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Redefining Gender Attitudes with Kerrin Bradfield

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Redefining Gender Attitudes with Kerrin Bradfield

How is biological sex different from gender, and how is that different from sexual orientation? 

In this episode, we are joined by Sexologist Kerrin Bradfield to guide us through the nuances, terminologies and considerations to be mindful of when we approach gender in a clinical context. 

Kerrin helps to bust some of the myths surrounding gender, sexual orientation and identity, and explores various issues that face persons who identify as LGBTQIA.

Covered in this episode

[00:41] Welcoming Kerrin Bradfield
[03:13] The mind/body/sexuality connection
[05:17] Gender vs sexual orientation
[09:30] Gender norms in different societies
[13:14] Best practices for practitioners 
[15:56] Issues facing persons who are trans
[18:45] Role of the practitioner
[20:25] Myths surrounding gender issues
[24:05] Resources for practitioners
[25:38] Sexuality and sexual orientation
[28:55] Gender identity over a lifetime
[30:22] The purpose of sex
[31:22] Final thoughts about clinicians can support their clients


Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Joining us on the line today is Kerrin Bradfield. Kerrin is experienced and qualified sexologist who studies the science of human sexuality. Having completed a Bachelor of Arts in psychology, a postgraduate diploma in public health with a focus on sexual health promotion and most recently a master's in sexology, she’s been able to bring together her years of experience with a solid theoretical foundation with specialist training in sexual education, psychosexual therapy and counselling. 

Kerrin is committed to providing a sex positive, confidential, and inclusive service that fosters openness around sexuality. She's worked both in Australia and internationally as a sexuality and media specialist, designing and implementing projects and counselling for a diverse range of audiences from community groups to United Nations staff. 

Kerrin currently works in private practice at Gold Coast Sexology as well as in several other roles as a sexuality educator and health promotion officer. She's also the current president of the Queensland branch of the Society of Australian Sexologists. Warmly welcome you to FX Medicine. Kerrin, how are you?

Kerrin: I'm good. Thanks Andrew.

Andrew: Now we're going to be talking about the big elephant in the room today and that's gender issues in clinic. Something that I never even contemplated, but I think it's really important that we cover this. So, I think first off, let's talk a little bit about your history. You did psychology. Why?

Kerrin: I think I have always been fascinated by people. I guess… A lot of people say that they are people watchers. And for me that was quite an important aspect that I really wanted to delve into more, and that's really where my studies started.

Andrew: Okay. But then sexual health promotion. So what was it that really intrigued you from the psychological perspective to delve further into the sexual aspects of people?

Kerrin: So really it started with the idea that we just don't talk about our sexuality. And part of my early life, I guess, was working as a dancer and for that expression and freedom of body and movement, for me, was always really important. And I saw how that didn't necessarily translate over into people's intimate lives and became really fascinated by that. And wanted to learn more, and wanted to understand why that was from the psychological perspective that I had already gained.

Andrew: So did you see a vast difference between that mind/body perspective?

Kerrin: Yes, definitely. I think increasingly people are living in their heads or living in these technological devices and they don't spend a lot of time connecting with the mind and the body in a holistic sense. Of late I guess, there's been a real push around mindfulness and just trying to get people to be in that here and now, present in their skin, and really connecting. 

And that's compounded around sexuality because we don't even necessarily use the right words for those body parts. We don't talk about those parts of our bodies. We refer to them in very abstract concepts around “down there” or “that bit.” So it becomes increasingly difficult then, for people to identify where they may be experiencing pain if they're unable to say words like vulva and penis. And for me, that all ties together around that connection between movement and mind.

Andrew: So it's a real historical discomfort with these taboo areas of the body, isn't it? You know? So, you know, parents will talk to their children and they won't say “penis,” they'll say “down there” or “private parts,” or you know, that sort of thing. And I guess part of that is protection, maybe? But it also shows this historical discomfort with our sex, with our gender.

Kerrin: Yes, absolutely. And interestingly, it's a fairly recent discomfort. So, when we go back a long way in human history, there was quite a lot more liberation and less shame and taboo around certain aspects of the human body and around sexuality. 

And to really highlight that, if we talk about the female clitoris was actually quite well understood and known in medical texts, until the Victorian era where they deleted it out of "Grey's Anatomy…” 

Andrew: What?

Kerrin: …and just decided that it didn't need to be in there. And it's only just starting to make a comeback now.

Andrew: You're kidding.

Kerrin: Yeah, I know, right? It's shocking. Yeah, they just deleted it, like ripped the pages out. Pretended it didn't exist.

