Deya Roy
California State University San Marcos
Suggested Citation:
Roy, D. (2025). Does gender-concordance matter when discussing sexual health with physicians? Utah Journal of Communication, 3(1), 27-34. https://doi.org/10.5281/zenodo.15312521
Abstract
Sexual health is an integral component of overall health and well-being. However, both physicians and patients admit to not broaching this topic with one another during regular visits. Prior research has uncovered various barriers to openly discussing sexual health during a medical encounter. Present study aims to understand if physician’s biological sex or gender matters when discussing sexual health with the patient. Using snowball sampling, 221 participants were recruited for the study. The participants completed an online survey with open-ended questions regarding their preferences of their primary care physician’s sex/gender when discussing sexual health and the reasons for these preferences. The responses were then coded and thematically organized. The majority of participants noted that they prefer same-gender physician. Five different themes emerged for reasons to want a same-gender physician: comfort, similarity, emotional support, non-judgmental demeanor, and identification of health concerns. While only a handful of respondents reported wanting cross-gender physicians, professional behavior was a theme best suited for those responses. Findings suggest that most individuals prefer same-gender physician while discussing sexual health and cited feeling comfortable as the main reason for this choice. By having a physician that meets a patient’s preference, it might enable patients to openly start sexual health discussions.
Keywords: sexual health, patient-physician communication, gender, uncertainty reduction
Sexual health is often deemed as a taboo topic in the United States. In many cases, conversations about sexual health are avoided in educational settings, with parental figures and even with healthcare providers (Haboubi & Lincoln, 2003). Sexual health is an important aspect of every individual’s life, and it is important to include topics of sexual health in general medical discourse (Williams & Wimberly, 2006). Ideally, in healthcare setting physicians and patients should be able to discuss any concerns about sexual health openly. Unfortunately, that is far from reality. Both men and women face a host of sexual health problems (Bittleston et al., 2024), which go unaddressed due to several barriers that impede open sexual health discussion (Haboubi & Lincoln, 2003). Physicians and patients alike are apprehensive broaching sexual health issues in a clinical setting. Due to this apprehension, patients suffer in silence. It is of paramount importance to understand the factors that may facilitate an open discussion among patients and physicians about sexual health. Talking about sexual health could not only improve an individual’s sexual health but also improve general health of the population (World Health Organization, 2010).
Discussing sexual health with a healthcare professional openly can help patients who suffer in silence or ignore problematic symptoms altogether. For instance, in 2022 alone, there were more than 2.5 million cases of chlamydia, gonorrhea, and syphilis in the United States (CDC, 2022). Scholars note that the true numbers as much higher because many individuals do not seek medical attention for these infections (CDC, 2021). Yet another sexual health topic that often goes unmentioned is sexual dysfunction. Sexual dysfunction can include but is not limited to premature ejaculation, erectile dysfunction, unable to achieve orgasm, painful sexual intercourse etc. (Lewis et al., 2010). In a study by Clark and Williams (2014), participants agreed that primary care physicians should discuss sexual dysfunctions with their patients; however, they were divided on who should broach this topic.
Physicians are guilty of not initiating these sensitive topics either. While many physicians are given basic training in tackling sexual health issues and most of them believe that is an important topic to discuss, a whopping 86% admit to avoiding the topic of sexual health with patients altogether (Ho & Fernandez, 2006). In another study, 92% of physicians reported that they have never instigated the topic (Corona et al., 2006). Reasons for this apprehension for both parties have been studied extensively, but ways to mitigate this barrier still remains relatively understudied.
Literature Review
Physicians’ Perspective
In general, individuals avoid discussing sexual related topics and unfortunately that holds the same for healthcare setting. Amongst several barriers, physicians lack of training in sexual health is one topic that emerges frequently in literature. Only 50% of medical schools in the United States require students to take sexual medicine courses, leaving a gap in understanding sexual health issues among patients and confidence to deal with said issues (Beebe et al., 2021). Due to this deficit, primary care physicians would rather defer such discussions to a specialist.
Embarrassment was another commonly cited reason among physicians for not broaching topics of sexual health. Around 39% of the physicians in a study stated they worried about embarrassing a patient (Temple-Smith et al., 1999). Besides the aforementioned reasons, physicians have also noted lack of privacy (Av et al., 2020), and conservative sexual beliefs (Tsimtsiou et al., 2006) as potential barriers to discussing sexual health.
