Driving through the streets of the capital over the last month, the eagle-eyed Beiruti may have spotted some striking billboards that cropped up around the city.
The posters, bearing phrases like “I’m not getting satisfaction when I ...” accompanied by an image of a patient covering their mouth in apparent embarrassment, seek to draw attention to a landmark program that approaches sexuality and sexual health in a radical new way.
Launched at the American University of Beirut’s Women’s Health Center on July 1 under the slogan “don’t silence sexual health,” the Women’s Integrated Sexual Health program is the first of its kind not only in Lebanon, but also in the wider Middle East region, its director Dr. Faysal El Kak said.
The program combines research, training, health care and outreach as a “truly integrated” program that “situates sexual health as part of wider health care,” he explained.
This reflects a shift in global medicine over the last few decades toward the idea that sexual health is an essential part of general health that cannot be sidelined.
Earlier this year, United Nations Secretary-General Antonio Guterres stressed that the U.N. recognizes “sexual and reproductive health as a fundamental human right.”
The idea of sexual health as a right is a key tenet of the WISH program, which Kak said “is important in a region that falls behind on that matter.”
The WISH program’s small team is made up of sexual health gynecologists, sexologists, oncologists, a psychiatrist, a psychologist and a urologist to provide a “comprehensive” service.
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Sandrine Atallah, one of the program’s sexologists, said WISH was unique because it provided “very specialized care ... on a hospital level,” as opposed to smaller sexual health clinics, which focus on primary care.
“A lot of diseases and health issues can affect sexuality, and a lot of people don’t realize they can actually address this,” she added.
For example, people living with or recovering from cancer who experience a detrimental effect on their sex lives can seek counseling and advice at WISH and be referred to an oncologist or sexologist like Atallah.
In addition to the billboards, AUBMC has advertised the WISH program through a series of posts on social media that use language not often seen by such prominent platforms in Lebanon, creating somewhat of a shock factor.
“Finally talking about sex and putting the word sex on billboards is very important and a great step,” Atallah said.
In one video, a middle-aged woman shares the message: “I don’t feel pleasure when I masturbate.” In another, a sheepish-looking young couple stands in front of the camera accompanied by the message “We don’t please each other during sex.”
Addressing issues of pleasure and sexual performance is central to the WISH program. Practitioners at the center have thus designed a questionnaire on clients’ sexual function, providing them with an opportunity to rate their levels of satisfaction, interest in sex or whether they experience any pain, among other factors. “We are providing a safe space to talk about sexuality and sexual health,” Kak said.
This safe space is designed to make people of all sexual orientations feel welcome and at ease when accessing sexual health care. It offers counseling for anyone struggling with their identity and can assist with the journey to gender reassignment surgery.
Sinine Nakhle, a former psychology instructor at AUB and now masters’ student in media and literature, set up an Instagram account called “beirutbydyke” in 2018 to share her experiences as a queer young woman in Lebanon. “I was never exposed to stories that were like mine,” she said when explaining why she decided to start the account.
When she heard about the WISH program, Nakhle decided to ask her almost 2,000 followers for their opinions on the campaign and experiences with accessing sexual health care in Lebanon, as she felt the program’s slogan, “don’t silence sexual health,” put the onus on patients to speak up, rather than doctors to make patients feel welcome.
The overarching theme of the responses to Nakhle’s Instagram poll was that doctors themselves were making opening up difficult, with many of her followers saying they were reluctant to seek sexual health care out of fear of being “outed” by a family doctor or feeling judged. “I have met a lot of doctors who are cringing before asking certain questions, or use metaphors ... it makes it very difficult when you’re seeking medical advice,” Nakhle said.
When designing the WISH program, Kak knew it was important to ensure all staff members at the AUBMC women’s center were equipped with the right knowledge and tools to provide a service that made patients feel at ease.
Over the last six months, staff have received several sessions on knowledge building and communication skills on how to use more inclusive and welcoming language.
“Some staff were a little uneasy in the beginning with the subjects tackled ... but after the [sessions] they felt more comfortable,” Kak said.
However, “it’s not a change that happens overnight.”
Nakhle agreed that medical professionals’ language when speaking with patients was paramount, as “language shapes perception.”
“That is where we want to doctors to get to - to be inclusive in the way that they talk.”
The AUB health center that houses WISH is expensive, with initial appointments setting clients back LL160,000 ($106) and follow-ups LL90,000, putting the program’s services out of reach for many people.
This is something that Kak said he recognized, adding that he was “working hard” to develop discount “packages” for certain services such as panel testing and online consultations.
In addition, as part of the program’s “outreach,” Kak said he was reaching out to NGOs and the Health Ministry to develop integrated sexual health programs and policies that would reach a wider public.
“We want to be a local and regional voice for sexuality and sexual health,” he said.
Nakhle commended the WISH program for setting an “amazing precedent.” “If someone like AUBMC is doing it, then you can be sure that the rest will follow.”
This article has been adapted from its original source.
