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Purpose of This Module
 The
information in this minicourse has been designed to give health care providers
some background necessary to address sexuality and incorporate a sexual
health approach in service delivery. This module will focus on how to
introduce these issues within services.
In this module, we will:
- Review potential obstacles
to addressing sexuality with clients
- Describe approaches to
discussing sexuality with clients within counseling and services
- Describe steps that can
be taken to institute change when introducing a sexual health approach
within services
Obstacles to
Incorporating a Sexual Health Approach
- Provider biases.
As service providers, we bring our own entrenched attitudes, biases,
and perceptions to our interactions with clients, and these attitudes
can negatively affect our ability to provide adequate services. Some
of us may feel conflict between our duties to assist our clients to
achieve sexual and reproductive health and our own morals, beliefs,
and values. In order to provide good services, it is critical that we
separate our own attitudes about sexuality and sexual practices from
our knowledge of the potential health consequences of those practices.
We must help our clients to achieve healthy sexuality without imposing
value judgments on their behaviors.
- Fear of offending clients.
Providers often feel that clients will not want to talk about their
sex lives, or that they will offend clients by doing so. However, many
providers who have done so have found that clients are actually relieved
to finally have someone to talk to confidentially—someone who can
provide accurate information and help them with their concerns.
- Lack of provider knowledge
and comfort. Providers are often just as uncomfortable talking about
sex as are clients, or even more so. Providers may lack knowledge about
sexuality, or they may not have come to terms with their own feelings
and experience related to sexuality. Providers may feel unable to handle
more-complex issues that could arise during such discussion, such as
sexual abuse, conflicts about sexual orientation, or sexual dysfunction,
and they may lack referral resources for such problems. Training to
develop knowledge, comfort, and skills, as well as development of referral
resources where possible, is an important support to service provision.
- Time limitations.
Health care providers may have limited time to spend with clients because
of heavy client loads or limitations imposed by management. In these
cases, providers can feel torn between a desire to give clients comprehensive
health care and the need to deal with only the most urgent physical
complaints in the short time allocated. In these situations, providers
may neglect considerations of clients’ emotional and situational
needs (including issues surrounding sexuality) in favor of perceived
medical demands. Some of these time limitations, however, can be mitigated
through changing the approach to health services. (For example, by gaining
a better knowledge of a client’s circumstances, the provider can
offer information that is less comprehensive and more tailored to the
client’s individual situation.)
Don’t confuse your exploration of a client’s sexual life,
needs, and concerns with therapeutic counseling. Your aim in this
process is to understand the issues relevant to the client’s
physical health and to learn about needs and concerns that may require
referral to other types of services, not to attempt to offer in-depth
therapeutic counseling.
- Targets and incentives.
Population and family planning service providers in some countries may
feel a conflict between the need to meet required contraceptive or service
“targets” and the need to provide clients with the information
and help they need to make informed choices about sexual and reproductive
health. In locations where financial incentives are given to providers
or facilities to meet set targets, providers may feel added pressure
to steer clients toward particular methods of contraception, regardless
of clients’ individual needs and desires, and the potential impact
of those methods on clients’ sexual lives. Providers may be tempted
to tell clients what is best for them rather than viewing clients as
the experts on their own situations and sexual lives.
© 2007 EngenderHealth
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