Healthcare Providers 'Have Not Been Taught to Talk About Sex at All,' Says OB/GYN: Why That's a Problem
A recent study has highlighted significant gaps in women’s healthcare, as well as barriers to comprehensive treatment - particularly when it comes to sexual health.
Dr. Mary Jane Minkin, a board-certified OB/GYN at Yale University School of Medicine and member of the PEOPLE Health squad says that the report from The Commonwealth Fund was “spot on” in identifying how issues of sexual health “really get put to the side.”
“Many healthcare providers, particularly primary care folks, have not been taught to talk about sex at all,” she says. “It's a taboo subject, so people will not bring up sexual health issues.”
“And many women themselves are embarrassed to bring these issues up" if their providers don't do so first, Minkin adds, "so these issues will get overlooked.”
The study also notes that many women — about 20 percent — consider their OB/GYN to be their primary care provider, which also can contribute to the lack of comprehensive health coverage women receive.
The Commonwealth Fund report, authored by Laurie Zephyrin, Lisa Suennen, Pavitra Viswanathan, Jared Augenstein, and Deborah Bachrach says "women between the ages of 18 and 44 found that the majority of respondents were not only more likely to be satisfied with care from their OB/GYN than from their primary health care provider, but also were more likely to be open and honest with their OB/GYN than with their primary health care provider.”
It also specifically notes that 80 percent of medical residents “report feeling ‘barely comfortable’ discussing or treating menopause.” Further, even within obstetrics and gynecology, only 20 percent of residencies offer training on menopause.
Minkin says these issues have been exacerbated amid the current coronavirus pandemic, as many primary care doctors have been seeing fewer patients or encouraging only telehealth visits. This has left many of her own patients concerned.
“I have patients coming into my office and my patients will say to me, ‘Well, my primary care person can't see me until December’ or something like that, and they're anxious,” she says.
For patients who want to best advocate for themselves at the doctor's office, Minkin recommends coming with a short list of questions in the order of priority, in case you're not able to get to them all.
"Don't quote from too many 'Dr. Google' type websites," she advises. "Many physicians are turned off by some of the less-than-accurate information that can appear on the web, so if you have a question about something you read, you may want to say 'I don't know if this is true, but could you comment on thus and such.'"
She also suggests making sure your doctor — whether a primary care provider or a specialized doctor — knows if you have other providers in certain areas. For example, if you don't have a primary care doctor and you're leaning on your OB/GYN for primary care, make sure they know that and can adjust your care accordingly, or refer you to a PCP they trust to make sure you're covered in all areas.
Still feel unsure about speaking up for yourself in front of a doctor? "You may want to have a friend come with you to your appointment" once office visits open up in a post-COVID world, Minkin adds. "Some women do get anxious and your close friend could give you some emotional support."