As time has changed, there has been more awareness and sensitization towards topics of sexuality and sexual health in healthcare. We often stress how crucial it is and can be to address these concerns but often feel less prepared to deal with such situations.
Most are aware of things and prepared to answer if any question pops up in our practice but, how do we take the onus and initiate these supposedly "awkward" conversations? Here are my five tips for instigating and addressing these conversations in practice.
Tip #1: NORMALIZE
When stigma and discrimination are all that surrounds the topic, the least one can do- be professional and normalize the word around it. Remember, the onus will always be on you.
In practice, when you introduce this topic to your clients, try to start and end with statements like, "We often ask these questions or face queries in this area, would you like me to discuss sexual health concerns with you?". This way, your clients do not feel singled out and know they can approach you if further concerns arise.
Tip #2: CONSENT
Respect your clients' boundaries and choices. You cannot start offering suggestions when the client is not seeking them. Start with statements like, "I am going to take a sexual health assessment which will involve asking some personal questions. You can revoke consent and have the right to skip or not answer questions, would that be okay?"- you have not only prepared them for what's coming next but also took their permission for assessing an area that's intimate to their life.
Tip #3: DEI (Diversity- Equity- Inclusion)
Be inclusive in your approach, language, and perception. We work with and within an entire range of genders, cultures, races, and human experiences. This implies that there's a need for inclusiveness when it comes to dealing with a variety of identities, expressions, and preferences. Reconsider the basics of holistic care. Use a gender-neutral language, and ask your client about their pronoun and identity preferences irrespective of their age, color, race, culture, caste, and/or religion.
Inclusiveness does not only come from within but also from the kind of space you create externally. A safe, welcoming environment, say with pride pictures, anatomy wall hangings, designated rooms, etc could be a great way to show and reflect your persona to your clients.
Tip #4: CONTEXT & TIME
Read the room! You do not have to bring up topics of sexuality any or every damn time. Context and timing play an essential role in determining if your client is going to trust you with this or not. Observe what time looks right to bring this topic up with your client. You can casually slip in by saying, "Talking of returning to self-care ADLs, we often assist clients in the areas of re-exploring their sexuality. We could proceed with this topic whenever you feel comfortable discussing it." and let them approach you in their own time.
Tip #5: KNOW YOUR LIMITS
Every human can't be good at everything. It is an unrealistic goal to preach. Some of us are not comfortable discussing this topic, while others may not accept the idea of identities as an extension, and that's okay! Know your limits and politely refuse your client if you do not have adequate resources and knowledge to treat them. Just because they do not fall under your perception of how things should be, does not give you the right to be mean and disrespectful to them. However, you can reassure them that you will try your best to direct them to the right person and service.
Be respectful, kind, and compassionate. Don't diss someone's choices and preferences just because they are beyond your scope of learning. If we honestly believe in sexual liberation, we cannot be doing so by oppressing our clients and depriving them of their engagement in meaningful occupations.