While it is often necessary to assess the relevance of physical disease or drug factors, understanding the current sexual relationship is usually of primary importance. Even when there is a clear physical cause for a sexual problem, it is usually the case that psychological factors also play a part, and counseling can often be helpful in improving the quality of sexual life in such cases. The mainstay of the assessment is a careful sexual history. When appropriate, other kinds of investigation will be carried out. These are most often used in assessing male erectile dysfunction, where assessment of spontaneous erections during sleep, or measurement of erections in response to drugs injected into the erectile tissues, or in response to psychological stimuli, are often helpful.
Hormonal assessment is carried out when indicated.
Referral for more complex forms of diagnostic assessment is also possible when indicated. In most cases where the patient has a sexual partner, the partner will be encouraged to attend the clinic with the patient, initially for assessment, and if sexual counseling or therapy is involved, for joint treatment. Transgendered Patients For transsexual or transgendered patients seeking sex reassignment, or simply advice, an initial assessment interview is carried out. After a period of time, more irreversible steps, such as hormonal treatment to produce feminizing or masculinizing effects, may be taken with the clinic's help. The clinic's director, Dr. John Bancroft has run sexual clinics previously in Oxford, England, and Edinburgh, Scotland.