Patients’ Perspective
Patients, on the other hand, are apprehensive to begin sexual health discussion for different reasons. Zimmaro and colleagues (2020) stated that patients can present “self-centered” barriers where they do not know how to start the conversation or feel uncomfortable with the idea of talking about sexual health. In addition to these barriers, patients cite reasons such as feelings of anxiety, guilt and embarrassment when discussing sexual health with their physicians (Hitchcock & Wilson, 1992). Patients may also think that discussing sexual problems with healthcare providers will not result in resolution. This is especially common among older males who experience erectile dysfunction (Gott et al., 2004). To further complicate matters, male patients might feel increased apprehension due to a perceived overlap between sexual functioning and masculinity (Komlenac et al., 2018).
While some barriers might be different for patients and physicians, one reason cited by both parties is common—the gender of the other party. Physicians have noted apprehension to broach sexual health topics when the patient is of a different gender (Gott et al., 2004). In the same vein, past studies have highlighted similar uneasiness when it comes to discussing sexual health with a physician of a different gender among patients (Kiss, 2004). There could be several factors but differing communication styles, which is learned from early childhood could be at play here (Hall et al., 1994).
Gendered Differences in Communication Style
Since early childhood, individuals are taught to behave a certain way based on the assumptions of the child’s gender. Society might see kindly to a male child’s rough-housing, but quickly admonish a female child’s attempt to get dirty. These early instances also influence individuals’ communication styles as one in socialized into a gendered speech community. Gendered speech community is the notion that a group of individuals have certain rules of communication and interpretation speech based on their gender (Mukhanovna, 2022). For instance, women are often times encouraged to smile more and give more response cues while listening to others, while men are expected to reserve emotions in various circumstances. An individual’s biological sex is often times a segue into socialization into certain gendered speech communities. In the case of cisgender persons, a young boy may be socialized to have more masculine speech, whereas a young girl could be expected to exhibit more feminine speech. These gendered communication patterns have been widely studied in the realm of romantic relationships and friendships; however, there is a lacuna of research that looks at gendered differences in communication and its effects in healthcare setting (Bertakis, 2009).
A few studies have discerned communication styles of female and male physicians. For example, female physicians were seen to hold longer visits, made more positive and partnership statement (such as, “we can beat cancer together”), asked more questions and smiled and nodded more. Males and females were seen to tackle some subjects similarly like social conversation, technical support, or emotional support (Hall et al., 1994). In a meta-analysis by Roter and colleagues (2002), it was uncovered that female physicians showed more active partnership behaviors, positive talk, and emotionally focused talk compared to their male counterparts. Overall, they concluded that female physicians provided more “patient-centered care” (p. 763). As such, female physicians may be socialized from early age to exhibit softer side of communication, which is decoded as patient-centered in the healthcare setting.
It is also important to note that being a part of gendered speech communities not only influences a physician’s communication style, but also the patient’s interpretation of the said communication. The extant literature about patient’s preference of physician’s gender is differing. A study by Schmittdiel and colleagues (2000) studied the effects of same-gender and cross-gender physician-patient dyad on satisfaction after a visit about preventive care. They found that patients who interacted with the opposite-gender physician were more satisfied with their visit. However, participants articulated that during “sensitive visits” they would like to meet with a same-gender physician. In the case of gynecologist-obstetrician visits, patients have stated an explicit preference for a same-gender physicians (Janssen & Lagro-Janssen, 2012).
Past studies have presented controversial findings about the importance of gender concordance of patient-physician in the healthcare setting. However, the common thread presented here is that patients seemingly have a preference for physicians, especially when it comes to conversations regarding sexual health. As patient-physician relationship is unlike any other professional relationship (Levinson et al., 1984), discussion is warranted about the gender concordance of physicians and patients in healthcare setting, especially for sexual health discussions.
As listed in previous section, both physicians as well as patients are apprehensive when it comes to sexual health dialogues in healthcare setting. While previous studies have inconsistent results, one thing is clear—the topic of sexual health is important. Exploring the reasons of subdued sexual health discussions is lacking attention from the scholarly community. The goal of this qualitative study; therefore, is to investigate the importance of a physician’s gender in inhibiting or facilitating an open discussion about sexual health from the patient’s perspective. Guided by the literature and the theoretical framework, the present study explores some reasons why patients might prefer to talk to cross-gender or same-gender physicians regarding sexual health.
