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Dr. Myrtle,
As a health care provider, sex seems like a pretty confusing topic - I get bombarded with different information from all sides every day, and I don't know how to answer these questions. Why did I learn more in school about filling out insurance forms than I did about sex?
 From a respectful medical point of view, sexuality is a topic that can be understood in a basic framework that allows people to be individuals, but still gives general principles. The problem is that a basic framework is missing from most health care provider's education, where sexuality is down-graded to a dysfunction or a perversion.
Experts continue to debate basic facts about genital anatomy, because so few research projects dare to quest for sexually related knowledge. Do you have any idea how hard it is to get a basic genital anatomy study funded these days, much less studies about the prevalence of orgasm in women with Type 2 diabetes? As a culture, this leaves us with advertisements for erectile dysfunction, limp libidos, and HIV prevention, but without any concrete information about erectile function, information about sexual desire, and ways to be sexual and prevent transmission of infections.
There are some basic things that you can do to begin to build your understanding of the vast topic of sexuality.
- First, learn about the structures of reproduction and the structures of sexual pleasure in differentiated females and males.
- Second, review the spectrum of genetic contribution to sexual differentiation (XXX [Mosaic triple X], XX, XO [Turner's syndrome], XXY [Kleinfelter's Syndrome], XY, XYY, etc).
- Third, pop back out to the Dr. Myrtle page, and consider the process of sexuality: Act 1: Willingness; Act 2: Interest/Libido/Desire; Act 3: Sexual Arousal; Act 4: Penetration & Act 5: Emotional Satisfaction. Read each of the topic headings - this will give you a sense of how to organize the questions you are getting from your clients.
- Last, consider that someone might be relaying concern even though their sexual health status is fine. This often occurs because they:
- lack information about their personal anatomy,
- lack information about how their anatomy and/or sexuality works,
- don’t know how to effectively stimulate themselves and/or others, and/or
- don’t have any place to gather accurate information about sexuality.
When you are able to adopt a framework something like this, you'll be able to put questions into context, which will help you find the answers to their questions.
Good Luck.
Dr. Myrtle
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