Skip to main content
Log in

Alternative Sexualities: Implications for the Urologist

  • Men's Health (R Carrion and C Yang, Section Editors)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Urologists routinely deal with sensitive issues of urinary function as well as sexuality in daily practice. Even experienced urologists may encounter patients who engage in sexual practices that are novel, unknown, or perhaps disturbing to the provider. This primer will serve as an introduction to sexual practices and lifestyle choices that may be foreign to many practicing urologists. It is by no means an exhaustive description of alternative sexualities, but will hopefully serve as a useful introduction to the topic and will enhance the ability of providers to care for, or appropriately refer, patients whose sexual practices and lifestyles may differ from their own.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Xu F, Sternberg MR, Markowitz LE. Women who have sex with women in the United States: prevalence, sexual behavior and prevalence of herpes simplex virus type 2 infection-results from national health and nutrition examination survey 2001–2006. Sex Transm Dis. 2010;37(7):407–13.

    PubMed  Google Scholar 

  2. Pathela P, Hajat A, Schillinger J, Blank S, Sell R, Mostashari F. Discordance between sexual behavior and self-reported sexual identity: a population-based survey of New York city men. Ann Intern Med. 2006;145(6):416–25.

    Article  PubMed  Google Scholar 

  3. Richters J, de Visser RO, Rissel CE, Grulich AE, Smith AM. Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): data from a national survey. J Sex Med. 2008;5(7):1660–8. This-population based manuscript examines the demographic and psychological profile of BDSM practitioners. It was determined that there were no substantial differences in psychological profiles between BDSM practitioners and non-practitioners.

    Article  PubMed  Google Scholar 

  4. Barker M, Langdridge D. Whatever happened to non-monogamies? Critical reflections on recent research and theory. Sexualities. 2010;6:748.

    Article  Google Scholar 

  5. Makadon HJ. Ending LGBT invisibility in health care: the first step in ensuring equitable care. Cleve Clin J Med. 2011;78(4):220–4.

    Article  PubMed  Google Scholar 

  6. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding [Internet]. 2011. Available from: http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx. Accessed 21 Oct 2013. This Institute of Medicine Report catalogs disparities in health care experienced by members of LGBT communities and addresses key priorities in improving health outcomes for LGBT persons.

  7. Healthy people. Lesbian, gay, bisexual, and transgender health [Internet]. 2020. Available from: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25. Accessed 21 Oct 2013.

  8. Liu RT, Mustanski B. Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth. Am J Prev Med. 2012;42(3):221–8.

    Article  PubMed  Google Scholar 

  9. Skegg K. Self-harm. Lancet. 2005;366(9495):1471–83.

    Article  PubMed  Google Scholar 

  10. Diagnostic and statistical manual of mental disorders (DSM) [Internet].; 2013. Available from: http://www.dsm5.org/about/Pages/DSMVOverview.aspx. Accessed 21 Oct 2013.

  11. Wismeijer AA, van Assen MA. Psychological characteristics of BDSM practitioners. J Sex Med. 2013;10(8):1943–52.

    Article  PubMed  Google Scholar 

  12. What psychology professionals should know about polyamory. [Internet]. Available from: http://ego.thechicagoschool.edu/s/843/images/editor_documents/What%20therapists%20should%20know%20about%20Polyamory.pdf. Accessed 21 Oct 2013.

  13. Meystre-Agustoni G, Jeannin A, de Heller K, Pecoud A, Bodenmann P, Dubois-Arber F. Talking about sexuality with the physician: are patients receiving what they wish? Swiss Med Wkly. 2011;141:w13178.

    PubMed  Google Scholar 

  14. Klitzman RL, Greenberg JD. Patterns of communication between gay and lesbian patients and their health care providers. J Homosex. 2002;42(4):65–75.

    Article  PubMed  Google Scholar 

  15. Durso LE, Meyer IH. Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sex Res Soc Policy. 2013;10(1):35–42.

    Article  Google Scholar 

  16. Ahlers CJ, Schaefer GA, Mundt IA, Roll S, Englert H, Willich SN, et al. How unusual are the contents of paraphilias? Paraphilia-associated sexual arousal patterns in a community-based sample of men. J Sex Med. 2011;8(5):1362–70.

    Article  PubMed  Google Scholar 

  17. Wentworth K, Ando K, Mark S, Vade D. Sexual history interview questions. In press 2012.

  18. Moser C. Health care without shame: a handbook for the sexually diverse and their caregivers. San Francisco: Greenery Press; 1999.

