(201) Young Adult Males Report Reluctance in Disclosing Sexual Health Concerns to Physicians: A Cross-Sectional Study
Authors: Pil E , Rabinowitz M , Eaton C , Haney N , Kohn T , Li O , Herati A 
Published: May 2023

Abstract

Introduction
The reported prevalence of sexual dysfunction in young adult males has recently increased, but estimates are highly variable, ranging from 1% to 30%. Sexual dysfunction can have organic, psychogenic, and multidimensional causes, and sexual concerns warrant medical assessment. However, both clinical management and epidemiologic research depend upon the willingness of patients to disclose symptoms. Despite this issue, there is limited research on the comfort level of young adult males in discussing sexual health or sexual dysfunction with physicians.

Objective
To assess the comfort level of young adult males in discussing their sexual health, including sexual side effects caused by medications, with doctors.

Methods
A cross-sectional, paid survey was designed in collaboration with our institution’s biostatistics core using Qualtrics XM. Biological males ages 18 to 35 were recruited using social media. The survey included demographic characteristics and contained several 5-point Likert scale questions to query perceptions of personal health. Additionally, respondents ranked the top three of seven subjects that they felt most difficult to talk about with their doctor (mental health, physical health, school/job achievement, maintaining body weight, ability to orgasm, libido, and erectile function). Participants also ranked the three items that were most important to them according to their current personal values. These ranked variables were subsequently transformed to calculate an “impact score” for analysis (3 points = ranked 1st; 2 points = ranked 2nd; 1 point = ranked 3rd; 0 points = unranked).

Results
505 out of 665 electronically delivered surveys were returned (76% response rate), and 486 had complete and evaluable responses. Age was normally distributed with a mean of 27.4 years (SD: 3.6). Participants were 40% non-white, 21% LGBTQ+, and 89% sexually active. 37% reported a history of major depressive disorder (MDD) and 34% reported a history of generalized anxiety disorder (GAD). 51% of respondents agreed or strongly agreed with the statement, “I am embarrassed to talk about sexual problems with my doctor.” As illustrated by Figure 1A, respondents ranked all sexual health topics as uniformly and significantly more difficult to discuss with their physicians compared to all other aspects of personal health assessed (p=0.0000-0.02). As displayed in Figure 1B, respondents indicated that sexual health subjects were of lower importance relative to the other areas of personal health. Grossly, there were no significant correlations between impact scores and age.

Conclusions
Our results suggest that young adult males display high rates of embarrassment and reluctance in sharing sexual concerns with physicians. Though young adult males place less value on sexual health, it is closely interconnected with mental and physical well-being. Our findings reinforce the crucial need for physicians to actively combat stigma around sexual health conversations, normalize these discussions with their young adult male patients, and directly inquire about sexual concerns in patients with medical conditions or medications with known sexual side effects.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Dadi, Teleflex, Lina.