Many sexual issues that are not addressed in primary health care by doctors and professionals in the field can become problems that are dragged into secondary and tertiary care, requiring more specialized intervention. To encourage this discussion, the 12st International Multidisciplinary Congress on Sexualities (Cimsex): Education, Inclusion and Transformation will be held, an event that begins this Wednesday (14) and continues until Friday (300), on the premises of the Faculty of Medical Sciences (FCM). The congress will address the emotional and psychological aspects of sexuality, sexual education, clinical and legal aspects related to gender identity, homophobia and legislation. Around XNUMX participants are expected. To discuss comprehensive care, the extension coordinator of the Faculty of Medical Sciences (FCM) and one of the event organizers, Rodolfo Pacagnella, gave an interview to Unicamp website. The professor says that the idea, when discussing the topic, is not to look for consensus but rather dissent. “We want to learn about multidisciplinarity and multiple perspectives, promoting the view that sexuality is not unique. It is multiple and, therefore, the international congress is multidisciplinary on sexuality(s)”, highlights the doctor from the Hospital da Mulher - Caism. see the programming of the event, which is organized together with the Institutto Paulista de Sexualidade (Ipasex) and the Latin American Association of Sexual Therapy and Couples. Follow the interview below.
Unicamp Portal - Do people have the culture of informing themselves about their sexuality?
Rodolfo - Usually yes. They seek to find out about different aspects. Sexuality is everything that involves interpretations of our body, from the understanding of bodily changes in childhood and adolescence, relationships of pleasure with the body, relationships of differences between men and women, gender roles, relationships hierarchical gender roles. All of this is sexuality and should be very present in medical consultations, in any specialty. So, people need to understand that sexuality is part of human behavior. It is an important response to the organization of human beings in society. It is also essential to offer quality medical care that meets the needs of each patient.
Unicamp Portal - What is ideal for this type of service?
Rodolfo - When we propose to offer comprehensive medical care and support, it is necessary to consider the approach to aspects of sexuality within the medical consultation, from childhood, with the discovery of the body, through gender relations, the discovery of one's own sexuality and perception of the body, and by the presence of the other. This permeates comprehensive health care for the individual and is one of the foundations of medical care. It is essential to be able to offer a comprehensive look at people and offer assistance for their needs.
Unicamp Portal - How is sexuality addressed in primary care?
Rodolfo - What happens is that issues related to sexuality are often relegated to the background. Despite its importance, the topic is little discussed, and questions are rarely accepted during the consultation. Many people seek medical care citing other reasons, mentioning chronic pain or another situation when, in fact, they want to know more about their sexuality. This is rarely recognized as a medical issue and ends up being disqualified even by the professional himself, who does not even inquire about the matter. Sexuality is part of our way of living in society and we have to recognize that people have doubts and concerns. We must embrace these issues, preventing them from becoming a problem, dysfunction or pathology. Health education is part of the medical consultation, the clinical consultation. So when it is said that there is a need to take care of sexuality in medical care, it is because we have an inverted pyramid in our care model, that is, most people who demand complaints related to sexuality have simple complaints that could be resolved with just guidance. or with reception. The office is the appropriate place to address these issues, even if it is only for people to have an opportunity to express their anxieties. Certainly, this initiative would help to find different paths. In particular, we believe that a much smaller number of people need to undergo specific therapy. So, if it is possible to offer this reception to people who need it, giving “permission” to talk about it, providing specific information about physiology and sexual response, these demands can be resolved in primary care.
Unicamp Portal - What is missing, in your opinion, for the topic to gain the relevance it deserves?
Rodolfo - In this case, people think they need many tools to work in assistance. Doctors believe they need to take courses to be able to talk about sexuality. But in reality, what is necessary is to welcome the person, respect their doubts and offer information, giving them permission to look, touch each other and feel pleasure, as this is not a problem. We see then that this strategy can be sufficient to resolve a large number of sexual complaints.
Unicamp Portal - How to address gender issues?
Rodolfo - In clinical care, if we don't ask whether the person is sexually interested in men, women or both, we will never know. The person would even like to talk about this subject, but they don't. So offering a look at diversity, to show that human behavior is very diverse in relation to sexual response, helps to value these aspects so that health professionals can also seek more knowledge about them.
Unicamp Portal - Can an unanswered question constitute a problem?
Rodolfo - A sexual complaint, which can be a doubt about one's own body, if not taken care of, can turn into sexual dysfunction. A woman complaining that she does not enjoy sexual relations may have other problems, which add to this, leading to dysfunction in the personal and marital relationship. They may reach a situation where they are unable to have sexual relations. If we pay attention to what she complains about at that first moment, it is possible that this situation will not constitute a problem in the future.
Unicamp Portal - Can problems be intensified if not taken care of?
Rodolfo - When primary care cannot be qualified for this type of care, more and more cases with these problems arrive. Therefore, it is essential that we are in communication with other levels of care in the public network so that we can qualify assistance, offering truly comprehensive care. Before this becomes a problem at the end (in primary care), it is there, theoretically, that something has to be done. And we are in this together. An initiative that takes place in parallel with primary care is that Caism at Unicamp is already studying the resumption of operation of the Sexology Outpatient Clinic. We will take care of sexual issues that have become unresolved sexual problems in the basic network. This first congress marks the beginning of our outpatient activities, which should begin with services soon. Additionally, we are conducting some research into sexual health. We had, for example, a recent evaluation of one of the aspects of women's sexual response in the postpartum period and now we will seek to find out whether medical students are having contact with this topic in their academic lives, to enable them to provide comprehensive care. We want to know what students' attitude and knowledge are regarding sexuality and the response to complaints about sexuality that occur during medical consultations. The idea is to know what the gaps are so that they can act to provide the expected service.
