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How Gynecologists Talk—And Don't Talk—About Sex

A new study examines how gynecologists and obstetricians talk about sexual activity with their patients—if they talk about it at all.


The worst gynecologist I ever had sat me down in his examination room and asked me one question about my sexual activity: "Do you have a boyfriend?"

I did.

"Good," he announced, in a tone that insinuated some moral failure in single women everywhere. That sort of judgment of my relationship status would feel uncomfortable coming from anyone. Coming from an older man tasked with probing my reproductive system, it felt downright skeevy. A few months later, my boyfriend and I broke up. I never went back to that doctor.

My bad ob-gyn isn't the only one who doesn't know how to talk about sex. A new study published in the Journal of Sexual Medicine examines how gynecologists and obstetricians talk about sexual activity with their patients—if they talk about it at all.

The results are troubling: In a survey of about a thousand American ob-gyns, only 63 percent discuss sexual activity with their patients. Just 40 percent ask about any sexual problems they might be experiencing; 28 percent discuss sexual identity and orientation; only 13 percent raise the issue of sexual pleasure. A quarter of doctors surveyed admitted to expressing "disapproval" of a patient's sexual activity.

Some ob-gyns are more open about discussing sexual issues than others—namely, younger, female physicians. Seventy-three percent of female ob-gyns reported discussing sexual activity with their patients, compared to 54 percent of male doctors. Female and younger practitioners were also much more likely to bring up issues of sexual orientation or identity.
Maybe that's part of the reason that most women prefer to see female gynecologists—in one study, a full 83 percent of patients chose female doctors over male ones. Other scholarship on the topic has shown younger patients prefer to see younger practitioners, and single patients prefer to visit women—perhaps because a woman is more likely to be shamed for her sexual activity if she's not partnered up. And the double standard goes both ways—one study found that "physicians were significantly more uncomfortable taking sexual histories when the patient was of the opposite gender."

Unfortunately, those numbers don't sync up with women's real health care choices: Most obstetricians and gynecologists are men. That's changing—two out of three residents in the field are women. That demographic shift may be what it takes to change the conversation. It's awkward to talk pleasure with your doctor, but it's better than the alternative.

Photo via (cc) Flickr user donotlick


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