Andrew: I tell you, this is sort of Caucasian Elizabethan-Victorian sort of era. Talk about suppression.

Kerrin: Yeah. Yeah. A lot of it comes from that. A lot of that shame and guilt and...

Andrew: So look, hopefully things are going to be improving now, but I think let's first off start with some gender issues versus sexual orientation. You know, we've got male/female, but there's more to it than that, right?

Kerrin: Yeah, definitely. So I guess the first important definition is really around the word "sexuality" itself, which we've already said quite a lot in today's podcast. Anna Freud wrote once that sex is what we do and sexuality is who we are. 

So sexuality is a whole lot of aspects of the human which relates to biological sex. It's the physical act of having sex. It's gender. It's orientation. It’s our thoughts. It's our feelings. It's really everything that makes us who we are. And we're able to express that in lots of different ways. 

So sex is, when we use the word "sex" to not refer to sexual activity, it's really around our biological differentiation of male-female. So there are variants to that binary, things like intersex or chromosomal conditions like Klinefelter’s. 

But really for the most part it's an XX or XY chromosomal pairing, and it's penis or vagina. So biological sex is very different from gender and that in turn is very different from sexual orientation.

Andrew: Okay. So now this is where I'm getting confused because I thought gender was that binary, but it's not so.

Kerrin: No. So gender really relates to several concepts which highlight an interaction between nature and nurture. Gender can be kind of a difficult concept for people to grasp because it's not something that can be quantified. It's really an experience of self. It's about who am I and what is me. It's qualitative and it's based on the way an individual interacts with their environment, and particularly around social ideas of what gender should be. 

So we have this complex thing happening where gender is how we interact with how society believes gender should be displayed. So, to kind of clarify that a bit more, I guess there are three kind of main concepts that make up gender and they are gender identity, gender roles, and gender expression.

So the identity is how the individual feels on the inside. They’re those aspects of personality that are intrinsic to the human, and they respond to the socialisation of gender norms. So that socialisation process, particularly of young children where we say “girls like pink and boys like cars,” those are gender roles, and the identity and the role interact with each other. 

So, identity is pretty much fixed by the age of three. And if anyone's ever asked a toddler if they think they're a boy or a girl, they can pretty confidently answer that for you. And that happens in societies even where there aren't quite rigid gender roles around that. Young children are very clearly able to identify “self.” And gender expression then is how you portray that to the world.

So when I work with young people, my explanation, which kind of simplifies that is that gender identity is how you feel in your head and your heart, and gender expression is how you choose to communicate that to the world.

Andrew: Okay. So, I'm just going to paint a picture to hopefully illustrate that I've got this right. You know, my wife commonly says that I'm the “gayest heterosexual she's ever slept with” because… I feel very male, you know, I'm heterosexual in my choices. But I have absolutely no problem telling Lee that she looks fantastic and that, you know, that handbag makes her eyes pop.

Kerrin: Yes, and that's a great example. So you started off by saying, “I feel male.” So that's your gender identity, it’s how you feel. You feel male. But your expression sits more on the feminine side of a spectrum…

Andrew: Yeah.

Kerrin: …that we define as men who are, you know… It's those stereotypes of “men are masculine and stoic, and women are flowery and emotional” and that’s… They're kind of all made up things anyway. And that's the thing about gender in that way, is that these ideas of stereotype are largely made up.

Andrew: I must be sort of constantly making it up because I love my tequila, I love my barbie, give me Bathurst as my sport. But you know, I love buying handbags for Lee.

Kerrin: Well, turn around, that is gender nonconforming. And they’re really people who just go, "You know what, I don't want anything to do with these societal norms. I'm going to walk my own road." And gender nonconforming is the term we use around that.

Andrew: Okay. Now you spoke about societal nonconforming. So what about differences in different societies?

Kerrin: Yeah, definitely. So we've seen a lot of indigenous tribes’ recognition of that third gender, or a two-spirit person. And that's really an umbrella term for people who are believed to have the spirit of both a male and a female inside them. So they, in a lot of cultures are quite revered. In Indian culture there's a recognition of the third gender. So we do see that. And also in a lot of tribal communities such as Papua New Guinea and Island Nations.

Andrew: What about also an acceptance of that gender identity? So for instance, young males in Greece will often hold hands, I'm told, forgive me, this is just what I thought I learnt. And it's quite accepted, but they're still male. They still choose to be a male. They're just holding hands.

