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How To Talk About Sex With Your Clients

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Clients come to you looking for support, knowledge and care. Sexuality related concerns often come up with clients and service users. When providing support to individuals about sexuality and/or sexual and reproductive health it is important to be sensitive to the needs of the client. Your clients might be unable to talk about sexuality issues for fear of rejection, lack of safety, and/or due to embarrassment. You can build a positive relationship with their clients by being open and nonjudgmental, allowing clients to overcome their concerns of discussing sexuality. Clients may have concerns about issues such as unintended pregnancy, sexually transmitted infections or relationships. Clients may lack sexuality information, life skills and knowledge of sexual health resources available in your community.

Providing a Safe Environment for Discussing Sexuality

You are important because you can provide a safe environment and often a first point of contact to explore issues that clients may not be able to discuss with friends, family or partners. Be sensitive to the needs of your clients in order to help them assess and reduce their risk of unplanned pregnancy or STI/HIV. You may consider the following as ways of providing a safe environment for discussing sexuality:

  • Do not assume to know why the client has come in for an appointment; ask open questions to allow the client to tell his/her own story.
  • Do not assume that older adults take fewer risks than adolescents.
  • Do not assume that the client has come to discuss only one issue; give them a chance to discuss additional concerns. If you don’t have the time, refer them to someone else they can talk to, and follow up on the referral, or schedule a follow-up appointment with the client yourself.
  • Do not assume that the presenting issue is the most important; give the client a chance to discuss the problem in detail.
  • Always make sure that the client knows that the support being provided is part of a collaborative process but that the final decision belongs to them.
  • Work with the client to prioritize the issues or problems when there is more than one.
  • Ask the client about their expectations of the session and what they hope to achieve.
  • Summarize and reflect on points discussed during the session.
  • When planning ways to work on the client’s concerns, always make sure that the pros and cons are considered, as well as the client’s knowledge, skills and self-esteem, and the client’s methods of coping.
  • Provide the full services needed, including referrals and counselling.
  • Be understanding and supportive, making it easy for the client to open up and talk.
  • Give details and facts in clear language, at the client’s pace.
  • Back it up by giving a pamphlet or video for later consultation.
  • Be confident and respect privacy.
  • Speak with respect.
  • Do not exert pressure for abstinence, but do explain the benefits of abstinence, especially with younger teens.
  • Be comfortable with sexuality and in talking about sex.
  • Accept the views and choices of the young person.
  • Be ‘youth positive’ and ‘queer positive’. This means being accepting, supportive, nonjudgmental and respectful of a client and their sexuality regardless of age or sexual orientation.
  • Encourage clients to make their own plan for reducing their risk of unplanned pregnancy and STI/HIV.
  • Key areas that should be covered with the client are:
    • sexual experience, and frequency;
    • total number of and sex of partner(s);
    • range of sexual behaviours (e.g., risk taking);
    • relationships; past experiences of abuse; and
    • drugs and alcohol and their influence on risk-taking behaviours.
Barriers faced by minority populations

Minority populations are groups of people who aren’t the dominant or majority population where they live or work. A person can be a minority because of age, gender, class, ethnic background, ability, sexual orientation, or other factors. It can be hard for minority populations to find health care providers and services that are sensitive to their specific needs and who won’t discriminate against them. Because of this, people in minority groups may feel that they don’t want to go through the stress of looking for a health care provider. Sometimes this means that people in minority groups go without proper health care. To help address barriers faced by minority populations, health care providers can:

  • remind clients that all their information is confidential 
  •  keep from making assumptions about people’s sexual orientation 
  • start discussions of sexual health matters with their patients, regardless of their age or ability 
  • have interpretation services available for patients who don’t speak English or French 
  • make sure that all doors are power-operated to allow for easier access. 
  • become educated about transgendered and intersex people 
  • be willing to admit to clients that they don’t have all of the information they need, but will do everything they can to get informed 
  • put rainbow stickers or other identifiers where they can be easily seen to show that the office is a GLBTQI-friendly space 
  • provide sensitivity training to all staff to make sure that their offices are positive places for clients
Additional suggestions for addressing sexuality issues with clients
  • Celebrate diversity. Recognize and appreciate the diversity of your clients and our society as a whole.
  • Be inclusive in your language. Use the term “partner” when discussing relationships. It will save you and your client the embarrassment of assuming the gender of his/her partner(s) and the circumstances that lead her/him to speak with you.
  • Challenge oppressive comments. Comments that put down others based on sexual orientation, gender, culture, religion, ethnicity or socio-economic status, need to be explored.
  • Understand that your opinion has no bearing on the question being asked. Although we may not always agree with the decisions of clients, we need to understand that our role is to share information, be supportive and make appropriate referrals, free of judgment.
  • Remember that sexual contact is a pleasurable experience. Positive sexuality is more than harm reduction. It is the celebration of sexuality and part of self-love is making healthy choices to maintain positive sexuality.
  • Be approachable, open-minded and non-judgmental.
  • Keep learning. Continue to get more information about sexuality issues to increase your comfort level and to stay informed.
  • Manage your personal values and attitudes. We all have values about sexuality issues, but it’s important to keep your values out of the picture and focus on your client’s issues.
  • Use clear language and avoid biased, euphemistic or judgmental terms when talking about sexuality issues.
  • Be aware of your personal and professional boundaries (including workplace policies and reporting laws). Find ways that you can be a resource person.
  • Display posters, pamphlets and other resources that indicate to clients that you are approachable and that raise their awareness of available community resources.
  • Connect with colleagues to discuss experiences and strategies for handling client’s sexuality concerns.
  • Be knowledgeable about community resources for referral.
  • Be an advocate. Help clients to access unbiased sexuality and sexual health information and services. Within your workplace and your community, advocate for people’s right to sexuality information and services.

CFSH’s publication Sexual and Reproductive Health Counselling Guidelines provides tools to improve support skills, train staff or provide additional information for clients in a clinical, community or educational setting. The guidelines cover the following 5 areas: sexuality, pregnancy options, safer sex, abuse and violence, and STI/HIV testing.

Updated September 4, 2009

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