Lack of Detail Poor Sexual Health Discussion

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    As a professional whose primary background is in sexual health this is a very poor discussion with a patient. The provider seems uncomfortable with the topic and does not provide any detail as to what safer sex practices means. With each patient we need to consider what treatment they are on, what their relationship life is like and also whom they have sex with, cultural barrier and so many other factors so that we can personalize a safe sex plan for them and ensure they understand how to get and utilize the right tools. I have done this work for 15 plus years and it is never good to assume adults know about safer sex practices or anything about sex for that matter. People do not talk about this stuff and often have poor education and information on all manner of sex topics. I have actively been working at my place of employment to ensure that our social work department is trained to provide at least the basic information to patients. Many practitioners are not versed in these topics and have to seek out additional training as well as practice becoming confident in discussing the topic.


    Completely agree – typically it is just glazed over in conversation, but we cannot assume patients know what ‘safe sex practices’ are and how to protect themselves.


    We struggle in my dept between the different levels of comfort of the physicians and teams within the same specialty. One physician and team is outstanding while another literally does not broach the topic. This leaves a surprising inequity of care level with regard to intimacy discussions within the same practice, and we try and fill in the gaps that are left. The discomfort with talking about sex is so puzzling to me when it is such a large part of people’s relationships with their partners and contributes a great deal to their emotional health. I have found leaving the excellent ACS booklets about sex in strategic places can really help patients who haven’t discussed it with their physician. It also gives us a nice opening to broach the topic “did you pick up the guide sex and the women with cancer?” (The men’s book is also great for our older men in discussing prostate issues). We go through cases of them every year!


    I totally agree with jybissar. This is a very poor sexual health discussion and gave the therapist, the patient, and us no information at all. Sounds as if she was just encouraging her to avoid other’s with a cold so as not to catch a cold.


    I agree with the initial comment about being an incomplete discussion about sexual health. At the same time, it is likely better than no conversation at all, which is far more common at my facility. It is possible that the SW mentioning the need for safe sexual practices leads the patient to explore online or local resources on her own to learn more. From my experience, AYA patients tend to be resourceful in finding online resources that promote sexual health. A more comprehensive discussion of sexual health is always ideal but may not always be practical. I believe mentioning sex safe is beneficial in situations that do not permit a more detailed discussion.


    I agree with others. Her use of the words “this stuff” present her as being uncomfortable. The ability to utilize exact terminology is profound.


    Yes to all of this, I agree, and think having a prompt, such as a brochure, to begin broaching the topic can be helpful. I do think that in this field, self-exploration and introspection to become comfortable is important.


    I absolutely agree with many of the points here. Both the verbal (accurate and comprehensive information) and nonverbal (affect, projected comfort level, confidence) communication are extremely important in terms of relying sexual health information. Patients can walk away with many different understandings of oncofertility planning and sexual health depending on the interplay between these two factors within the clinician.


    Agreed, this is a poor sexual health discussion. I would love to hear if anyone has conversation starters for clinicians about this topic! I do not have much experience with talking about this topic with patients – and would like to know if there are good open ended questions to start with, such as “Are you sexually active? Or considering becoming sexually active in the future?”

    Or even starting the topic by saying “I’m going to spend some time with you talking about sexual health. This topic may be uncomfortable to talk about for many people, but it is an important part of your health – especially while going through treatment.”

    It is important to discuss how the patient can protect themselves against STI’s, and also important to discuss keeping their partner safe if on certain types of chemotherapy treatment.

    Would love to hear from the group if there are other talking points they use.  Thanks for recommending the ACS booklet!

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