Professional Perspectives on Asking Patients About Unmentioned Sexual Health Concerns & Violence: The Adult Version of the SEXual Health Identification Tool (SEXIT).
Gainza Solenzal A, Elmerstig E, et al. • Journal of sex & marital therapy • 2025
Using a Delphi methodology with 19 expert panelists, this study identified 25 highly relevant questions covering diverse sexual health areas that professionals believe healthcare providers should ask adult patients, which have been incorporated into the development of the SEXIT Adult questionnaire.
Key Findings
Background
Few patients disclose sexual health problems to healthcare providers due to shame and fear, while providers face barriers including time constraints, lack of knowledge, and fear of embarrassing patients.
Sexual health concerns, experiences of violence, and risk-taking behaviors significantly impact various aspects of life and lead to adverse health outcomes.
Healthcare providers (HCPs) recognize the importance of addressing sexual and reproductive health related issues but are hindered from thorough investigation.
Barriers on the provider side include time constraints, lack of knowledge, and fear of embarrassing patients.
Background
The SEXIT (SEXual health Identification Tool) was originally developed for youths aged 13-24 to facilitate conversations about sexual health, violence, and risk-taking behaviors with HCPs, but no comparable method existed for adults prior to this study.
SEXIT was designed to initiate conversations about sexual health, experiences of violence, and risk-taking behaviors.
The original tool targets youths aged 13-24.
This study was conducted to address the gap in tools for the adult population.
Methods
A Delphi methodology was used with 19 academic and/or clinical experts participating in two online questionnaire rounds and a web meeting.
The panel consisted of 19 experts with academic and/or clinical backgrounds.
The process included two online questionnaire rounds.
A web meeting was also held as part of the Delphi process.
The study aimed to explore which questions professionals believe HCPs should ask adult patients.
Results
The expert panel identified 25 highly relevant questions for assessing adult sexual health in clinical settings.
The 25 questions cover diverse areas including sexual and gender identity, sexual satisfaction, experiences of violence, and substance use.
The questions were identified through consensus among the 19-member expert panel.
These questions are intended to empower adult patients to disclose sexual health concerns.
The identified questions enable HCPs to comprehensively address sexual health issues during medical history assessments.
Results
The 25 identified questions have been incorporated into the development of the SEXIT Adult questionnaire.
The SEXIT Adult questionnaire is intended as a tool for use with adult patients.
The questions are designed to facilitate conversations between adult patients and healthcare providers.
The tool aims to help patients disclose sexual health concerns they might not otherwise raise spontaneously.
What This Means
This research suggests that many adults do not tell their doctors or other healthcare providers about sexual health concerns, experiences of violence, or risky behaviors, often because of shame or fear. At the same time, healthcare providers want to ask about these issues but frequently hold back due to time pressure, not knowing how to approach the topic, or worry about making patients uncomfortable. To address this gap, researchers worked with a group of 19 clinical and academic experts to identify the most important questions that healthcare providers should ask adult patients about their sexual health.
Using a structured process called the Delphi method — which involves multiple rounds of expert input and discussion to reach consensus — the panel agreed on 25 key questions. These questions cover a wide range of topics including sexual and gender identity, sexual satisfaction, experiences of violence, and substance use. The findings were then used to develop a new screening tool called the SEXIT Adult questionnaire, extending an existing tool previously used only with young people aged 13-24.
This research suggests that having a standardized set of questions could make it easier and less awkward for healthcare providers to routinely ask adults about sensitive sexual health topics. By giving patients a structured opportunity to disclose concerns they might not otherwise bring up, such a tool could help healthcare providers offer more complete and appropriate care. The development of the SEXIT Adult questionnaire represents a step toward making sexual health conversations a more normal part of routine medical care for adults.
Gainza Solenzal A, Elmerstig E, Bjerså K, Weineland S, Hammarström S. (2025). Professional Perspectives on Asking Patients About Unmentioned Sexual Health Concerns & Violence: The Adult Version of the SEXual Health Identification Tool (SEXIT).. Journal of sex & marital therapy. https://doi.org/10.1080/0092623X.2025.2564706