RP101 – Sexuality (Sept 2017)



Session Readings

 

**PRIOR TO THE PANEL ON SEPT 12, PLEASE WATCH THE FOLLOWING**

— https://www.shortoftheweek.com/2015/09/04/the-next-part/

— https://www.nytimes.com/2015/06/04/opinion/transgender-at-war-and-in-love.html/

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Background:

Regardless of age, gender, sexual preference, or sexual identity, one’s sexuality is inherently tied to one’s sense of well-being. As such, addressing sexuality (perhaps best defined as the sexual habits and desires of an individual) with our patients is an essential component of providing them comprehensive, compassionate, high-quality care. Despite this reality, providers frequently avoid the topic, stating that their hesitancy stems from a belief that their patients are uncomfortable discussing the topic.  The reality it is just as often (if not more often), providers are the ones who are uncomfortable discussing sexuality. As such, it is essential that we consider our own reactions to discussing sexuality and examine the way these reactions might impact the way we care for our patients.

Prior to the session, consider your own views on sexuality and your comfort discussing sexuality with people of different ages, gender, sexual preference and sexual identity. I also ask you to consider your reaction to discussing sexuality with individuals who have sustained spinal cord injuries, amputees, those who have experienced trauma, and those with mental disability. How do you presently see sexuality fitting in patient care? How have you reacted to experiences you have encountered thus far with sexual overtones such as conducting (or omitting) a sexual history in your patient interviews, studying the anatomy of the genitalia, and performing examinations of the penis, vagina, and anus? How might your context impact the way you would (or wouldn’t) address the topic with one of your patients? How might this impact the quality of care you deliver?

Objectives: By the end of the session on the topic of Sexuality, students will demonstrate the ability to:

  1. Identify one’s reaction to sexuality in various populations and consider what factors impact this reaction, to include but not be limited to:
    • The individual’s age, gender, sexual preference and sexual identity
    • The individual’s own view of their sexuality
    • The individual’s apparent comfort/discomfort discussing sexuality
    • The relationship of the individual to you
  2. Reflect on the source(s) of those reactions, including:
    • one’s own experiences with their sexuality
    • one’s beliefs and values regarding sexuality
    • beliefs about who should and should not be sexually active
    • how one perceives sexuality to be viewed in the family/community in which you grew up
    • how one perceives sexuality to be viewed in the medical and/or military community
  3. Identify the implications (both positive and negative) of those reactions for your ability to address issues related to sexuality in the care of your patient(s).
  4. Develop a plan to enhance the positive and mitigate the negative implications of your reaction(s).

Panelists

  • SFC Aaron Causey was an Explosive Ordinance Disposal Specialist – first with the Air Force and later with the Army. His service includes assignments overseas as well as three deployments – two to Iraq and one to Afghanistan.
  • Kathleen “Kat” Causey is a member of the Elizabeth Dole Foundation and a vocal advocate for veterans rights.
  • Dr. Jamie Lee Henry is a Graduate of the F Edward Hebert School of Medicine and currently a staff Internal Medicine Physician at Walter Reed National Military Medical Center.
  • Dr. Anna Gabrielian is a graduate of University of Pittsburgh School of Medicine and is currently finishing her last year of Anesthesia residency at Allegheny Health Network in Pittsburgh, PA.
  • Mrs.  Caroline “Tiger” Stafford Pastel – is a 79-year-young life coach, who graduated from SUNY NYC, has had a wonderfully wide range of life experiences, and is an expert in neurolinguistics.

Assignment: Reflective Essay

  • Reaction – As you reflect on the panel and supplemental resources, identify your reaction to the topic of sexuality and to discussing it with others.  In identifying these reactions, consider to what extent your reaction varies when considering discussing sexuality with people of different ages, gender, sexual preference, sexual identity, as well as those who have physical and/or mental challenges. Please ensure you include at least two (2) reactions.
  • Sources – Through the medium of your personal narrative, explore the sources of these reactions. Your narrative must include specifics and be written in the first person. Your sources will likely include one or more of the following:
    • your own experiences with sexuality
    • your beliefs and values regarding sexuality
    • your beliefs about who should and should not be sexually active
    • how you perceive sexuality to be viewed in the family/community in which you grew up as well as your current community
    • how you perceive sexuality to be viewed in the healthcare community
  • Implications – Identify the positive and negative implications of your reactions to the topic of sexuality as well as the idea of discussing the topic of sexuality with others. In what ways might your reactions improve your communication with your patients and the quality of care you deliver?  In what ways might it detract from that quality of care?
  • Plan: Develop a realistic and specific plan, that you can start to implement now,  to mitigate the negative and enhance the positive implications described in your Implications section.
Military Times imageWounded troops battle obstacles to sex and intimacy A Military Times piece looking at how the DoD is addressing sex/intimacy after injury and how they are faring.
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PulseTaboo by Ralph B. Freidin Dr. Ralph Friedin addresses how sexual feelings may inevitably occur during an examination, and emphasizes the need to teach students how to navigate such reactions rather then ignore the subject entirely.
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New York TimesToo Old for Sex? Not at This Nursing Home. Respecting the fact that the elderly still yearn for intimacy and relationships, this nursing home works to create guidelines and opportunity for those that are interested.
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50513_2219590487_2204_n(Sex)abled: Disability Uncensored by Dan Nokavich This provocative documentary does an excellent job identifying and challenging some common assumptions about sexuality and disability.
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New York TimesWhen Did Porn Become Sex Ed? If parents don't talk about sex, and doctors don't talk about sex, and abstinence is reinforced in schools, where are our kids turning for knowledge?
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Session originally created by: Adam Saperstein | SOM/GSN, Uniformed Services University | Director, Reflective Practice | Family Medicine