Sandra Leiblum, PhD, director of the Human Sexuality Program
Leiblum begins the day with a lecture on sexual inquiry and history taking. She and Raymond Rosen, PhD, professor of psychiatry and medicine at RWJMS, speak on sex therapy.
Leiblum gives examples of questions that may have to be asked to uncover sexual problems: Is the patient monogamous? What is his sexual orientation? Is he on any drugs? Which ones? "You must feel comfortable asking questions about things like erections and orgasms," she says. "Otherwise, the patient won't be comfortable answering."
Wednesday's matinee is "Sex After 50: A Guide to Lifelong Sexual Pleasure." It is an upbeat collection of interviews with older couples who are enjoying a romantic and sexual life. Sexual changes that occur with aging are also reviewed.
A 50-plus male in the film says sex in later life is analogous to an old car. "It may not start right away, and it may not run smoothly at first, but eventually you'll get where you're going."
The program turns to adolescent sexuality. Robert L. Johnson, MD, director of the Division of Adolescent and Young Adult Medicine at NJMS, says 64 percent of all 17-year-olds in America are having sex. A few more than half of them use condoms occasionally, and only about one-third use them regularly. "Our goal by 2000 is to reduce the proportion of teens having sex and increase the number using condoms," he explains.
Johnson says physicians must do several things to get teens to talk. "Remember they have their own culture," he says. "They may come in wearing frayed jeans and rings in their noses. That doesn't make them bad. They also have their own language, so be sure you understand what they're saying. Have them define any unfamiliar words. And kids need privacy," he continues. "If a teen doesn't want to talk with a parent in the room, don't force the issue. Most of all, be yourself," he says. "There's no need to act like a 40-year-old teenager."
A panel of adolescents follows. A 17-year-old female, afraid to tell her mother she was sexually active, went to a clinic to get the pill. "I lied and said I was 18," she recalls. She didn't go to a gynecologist for fear he would tell her mom. "You try to be independent at this age, but you can't," she says. "It's tough being a teenager."
The 16-year-old male next to her disagrees. "I think this is a great time," he says. "I got my license and I had sex for the first time, all this past year."
A female of 19 says she started having sex at 13. She went to a gynecologist after her first sexual encounter, but had a bad experience. The examination was painful, she explains, and the physician didn't tell her what to expect. He also berated her for having sex at such a young age. "I'll never, ever go to another gynecologist," she says.
The teens agree they would like physicians to help them understand their sexuality, even if they haven't had sex; not talk down to them; and understand their need to be independent.