CME | From Awkward to Affirming: Mastering the Sexual History

In this episode of CME On the Go, our hosts discuss how family physicians can take a comprehensive, sensitive sexual history. They highlight common discomfort and bias in asking "Are you sexually active?" and emphasize using respectful, gender-inclusive language, humility, trauma-informed care and clear medical purpose to avoid voyeurism, with supportive EHR documentation when possible. They review terminology around sex, gender and sexuality and outline the CDC "Five Ps" framework—partners, practices, protection from STIs, past history of STIs and pregnancy intention—adding two additional Ps: permission and primary sexual and gender identity. They suggest open-ended questions, assess STI risk and prevention, address sexual function and trauma and revisit the sexual history during major life transitions.

Learning Objectives

1. Recognize the clinical and relational consequences of poorly conducted sexual histories, including the role of implicit bias and documentation challenges in EMRs and patient portals.

1. Differentiate between sex, gender, and sexual identity to enhance inclusive, respectful communication during sexual history taking.

1. Demonstrate strategies to reduce personal discomfort and foster a safe, affirming environment for patients during sensitive conversations.

The AAFP has reviewed From Awkward to Affirming: Mastering the Sexual History and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 05/18/2026 to 6/4/2027. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this Enduring Materials for a maximum of 0.50 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME activities approved for AAFP credit are recognized by the AOA as equivalent to AOA Category 2 credit.

After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link.

https://www.aafp.org/assessment/take/19939/e

References and Resources

Yale Reflections – Gender Glossary
A clear, accessible glossary of terms related to sex, gender and sexual orientation.

https://reflections.yale.edu/article/sex-gender-power-reckoning/gender-glossary

CDC – Taking a Sexual History
CDC guidance on taking an inclusive, patient-centered sexual history in clinical care.

https://www.cdc.gov/sti/hcp/clinical-guidance/taking-a-sexual-history.html

American Family Physician – Sexual Health History: Techniques and Tips
Evidence-based strategies for comprehensive, affirming sexual health histories in primary care.

https://www.aafp.org/pubs/afp/issues/2020/0301/p286.html#afp20200301p286-b3

Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.  All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. 

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