Sexual health is essential for patient care, but many U.S. medical schools lack standardized training in this area. While some schools, like the University of Minnesota and Robert Wood Johnson Medical School, offer dedicated sexual health courses, others only integrate the topic into broader modules.
Studies reveal that many medical students feel unprepared to address sexual health concerns, even by their clinical years. This highlights the need for better and more consistent education. Tools like the Sexual and Gender Minority Curriculum Assessment Tool have helped identify gaps in areas like gender identity and sexual dysfunction, but a clear standard for comprehensive training is still missing.
Given this information, a new study reviewed sexual health content in medical schools across the Northeastern U.S., using expert-recommended guidelines to evaluate how well current curricula meet the needs of future doctors and their patients.
For the study, researchers collected sexual health teaching materials like lectures, handouts, and syllabi from 10 medical schools across nine Northeastern states, focusing on 15 categories recommended by global sexual health experts. These categories included birth control, STIs, sexual dysfunction, and vulvar conditions, among others. Schools were asked to provide materials for all topics, and researchers followed up if anything seemed missing.
A detailed checklist was used to analyze the content, ensuring consistency and accuracy. Two researchers independently reviewed each school’s materials and resolved any differences together. The data was then analyzed to see what topics were included and whether male or female-specific content was adequately covered.
The researchers found that while certain areas like embryology, birth control, and STIs were well-covered, significant gaps were found in others. Vulvar conditions (covered in 12% of curricula) and postpartum sexuality (20%) were the least represented topics. Female-specific topics, such as female arousal disorders, were notably underrepresented compared to male-focused content like erectile dysfunction (10% vs. 70%).
Most schools addressed basic topics like contraception and STI prevention, but fewer included crucial details on issues like sexual violence, with only 40% covering its mental, physical, and sexual health impacts. Similarly, only 30% provided training on managing sexual assault cases. Information on psychosocial factors influencing sexuality, such as aging and mental health, was also scarce (40%).
Although topics like infertility and genital anatomy were generally well-represented, female-specific anatomy, such as the corona of the clitoris, was entirely absent. Male-focused topics like penile anatomy and erectile function were covered by most schools. While 80% included the physiology of penile erection, only 40% covered clitoral engorgement.
This study underscores the need for balanced education that addresses gender disparities and improves training on female and non-male-specific sexual health topics. Expanding these areas would better equip physicians to deliver inclusive care for diverse populations.
While LGBTQ+ health topics are relatively well represented, gaps remain, particularly concerning asexuality and other specific identities. A standardized sexual health curriculum could ensure all physicians are prepared to address the varied needs of their patients.
Limitations include the study's focus on Northeastern schools and early curricula, which may not reflect later clinical training or other regions. Nationwide research could explore how cultural and political factors shape medical education. Despite these limitations, the findings emphasize the need for comprehensive, equitable training to improve healthcare outcomes and patient quality of life.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
A Medical Education Recommendation for Improving Sexual Health and Humanism and Professionalism
References:
Milazzo, M., Parwatkar, K., Perelmuter, S., Blackman, C., Tomaszewski, A., Williams, A., Rubin, R. S., & Lufler, R. S. (2024). What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States. The Journal of Sexual Medicine, 21(12), 1131–1136. https://doi.org/10.1093/jsxmed/qdae132
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