Methods
Participants
The sample analyzed included 139 women (62.9%) and 82 men (37.1%) between the ages of 18 and 81 years (M = 29.20 SD = 13.83). The majority (95.9%) of the sample identified as heterosexual (2.3% as lesbian/gay; 0.8% as bisexual). The sample was predominantly Caucasian (68.2%), followed by Asian (15.5%), African American (7.2%), Hispanic (3.4%), and those who identified as multi-racial (3.1%).
Procedure
An online survey was completed by 221 participants. The participants answered questions about sex/gender preferences of physicians while discussing sexual health concerns. The protocol for the present study was approved by Institutional Review Board prior to data collection. Initial set of participants were recruited from an undergraduate course at a large public university located in Northeastern United States. The study employed a form of snowball sampling (e.g., Quick, 2009), where students in a communication course were asked to recruit up to four participants in order to receive extra credit toward the course. Recruiting students were encouraged to approach potential study participants from diverse demographic backgrounds and did so using a recruitment message provided to them by the research team.
Individuals who were willing to participate were directed to an online survey consisting of a battery of questions regarding sexual health discussion preferences. Participants were asked to list their contact name, phone number, and referent’s name as a quality control measure. The author contacted the participants via phone to ensure that a student had not completed the survey on their behalf. Later, any identifying information was deleted to maintain anonymity of the participants. Once the identifying information was removed, the author presented the data to research assistants for coding and analysis.
For the present study, the participants were asked to specify the gender/sex of the primary care physician with whom they would like to discuss sexual health. Next, they were also asked to describe in detail the specific reason for their choice. Both these questions were open-ended; thus, participants could answer to their liking.
Two coders reviewed the participant responses separately to generate broad themes. These themes were generated by systematically combing through all participant responses. The coders selected quotes that exemplified a certain theme. Following individual review of the responses, the coders reviewed each other’s themes, summaries and quotes. If any inconsistencies were present, the coders reviewed the response till there was an agreement to reclassify the said response. For the next step, the coders narrowed down the themes further and collapsed different categories into one large theme to make the findings parsimonious. This resulted in an emergence of patters and explanations of certain gender preference of the physician over another.
Results
This study attempted to understand if a preference for gender/sex of the physician exists while discussing sexual health in a clinical setting. The participants were asked if they had a gender-preference and if yes, then why. Participants’ responses were coded to understand the specific sex/gender preference of physicians while discussing sexual health. The majority of the participants (90.9%) noted that they would be more comfortable discussing sexual health with a same-gender physician. Around 3.7% expressed that they would prefer a cross-gender physician and finally around 5.5% of the respondents said they had no preference.
Participants were also asked to explain why they held the specific preference. Five themes emerged after data analysis for the same-gender group: (1) comfort, (2) similarity, (3) emotional support, (4) non-judgmental demeanor, and (5) identification of health concerns. By the same token, one super theme emerged for the cross-gender group: professional behavior. Below, the themes are explained in detail with exemplary quotes.
Same-Gender Preference
A rather large number of participants (n = 199) noted that they would rather speak to a same-gender physician than cross-gender physician about sexual health concerns. As the responses were coded, five themes emerged noted below.
Theme 1: Comfort. Comfort was the most frequently cited reason for same-gender preference of physicians. Some participants simply stated that talking to the same gender physician would yield more comfort. For instance, a female participant (18 years) simply stated “I guess it make me feel more comfortable.” However, few participants went in depth to explain why they would feel more comfortable discussing sexual health with a same-gender physician.
Patients regard physicians as unfamiliar persons. Discussing sexual health with an unfamiliar person of cross-gender could be uncomfortable. The following statement captures this sentiment: “It makes the conversation with a complete stranger less awkward” (female, 19). Additionally, having the same-sex physician may help facilitate a conversation about sexual health. A male participant, 21, stated, “I would be able to discuss certain topics.”
Physical examination by cross-gender physician was also regarded as uncomfortable. Participants mentioned that it would be preferred if a same sex physician conducted the physical examination. For example, a female participant, 52, wrote that she has “had both male and female [gynecologists] and [I] feel that the females are more understanding of my specific issues. I am also more comfortable having a female physically examine my ‘female’ parts.” A male participant, 20, stated, “I feel it would be awkward talking about my sexual health in front of a woman and having her check what the problem is.”