Kerrin: Yes. And that is societal norm is about what we believe to be acceptable behaviour. And that starts to tip over a little bit into this orientation stuff because we live in a culture that says if two men are holding hands, they must be gay. 

But for a lot of cultures around the world, there isn't that association or that pairing. Men showing affection is quite welcomed. You will see, particularly in Asian countries is men are quite often have their arms around each other and quite affectionate in their hugging and handholding. So there isn't that pairing and that stigma around same sex bonding and friendships.

Andrew: You know, an interesting thing here is, with regards to that hugging for instance, is the classic thing. A male hug can't be longer than a second, mate. You know, it's got to be that sort of thing. I feel quite comfortable giving a close male friend a longer hug. 

Now it's not minutes, you know, but I feel quite comfortable in just taking a breath and going, "I'm here with you mate," but I'm male. There's no sexual preference to that. He's a mate. So where are we? Like is this part of this gender confusion that we have? Or are we just laying down these social mores that are really outdated?

Kerrin: I think it's a little bit of both. I think that we particularly live in a society that has very rigid and very traditional gender roles. Australia in particular has a very “blokey” culture where men are expected to behave a certain way. 

That then transitions to a certain level of homophobia where it's just not really accepted. And what that then does, is it neglects and negates the whole range of human emotion and affection that's actually really important for well-being.

Andrew: So we're stigmatising ourselves. But what about stigma versus self-stigma?

Kerrin: That’s an interesting difference. I think stigma is… A person doesn't have a stigma, a stigma is put on a person. 

Andrew: Right.

Kerrin: And it's really a negative thing that, again, that society puts on a person because they see them as different. So they stigmatise them, or mark them, in effect. 

Andrew: Right.

Kerrin: What we know about stigma is that it really acts as a chronic stressor. And that impacts outcomes, health outcomes particularly, over the life course. And it definitely increases an individual's vulnerability to disease. So it can operate across a range of levels, when we talk about stigma more broadly, really at an individual level and that's that self stigma and internalised homophobia.

So that comes about when an individual lives in an environment that sees their identity as abnormal. And what happens is the individual then kind of takes on that idea that there's something wrong with them, or that they're abnormal in some way, and begins to stigmatise themselves. 

And what we know from the research is particularly with young people, when they're able to express their minority identity, particularly in a heterosexual community, they have high levels of self-confidence. And that self-confidence directly translates into protective factors for health.

Andrew: Okay. So, let's take this into the clinical setting. How do we address the elephant in the room?

Kerrin: Look, I think the first general rule is really about respect and that if the questioning isn't relevant to the therapeutic investigation, then it really isn't any of your business. And I think that's really important because sometimes particularly when we see patients or clients who might be presenting, particularly as trans, it's easy to make that the focus of the session. When in actual fact, they may be there for a completely different reason. 

So, I think it's very important to treat them like everyone else and be respectful of their identity. I guess going back to that point I made before too, particularly around confidence and self esteem, a really practical thing that can be done in a clinic is to have a pride flag or a small rainbow sticker in the waiting room, to have magazines that might show a more diverse range of people in relationships, and certainly to have health promotion materials that really represents the diversity of human identity.

And those things when a, particularly a young person, but anyone who's a member of the LGBTQIA community comes into your clinic instantly feels that they may be welcomed there. 

Andrew: Yes.

Kerrin: That’s a great first step into then showing that you are running a clinic that's sensitive and welcoming to diversity. So the next suggestion I guess that I would make, is to really look up and be aware of language. And there's a great online media reference which is from GLAAD and I highly recommend people go and just have a read through that. 

It's updated regularly, which is important because language changes and is constantly evolving. And an example of that is the word homosexual, which is no longer used. It's actually quite a derogatory and negatively laden term. 

Andrew: Ah.

Kerrin: But it's important to be up to date with those kinds of words just to make sure that the service you're providing is inclusive and very aware of people.

Andrew: So there's something that I've learnt, because I thought that was being more medical and scientific, you know, and that you basically addressing self. We now need to move on from that.

Kerrin: No. Definitely. And a good rule of thumb is personhood. And this applies to a whole range of things, but the person should always come first. So, an example of that is that we don't say “blind person” anymore. We say “a person who is blind.” Because the fact that they're a person is the most salient part, and that they're blind, or that they're trans, or that they're gay, is kind of somewhere further down the sentence. So they're people, it's a person who is blind, a person who's gay.

Andrew: Oh. Well see, I find myself constantly falling into this, that addressing the disease rather than the person.

