Periodically, I complain about what doctors don’t know about sex, or about how they mishandle sexual cases. Today I want to talk about doctors who get it right. They’re my heroes.
~ Wouldn’t prescribe Viagra
Every week I get at least one call from someone referred by their physician. Often the doctor has prescribed an erection drug, and it hasn’t helped. Why? Because the patient’s problem is that he’s half-drunk when he has sex, or he’s having sex with a near-stranger whom he’s afraid will judge him, or he’s using the withdrawal “method” of birth control and he’s nervous about getting it perfectly right (as he should be).
Once in a great while I see a new guy with unreliable erections whose doctor won’t prescribe him Viagra. “He says the problem is between my ears, not between my legs,” the patient will say. Or “The doc says there’s nothing wrong with my penis, I need to think about my goals in sex.”
These doctors understand that once a young guy starts using Viagra, it’s hard for him to stop. If the erection problems are situational—new partner, pressure to conceive, too much pot—and the problem goes away, the guy will credit the drug. And if the problem persists, he’ll get even more anxious, which is the last thing he needs.
Getting a guy curious about why his body won’t jump through sexual hoops on command is usually the best intervention. Smart doctors know that.
~ Challenged mom who wouldn’t vaccinate kid against HPV
HPV is the most common sexually transmitted infection, affecting over 40 million Americans. For most, it’s a nuisance to be managed. But according to the CDC, some 46,000 new cases of cancer are connected with it each year.
If you could protect your kids from such an outcome, wouldn’t you want to? Sure—but millions of parents won’t vaccinate their kid against HPV, fearing that this will “encourage” early sex. I guess the thinking is “My 16-year-old refuses sex solely because she’s afraid of cervical cancer when she’s 50. If we reduce that fear, she’ll jump into bed with her boyfriend now.”
Exactly how clueless is that?
My hero is the pediatrician who challenges this mom or dad. “This isn’t a morality issue, it’s a health issue,” that doc says. “Cancer doesn’t know that some body parts are “dirty” and some are “clean.” And people who suffer and die from cervical cancer are just as dead as those who die from lung cancer or liver cancer.
Waiting until children are old enough to make their own choice about vaccination isn’t good health management—because most American have sex before they’re adults, and by then, they may already have the virus. Just like good parents feel obligated to teach their kids to brush their teeth, good parents should feel obligated to vaccinate their kids against HPV—even if it makes the parents squirm a bit.
~ Discussed birth control with college kid who gave abstinence pledge
Most humans are pretty poor at predicting their own future decision-making. High school and college kids are among the worst at it.
Every year, over a million young adults make abstinence pledges, promising God that they won’t have sex until they’re legally married. These people learn less about contraception than their peers, and are far less prepared when they have sex the first time—unexpectedly, impulsively, manipulatively, whatever. Virgins-until-marriage are more likely to get pregnant and to pick up an STI than their age peers.
My hero is the doctor (or nurse practitioner) who tells college kids that they need to know about birth control “just in case.” They may encourage an IUD or oral contraceptives to help control periods. They may even suggest a condom. A great doc will move heaven and earth to sex-educate a virgin-until-marriage kid even while the kid rolls their eyes at the “pointless” information.
~ Told woman with painful intercourse to stop having intercourse for now
Millions of women experience pain with intercourse. Their responses vary: some choose to put up with it, some let themselves be pressured into more intercourse, some feel the pain is “normal,” and some deal with myths like “sex after menopause always hurts” or “if my partner’s penis is large, sex will hurt no matter what.”
Some docs (not all!) urge such women to use lube every time, which is good advice.
But more importantly, anyone experiencing pain with intercourse should feel entitled to: 1) say no; 2) interrupt it in the middle; and 3) focus more on enjoying outercourse (oral sex, hand job, vibrator, etc.). Then the person and their partner should have a few honest conversations about what’s going on.
This is medical care at its finest—empowering patients to take their body seriously and to advocate for themselves. “Try a glass of wine before sex” isn’t sexist advice, it’s bad medicine. These are the same docs who don’t take testicular pain seriously enough.
And to any patient (or patient’s partner) who says “outercourse isn’t real sex,” a professional can reply “if you found your girlfriend/boyfriend doing it with someone else, would you simply say “well, that’s not really sex,” and just ignore it?
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I hope your doctor is a hero. I hope all your medical professionals–nurse, physical therapist, pharmacist, whomever–are heroes, too. If one of them isn’t, consider finding one who is. They’re out there–I promise.
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