Doctors receive very little sex education as part of their professional training. Most commonly, MDs get a day or two (about 10 hours) of sex ed. Even when they are very well versed on the reproduction system (in the case of GYNs) they often won’t be provided information on other issues such as desire, behavior and pleasure. This leaves out sexual orientation, different relationship styles, sex toys and lube. It can lead to asking the wrong questions, i.e. “Are you using condoms?” being asked to a cisgender woman in a monogamous relationship with another cisgender woman, or failing to ask the questions at all. This is particularly the case when it comes to sex toys. But one woman is trying to change all that.
Andrea Renae is a sex specialist and workshop facilitator at the Pleasure Chest, and consultant for the American Medical Students Association (AMSA) Sexual Health Scholars program. She Skypes every few weeks with a co-facilitator and a group of three medical students, comprehensively addressing a very broad range of sex-ed topics. Later, these students meet with a much larger group during their primary class time, further discussing and expanding upon what they’ve learned from Andrea.
In the few cases where doctors do bring up sex with patients, they don’t always have all the information or language needed to discuss sexual pleasure, or to properly recommend products like lube or sex toys. –Andrea Renae, The Pleasure Chest
Women have many concerns about their sexual health that they aren’t discussing with their doctor. Because the sex toy and lube industry, much like the cosmetic industry, is unregulated, companies can use any materials or chemicals in the manufacturing of their products. When certain materials or chemicals are introduced to the vagina, they can cause irritations or throw off pH balance, resulting in a yeast infection or bacterial vaginosis. Additionally, all of these conditions can open the body up to STIs and other infections through microtears in the vaginal lining. If a woman has a poor experience with a toy, she might not buy another one.
Andrea’s knowledge of these issues came from eight years of working as a sex educator, in the public health sphere (Planned Parenthood and other STI testing centers), in sex toy stores, and independently through her own research. She is currently in graduate school for education in human sexuality.
I asked Andrea, who has also worked in an outpatient cancer center, about patients who are ill, and what role, if any, sexual desire plays with them.
“Doctors in all areas of healthcare need to understand sexual health and pleasure, even oncologists,” she said. “People with chronic illness, including cancer, can (and often do) experience sexual desire, even if it’s different than the desire they had pre-diagnosis. The conversation can’t stop just because someone’s sick.
“A lot of times, patients want to talk about sex with their doctor but don’t know how to initiate the conversation. In the few cases where doctors do bring up sex with patients, they don’t always have all the information or language needed to discuss sexual pleasure, or to properly recommend products like lube or sex toys. I’ve had customers with various chronic conditions who have come into the sex stores who tell me their doctors told them to ‘get lube’ or ‘masturbate’ with no context or reasoning as to why any of this was being recommended. When they come into the sex store (Note: Andrea’s worked at three of them), these patients don’t know what they’re looking for and are unable to describe what they need. Then those of us working on the sales floor really have to dig to figure out the best products to offer them.”
Andrea urges sex toy manufacturers of body-safe products to connect with medical professionals, show them how their products are helpful to their patients, provide them with sex-positive language around sex, masturbation, desire and pleasure. This is an area where partnering with a sex educator can be especially helpful, someone who can develop lesson plans and conduct sex-positive education and product trainings for doctors and their staff. This is one of the areas Andrea specializes in, but, she says, “There are also plenty of other excellent educators out there.
Liz Dubé, M.A., M.S., certified sex therapist is a professional who is educated in desire, behavior and pleasure. “I give patients permission to be curious.”
I asked Liz about some of the issues her patients struggle with. “Low desire. I ask them to pay attention to any flicker of yearning they may have. ‘What do you do to extinguish or fuel desire?’ For homework, I have them schedule ‘pleasure sessions.’ I also suggest sensual shopping activities that will help them create greater awareness of what may ignite arousal.
“So often they stop making an effort, not even thinking about feeling attractive or sensual for themselves, let alone their partner.”
So much of her work is building safety. Many patients have the fear that their partner may reject them and use their insecurities against them. “Tiny slivers of rejection can turn into years of shutdown.
“A big part of sex education is dispelling myths people have. There’s a lot of misinformation about sex. And there’s the fear of being abnormal. ‘Tell me, is what I want normal?’ is a question I’m often asked.
“We need to create space for desire. Women fill their minds with things to do. ‘Slow down and allow space for eroticism’ is what I suggest. There’s a lot of learning involved, and people learn differently. One partner may learn visually or by doing; another from hearing something. If you feel you may disappoint your partner, it makes learning harder. Learning is more difficult when emotions are involved. ‘I’ve got to do it right,’ a woman thinks. The man is afraid, ‘she’s going to leave me if I don’t please her.’ Anxiety blocks them, rendering them unable to be present in the moment.
Finally, educating doctors can only grow the sex business. As discussed in my memoir, “My Sexual Awakening at 70,” I received “permission” from both my therapist, Dr. Steve David, and my urologist, Dr. Sharron Mee, to enjoy sex far more than ever before by opening up the door for me to greater knowledge. As a result, my life has become infinitely richer.
Lynn Brown Rosenberg is a sexuality speaker, and the author of “My Sexual Awakening at 70.” She can be contacted at www.lynnbrownrosenberg.com. Her memoir can be found on Amazon.com.