Kerrin: Particularly as practitioners it is easy to become diseased-focused and that you're so used to working with the condition or the presenting issue that it's easy to put that first, but it's always the person in front of you that should be paramount.

Andrew: You mentioned trans clients before. Are there any particular issues that they face?

Kerrin: There're quite a lot of issues that trans people face and I guess staying with the language thread for starters, the first one is around pronouns. The pronouns are the words we use to refer to people when we don't say their name, and that's pretty much the definition of a pronoun. So “she/her/hers, he/him/his.” The best way to approach that is just to ask the person, "What pronouns do you prefer?" Some people will prefer she/her/hers, some may go with a more gender neutral pronouns such as they/them/theirs. So the presenting gender of the person is what's important. And for the most part, what genitals a person has aren't relevant. 

However, in a clinical setting, they do need to be considered on a number of occasions. And one of those is particularly around preventative health measures. So we make a mindful of the fact that trans men will need pap smears and breast screens and they're susceptible to the same issues that female anatomy will undergo. 

So there's actually a great Canadian health promotion campaign called Check it Out Guys. And their motto is really, "If you've got a cervix, get a pap smear." So, it's aimed at trans men and it's trying to do away with this idea of it doesn't matter what your gender identity is, it doesn't matter how you express yourself. If you've got a cervix, you need a pap smear, full stop.

So, they've produced a really great range of free posters, which are a good clinic resource. And I guess by that same reasoning, trans women need prostate checks, they need testicular cancer screening, and they need investigations that are associated with male anatomy. 

And another addition to that is that if trans women have been taking hormones and they've developed breast tissue, they do need to undergo breast screens and will have many of the issues or complications associated with breasts.

So, I guess given the negative experiences that a lot of trans people have with health professionals, a great way to approach this is just to have a generic organ screening form, and have all your patients fill it out with a matter of just ticking boxes to indicate what organs they've got. And that list can be quite comprehensive. So, it might include things like foreskins and tonsils and adrenal glands, legs, any body part that really can be removed. 

And that way you're not singling people out, but it gives you something to work with where you can actually then look and go, "Okay, so this person does have this anatomy and that anatomy." And by doing that broadly to all your patients, it's a great resource just to have on client files anyway.

I guess another important part on that too, is that if a woman has a penis, she may not want to be reminded of that. And so if you've used that organ screening form first, it gives you a great opportunity to then say, "Look, is there a word that you would prefer using instead of penis?" Because particularly for trans people, they don't often want to hear the anatomical names and they might refer to them in ways that minimise the presence of that organ. So it's really important just to ask, and that's probably the number one rule is just when in doubt, check it out.

Andrew: Yeah, I think it's really interesting that the practitioner has got to be comfortable with their own sex and gender identity to be able to ask these questions. And I think it's just part of the responsibility of being a practitioner, to do a self check-in. How comfortable are you with you?

Kerrin: Yes, absolutely. And a recent study that just came out looking at the experiences of young people who are trans really found that many of them were... In fact, 42% of them had reached out to a service provider who didn't understand or respect them, and who had brought their own transphobia into the clinic room. 

And I think that's quite a worrying statistic. That's almost half of young people reaching out for medical help who are experiencing negative attitudes and values because that practitioner hasn't addressed their own values.

Andrew: Yeah. So with regards to these online resources like GLAAD and you said Check it Out Guys, how can we basically do a check-up from the neck up of ourselves? What resources are there for practitioners to make sure that they're doing and saying and being the right carer for these people with gender issues?

Kerrin: I guess the internet is really full of the lived experience. And that's what's really important here, is it's not about us taking our opinions into the room, it's about understanding the lived experience of our patients. So reading widely, reading about what it is actually like to be an LGBTQIA person, particularly in Australia at the moment. But what is that experience like of help-seeking? What is it like to inhabit that body, and really understand that? Because the more we understand the experience of other people, the greater empathy we are able to have.

Andrew: Let's delve into some of these myths that are propagated, particularly coming to light in with the yes/no plebiscite in Australia. Is it going to make people more gay? Is it going to change their gender identification?

Kerrin: No, not at all. And I think myth is the right word for that. You can't make someone gay any more than you can make someone straight. We're born that way. We're born sexual beings, and our sexuality is as much a part of us as our sense of humour and any other aspect of our personality. 

So I mean, if we apply that to our friendships, we all like and dislike different people for all sorts of different reasons. That doesn't change if we apply it to sexual activity over friendship. It's about how we experience and express love and affection.

