How To Talk To Your Doctor About Sex

You Deserve Good Medical Care For Sexual Health

Let's face it; looking at sex information on the internet anonymously is a lot easier than talking with your doctor about your sexual concerns. For many, just the idea of talking to a doctor about sex or a gender-related issue can cause significant anxiety.

It's okay to feel a little embarrassed, but keep in mind that sexual health is simply a part of your health and doctors understand this. It really is about taking care of yourself. To get the best care you deserve, you need to communicate your questions during exams or make an appointment, especially if there is a persistent sexual health issue.

Whether you want to discuss using sex toys during pregnancy or issues regarding Erectile Dysfunction or Female Sexual Dysfunction, it can be empowering to bring up sexual topics with your doctor to allow you to be healthier.

You May Need To Ask For Extra Time

When you make your appointment, if you feel you will need some extra time, let the scheduling desk know. Communicate what you need to be seen for and ask whether you'll need any extra time with the physician. This will allow them to schedule the time you need if what you're being seen for isn't routine.

Get Prepared

Doctors have tight schedules, so have things written down so that you can quickly review everything. You can even hand them a list of things to put in your medical record, such a list of your menstrual cycles, ejaculation frequency, etc.

Things to include on your list (if applicable):

• What is your sexual health concern(s)?
• How long you've had the problem?
• Where is the problem located?
• What does it feel like?
• What treatments or solutions have you tried is any?
• Does anything make the problem better or worse?
• Relevant details about your partner(s). Are they having symptoms?
• Mention the related type of sexual activity: Vaginal Sex, Oral Sex: Fellatio or Cunnilingus, or Anal Sex.
• Review any type of birth control or STD protection you're using.
• Review medications you're currently taking.
• Discuss what do you want from the appointment (RX, a referral, more information, exercises, etc.).

Doctors Get Nervous Too

Remember that a doctor is also a human being, and they may also have fears and anxiety regarding sexual topics. Sometimes this is because of their need to maintain appropriate boundaries with their patients, and in some cases, it may be because they have sexual issues or a bias themselves.

Medical Schools Often Minimize Sexual Health

Medical school courses on sexual anatomy and human sexuality are relatively recent and are not addressed in all medical schools. If you do not get the information you need, don't take no for an answer, even if you have to ask your doctor for a referral to someone who can answer your questions.

Some doctors may minimize problems or dismiss them, but that's usually because they don't know how to help. They may be uneducated about what you are asking about, unaware of potential treatments, or even jump to conclusions that it may be all psychological. 

Be empowered, educate yourself and use sexual health resources online to become more educated in discussing these matters with your physician.

Doctors Can Be Quite Helpful

Most doctors will be receptive to your comments and new information, particularly based on science and research. An excellent way to start the conversation is: "I was hoping that you might be able to help me with a concern (or question) I have." Many find it helps to reference an article or book and starting the conversation with "I was reading this and wondered what you thought."

You can also write down your questions using the correct terms for anatomical parts while framing things in a positive manner, such as "What is the healthiest way to deal with vaginal dryness?"

Again, be persistent. If you don't get the assistance you need, don't feel bad about finding another physician. Even if your doctor does not specialize or treat sexual health issues, they can always refer you to someone who can.

 

When Doctors Are Not Helpful

A doctor is your healthcare consultant. The key for advocating for yourself is asking a lot of questions and better understanding your health knowing that you are in charge of determining what is in your best interests.

If you feel like your doctor is not taking your health concerns seriously and that they may be disregarding serious concerns by telling you that it is nothing to be concerned about, ask them these questions:

• What would be your differential diagnosis?
  
  This would be any other health condition that would have similar signs or symptoms. This gets them thinking about what else your symptoms might indicate.
  
  
• How have you ruled those other health conditions out?
  
  This might get them to think about the testing that would be appropriate for ruling out other health conditions that may be of concern.
  
  
• Why is the evidence for or against any differential diagnoses?
  
  This allows them to consider how they have proven that your symptoms are nothing to be concerned about and why they have dismissed other causes.

When Your Doctor Refuses

If your doctor refuses to explore a diagnosis, treatment, or concern, you can request that they document their refusal in your medical record. Some doctors may reconsider your concerns if they know they are going on record with their refusal to address something. 

You can also let them know you will be getting a second opinion, as some doctors feel added pressure to do their best when they know their work will be reviewed by another professional.

When Tests Results Are Normal

If you are experiencing challenging physical symptoms and the tests that your physician has performed come back normal, it may feel like there is some relief but it may also be discouraging.

