TAKING THE SEXUAL

HISTORY
ANNA JOSEFINA VAZQUEZ-
GENUINO, M.D.
CHILD, ADOLESCENT & ADULT
PSYCHIATRIST
 TAKING THE SEXUAL
HISTORY
 PURPOSE
 Assess the Ff:
 Risk for STD
 Hx of Sex Abuse
 Quality of Intimate Relationships
 Symptom of Psych D/O
 BARRIERS TO TAKING THE
SEXUAL HISTORY
 LTD PERSONAL FRAME OF REFERENCE

 The inexperienced feels at a disadvantage

 Can’t rely on own sexual background as clinical

point of reference

 Gain Experience & Broaden Frame of Reference

 BARRIERS TO TAKING THE
SEXUAL HISTORY
 FEAR OF AROUSAL
 If Talk Sex  Invite Intimacy  Exciting,
Disturbing, Scared, Guilty
 Flgs might show: What if ptt senses I am too
curious or aroused? What if I get attracted to ptt?
 What if ptt gets aroused by my questions? What if
I give wrong msg?
 BARRIERS TO TAKING THE
SEXUAL HISTORY
 AWKARDNESS WITH SEX LANGUAGE
 Penis, Erection, Ejaculation
 Vagina, Orgasm
 Testes, Sperm, Seminal Vesicles
 Clittoris, Egg, Ovary, Uterus
 TAKING THE SEXUAL
HISTORY
 TIMING- CC, HPI, Past Personal & Social Hx,
ROS

 APPROACH – relaxed, interested, comfortable,

non-judgmental

 CONTENT – Childhood Sexual Development,

Current Functioning, Relationships
 TAKING THE SEXUAL
HISTORY
 DEVELOPMENTAL
 Acquisition of Sexual K
 How did you learn about sex?
 What were your parents’ attitudes toward sex?
 Child hood Gender Id? Sexual Feelings?
 TAKING THE SEXUAL
HISTORY
 DEVELOPMENTAL
 Sexual Experiences
 When did you first begin dating?
 When was your first time to engage in sex? STD?
 Were you attracted to men, women or both?
 Have you ever been sexually abused?
 TAKING THE SEXUAL
HISTORY
 CURRENT SCREENING QUESTIONS
 Are you sexually active? Frequency? With whom?
Have you noticed any changes or problems with sex
lately?
 How do you feel about sex? Are you satisfied with
your sex life?
 TAKING THE SEXUAL
HISTORY
 CLARIFICATION OF SEXUAL PROBLEM
 Desire- Fantasies? Object? Initiate?
 Excitement- Arousal? Erection? Lubrication?
Foreplay?
 Orgasm- Ejaculation? Satisfied?
 Resolution- Feelings?
 Paraphilias?