Recently I had the chance to catch up with MSNBC’s resident medical doctor and sex therapist, Dr Michelle Moore. We discussed the connection between the U.S. presidential election and the state of American’s sexual health, the importance of a good doctor-patient relationship, and the evolving role of the #metoo movement.
The State of Sexual Health In America
To start off, let’s discuss the status of American’s sexual health. In the 2016 election, President Trump made reviving the American economy a key part of his campaign. One of the many promises he made was to improve the lot of the country’s least fortunate citizens and provide them with better healthcare. Well, Trump’s election has indeed brought about some positive changes, particularly in the area of sexual health. For example, under the Affordable Care Act, or Obamacare, insurance companies are prohibited from discriminating against medical conditions that interfere with a patient’s ability to engage in sexual activity. This could include mental health conditions or erectile dysfunction (ED), for which Viagra and other ED medications are prescriptions. Additionally, under the ACA, insurance companies must provide coverage for preventative healthcare, including pregnancy tests and STD checks.
This is a far cry from the sexual health care available to Americans under previous administrations. In 1965, Medicare and Medicaid introduced sexual health screening and treatment to American hospitals for the first time. Prior to this, hospitals didn’t have to provide for these matters, as patients were expected to fund their own care. After this time, the number of Americans without healthcare increased. Coercive sterilization programs were also implemented to control the population of the “undesirables”. This period of time is referred to as the “sexual revolution” and was led by doctors and other healthcare providers, who were at the forefront of sexual health care in America.
Drs and Patients
So, as mentioned above, under Obamacare and the Medicaid expansion, insurance companies must provide coverage for preventative healthcare. This includes HIV testing, syphilis testing, and, for women, domestic violence testing and treatment. While Obamacare has certainly brought about many beneficial changes for Americans, it has also created a new category of people: patients. Because the ACA mandates that insurance companies cover preventative healthcare, those who qualify for Medicaid are considered patients. For example, under the ACA, patients cannot be denied care due to the lack of a permanent address. This has created a major population of the uninsured, as over 20 million people have recently gained Medicaid or ACA-related coverage. (This figure does not include those who gained coverage under the Children’s Health Insurance Program, which is a joint initiative of the federal government and states that provides coverage for children from low-income families. This figure does not take into account those who have obtained coverage through private health insurance plans that also cover pre-existing conditions.)
The Growing Role Of The #MeToo Movement
The #MeToo movement began on October 15, 2017, when British actress and comedian Emma Watson tweeted, “All women must stand up for themselves,” in response to the Harvey Weinstein scandal. In less than a week, the hashtag went viral and continues to be used today to highlight instances of sexual harassment and assault. Since then, people from all walks of life have used the hashtag to share their stories of harassment and assault.
One of the most significant developments since the #MeToo movement began is the growing number of female politicians around the world. Between 2017 and 2018, the number of female deputies in the parliaments of the G7 countries (France, Great Britain, Canada, Italy, Germany, Japan, and the United States) increased by 26%. Canada now has its first female Prime Minister, and the youngest ever U.S. Congresswoman was just inaugurated, adding their voices to the growing number of women demanding change.
The Impact Of The #MeToo Movement On Sexual Health Care
The most significant impact of the #MeToo movement on sexual health care has been the increased number of women approaching physicians and therapists with concerns about their sexual health. Some of these women might be experiencing conditions that they’re not used to discussing with their doctors, such as low libido or difficulty getting aroused. They’re also worried about the effects that the #MeToo movement might have on them professionally. (For a graphic explaining how the #MeToo movement might affect your career, check out this informative guide by the Canadian Psychological Association.)
This increased demand for healthcare has led to new challenges for physicians and therapists. One of the most significant is being able to provide quality care to patients while still adhering to professional guidelines and treating everyone with respect. Further complicating matters is the growing proportion of women in senior academic and administrative positions in healthcare. (Indeed, the proportion of doctors in senior academic and administrative positions increased by 13% between 2015 and 2018, while the proportion of nurses in those same positions increased by 26%.)
The Presidential Election: What Does It Mean For Sexual Health?
The U.S. presidential election has always had a significant impact on the wellbeing of American citizens. However, in the current climate, with the specter of a pandemic looming and a new administration in place, the impact could be far-reaching. (For historical reference, in the years prior to the founding of the American Republic, there were between 22 and 24 million Americans living in poverty. In the years since, the country has seen an incredible economic boom, but also a rise in inequality.)
It is impossible to know how the next four years will affect the healthcare system. However, if history is any guide, patients will need to be vigilantly vigilant to ensure that their needs are being met. One thing is for sure: we can expect a new approach to healthcare under the Trump administration, and that, in turn, will undoubtedly affect the way we approach sexual health.