Taking a Sexual History

An open-ended sexual history can help a provider assess what resources and services can be offered to the patient and guide appropriate counseling and information. Even if a person does not currently consider themselves sexually active, it is still important to take a sexual history. Approach and questions can be tailored to each person’s identity and understanding.4, 72 Providers can take a few steps to reduce stigma and build rapport at the outset of taking a sexual history:

• Ensure that the patient understands that they can decline answering questions or sharing information; respect their right to decline.
• Avoid any judgment of the patient’s behavior or preferences.
• Avoid using terms that make assumptions about sexual behavior or orientation.
• Ensure shared understanding around terminology and pronunciation to avoid confusion.
• Use a sensitive tone that normalizes the topics being discussed.

The 6 Ps, described in Exhibit 6, can be a useful way to remember the main elements of the sexual history. To complete a full sexual history, providers may consider adding questions about sexual satisfaction and sexual (dys)function. Open-ended questions can introduce each of these topics, with more specific questions being used to obtain more information when and if needed. NCSH resources offer examples to guide providers in asking about—and responding to—patients’ sexual health needs and desires.39 Providers should be prepared to answer patients’ questions and concerns about sex and make referrals to appropriate care. Patients experiencing sexual concerns or dysfunction can be referred to a qualified sex therapist or a physical therapist. Online resources such as Bedsider.org offer sources of additional information and sex-positive perspectives on sexuality and sexual health for both patients and providers.41

Exhibit 6: 6 Ps of Sexual History