Sexual History

Avoid assumptions about sexual orientation and practices
Gender Identity
1. See Transgender Person
2. Ask patients about both their Gender Identity and their sex assigned at birth
Trauma Informed Care
1. See Sexual Abuse in Children
2. See Sexual Assault
3. Consider prior sexual Trauma when taking the history

Approach
1. Mnemonic: 5 "P"s (Partners, Practice, Protection, Past STI history, Pregnancy)
Gender
1. What is your birth gender?
2. What gender do you identify with?
3. What pronouns do you prefer?
Sexual Activity
1. Have you ever been sexually active?
2. Are you sexually active currently (in the last 12 months)?
Partners
1. What are the birth genders of your partners and what gender do they identify with?
2. How many partners have your had
  1. In last month?
  2. In last 6 months?
  3. In lifetime?
Practices
1. In which sexual practices do you engage?
  1. Oral sex?
  2. Vaginal sex?
  3. Anal sex?
2. Do you protect yourself against Sexually Transmitted Infection (e.g. HIV)?
  1. Condoms?
  2. Dental Dam?
  3. Preexposure Prophylaxis (e.g. HIV PrEP)
3. Pregnancy planning
  1. See Preconception Counseling
  2. What method do you use for Contraception?
  3. Are you planning for pregnancy?
Sexually Transmitted Infection
1. Have you ever had a Sexually Transmitted Infection (e.g. Chlamydia, Gonorrhea, Syphilis, HIV)
2. HIV Risk Factors
3. Are you interested in testing for Sexually Transmitted Infection?
Functioning
1. See Sexual Dysfunction
2. Are you satisfied with you and your partner's sexual functioning?
3. Has there been any change in your partner's libido?
4. Do you have any pain with intercourse (e.g. Dyspareunia)?