    Google Scholar 

  19. Mindel A, Sawleshwarkar S. Condoms for sexually transmissible infection prevention: politics versus science. Sex Health. 2008;5(1):1–8.

    Article  PubMed  Google Scholar 

  20. Bennett SE, Assefi NP. School-based teenage pregnancy prevention programs: a systematic review of randomized controlled trials. J Adolesc Health. 2005;36(1):72–81.

    Article  PubMed  Google Scholar 

  21. Dewaele A, Van Houtte M, Cox N, Vincke J. From coming out to visibility management–a new perspective on coping with minority stressors in LGB youth in flanders. J Homosex. 2013;60(5):685–710.

    Article  PubMed  Google Scholar 

  22. Buffie WC. Public health implications of same-sex marriage. Am J Public Health. 2011;101(6):986–90.

    Article  PubMed Central  PubMed  Google Scholar 

  23. LGBT terms and definitions [Internet]. Available from: http://internationalspectrum.umich.edu/life/definitions. Accessed 21 Oct 2013.

  24. Diamant AL, Wold C, Spritzer K, Gelberg L. Health behaviors, health status, and access to and use of health care: a population-based study of lesbian, bisexual, and heterosexual women. Arch Fam Med. 2000;9(10):1043–51.

    Article  CAS  PubMed  Google Scholar 

  25. James P. National policy and sexual health of men who have sex with men. Br J Nurs. 2009;18(3):181–7.

    PubMed  Google Scholar 

  26. Sandfort TG, de Keizer M. Sexual problems in gay men: an overview of empirical research. Annu Rev Sex Res. 2001;12:93–120.

    CAS  PubMed  Google Scholar 

  27. Mail P, Safford L. LGBT disease prevention and health promotion: Wellness for gay, lesbian, bisexual, and transgender individuals and communities. Clin Res Regul Aff. 2003;20(2):183.

    Article  Google Scholar 

  28. Urban RR, Teng NN, Kapp DS. Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance. Am J Obstet Gynecol. 2011;204(5):e9–e12.

    Article  PubMed  Google Scholar 

  29. Lee PA, Houk CP, Ahmed SF, Hughes IA. International consensus conference on intersex organized by the Lawson Wilkins pediatric endocrine society and the European society for paediatric endocrinology. Consensus statement on management of intersex disorders. International consensus conference on intersex. Pediatrics. 2006;118(2):e488–500.

    Article  PubMed  Google Scholar 

  30. Moser C, Levitt E. An explanatory–descriptive study of a sadomasochistically oriented sample. J Sex Res. 1987;23:322–37.

    Article  Google Scholar 

  31. Moser C, Kleinplatz PJ. Introduction: the state of our knowledge on SM. J Homosex. 2006;50(2–3):1–15.

    Article  PubMed  Google Scholar 

  32. Taylor G, Ussher J. Making sense of S&M: a discourse analytic account. Sexualities. 2002;4:293–314.

    Article  Google Scholar 

  33. Sandnabba K, Santtila P, Alison L, Nordling N. Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: a review of recent research. Sex Relationsh Ther. 2002;17(1):39–55.

    Article  Google Scholar 

  34. Kinsey A, Pomeroy W, Martin C. Sexual behavior in the human male. Philadelphia: Saunders; 1948.

    Google Scholar 

  35. Janssen W, Koops E, Anders S, Kuhn S, Puschel K. Forensic aspects of 40 accidental autoerotic deaths in northern germany. Forensic Sci Int. 2005;147(Suppl):S61–4.

    Article  PubMed  Google Scholar 

  36. Sauvageau A. Autoerotic deaths: a 25-year retrospective epidemiological study. Am J Forensic Med Pathol. 2012;33(2):143–6.

    Article  PubMed  Google Scholar 

  37. Garza-Leal JA, Landron FJ. Autoerotic asphyxial death initially misinterpreted as suicide and a review of the literature. J Forensic Sci. 1991;36(6):1753–9.

    CAS  PubMed  Google Scholar 

  38. Hazelwood R, Dietz P, Burgess A. Autoerotic fatalities. Massachusetts: Lexington Books; 1983.

    Google Scholar 

  39. Ando K. Attitudes and behaviors concerning erotic breath control. 2009.

  40. Bergelson V. The right to be hurt: testing the boundaries of consent. George Wash Law Rev. 2007;75(2):165–236.

    Google Scholar 

  41. Pa M. Beyond the pleasure principle: the criminalization of consensual sadomasochistic sex. Tex J Women Law. 2002;11:51–92.

