Medical Community
Don’t be afraid to respectfully question a health practitioner’s doubts about your sexual capabilities. Don’t doubt what you know is true for you when it comes to your sexual response, despite what physicians will tell you. They have been known to be wrong.
Consider that, when women with complete spinal cord injury told their physicians that they were experiencing orgasm via genital stimulation, their providers reacted by telling them that they must be imagining the sensation. Such claims went against their medical knowledge. Given research has since proven that these women were indeed experiencing orgasm, you can bet those doctors are eating their words.
Fight for Your Sexual Rights
Write your elected representative, e.g., governor, state health commissioner, senator, city council member, mayor.... Mention how you’re part of their constituency, e.g., voter, political party, taxpayer, or a minority. Make your letter personal and speak from experience.
A recent Gallup Poll found that over 70 percent of lawmakers pay a great deal of attention to personally written letters, while only 19 percent pay attention to form letters. Go one step further and draft a brief, respectful letter others can use as a template, stating your purpose in the first and last sentences. Circulate a petition.
Get Involved With Sex Advocacy Campaigns
Existing movements, like those that want evidence-based comprehensive sex education taught in schools, already have your agenda as part of theirs. Look at what’s going on and see how you can become part of their effort.
Be Visible
Create a website or online bulletin board regarding your issue. Create posters. Make presentations. Talk to key community leaders, e.g., school board members and school superintendents, about healthy sexuality efforts in your area. Create a coalition of educators, healthcare providers, and others who can speak out on issues regarding sex information and services for people with disabilities.
Get Local Media Involved
Put together a press kit about your issue. Contact reporters who cover health issues, asking them to bring attention to your cause. Invite them to meetings, rallies, or other important events.
Learn From the Pros
Groups that have advocated around sex-related issues can teach us a lot when it comes to our own causes. The Global Campaign for Microbicides and HealthGap are amongst the many advocacy organizations fighting for our rights all the time. Check out their websites and learn more about their strategies and what’s worth modeling.
Find Continued Inspiration for Your Cause
Change tends to happen slowly with it comes to sex issues, so make sure you keep your batteries charged, especially by reminding yourself of your purpose. Sexual health definitions, like those drafted by the World Health Organization, and declarations of sexual rights, like that written by the World Association for Sexual Health, can give you just the right boost when you need it.
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