A rationale and method for the sexual history in family practice.

The taking of a sexual history produces a therapeutic effect for the patient by giving the patient permission to be sexual, filling patient knowledge gaps, providing a reality check, and beginning the process of self-acceptance by the patient. The physician's own empathy may seem to interfere with his feeling comfortable while eliciting a sexual history; at the same time the patient may struggle with feelings of shame and embarrassment. The physician can alleviate patient discomfort by being accepting and empathetic, and by assuming the patient has thought, felt, and done everything in the sexual area. He can also help by beginning with general questions, avoiding "why" questions and jargon, and gently reporting inconsistencies.