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Sexual health in general practice: introductory skills
  1. Philippa Matthews
  1. General Practitioner, Birmingham, UK
  1. Correspondence to Dr Philippa Matthews; p_m_matthews{at}hotmail.com

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Sexual history taking

General practice consultation is quite a lonely craft. In the early days of our training we share consultations – sitting in with our trainers, or having our trainers sit in with us. Then we have the company of the video camera and can share and discuss the highs, the excruciating moments – and the ‘probably good enough’ followed by decades of practice. A minority of the brave may turn again to the use of videoing, or may share occasional consultations with colleagues. Some of us talk through case histories and difficult consultations. But for almost all of us, almost all of the time, it is our four walls and the patient. Oh – and patient feedback questionnaires.

GPs hold a whole array of potential questions in their heads – questions to elicit important information in the assessment of, for example, respiratory, psychiatric or abdominal problems. However, for sexual history taking, for me, there was a blank space. I had been taught nothing. It took me several years to find out that being able to take a sexual history was quite useful. I had never seen another doctor use – and certainly not teach – this skill.

In teaching myself (and, at the time, finding myself needing to work out how to teach others) to take a sexual history, I found I first needed to establish a comprehensive list of stereotypical questions to draw on, such as I had for every other area of history taking. When I am assessing someone with depression, I will try to be as sensitive and empathic to the individual patient as I can, but it is striking how ‘samey’ the questions are that I use, the ways that I word them. Even the questions I use to assess suicide risk. I use the wording that …

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  • Provenance and peer review Commissioned; internally peer reviewed.

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