The First Principle of Clinical Sexuality

After completing my psychiatric training, I was hired to develop a curriculum in sexuality for medical students. The students had been advocating for this topic since learning that medical students' sexual knowledge lagged behind their peers [ 1 Lief H.I. New developments in the sex education of the physician. JAMA. 1970; 212: 1864-1867 Crossref PubMed Scopus (26) Google Scholar ]. In 1973, inspired by Masters and Johnson's data-based optimism about improving the nation's sexual health [ 2 Masters W.H. Johnson V. Human sexual inadequacy. Little Brown, Boston, MA1970 Google Scholar ], I embarked on a career to study, teach, and provide services to those with sexual problems. Soon patients with problems I had never before encountered began speaking of their gender identity discomfort; distress over their homosexual desires; paraphilic interests; childhood sexual abuse; and sexual excesses, disinterest, and aversion. My curriculum was obviously too narrow.