1. What do you think went really well during your patient interview(s)?

•      Normalizing sex and sexual health is a passion of mine that I hope to make a focus of my career as a PA. Due to the culmination of my experiences, I feel as though I am more comfortable talking about sex than the average person is – As a member of the LGBTQ+ community, discourse about sexuality and gender has always been at the forefront of my identity and the identities of many of those around me. I spent three years researching sex and consent as a member of Binghamton University’s “Sex Lab,” which is where I initially learned the importance of talking about sexual behaviors, attitudes, and acts on a greater scale. From there, working as an EMT in an urban area and as a residential assistant in a large undergraduate dorm building, I have had multiple experiences handling crises of interpersonal violence. Overall, having candid, destigmatized conversations about sex is something that I consider to be a strength of mine. I believe that was to my benefit during my patient interviews and I hope for it to be in my career as well. 

2. What was the hardest part for you in taking a sexual history?

•      During my interviews, I think that my normalized attitude towards sex may have made those who are less comfortable talking about it feel uneasy. Although I myself have spent time in environments where discourse surrounding sexual health is entirely destigmatized, I need to remember that is not the case for most people. Sex is still very private in our society, and taking a patient’s sexual history may be something that will feel more uncomfortable to them if I am too uninhibited. It’s important to maintain a middle ground between enthusiastic normalization and respectful formality when taking a sexual history. 

3. Please talk a little about your experience as the patient in the scenario.  What made you feel more comfortable or less comfortable talking about sexual concerns (i.e. how did the interviewer put you at ease or not make it easy? – Your partner will not see your response unless you choose to share it). 

•      Both of the characters that I played were members of the LGBTQ+ community. I found that my partners made me more comfortable when their questions were asked confidently as opposed to when they were asked with hesitation. I think any hesitation in reaction or inquiry can easily be misconstrued as judgment or concern while talking about sex, especially with patients who participate in sex that may be viewed as controversial by some members of our society. In a conversation about sex, silence from the professional is really awkward. From the patient’s perspective, I think maintaining a seamless, objective, and positive conversation should be the clinician’s top priority.

4. What suggestions do you have about how this exercise could be done more effectively?

•      I think including a brief lesson or “glossary” hand-out on the various ways that people identify their gender and sexuality and how they engage in sex would be beneficial. Recent studies have shown that a growing percentage of young Americans are identifying with a sexuality other than exclusively heterosexual – in other words, as members of the LGBTQ+ community. The extent of everyone’s sexual education varies, especially when it comes to queer sex, and I think acknowledging that by providing a baseline knowledge in the context of this class would be to the benefit of future clinicians and their patients. Specifically, I think providing the class with the vocabulary used to clinically describe sexual acts would increase confidence while interviewing, resulting in increased patient comfort.

https://news.gallup.com/poll/389792/lgbt-identification-ticks-up.aspx