Talking about sex in the Gender Identity Clinic: Implications for training and practice

This article provides the first systematic examination of the ways 'talk about sex' is occasioned and managed by doctors and patients in real-life interactions in a National Health Service Gender Identity Clinic. Drawing on a corpus of 194 recordings of psychiatric assessment sessions, the...

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Bibliographic Details
Published in:Health (London, England : 1997) England : 1997), 2013-11, Vol.17 (6), p.622-639
Main Author: Speer, Susan A
Format: Article
Language:English
Subjects:
Client Relations
Clinics
Communication
Consultation
Doctor-patient relationship
Doctors
Education, Medical
Female
Gender Identity
Gender studies
Humans
Male
Patients
Physician-Patient Relations
Physicians
Psychiatry
Recording
Research methods
Sex
Sex Role Identity
Sexual Behavior - psychology
Socialized Medicine
Talking
Training
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Summary:This article provides the first systematic examination of the ways 'talk about sex' is occasioned and managed by doctors and patients in real-life interactions in a National Health Service Gender Identity Clinic. Drawing on a corpus of 194 recordings of psychiatric assessment sessions, the article examines how parties initiate and develop talk about sex, and which strategies appear to work best for doctor–patient alignment. The analyses revealed that the most aligning methods were for clinicians to make transitions from asking questions about relationships in general to talk about sex, or to build opportunistically on patients' relationship talk. However, talk about sex that lacked specificity or which made inaccurate presumptions about patients' sex lives, generated misalignment between clinician and patient. I suggest that such misalignment is not intrinsically bad. Rather, it provides evidence for the virtues of a more nuanced understanding of patient-centred communication. The article concludes with a discussion of the importance of grounding communication skills training and clinical practice in recordings of actual consultations.
ISSN:1363-4593
1461-7196
DOI:10.1177/1363459312472085