Andrew: What about these that are scared of...you know, if there's more liberal attitude to gender, that their offspring for instance, their children might therefore be confused?

Kerrin: Again, that is a myth. I guess really the liberalisation of gender means an undoing of those really rigid and traditional notions of gender that we spoke about at the beginning. So that liberalisation is actually not confusing their children. It's giving their children greater opportunity to express their true selves.

Andrew: And therefore...

Kerrin: And I think that's actually positive.

Andrew: Yeah, and empowering them, giving them more self-worth.

Kerrin: Absolutely.

Andrew: What about with regards to this TV ad that was aired voicing concerns about my male child wearing a dress?

Kerrin: That's another interesting one. The first part of that is around that gender expression, and if the child wants to wear a dress, it's not going to hurt them. I think the fear and a lot of the mixed messaging around that is that we're somehow allowing young children to transition and become trans. And that really simply isn't true. 

What young children are allowed to do is what we would call social transition. And a social transition is really just recognising and adopting those roles and expressions of the gender they feel they identify with. So, that might be wearing a dress, it might be playing more with cars. That social transition is completely reversible. They can change their clothes back, they can change their pronouns back, they can change their name back.

All of that stuff is something that we do allow young people to do. And the research shows that when children are allowed to socially transition, particularly at young ages, the long-term outcomes for their mental well-being, particularly around depression and anxiety, are at normative levels. 

So opposite of that, you know, is the alternative of denying young children the right to socially transition, is early onset depression, it's increased rates of suicide and self harm. It's increased rates of anxiety, self stigma… loads of negative things that actually do have some really serious long-term consequences.

Andrew: You know, I think what's really interesting to me here is this social stigma, if you like, of boys play with trucks and girls play with dolls. And yet what's GI Joe? I mean back in my day...so we're talking decades ago, there was still, you know, Steve Austin, the $6 million man. That was a doll, but it was a male identifying doll.

Kerrin: If you compare the GI Joe doll that you played with to the GI Joe doll that's available on the market today, you'll see a significant change in the body shape, the musculature, the overall appearance of that doll has become hyper-masculine.

Andrew: Really?

Kerrin: Yeah. So you know, originally that GI Joe doll would've looked quite like just a normal man. He was a normal man. Whereas now he's very triangle shaped. He has huge muscles, he has an eight pack, he has very strong jaw. So, the actual appearance of boys toys have become more masculine.

Andrew: So, getting back to how we check in about ourselves, about being practitioners, people caring for others… Apart from becoming a sexologist like yourself, are there any short courses or are there any other responsible resources around where people can basically check in?

Kerrin: Yeah. Look, the process that I would recommend is what's called a "Sexual Attitude Reassessment." And that's often offered as a half or full day workshop. And it's really a process of challenging your own attitudes and values around sexuality, to unpack them, to explore what your biases might be, to understand why you carry certain baggage or certain ideas around sexuality. Which, truth be told, for most of us stem from our own childhood experiences and are passed on from our parents’ ideas and attitudes and values around sexuality, and particularly how those conversations played out in our homes. So that's a great process for people to check in.

I mean, journaling is always a great thing to do, is to really reflect back at the end of the day or after interactions and think, "Well see why did I behave that way? What triggered that? Why do I hold this belief?" And really unpack and challenge some of those beliefs that at times it's easy to just blanketly accept.

Andrew: So how do people find out about "Sexual Attitude Reassessment?" Where are these courses run from?

Kerrin: Probably the best way to find one is to look online. Some of them are offered online and there you'll be able to find some contacts for people in Australia who offer them as well. They at times travel around.

Andrew: We'll definitely put those resources up on the FX Medicine website for our listeners to access. 

Can I just go back to the beginning and re-investigate this sexual orientation, because you've sent me a few graphics through. One of them is really interesting to me where it talks about aromantic asexuality, romantic asexuality and various others.

Kerrin: Yes, yes. So sexual orientation, I guess to give some context to it is, Alfred Kinsey in the 1940s did an investigation where he decided that sexual orientation was either entirely heterosexual, entirely homosexual, or you could sit in the middle and be bisexual. And for quite a long time that's been the working definition of sexual orientation. The more that we begin to understand that, we realise that there is a whole range of wonderful experiences in there that actually don't fit into any of those boxes. 

And part of that is acknowledged in the LGBTQIA acronyms. So there's lesbian, gay, bisexual, trans, intersex, queer, and asexual. So what we use now is a climb grid, which actually a bit better gives some clarity and some definition to that diversity of experience.