Theme 2: Similarity. When asked about reasons for preference of a same-gender physician, many participants alluded to the notion that physical similarity can lead to more comfort and can help physicians relate to the problem better. Participants also mentioned that it would be generally easy to strike a conversation about sexual health with a physician of the same gender. One participant underlined this theme by writing, “Just seems easier to talk to someone with the same ‘equipment’” (male, 25), implying that same-sex physician would better understand biological issues pertaining to sexual health.
Most participants mentioned that physicians will be able to understand the problem better because they are “in the same shoes” as the participants. A female participant, 59, mentioned, “I [will] feel more comfortable with someone who ‘knows what it’s like.’ The same sex physician would understand hormone fluctuations, [menopause] symptoms first hand [and] not from a textbook.”
As per the participants, same-gender/sex physician would not only understand the biological aspects but also understand the social pressures associated with belonging to a particular sex. The following statement captures the sentiment of this subject, “A female doctor might understand my personal feelings about weight and stress better” (female, 20).
Theme 3: Emotional Support. Emotional support was another theme observed. Participants have explicitly stated that same-gender physicians lend more emotional support and might understand the patients better. A male participant, 25, explained, “Perhaps because someone of the same sex can have empathy. There is desire for understanding. What better way to feel you’re understood than by someone with the same type of reproductive organs?” Another female participant, 25, resonated the same sentiment. She wrote, “I feel more comfortable speaking to another woman because I feel she will be more understanding knowledgeable and empathetic because of her own sex.”
Theme 4: Non-Judgmental Demeanor. As sexual health is a sensitive topic, participants have expressed the need for physicians to be nonjudgmental. Many participants attributed nonjudgmental behavior to same-gender physicians. A male participant, 20, highlighted this feeling by stating, “I would be more comfortable discussing my sexual activities with a male doctor instead of female doctor. I would feel like the female would be judging me.” Another female participant (18) shared the same sentiment: “If I were to discuss sexual [matters], I would just feel more comfortable talking to a woman since I think I would feel less judged than by talking with a male.”
Theme 5: Identification of Health Concerns. The last theme for preference for same-gender physicians is about identification of health concerns. A few participants believe that if the physician is the same-gender as the patient, it is easier for the physicians to identify the symptoms. For instance, a male participant, 21, stated, “I feel like a male physician would know more about things about guys and can give me the right answers.” A female participant, 81, echoed the same by saying, “It is easier to talk with the [doctor] who is of my sex and there should be more understanding of my concerns.”
Cross-Gender Preference
Just a handful of participants (n = 8) expressed that they would prefer a cross-sex physician. The participants’ responses can be best described under the theme “professional behavior.”
Theme: Professional Behavior. Participants noted that physicians of the cross-sex/gender might conduct themselves in a professional manner without getting too personal about sexual health issues. This theme primarily deals with physician’s behavior and demeanor.
A small number of male participants expressed that they feel that female physicians are better at communicating in the healthcare setting; thus, they prefer talking to a female physician regarding sexual health. The following quote captures this emotion: “I feel better for it to be a woman because females generally are better at expressing bad information or good information” (male, 22).
Few participants articulated that talking to a cross-gender physician might bring in a different perspective. An individual of the same sex may not to be able to present an array of perspectives; hence few individuals turn to a physician of the opposite sex. A female participant, 23, expressed, “At times [it is] helpful to get the perspective of someone of the opposite sex.”
Discussion
The present study asks a simple yet important question that can foster better sexual health communication between patients and primary care physicians by investigating the importance of gender of the physician when discussing sexual health. In particular, participants were asked to indicate if they prefer same-gender or cross-gender physician. While the study at hand evidenced that majority of participants favor same-gender physician, there is scholarly contention regarding this topic. For instance, Schmittdiel et al., (2000) found that patients were more satisfied with opposite-gender physicians in a preventive care setting, whereas Janssen and Largo-Janssen (2012) noted that women prefer seeing female gynecologist and report higher levels of satisfaction after such interactions compared to male gynecologists. After taking a hard look at the matter, it is evident that the context of patient-physician interaction is the key.