After all, you may be happy to know that the things that were being checked are in good health, but it may be frustrating to still be in the dark about what is causing your symptoms.

A good physician will review your symptoms again and examine whether something was overlooked or if new avenues should be explored. If they are unable to help you, they should offer to refer you to another healthcare provider that may assist you further.

Annual Labs

Your primary care physician (PCP) should provide you with labs to examine your overall health every year. This can give a helpful idea of a variety of influences and functions for your general health as well as your sexual functioning.

The following labs are an excellent place to start:

CBC With Differential

Specifically, a test with a differential will measure your white blood cell count and other blood cell levels, including red blood cells and platelets. Making sure this test is done with the differential will show how many of each kind of white blood cell you have. It indicates the health of your immune system.

Metabolic Panel

A comprehensive metabolic panel (CMP) demonstrates the body's fluid balance, as well as levels of electrolytes like sodium and potassium. It also indicates how well the kidneys and liver are working.

Thyroid Panel

A thyroid panel measures the level of thyroid hormones in the blood, which tests thyroid-stimulating hormone (TSH), thyroxine (Free T4), and triiodothyronine (Free T3). This can determine if you may have a thyroid condition such as an underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism).

Lipid Panel

A lipid panel is a standard blood test that healthcare providers use to monitor and screen for your risk of cardiovascular disease, types of pancreatitis, and other conditions.

The panel includes three measurements of your cholesterol levels and measurement of cholesterol and triglycerides. Specifically, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and your total cholesterol.

Iron Panel

This test helps determine iron deficiency (anemia), liver function, and nutrition.

Inflammation Markers (HSCRP & Homocysteine)

A hs-CRP test is a high-sensitivity C-reactive protein test that can test for and find lower levels of CRP. It can help to predict your risk of heart disease or stroke. Raised levels of hs-CRP have been linked to an increased risk of having a heart attack.

A homocysteine test measures the amount of homocysteine, an amino acid in the body, and can determine if you have Vitamin B6, B9 or B12 deficiencies. Elevated homocysteine levels may also indicate a higher risk for cardiovascular disease.

Blood Glucose: Hemoglobin A1C or HbA1c Test

It measures your average blood sugar levels over the past three months and is one of the commonly used tests to diagnose pre-diabetes and diabetes.

Vitamins (D & B12)

This test determines if you are deficient in these essential vitamins, which dramatically impact your immune system and overall health.

• B12 deficiency can lead to anemia, damage to the nervous system, deep depression, paranoia and delusions, memory loss, incontinence, loss of taste and smell, and more.
  
  
• Vitamin D deficiency can cause lower immune functioning, fatigue, bone pain, osteoporosis, and depression.

Autoimmune Markers

This is typically thought of as an antinuclear antibodies (ANA) test. A positive ANA test does not mean you have an autoimmune disease or need treatment. It may mean that there are autoantibodies present. There are several other types of autoimmune blood tests which include:

• C-Reactive Protein (CRP)
• Erythrocyte Sedimentation Rate (ESR)
• Ferritin
• Enzyme-linked Immunosorbent Assay (ELISA)
• Rheumatoid Factor (RF)
• Anti-cyclic Citrullinated Peptide (Anti-CCP) Antibodies
• Immunoglobulins

Hormone Levels

This test will check estrogen, progesterone, FSH, testosterone/DHEA, and thyroid hormone levels to determine if there are hormonal imbalances. Typically these are not ordered on perimenopausal women who go through extraordinary hormonal swings during this transitional time.

Doctors Are Often Uneducated About Sexual Products

If you need a product for a sexual health issue, keep in mind that most physicians are not knowledgeable or up to date on the latest and best sex toys out there to help you.

For example, upon going to a doctor for help with vulvar pain (vulvodynia), a doctor referred one of our customers to a vaginal dilator set that was an ancient model. There are so many newer dilators on the market that are made with body safe materials, tapered to fit vaginal anatomy better, and have more comfortable handles, unlike the old models.

Other doctors may not be aware of the advancements made for erectile dysfunction, such as the male vibrators that help increase blood flow to the penis but do not require an erection (designed for a flaccid penis).

They may also be unaware of ED friendly double holed harnesses or how advanced penis rings are now for firmer erections and addressing premature ejaculation with testicle rings.

When it comes to sex toys for sexual health, we are the most comprehensive resource you will find as we work directly with all of the best sex toy manufacturers that make sexual health products around the world.

If you do not see something on our sexual health website that you need, let us know, and we can do more research for you.