Aromantic really refers to people who may have sexual attraction but don't feel romantic attraction to people. And asexual is people who may feel romantic attraction but often don't feel sexual attraction. 

Andrew: Right.

Kerrin: So within that there is, I guess, additional layers of complexity. So someone can be bisexual and heteroromantic, meaning that they like to have sex with both genders, but they would only form romantic relationships with a person of the opposite gender. So, that would be the heteroromantic, but the bisexual part...So there's a whole different, lots of combinations I guess. And then when we look, particularly at attraction types, there are different kinds of attraction.

So when we think of sexual response and that burning desire, when we look at someone and just want to have sex, that's really our primary sexuality. And that can apply again to a whole lot of different genders, but also to different sexes. So, that's interesting definition as well is that we're not often attracted to the kind of genitals a person has. We're often attracted to the person, clear aspects of their personality, to their expression of their own identity, much more than we are about what's in their pants, which may sort of come later down the track when we talk about attraction.

So, some people, however they need to be in a relationship where there are a lot of elements of trust and safety, and then that attraction and sexual activity will start to grow from there. And that's really this idea around secondary sexuality. So, they may feel a primary sexual desire towards a male, but in relationships with females they may experience attraction that's much more of a secondary style attraction.

Andrew: Do you have any tools that this grid, sort of, explain to patients so that they can help with their identification?

Kerrin: Yeah, definitely. So there is a great resource which asks a whole lot of questions around feelings, around behaviours, around identity, and also around how they play out in different contexts. And so, the client can then fill that out and it will really help them clarify how these ideas around attraction and orientation are working for them, and we can certainly make that available to your listeners.

Andrew: Great. Does gender identity waiver much over a lifetime from one's own experiences, whether a relationship was successful or not? Do you find that some people are fluid in exploring different retractions?

Kerrin: Yeah, so I guess when we talk about gender identity, it really is fixed by the age of three. We see it becoming a little bit more flexible between the ages of 5 and 13, as the young person becomes what we would call a “gender explorer.” And that's really about challenging social structures as part of adolescence anyway, and we see that become more fluid. 

It then tends to become a little bit more rigid through early adulthood. But for some people they are constantly exploring identity. And for many people, we change. We change as we grow, we change as we learn, we change as we get older and some aspects of us will change. However, the notion of who we feel like in our head and our heart is relatively fixed.

Orientation, again, is the same. So we are born with our sexual orientation as part of being born as sexual beings. We explore that, we may find at different points in our lives we're attracted to different people, the same as anybody else would be, that and sometimes you might be attracted to tall people and sometimes you have a bit of a thing for shorter people. So there definitely is flexibility in that. However, your kind of basic notion of orientation does tend to stay the same because you are born with that.

Andrew: What would be your answer to someone who said that the purpose of sex is to further the species, and that all of these gender choices and things like that is really just confusing the issue regarding the propagation of humankind?

Kerrin: If we only had sex to have babies, they would either be a lot more humans or a lot less sex. That's just not the reason people have it. The physical act of sex includes an awful lot more than just penetration. When people use the term "sex" they're often referring to intercourse, to penis and vagina penetration. When you ask people to really unpack what sex is to them, it's very rarely about penetration. It's about togetherness, connection. It's about all those yummy, amazing feelings of intimacy and affection, and communicating with another human. So, I think that's the thing, is that if people are saying, well, the whole point of sex is to have babies, they've really missed the amazing, wonderful purpose of sex.

Andrew: Just one last question. Given the plebiscite, how can we as clinicians better support our patients?

Kerrin: Firstly, I think by recognising that sexual health isn't just about infection and dysfunction, it is a holistic approach that needs to take in the mental and social well being of a person. The plebiscite, whether we agree with it or not, is placing a disproportionate of burden on a group of people who are already disadvantaged. Who already live in a stigmatised society. Who already feel abnormal in their daily lives. 

So as clinicians, as I said before, part of it is just about creating that welcoming environment. It's about checking your own issues. It's about understanding that everyone is welcome, and making them feel that way too, from the moment they walk in the door and then following that up with sensitive approaches to your treatment.

Andrew: Kerrin Bradfield, thank you so much for opening up my ears and eyes to the issues of gender and sexuality, which I had no idea of. I'm of the opinion that I'm quite liberal, but I really think I'll be doing that Sexual Attitude Reassessment as a first step to making sure that I'm checking in and being empathetic to people who have different orientations. So thank you so much for joining us on FX Medicine today.

Kerrin: My pleasure, Andrew. Thanks for having me.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.



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