Monday, February 1, 2010

Sex is Complex

Her soft voice in an English accent floats across the room as I struggle to focus and keep my eyes open.

So are you firm in the morning? [pause] Well, how firm are you?

The husband shifts in his seat, about to answer but his young wife cuts him off. The steady stream of her pressured speech has been non-stop for most of the last hour. After several years, their marriage is still unconsummated, apparently a situation that is seen quite commonly at the sexual dysfunction clinic. A comment from the wife sets off another line of questioning.

Oh, well… does your penis have a bend? Some penises do you know?

At once trying to normalize all experiences and put people at ease but yet creating pathology where there sometimes was none. The truth was, the problem was not his penis.

As a clinician our mandatory sexual medicine clinic is drearily painful for me. While I appreciate the importance of the clinic and the issues at hand, I am no psychologist and would make a poor counselor. We spend hours probing the ins and outs of the couples’ sexual lives (no pun intended). Bringing up sensitive issues from their past, guilt, abuse, fear. Low desire, no orgasm, and pain. Its all a bit depressing, there are few ‘happily ever after’ tales here.

They tell me there is hope though, with patients who are motivated and committed to treatment. I’ll let you know what I think in two months at the end of the rotation. All I know right now, is that sex is complex.