Doctors Still Use Lubricants With Parabens For Exams

You may think that the lube the doctor is using on you to give you a Pap Smear (Papanicolaou test) or a prostate exam (digital rectal examination) is pure and healthy. However, most doctors are still using a lubricant that contains parabens, which are known as endocrine (hormone) disruptors. 

Lubricants are absorbed directly into your bloodstream when put them into the mucous membrane of your vagina and rectum. Therefore, you may wish to bring in your own paraben-free water-based lubricant for them to use for your exam.

Let them know that we educated you about the health risks of parabens. And feel free to let them know that we have great educational resources for their practice, as we work with many physicians who want to use safer products for their patients.

See our Ultimate Personal Lubricant Guide as well as Toxins in Sex Toys Guide for more information.

Helpful Sexual Health Organizations

• American Association of Sexuality Educators, Counselors and Therapists: AASECT.org
  
  
• American Board of Sexology: TheAmericanBoardOfSexology.com
  
  
• International Society for the Study of Women's Sexual Health: ISSWSH.org
  
  
• Planned Parenthood: PlannedParenthood.org

Protecting Your Medical Chart

What goes in your medical chart is essential as it will be seen by future healthcare providers as well as insurance companies. You have a right to see your medical chart at any time.

Should you disagree with a diagnosis documented in your medical chart, you have a right to request how that diagnosis was made, including all of the tests and evaluations used to determine that diagnosis.

If you think there's a mistake or something is inaccurate or incomplete in your health record, you have a right under the HIPAA Privacy Rule to request a change, or amendment, to your record.

While medical records cannot usually be changed, a note can be added explaining why they are incorrect. Your records must be accurate because your treatment may depend on them.

Anything you disclose to your healthcare providers could become part of your permanent record and may be reported to your insurance company which can impact the medical care you receive and your future ability to get healthcare benefits should you change healthcare providers.

In addition, your medical records can be used in legal matters in the future. You should certainly ask for help should you need it, but take care in how you phrase things with the understanding that what you say is important.

How To Talk To Your Doctor If You Are LGBT+

Discussing health issues when you are LGBT+ may increase anxiety as well as raise concerns about how your physician views sexual orientation and sexual identity.

Before you contact a physician, here are some tips to make your visit more comfortable:

• Before you visit, call the office by phone and ask if the practice is LGBT+ friendly and if they have any LGBT+ patients. You do not have to give your name if you have concerns.
• Bring support such as a friend or partner with you. They can come in the exam with you or stay outside in the waiting room.
• Ask your questions while you are still clothed and comfortable.
• Learn about the specific healthcare issues facing LGBT+ people and have your questions ready.

LGBT+ Health Care Provider Resources:

• GLMA (GLMA.org): A national organization committed to ensuring health equity for lesbian, gay, bisexual, transgender, queer, and all sexual and gender minority individuals.
• Transgender Care Listings (TransCareSite.org): For trans friendly health care provider listings.
• QSpaces (Qspaces.org): Get recommendations from other LGBTQ+ people for therapists, primary care doctors, psychiatrists, dentists, massage therapists, fitness instructors, and everything in between.

Dealing with Insurance Denials
Deny, Defend, Depose

If you find yourself in a situation where your insurance is denying care, here’s a strategy that has helped many. When your treatment is deemed "not medically necessary," consider making the following written requests to your insurance company. I will provide a sample email/letter for you below:

Request the Doctor's Information

The name, board specialty, and license number of the doctor who determined your treatment was not medically necessary.

• Supporting Materials
  Copies of all materials the doctor relied on to make their determination.
  
  
• License Verification
  Proof that the doctor making the determination is registered in your specific state and has fulfilled all continuing education requirements.
  
  
• Approval/Denial Rates
  The aggregate rate at which similar treatments are denied versus approved by the specific doctor used for the peer review.
  
  (Note: While you may not be legally entitled to all of this information in most states, you are entitled to some of it—and it never hurts to ask.)

Why This Tactic Works

This approach is often highly effective for several reasons:

• Exposes Violations
  If the insurance company responds honestly, it can reveal that the doctors making these determinations are practicing medicine outside their scope of expertise, without proper licensing or qualifications in areas they are not competent in.
  
  
• Regulatory Pressure
  Such practices by insurance companies violate multiple regulations. When companies realize providing this information could prove their noncompliance, they often prefer to avoid further scrutiny.
  
  
• Payment as a Resolution
  Rather than risking exposure of regulatory violations, the company may choose to approve and pay the bill.
  