    Google Scholar 

  42. Wright S. Discrimination of SM-identified individuals. J Homosex. 2006;50(2–3):217–31.

    Article  PubMed  Google Scholar 

  43. Norris AE, Ford K. Sexual experiences and condom use of heterosexual, low-income African American and Hispanic youth practicing relative monogamy, serial monogamy, and nonmonogamy. Sex Transm Dis. 1999;26(1):17–25.

    Article  CAS  PubMed  Google Scholar 

  44. Jokela M, Rotkirch A, Rickard I, Pettay J, Lummaa V. Serial monogamy increases reproductive success in men but not in women. Behav Ecol. 2010;21:906–12.

    Article  Google Scholar 

  45. Laumann EO, Gagnon JH, Michael RT, Michaels S. The social organization of sexuality: sexual practices in the United States. Chicago: University of Chicago Press; 2000.

    Google Scholar 

  46. Atkins DC, Baucom DH, Jacobson NS. Understanding infidelity: correlates in a national random sample. J Fam Psychol. 2001;15(4):735–49.

    Article  CAS  PubMed  Google Scholar 

  47. Easton D, Liszt C. The ethical slut: A guide to infinite sexual possibilities. Greenery Press; 1997. One of the preeminent sources of information on healthy cultivation of non-mongamous relationships.

  48. Lehmiller JJ. Secret romantic relationships: consequences for personal and relational well-being. Pers Soc Psychol Bull. 2009;35(11):1452–66.

    Article  PubMed  Google Scholar 

  49. Conley TD, Moors AC, Ziegler A, Karathanasis C. Unfaithful individuals are less likely to practice safer sex than openly nonmonogamous individuals. J Sex Med. 2012;9(6):1559–65.

    Article  PubMed  Google Scholar 

Resources for further reading

  1. Association of Reproductive Health Professionals (ARHP). 2010. Sexual Health Fundamentals for Patient Care Initiative: Report of a US Consensus Process. Available at: http://www.arhp.org/uploadDocs/RH10_Dominguez2.pdf.

  2. Dibble R, Robertson P. Lesbian health 101: a clinician’s guide. San Francisco: UCSF Nursing Press; 2010.

    Google Scholar 

  3. Easton D, Hardy J. The ethical slut: a roadmap for relationship pioneers. Berkeley: Celestial Arts; 2009.

    Google Scholar 

  4. Easton D, Hardy J. When someone you love is kinky. Emeryville: Greenery Press; 2000.

    Google Scholar 

  5. Eliason MJ, Dibble S, DeJoseph J, Chinn P. LGBTQ Cultures: what health care professionals need to know about sexual and gender diversity. 2009.

  6. Family Acceptance Project: http://familyproject.sfsu.edu/.

  7. Gay & Lesbian Medical Association: http://www.glma.org/.

  8. Human Rights Campaign: http://www.hrc.org/.

  9. Parents, Families and Friends of Lesbians and Gays: http://community.pflag.org/.

  10. Taormino T. Opening up: a guide to creating and sustaining open relationships. San Francisco: Cleis Press; 2008.

    Google Scholar 

  11. World Professional Association for Transgender health: http://www.wpath.org/.

  12. Youth Resource (website by and for LGBT youth): http://youthresource.com/.

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Kathryn Akemi Ando and Dr. Tami Serene Rowen each declare no potential conflict of interest relevant to this article.

Dr. Alan W. Shindel is a board member for SF Center for Sex and Culture, International Society for Sexual Medicine, and Sexual Medicine Society of North America. Dr. Shindel is a consultant for American Medical Systems, Cerner, and groupH. Dr. Shindel received a grant from UC Davis Loss Prevention Program and honoraria from International Society for Sexual Medicine, International Society for the Study of Women’s Sexual Health, Endo, and Elsevier. Dr. Shindel has had travel/accommodations expenses covered or reimbursed by International Society for Sexual Medicine.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alan W. Shindel.

Additional information

This article is part of the Topical Collection on Men’s Health

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ando, K.A., Rowen, T.S. & Shindel, A.W. Alternative Sexualities: Implications for the Urologist. Curr Urol Rep 15, 405 (2014). https://doi.org/10.1007/s11934-014-0405-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-014-0405-6

Keywords

Navigation