The findings of this study fall within the broad framework of Uncertainty Reduction Theory (URT) (Berger & Calabrese, 1975). The main tenant of this theory is that individuals feel uncertain during an initial interaction and they employ various strategies to reduce this uncertainty. URT’s prediction that similarity fosters liking which in turn increases disclosure (Berger & Calabrese, 1975) can be found under Theme 2 in same-gender preference. Prior research on this topic states that patients are already sensitive about the perceived social distance between themselves and the physicians. This is characterized by the use of filler words, long pauses or not discussing a health issue altogether (Sheer & Cline, 1995). Perceived social distance coupled with dissimilarity in basic physiological aspects can make discussing sexual health with physicians a tough task (Fuzzel et al., 2016). Respondents in this study have highlighted that due to the fact that same-gender physicians share similar experiences or social proclivities; they are more comfortable sharing information with them. Moreover, this extends to physical comfort where participants insist that same-sex physician touch them during routine sexual health examination. In fact, few participants articulated that they feel more comfortable discussing sexual health with same-gender physicians because of similarity between the patients and physicians.
Two themes, emotional support and non-judgmental demeanor, can be justified using one of URT’s axioms as well. URT states that non-verbal affiliative expressiveness or in other words “warmth” plays an integral factor to decreasing uncertainty in situations (Knobloch & McAninch, 2015). A simple nod or an appropriate eye contact can put a person at ease. However, appropriate non-verbal cues are subjective and can be difficult to discern based on context. As previously mentioned, children are often times socialized into gender-based speech communities, and one of the aspects of belonging to a certain speech community is the ability to decode certain non-verbal cues. What may seem as a kind gesture to a person belonging to one speech community, might be interpreted as a hostile gesture in another. For instance, after breaking news about a health ailment, a female physician might say “you may want to bring your partner to the next appointment.” This can be interpreted as providing support or creating equality by female patients, but male patients could deem this communication as an act of a non-confident physician because of the use of words “may want to bring,” which is a tentative style of speaking. In the present context, same-gender dyads who have similar speech patterns maybe a better match to talk about sensitive issues such as sexual health.
While the majority of the participants articulated their preference for same-gender physicians, a small number of participants stated they would like cross-gender physicians. Their responses were coded into one theme, namely professional behavior. Participants articulated that a variety of perspectives and answers regarding sexual health could be beneficial. A few participants preferred non-prying behavior, limited judgment and being touched by opposite-sex physician. Further, it is important to note that a handful of male participants stated that they would prefer a female physician because they can communicate better. This preference has been noted repeatedly in the gynecology/obstetrics department, but not in family medicine. Calling back to gendered speech community, we see that feminine speech is characterized by showing support and maintaining relationships (Wood & Fixmer-Oraiz, 2019). Healthcare providers can take note of this response, as feminine speech style may work for individuals who are not open to sexual health discussions with their physicians.
Finally, all participants regardless of their preference of physician’s gender echoed the idea of openly discussing sexual health with physicians. While gender of the physician was one of the several barriers discussed in this patient-centered study, physicians should not be inhibited to broach the topic of sexual health. Immediate attention should be given to the topic of sexual health as many patients suffer in silence, waiting for physicians to broach the topic (Corona et al., 2006).
The present study provides one piece of the puzzle when it comes to discussing sexual health in a healthcare setting. The findings of this study have implications for clinical-setting—not just for physicians but for any individual who comes in contact with the patient including the appointment scheduler. In a larger hospital setting, patients are often offered an appointment with the next available physician. Keeping the findings of this study in mind, patients should be given options patients should be given options to choose their physician. Rather than just listing ambiguous names of the next available physician, the scheduler should be sensitive to the patient’s preferences. The appointment scheduler can state the name and other identifying factors (gender, languages spoken etc.) while listing the available physicians. Furthermore, many patients pick their physician based on their insurance network. Insurance companies web portals should clearly state the sex/gender of the doctor for the patients to see. By taking such measures, healthcare professionals can eliminate the guessing game, and let the patients be in charge of whom they are picking as their physician based on their gender preference.
Conclusion
Several factors should be considered when looking at the results of this study. As this study was conducted in United States, the findings of this study may not be extended to different cultures and countries around the world. Studies could use minority groups and patients from various cultures as their population and compare the results to the present study. Future research could also look into role of ethnicity concordance while talking about sexual health. Various ethnicities may have different predispositions towards gender preferences. While this study uses a robust snowball sample yielding responses from individuals of various ages and backgrounds, it should be kept in mind that the sample could have certain biases. For instance, the sampling was initiated from undergraduate students at a large public university resulting in a particular leaning in certain demographics (i.e. education, race, income). As this study uses qualitative data, future researchers are cautioned not be broadly generalize its findings. Next, the present study only takes into account preferences of patients. Studies in the future should also look at physician’s preferences for treating same-sex/gender or cross-sex/gender patients.