  This strategy has proven successful for many individuals. It leverages the fact that while everyone knows these violations occur, they are rarely addressed directly. By holding the company accountable, you create a situation where compliance or payment becomes their path of least resistance.

Sample Letter or Email for Claim Denial

Subject: Request for Information Regarding Medical Necessity Denial

Policy Number / Name of Patient

Dear [Insurance Company Representative or Appeals Department],

I am writing regarding your determination that my treatment [insert treatment name] was "not medically necessary" as per your decision dated [insert date]. In order to evaluate this decision, I am requesting the following information under applicable laws and regulations:

1. Doctor’s Credentials
   The name, board specialty, and license number of the doctor who made this determination.
   

2. Supporting Materials
   Copies of all materials, studies, and guidelines that were relied upon to make this determination.
   

3. License Verification
   Proof that the doctor making the determination is currently registered in my state of residence ([insert state]) and documentation confirming that they have met all continuing education requirements.
   

4. Approval/Denial Data
   The aggregate rate at which this specific doctor has approved or denied similar treatments during peer reviews.

While I understand that some of this information may not be legally required in all states, I am formally requesting this documentation for my records and to ensure the decision aligns with applicable standards of care and regulatory compliance.

Failure to provide this information may raise concerns about whether the decision was made within the appropriate scope of medical expertise and licensing requirements.

Please respond to this request in writing within [insert reasonable timeframe, e.g., 14 or 30] days. If you have any questions or need further clarification, you may contact me at [insert phone number or email address].

Thank you for your prompt attention to this matter.

Sincerely,
[Your Full Name]

Medical Bias

Unfortunately, there are still disparities and biases in health care due to race, stereotyping, language barriers, cultural differences, economic factors, weight bias, and a general lack of respect for patients.

If you are a person of color (POC) disabled, or plus-sized, you may have already experienced this as such patients may feel unheard in healthcare settings. Social and medical studies show there are indeed discrepancies and they are not imagined.

Racial Bias

Examples of racial bias are often seen through false narratives communicated to doctors during medical school, including such falsehoods that people of color have a higher tolerance for pain, which is untrue. Furthermore, stereotypes of drug abuse keep physicians from prescribing pain medicine when it is medically justified.

Even testing can have racial effects, such as seen through the pulse oximeter, which measures your blood oxygen saturation levels. Because of differences in how the skin absorbs light, black patients are more than three times as likely to have inaccurate overestimated oxygen saturation levels compared to white patients.

This can mean darker skinned patients are not properly treated because the diagnostic criteria is not accurately measured. Understanding and addressing racial bias in medicine can help save lives.

Weight Bias

It is also not uncommon for people with excess weight to have serious medical conditions disregarded and told that it is just a matter of being overweight and to go on a diet by medical health care professionals.

Weight bias is another serious issue that can lead a doctor to disregard the importance of your health. Please see our Plus-Size Sex Education, Resources & Products for more information.

Disability Bias

When disabled persons seek out medical care, they can experience what is referred to as fragility bias or catastrophe bias which is when they are perceived as suffering more than non-disabled patients who present with the same medical facts.

This can lead to more conservative treatments and for medical professionals to give up on pursuing care for disabled patients due to assumptions that disabilities diminish their quality of life.

Visiting with health practitioners may also prove challenging for those with disabilities because unless there is a specialization in the specific disability that someone is struggling with, there may be a lack of complete understanding of their needs.

Furthermore, there may be a lack of sensitivity to some disabilities as well as poor accessibility through poorly trained staff, assistive devices, wheelchair access, and other resources.

This can lead to being turned away or having difficulty obtaining the appropriate level of care one needs. This is why healthcare providers need to be aware of the different needs that disabled people may have and what they need to have in place to provide the same access to care, services, and products as those without disabilities.

These are just some of the many examples of how we all must do better in providing representation, awareness, and accessibility to those with disabilities.

See our Disability, Sex & Discrimination Guide for more information on this topic.

Understand Your Rights

Choosing a medical professional that is body positive concerning extra weight or who is or relates to your abilities, race, and ethnicity may be helpful. If you see a physician and you feel concerned as a disabled person, an overweight person, or as a minority, you can ask questions that may help you to understand better the care that you are receiving, such as:

• What are my rights as a patient?
• Why do you want to run this test or do this procedure?
• What will the results of this test or procedure tell us?
• How many times have you performed this procedure?
• Do I need any additional screenings?
• Would you recommend a second opinion?
• Can we schedule another visit?

Being an advocate for yourself is always recommended, so do not feel embarrassed for asking questions. You are worth it!