Medicine's Role in Validating Sexual Norms

Beyond treating dysfunction in human sexual reproduction, medicine has acquired a normative role—alongside the law and religion—in commenting on sexual behavior. How physicians got that role, how well they function in validating norms of sexual conduct, and their actual and possible advisory roles are the subjects of the November issue. Contributors to the issue discuss, among other topics, the profession’s formal guide to sexual disorders—the Diagnostic and Statistical Manual of Mental Disorders—and propose ways in which physicians can improve how they talk with patients about sex-related concerns.

Volume 16, Number 11: 861-954 Full Issue PDF
  • Viewpoint
    Nov 2014

    Religious Exemptions in Insurance Coverage and the Patient-Clinician Relationship

    Adam Sonfield, MPP
    Restrictions on employer-based health insurance coverage of medical services or treatments, whether motivated by religious prohibitions, political objections, or concerns about cost, degrade quality of care and undermine the patient-clinician relationship.
    Virtual Mentor. 2014;16(11):864-869. doi: 10.1001/virtualmentor.2014.16.11.spec1-1411.
  • From the Editor
    Nov 2014

    Sex: Where Morals and Medicine Collide

    Faith Lagay, PhD
    Discussing sex in the medical context is rarely a matter of facts. Patients who ask “is it normal?” are looking for moral, not statistical, answers.
    Virtual Mentor. 2014;16(11):870-871. doi: 10.1001/virtualmentor.2014.16.11.fred1-1411.
  • Case and Commentary
    Nov 2014

    Interviewing a Patient about Intimate Partner Violence

    Charles Moser, PhD, MD
    In the same way that we learn about normal variations in blood pressure, we need to learn about “normal” variations in sexual interests and practices. We want to avoid clueless questions or unintentionally inflammatory statements.
    Virtual Mentor. 2014;16(11):872-876. doi: 10.1001/virtualmentor.2014.16.11.ecas1-1411.
  • Case and Commentary
    Nov 2014

    A Request for “Conversion Therapy”

    Philip Zachariah, MD, Gregory S. Blaschke, MD, MPH, and Melissa Weddle, MD, MPH
    Physicians should support the sexual orientation of LBGT youth while educating and developing a trusting relationship with the parents, who may pose religious objections and favor ineffective and potentially harmful therapies.
    Virtual Mentor. 2014;16(11):877-883. doi: 10.1001/virtualmentor.2014.16.11.ecas2-1411.
  • Case and Commentary
    Nov 2014

    Teen Pregnancy and Confidentiality

    Mary A. Ott, MD, MA
    Confidential care for adolescents supports their emerging autonomy, engagement in health care decision making, and access to and use of reproductive health services.
    Virtual Mentor. 2014;16(11):884-890. doi: 10.1001/virtualmentor.2014.16.11.ecas3-1411.
  • Case and Commentary
    Nov 2014

    Medicine's Authority to Advocate: Responsibilities and Limitations

    Abigail Cline, PhD
    By virtue of their education and expertise, physicians have a responsibility to challenge scientifically inaccurate information about sexual health, but they may not opine about sexual norms for society in their professional capacity.
    Virtual Mentor. 2014;16(11):891-895. doi: 10.1001/virtualmentor.2014.16.11.conl1-1411.
  • AMA Code Says
    Nov 2014

    AMA Code of Medical Ethics’ Opinion on Adolescent Care

    AMA Council on Ethical and Judicial Affairs
    The AMA Code of Medical Ethics' opinion on adolescent care affirms competent minors' right to confidentiality except in situations for which confidentiality for adults may be breached.
    Virtual Mentor. 2014;16(11):901-902. doi: 10.1001/virtualmentor.2014.16.11.coet1-1411.
  • Medical Education
    Nov 2014

    Sexual Health Education in Medical School: A Comprehensive Curriculum

    Eli Coleman, PhD
    A comprehensive sexual health course for medical students makes use of a variety of pedagogical methods and develops students' foundational knowledge, interviewing and communication skills, medical judgment, and respect and empathy for people different from themselves.
    Virtual Mentor. 2014;16(11):903-908. doi: 10.1001/virtualmentor.2014.16.11.medu1-1411.
  • State of the Art and Science
    Nov 2014

    Will Risk Compensation Accompany Pre-Exposure Prophylaxis for HIV?

    Jill Blumenthal, MD and Richard H. Haubrich, MD
    Introduction of an intervention that reduces the perceived risk of a given behavior may cause a person to increase risky behavior—this is called “risk compensation.”
    Virtual Mentor. 2014;16(11):909-915. doi: 10.1001/virtualmentor.2014.16.11.stas1-1411.
  • Health Law
    Nov 2014

    The Decriminalization of Sodomy in the United States

    Richard Weinmeyer, JD, MPhil
    State laws prohibiting sodomy were on the books throughout US history until struck down by the US Supreme Court, which argued in Lawrence v Texas (2003) that the state cannot criminalize private sexual conduct.
    Virtual Mentor. 2014;16(11):916-922. doi: 10.1001/virtualmentor.2014.16.11.hlaw1-1411.
  • Medicine and Society
    Nov 2014

    Medicine, Sexual Norms, and the Role of the DSM

    Leonore Tiefer, PhD
    Every physician should know that erotic pleasures occur in more diverse situations than one can imagine and that gender identity is a complicated idea.
    Virtual Mentor. 2014;16(11):923-927. doi: 10.1001/virtualmentor.2014.16.11.msoc1-1411.
  • Medicine and Society
    Nov 2014

    Ethical Implications of Drugs for Erectile Dysfunction

    Arthur Caplan, PhD
    The author examines ethical questions related to the sale and marketing of Viagra and the social ramifications of the drug.
    Virtual Mentor. 2014;16(11):928-931. doi: 10.1001/virtualmentor.2014.16.11.msoc2-1411.
  • History of Medicine
    Nov 2014

    Sexual Sunday School: The DSM and the Gatekeeping of Morality

    Edward Shorter, PhD
    The successive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have not responded to changing American sexual practices and mores, instead pathologizing sexual behavior that its authors considered to be atypical and conflating innocuous behavior and harmful treatment of other people in its diagnostic categories.
    Virtual Mentor. 2014;16(11):932-937. doi: 10.1001/virtualmentor.2014.16.11.mhst1-1411.
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    Podcast
    Nov 2014

    Ethics Talk: Educating the Public about Love, Sex, and Relationships

    This month, Virtual Mentor interviewed Drew Pinsky, MD, assistant professor of psychiatry at the Keck School of Medicine of the University of Southern California and media personality who has been talking to and educating the public about love, sex, and relationships for more than 25 years.