The influence of gynecologists’ sexual experience on management of patients’ sexual health

Objectives: The stigma surrounding sexuality often prevents patients from discussing sex with their providers. Gynecologists may experience similar stigma or their own sexual dysfunction that impedes discussions about sex with patients. Overcoming the stigma surrounding sexuality in order to optimize their patient’s sexual function may require that gynecologists have attained personal sexual health and wellness themselves; this association has yet to be investigated. The objective of this study was to characterize the sexual experience, health, and education among gynecologists, and to examine the influence of these factors on management of patients’ sexual health.

Methods: We distributed a 30-item, anonymous, online survey to a convenience sample of gynecologists, including residents, fellows, and attendings, from February 2020 until March 2023. Respondents could enter a raffle for a $25 gift card. The survey included respondents’ socio-demographics, training level, educational experience, sexual experience, and sexual function. We additionally queried respondents’ comfort discussing sexual topics and willingness to optimize their patient’s sexual healthcare. We report descriptive statistics on respondents’ sexual health and clinical practices surrounding sexual healthcare. We conducted bivariate analyses (e.g., Chi-square, t-tests) to explore factors linked to gynecologists’ desire to optimize their patients’ sexual health.

Results: We received 189 surveys from a majority non-Hispanic white (60.4%), female (85.0%), and medical trainee (63.1%) population. Most respondents were sexually active (82.4%), comfortable discussing their own sexual health (82.0%), and satisfied with their own sexual function (74.6%). More than a quarter of respondents reported a history of sexual trauma (27.0%).

Approximately half (50.8%) of respondents reported optimizing their patients’ sexual health. No significant differences in sexual healthcare practices were found between gynecologists identifying as different races (p=0.41), gender (p=0.35), or sexual orientation (p=0.68). Respondents who identified as attendings (p=0.05) or reported personal sexual satisfaction (p=0.01) were more likely to report optimizing sexual health. Respondents reporting low libido were less likely to optimize their patients’ sexual health (p < 0.01). Respondents who received education on a greater number of sexual health topics were more likely to optimize their patients’ sexual health (p=0.04). Those reporting that they were comfortable managing low libido, arousal disorders, anorgasmia, and dyspareunia (p < 0.01) were more likely to optimize their patient’s sexual health.

Conclusions: While clinical education about sexual health can influence gynecologists’ sexual health counseling practices, their personal sexual experiences and satisfaction may also play a role. Sexual satisfaction was associated with a greater likelihood of optimizing patients’ sexual health; however, a quarter of gynecologists reported low sexual satisfaction. These findings highlight the potential importance of gynecologists considering their own sexual health; whether this will impact the quality of the care they provide remains to be studied. Our data also show that a broader sexual health curriculum likely improves gynecologists’ sexual healthcare practices.