What We Don't Talk about When We Don't Talk about Sex: Results of a National Survey of U.S. Obstetrician/Gynecologists


  • Janelle N. Sobecki MA,

    Corresponding author
    1. Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
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  • Farr A. Curlin MD,

    1. Section of General Internal Medicine and the MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois, USA
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  • Kenneth A. Rasinski PhD,

    1. The University of Chicago Section of General Internal Medicine, Chicago, Illinois, USA
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  • Stacy Tessler Lindau MD, MAPP

    1. Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
    2. Section of Geriatrics, the Comprehensive Cancer Center, and the Center on Demography and Economics of Aging Core on Biomeasures in Population-Based Aging Research, University of Chicago, Chicago, IL, USA
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  • Title adapted from the following: Carter, Raymond. What We Talk About When We Talk About Love. USA: Vintage Books, 1989.

  • This study was conducted at The University of Chicago, Chicago, IL.

  • Funding: This study was supported by grants from the Greenwall Foundation, John Templeton Foundation, the National Center for Complementary and Alternative Medicine (1 K23 AT002749, to Dr. Farr Curlin), and the National Institute on Aging (NIH/NIA 1K23AG032870-01A1 and NIH/NIA 5P30 AG 012857 to Dr. Stacy Lindau, Linda Waite, Principal Investigator).

Janelle Sobecki, MA, Department of Obstetrics and Gynecology, the University of Chicago, Chicago, IL 60637, USA. Tel: (773) 718-1252; Fax: (737) 702-5161; E-mail: janellesobecki@gmail.com; jsobecki@babies.bsd.uchicago.edu


Introduction.  Sexuality is a key aspect of women's physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female genital tract across the female life course, obstetrician/gynecologists (ob/gyns) are well positioned among all physicians to address sexuality issues with female patients. New practice guidelines for management of female sexual dysfunction and the importance of female sexual behavior and function to virtually all aspects of ob/gyn care, and to women's health more broadly, warrant up-to-date information regarding ob/gyns' sexual-history-taking routine.

Aims.  To determine ob/gyns' practices of communication with patients about sexuality, and to examine the individual and practice-level correlates of such communication.

Method.  A population-based sample of 1,154 practicing U.S. ob/gyns (53% male; mean age 48 years) was surveyed regarding their practices of communication with patients about sex.

Main Outcome Measures.  Self-reported frequency measures of ob/gyns' communication practices with patients including whether or not ob/gyns discuss patients' sexual activities, sexual orientation, satisfaction with sexual life, pleasure with sexual activity, and sexual problems or dysfunction, as well as whether or not one ever expresses disapproval of or disagreement with patients' sexual practices. Multivariable analysis was used to correlate physicians' personal and practice characteristics with these communication practices.

Results.  Survey response rate was 65.6%. Sixty-three percent of ob/gyns reported routinely assessing patients' sexual activities; 40% routinely asked about sexual problems. Fewer asked about sexual satisfaction (28.5%), sexual orientation/identity (27.7%), or pleasure with sexual activity (13.8%). A quarter of ob/gyns reported they had expressed disapproval of patients' sexual practices. Ob/gyns practicing predominately gynecology were significantly more likely than other ob/gyns to routinely ask about each of the five outcomes investigated.

Conclusion.  The majority of U.S. ob/gyns report routinely asking patients about their sexual activities, but most other areas of patients' sexuality are not routinely discussed. Sobecki JN, Curlin FA, Rasinski KA, and Lindau ST. What we don't talk about when we don't talk about sex: Results of a national survey of U.S. obstetrician/gynecologists. J Sex Med 2012;9:1285–1294.