To conclude, sexual health is a part of overall health and well-being. Patients and providers have listed various reasons for not discussing sexual health with each other. However, previous research has ignored something as simple as the other party’s gender as a facilitator or inhibitor of open sexual health discussion. The present study asked individuals with diverse demographics to express their desire to talk to same-gender or cross-gender physician. Majority of the respondents felt that same-gender physician was a better option while discussing sexual health. Various themes like comfort, similarity, emotional support, non-judgmental demeanor, and identification of health concerns emerged after coding for their responses. Using URT, it can be justified that similarity, even if it is gender or biological sex, reduces uncertainty and in turn fosters open conversations. Future studies should look at the influence of other demographics factors such as ethnicity on sexual health discussions.
References
Av, R., Lawrence, T., & Pv, S. (2020). Doctors Attitude towards Sexual Health Problems – A Practise Survey. The Journal of the Association of Physicians of India, 68(3), 24-27. https://pubmed.ncbi.nlm.nih.gov/32138478/
Beebe, S., Payne, N., Posid, T., Diab, D., Horning, P., Scimeca, A., & Jenkins, L. C. (2021). The Lack of Sexual Health Education in Medical Training Leaves Students and Residents Feeling Unprepared. The Journal of Sexual Medicine, 18(12), 1998–2004. https://doi.org/10.1016/j.jsxm.2021.09.011
Berger, C.R., & Calabrese, R.J. (1975). Some explorations in initial interaction and beyond: Toward a developmental theory of interpersonal communication. Human Communication Research, 1(2), 99-112. https://doi.org/10.1111/j.1468-2958.1975.tb00258.x
Bertakis, K. D. (2009). The influence of gender on the doctor–patient interaction. Patient education and counseling, 76(3), 356-360. https://doi.org/10.1016/j.pec.2009.07.022
Bittleston, H., Hocking, J. S., Temple-Smith, M., Sanci, L., Goller, J. L., & Coombe, J. (2024). What sexual and reproductive health issues do young people want to discuss with a doctor, and why haven’t they done so? Findings from an online survey. Sexual & Reproductive Healthcare, 100966. https://doi.org/10.1016/j.srhc.2024.100966
Centers for Disease Control and Prevention (2021). CDC estimates 1 in 5 people in the U.S. have a sexually transmitted infection. https://archive.cdc.gov/www_cdc_gov/media/releases/2021/p0125-sexualy-transmitted-infection.html
Centers for Disease Control and Prevention (2022). Sexually Transmitted Infections Surveillance, 2022. https://www.cdc.gov/std/statistics/2022/default.htm
Clark, R. D., & Williams, A. A. (2014). Patient preferences in discussing sexual dysfunctions in primary care. Family Medicine, 46(2), 124–128. https://pubmed.ncbi.nlm.nih.gov/24573520/
Corona, G., Jannini, E.A., & Maggi, M. (2006). Inventories for male and female sexual dysfunctions. International Journal of Impotence Research, 18(3), 236-250. https://doi.org/10.1038/sj.ijir.3901410
Fuzzell, L., Fedesco, H. N., Alexander, S. C., Fortenberry, J. D., & Shields, C. G. (2016). “I just think that doctors need to ask more questions”: Sexual minority and majority adolescents’ experiences talking about sexuality with healthcare providers. Patient Education and Counseling, 99(9), 1467-1472. https://doi.org/10.1016/j.pec.2016.06.004
Janssen, S. M., & Lagro-Janssen, A. L. (2012). Physician’s gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: a systematic review. Patient education and counseling, 89(2), 221-226. https://doi.org/10.1016/j.pec.2012.06.034
Haboubi, N., & Lincoln, N. (2003). Views of health professionals on discussing sexual issues with patients. Disability & Rehabilitation, 25(6), 291-296. https://doi.org/10.1080/0963828021000031188
Knobloch, L. K., & McAninch, K. G. (2015). Relational Uncertainty. The International Encyclopedia of Interpersonal Communication, (pp. 1-9). https://doi.org/10.1002/9781118540190.wbeic101
