Sexual shame can keep people from getting the health care they need. For example, a 2016 study found many women hide their use of health care services from family and friends to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).
While doctors should be considered crucial resources for those struggling with their sexual health, many find the questions asked during checkups to be intrusive. And sometimes doctors themselves are uncomfortable talking about sexual health. Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years.
Websites such as HealthTap, LiveHealth Online and JustDoc allow you to video chat with medical specialists. L and Nurk allow you to order contraceptives by phone. And there are a slew of STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.
Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. He didn’t want to talk to a doctor for fear of what he would learn. . But after three months of pain, a urologist friend convinced him to see a doctor. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis.
“It’s that first step that’s so hard,” Stacy says. “People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”
So Stacy set out to create that environment. With Biem, users can video chat with a doctor to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for testing, or Biem will send someone to the user’s house. The patient will eventually receive his results on his phone.
There’s excitement for tools like these. One study showed people ages 16 to 24 would get tested more often if the service was available. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”
But something can get lost when people avoid going to a doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools will end up being disempowering, especially for women.
“Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” which only increases the shame.
Those who have created these tools insist they’re not trying to replace the doctor-patient relationship but are trying to build upon and strengthen it.
“We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. (SmartJane) has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”