General Articles

How did you come to do what you do? Tell me a little about yourself. 

I think it would be safe to say I am not your traditional doctor or physician executive! While my career has enjoyed escalating roles and responsibilities at the state and national level, I have always kept room in my schedule and life for my favourite subject, sexual health. Throughout my career I have enjoyed teaching to lay and professional audiences on this topic – whether a church youth group, a college orientation, or a senior Bible Study – everyone can learn a little more about the trends and patterns in sexual health.

You believe in 'health for all', why are you determined to provide for everyone through your work? 

When I was in college discerning graduate education, I was torn between being a veterinarian or a physician. After a series of rotations in a local pediatric office, emergency room and hospital, and seeing how the lack of access to healthcare impacted people so dramatically, it became clear that I would be a family doctor and spend my career in service to the underserved. And I have done just that! From starting up migrant farm clinics to entire primary care networks for the uninsured population. Currently I am the medical leader for Medicaid in North Carolina, a programme that offers health insurance to 3 million low-income adults, children and pregnant women.

Your book focuses on sex after your 50s, why is this something you want to spread the message about? 

Realistically, most of the 50+ population has either never had Sex Education or the last time they had it was decades ago. A lot has changed in the sexual health world in that time! In fact, every year there are changes that doctors have to scramble to keep up with. In my clinic I have observed a major shift of who walks into the clinic. In the early 2000's it was teens and college-aged young adults. Today, there are as many people over 50 as under 30.

Have you seen attitudes towards sex and STIs change throughout your career? How? 

So much has changed in the world of sex over the decades! From gender fluidity to sexual preferences and attitudes towards our bodies and intimacy, people seem to be having more (and better) sex than ever before. But, there are also the highest rates of sexually transmitted infections in our nation's history. On top of that, we are seeing incredibly scary patterns of antibiotic resistance in these infections for the first time ever.  Technology has also made an undeniable impact on the sexual networks and the easy accessibility of partners comes at the cost of higher chances of infections.

What are some of the key misconceptions surrounding STIs? Can you bust them? 

"They won't kill you." Actually, they will. Several circulating sexually transmitted infections are life-threatening or life-limiting. 

"It means you're dirty." Nope. It means you had (hopefully) an intimate encounter with the inevitable transfer of body fluids and there was a virus or bacteria hiding out in there. We have to get rid of the shame associated with genital infections. 

"If I don't have actual sex, I'm safe." Well... if there is genital contact with oral fluids or other mucosa(anal sex) you absolutely can get infections. In all the parts. We are seeing a surge of "extragential" infections(throats, anus) in men and women alike and our screening for infections is constantly developing and expanding.

Lots of people feel too embarrassed to address sexual health issues they might be having. What is your advice for this? 

Talk about it. Out loud. Start with your mirror. Move to your dog. Advance to a good friend. Role-playing and practising saying the words out loud is a key tenet when I train young doctors on sexual history taking and it works for everyone. You can also write down your questions before a doctor's appointment to remind you to ask them. The most important thing of all is don't let your doctor skip over your sexual health. It's too important for you, and all your future partners!

Why is looking after your sexual health so important for the rest of your health?

Healthy and satisfying intimacy has great benefits. Our brains get a release of healthy neurotransmitters and it is a sign of overall health and vigor for many. And with the advances in pharmaceutical and medical interventions, people can have sex for longer than ever before. Sure, some changes mean you might not enjoy the same positions of your youth, but that's for you to decide. Maybe you are not thinking you will be sexually active again, but the odds are a good friend or a sibling or neighbour are, so why not arm yourself with the knowledge to help them out even if you think that chapter may be closed for you? And, spoiler alert. Many older adults who think they are "done" discover (rather beautifully) that they are not! 

You can also catch Shannon rapping on YouTube here