Ho, T., & Fernandez, M., (2006). Patient’s sexual health: do we care enough? Journal of Renal Care, 32, 183-186. https://doi.org/10.1111/j.1755-6686.2006.tb00019.x
Gott, M., Galena, E., Hinchliff, S., & Elford, H. (2004). “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Family Practice, 21(5), 528-536. https://doi.org/10.1093/fampra/cmh509
Hall, J. A., Irish, J. T., Roter, D. L., Ehrlich, C. M., & Miller, L. H. (1994). Gender in medical encounters: an analysis of physician and patient communication in a primary care setting. Health Psychology, 13(5), 384-392. https://doi.org/10.1037/0278-6133.13.5.384
Hitchcock, J. M., and Wilson, H. S. (1992). Personal risking: Lesbian self- disclosure of sexual orientation to professional health care providers. Nursing Research, 41, 178-183. https://doi.org/10.1097/00006199-199205000-00010
Kiss, A. (2004). Does gender have an influence on the patient-physician communication? The Journal of Men’s Health and Gender, 1(1), 77-82. https://doi.org/10.1016/s1571-8913(04)00027-5
Komlenac, N., Siller, H., Bliem, H. R., & Hochleitner, M. (2018). Associations between gender role conflict, sexual dysfunctions, and male patients’ wish for physician–patient conversations about sexual health. Psychology of Men & Masculinities, 20(3), 337-346. https://doi.org/10.1037/men0000162
Levinson, R.M., McCollum, K.T., & Kutner, N.G. (1984). Gender homophily in preferences for physicians. Sex Roles, 10(5-6), 315-325. https://doi.org/10.1007/bf00287549
Lewis, R. W., Fugl-Meyer, K. S., Corona, G., Hayes, R. D., Laumann, E. O., Moreira, E. D., Rellini, A. H., & Segraves, T. (2010). Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. The Journal of Sexual Medicine, 7(4-2), 1598–1607. https://doi.org/10.1111/j.1743-6109.2010.01778.x
Mukhanovna, K. D. (2022). Gendered Speech Communication. American Journal of Interdisciplinary Research and Development, 4, 314–319. http://www.ajird.journalspark.org
Roter, D. L., Hall, J. A., & Aoki, Y. (2002). Physician gender effects in medical communication: a meta-analytic review. JAMA, 288(6), 756-764. https://doi.org/10.1001/jama.288.6.756
Quick, B. L. (2009). The effects if viewing Grey’s Anatomy on perceptions of doctors and patient satisfaction. Journal of Broadcasting & Electronic Media, 53, 38-55. https://doi.org/10.1080/08838150802643563
Schmittdiel, J., Grumbach, K., Selby, J. V., & Quesenberry Jr, C. P. (2000). Effect of physician and patient gender concordance on patient satisfaction and preventive care practices. Journal of general internal medicine, 15(11), 761-769. https://doi.org/10.1046/j.1525-1497.2000.91156.x
Sheer, V. C., & Cline, R. J. (1995). Testing a model of perceived information adequacy and uncertainty reduction in physician-patient interactions. Journal of Applied Communication Research, 23(1), 44–59. https://doi.org/10.1080/00909889509365413
Temple-Smith, M., Mulvey, G., & Keogh, L. (1999). Attitudes to taking a sexual history in general practice in Victoria, Australia. Sexually transmitted infections, 75(1), 41-44. https://doi.org/10.1136/sti.75.1.41
Tsimtsiou, Z., Hatzimouratidis, K., Nakopoulou, E., Kyrana, E., Salpigidis, G., & Hatzichristou, D. (2006). Predictors of physicians’ involvement in addressing sexual health issues. The Journal of Sexual Medicine, 3(4), 583-588. https://doi.org/10.1111/j.1743-6109.2006.00271.x
Williams, C.R., & Wimberly, Y. (2006) Sexually transmitted disease prevention in adolescents and young adults. Journal of the National Medical Association, 98(2), 275-276.
Wood, J. T. & Fixmer-Oraiz, N. (2019). Gendered lives: Communication, gender, and culture (13th eds). Thomson Wadsworth.
World Health Organization. (2010). Developing Sexual Health Programmes: A framework for action. https://iris.who.int/bitstream/handle/10665/70501/WHO_RHR?sequence=1
Zimmaro, L. A., Lepore, S. J., Beach, M. C., & Reese, J. B. (2020). Patients’ perceived barriers to discussing sexual health with breast cancer healthcare providers. Psycho-Oncology, 29(7), 1123-1131. https://doi.org/10.1002/pon.5386