Teaching sexuality in Brazilian medical schools

To include training in sexual medicine into the curricula of medical schools is justified because of the association between sexuality and health, which is commonly part of the discussion of practice of the medicine. This association is observed by the importance given to sexuality in interpersonal relationships and quality of life, and, also by the prevalence of sexual dysfunctions in the population. In addition, high expectations exist regarding training in sexual health for physicians, including the assistance for vulnerable groups such as lesbian, gays, bisexuals, and transgender individuals. Despite this current scenario of demands and expectations, several barriers are pointed out for adequate assistance in sexual health. Such barriers have been discussed for long-time and they are related with discomfort of professionals because of patients' sexual complaints along with beliefs about normative heterosexuality that reinforces vulnerabilities. The lack of communication ability to collect sexual anamnesis and the unknown intersection between sexuality and health are also highlighted factors. In this context recommendations are reinforced concerning improvements needed for teaching sexuality in medical schools. The offering of sexual-related topics in the curricula of medical school remains a discussion worldwide in studies related with sexuality in the last 65 years. The positive impact of sexual subjects inclusion in the curriculum of medical education was showed by students who pointed out sexual education as a tool able to help them to better deal with their own sexuality, recognize sexual diversity of individuals and give more consideration to patients' sexual complaints. A consensus exist that sexuality must be offered in curricular model centered in the student and supported on the knowledge, attitudes and skills. Knowledge acquisition must cover biological, psychological and sociocultural aspects of sexuality. The topic " attitudes " is considered the most valuable one for the observation that students were unable to learn when facing discomfort situations. For this reason, to promote changes of attitude in situations that involve sexuality stimulate behavioral changes, improve the comfort of students with the subject their communication skills and, in addition, favor the absorption of knowledge. Skills acquisition prepares for assistance in sexual health. For this reason, communication skills that must be emphasized include