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. 2024 Apr 5;12(4):e5614.
doi: 10.1097/GOX.0000000000005614. eCollection 2024 Apr.

Pilot Test of A Gender-conscious Sexual Health Intake Questionnaire: Increasing Inclusivity and Mitigating Bias in Sexual History Taking

Tenny R Zhang  1   2 , Elijah Castle  1   3 , Charlie Dubach-Reinhold  1   4 , Gaines Blasdel  5 , Carmen Kloer  6 , Ashley Alford  1 , Rachel Bluebond-Langner  6 , Lee C Zhao  1
Affiliations

Pilot Test of A Gender-conscious Sexual Health Intake Questionnaire: Increasing Inclusivity and Mitigating Bias in Sexual History Taking

Tenny R Zhang et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Sexual health is critical to overall health, yet sexual history taking is challenging. LGBTQ+ patients face additional barriers due to cis/heteronormativity from the medical system. We aimed to develop and pilot test a novel sexual history questionnaire called the Sexual Health Intake (SHI) form for patients of diverse genders and sexualities.

Methods: The SHI comprises four pictogram-based questions about sexual contact at the mouth, anus, vaginal canal, and penis. We enrolled 100 sexually active, English-speaking adults from a gender-affirming surgery clinic and urology clinic from November 2022 to April 2023. All surveys were completed in the office. Patients also answered five feedback questions and 15 questions from the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction (PROMIS-SexFS) survey as a validated comparator.

Results: One hundred patients aged 19-86 years representing an array of racial/ethnic groups, gender identities, and sexuality completed the study. Forms of sexual contact varied widely and included all possible combinations asked by the SHI. Feedback questions were answered favorably in domains of clinical utility, inclusiveness of identity and anatomy, and comprehensiveness of forms of sexual behavior. The SHI captured more positive responses than PROMIS-SexFS in corresponding questions about specific types of sexual activity. The SHI also asks about forms of sexual contact that are not addressed by PROMIS-SexFS, such as penis-to-clitoris.

Conclusions: SHI is an inclusive, patient-directed tool to aid sexual history taking without cisnormative or heteronormative biases. The form was well received by a diverse group of participants and can be considered for use in the clinical setting.

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Conflict of interest statement

The authors have no financial interest to declare in relation to the content of this article. Part of this study was completed with a grant from the French Foundation.

Figures

Fig. 1.
Fig. 1.
SHI form (as it appears for patients).
Fig. 2.
Fig. 2.
Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction questions.
Fig. 3.
Fig. 3.
SHI sexual contact responses (circles) and corresponding Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction responses (center).
See this image and copyright information in PMC

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