Appendix D.

Further comments

I am more aware of the problems my patients might experience. I feel more able to talk openly and engage with my patients. However, given that most of the sexual problems are encountered in men (erectile dysfunction), I do not find many men wish to discuss this with a female doctor. (woman, cardiology)

I am aware of the sexual history questions to ask and of services and treatments available, which help me feel more confident to discuss with the patient. (woman, general practice)

Having done a placement in genitourinary medicine in addition to the standard curriculum, I felt better equipped with both knowledge and communication skills to discuss sexual health with patients. (woman, general practice)

Students should be able to attend consultations/clinics to appreciate the approach to this difficult area. (man, obstetrics and gynecology)

Practice consultations/practical skills should be the emphasis. (man, general practice special interest in sports medicine)

I had no idea how to approach the subject prior to teaching at medical school but felt more confident in discussing with patients after I'd practiced in clinics, etc. (woman, oral and maxillofacial surgery)

I do, especially with women with pelvic pain or menopausal symptoms. I also ask men who consult regarding diabetes, urinary problems, or erectile dysfunction itself. I always feel better if I start with “a lot of women/men can have a problem with libido/erection problems but feel embarrassed to talk about them …” (woman, general practice)

I don't routinely ask because of time constraints of out-patient clinic appointments. I rely on the patients' general practitioner to discuss the issue of erectile dysfunction with the patient unless there is a drug compliance issue that might be secondary to erectile dysfunction or if the patient initiates conversation with regards to this. (woman, cardiology)

Time is the most restrictive factor. My exposure to GUM/gynecology is limited. I don't think my chronic disease patients expect me to ask about sexual function during routine reviews, and although some patients will be relieved you have brought up something they want to discuss, I think others will be either offended or embarrassed (which could end up affecting the patient-doctor relationship). (man, general practice)

I don't think it would be appropriate. If the topic arose I would be supportive but refer them to their general practitioner or local sexual health clinic. (woman, oral and maxillofacial surgery)

In my diabetic clinic it would be easy to add in questions about erectile dysfunction when running through other complications and in my ischaemic heart disease/hypertension reviews. I could ask about erectile dysfunction/sexual dysfunction when enquiring about drug side effects. (man, general practice)

Plenty of cases of male hypogonadism, and false positive raised prostate-specific antigen in a practicing man having sex with men. (man, general practice)

Sickle cell priapism and rarely the discussion around semen storage before chemotherapy. (man, pediatric hematology)

We regularly see pituitary adenoma patients. (man, neurosurgery)