Our 16-year-old daughter recently told us she plans to transition from female to male. We just discovered that our 14-year-old autistic son has been downloading child pornography. I recently had colostomy surgery, and I am afraid that my husband will no longer want to be intimate with me. As a former male, do I need to remind my gynecologist to examine my prostate gland?
Such scenarios, while rare for many providers, are familiar territory for the clinicians of the Sexual Behaviors Consultation Unit (SBCU). Located in The Johns Hopkins Hospital, the SBCU has served patients with human sexuality issues and gender variance concerns since its founding in 1971. Its specialists also undertake research in those areas and teach medical trainees.
Experience has made the clinic a natural partner in Johns Hopkins Medicine’s recently launched lesbian, gay, bisexual and transgender (LGBT) health initiative, a commitment to ensure that patient care and services respect the individuality of all patients, employees and visitors.
“Johns Hopkins wants to provide the highest-quality mental and physical care to those with a diversity of backgrounds,” says SBCU Director Frederick Berlin. “People with gender issues have suffered because of the disparity between how they feel subjectively and what they see in the mirror. We want to be absolutely sure these folks have the kindest possible care, and not have prejudice and biases expressed against them.”
The only clinic of its sort in any major U.S. teaching hospital, the SBCU covers three broad areas: sexual dysfunction—difficulties with performing or enjoying sex; sexual disorders, such as a desire to expose oneself in public; and gender identity or gender dysphoria—a feeling of mental discomfort when gender and anatomy are out of sync. All SBCU psychiatrists, psychologists and psychotherapists hold faculty appointments in the school of medicine.
Because sex intersects so many health issues, collaboration has long been one of the SBCU’s strengths, Berlin says. Faculty members routinely consult with surgeons, endocrinologists, child and adult psychiatrists, social workers, plastic surgeons and cancer specialists, among others. Weekly collaborative seminars for medical trainees at the SBCU offer insight into conditions physicians encounter in a variety of specialties. “All doctors,” says Berlin, “need to know about sex and be comfortable discussing sex with patients.”