Psychosexual Medicine Research Articles

Gender identity in Klinefelter Syndrome: a patient-centered approach to treatment

Introduction There is increasing evidence that gender dysphoria (GD) is more prevalent in the Klinefelter Syndrome (KS) population than in males in the general population; however, the exact incidence is uncertain. The aim of this study was to further explore the prevalence of gender-related issues, the role that physical characteristics play in gender identity, and the issues surrounding Hormone Replacement Therapy (HRT) in KS. Methods As part of a registered Quality Improvement Project (QIP), one online 23-point questionnaire on KS patient attitudes toward gender identity was shared with members of the Klinefelter Syndrome Association (KSA). In total, 139 anonymous responses were collected between December 2021 and January 2023. The questionnaire was developed with the guidance of multiple clinicians (including gender psychiatrists, urologists, psychosexual medicine specialists, and endocrinologists) and patient Delphi rounds. Data was reviewed and analyzed by 4 independent researchers within the QIP team. Results Only 53% of KS patients responding to this survey fully identified as male and 19% stated that they did not enjoy living as the sex on their birth certificate, with 43% considering changing aspects of their physical appearance to better match their gender. Regarding HRT, 67% of respondents were receiving Testosterone Replacement Therapy (TRT). 63% wanted TRT and 17% wanted estrogen, including 6% of TRT users who would prefer estrogen instead. 36% that were currently receiving TRT did not identify as male, and 3 participants stated that they have GD. Conclusion These results indicate that a significant proportion of KS patients do not fully identify with the male gender and are unhappy living as the sex on their birth certificate. Although TRT worked for most, its use should be discussed carefully with those with gender identity concerns.

MP72-18 GENDER DYSPHORIA IN KLINEFELTER SYNDROME: HORMONE THERAPY IN KLINEFELTER SYNDROME - IS TESTOSTERONE ALWAYS THE ANSWER?

You have accessJournal of UrologyCME1 Apr 2023MP72-18 GENDER DYSPHORIA IN KLINEFELTER SYNDROME: HORMONE THERAPY IN KLINEFELTER SYNDROME - IS TESTOSTERONE ALWAYS THE ANSWER? Tiffany Kago, Daniel Clark, Kathryn Moore, Benjamin Moore, and Tet Yap Tiffany KagoTiffany Kago More articles by this author , Daniel ClarkDaniel Clark More articles by this author , Kathryn MooreKathryn Moore More articles by this author , Benjamin MooreBenjamin Moore More articles by this author , and Tet YapTet Yap More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Klinefelter Syndrome (KS) is the most common sex aneuploidy (47, XXY). The physical manifestations of the disorder differ for each patient; so, an individualised treatment plan usually in the form of hormone replacement therapy (HRT) with Testosterone is used. However, there is increasing evidence that some KS patients question their gender identity when diagnosed and throughout their KS journey. The aim of this study is to investigate the issues surrounding HRT in KS as well as determine the preference of hormone treatment amongst adolescent and adult patients with KS. METHODS: As part of a registered Quality Improvement Project (QIP), data was collected from a 23-point questionnaire of KS patients’ attitudes to gender identity. This was shared with members of the Klinefelter Syndrome Association (KSA) from February to June 2022, and anonymised responses were collected via SurveyMonkey. The questionnaire was developed by multiple clinicians (including gender psychiatrists, urologists, psychosexual medicine specialists and endocrinologists) and patient Delphi rounds, in collaboration with the KSA. Data was reviewed and analysed by 4 independent researchers within the QIP team. RESULTS: Out of 114 respondents, only 55% of KS patients identified as male and 70% were on testosterone replacement therapy (TRT). 12% of KS patients were receiving Oestrogen as their HRT, with 18% of all patients saying they would prefer to take Oestrogen. 2 testimonies given by patients supported this, expressing the difficulties they found when seeking this form of HRT. 34% believed that HRT (Oestrogen or Testosterone) made them look more like their desired gender, but 11 comments highlighted the negative behavioural side effects they had experienced when using TRT. 11% chose to discontinue their treatment, with the major cause being changes in their personalities, particularly mood swings and aggression. 19% of the cohort were not on HRT and 9% preferred to take neither TRT nor Oestrogen. CONCLUSIONS: Overall, only a third of individuals receiving HRT seemed satisfied with the physical changes they saw. Based on the data collected, a tenth stopped their HRT treatment, including those that were unhappy with the behavioural changes they had experienced on TRT. The data suggests that more research should be done to explore and address the complex needs KS patients may have, including gender identity issues, prior to starting any form of HRT. Patients must be counselled as to short- and long-term risks of each form of HRT. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1031 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tiffany Kago More articles by this author Daniel Clark More articles by this author Kathryn Moore More articles by this author Benjamin Moore More articles by this author Tet Yap More articles by this author Expand All Advertisement PDF downloadLoading ...

The first year of a national-access adult Klinefelter's Syndrome multi-disciplinary team (KSMDT) clinic: patient and clinician reported outcomes

ABSTRACT Introduction Klinefelter's syndrome is the most common chromosomal abnormality seen in men, affecting 1 in 650 men. It is a group of chromosomal disorders with at least one extra X chromosome (47, XXY) occurring due to non-disjunction at the time of gametogenesis. Most adult men are diagnosed at the time of fertility investigations. However, the syndrome has an array of clinical presentations which patients require input from numerous medical specialities during their lifetime. The setting up of a national-access Klinefelter Syndrome multidisciplinary clinic (KSMDT) approach comprising Urology, Endocrinology, Genetics, Reproductive medicine, Radiology, Psychosexual medicine, a specialist pharmacist as well as a patient representative has led to improvements in fertility and long- term management and waiting times. Here we describe the patient-reported outcomes and clinician perspectives of the clinic as it approached its 1st year. Method Between 2019 and 2020, 72 patients were seen in the adult KS MDT clinic. To assess the quality of care received in the clinic, an 8 -point feedback questionnaire was given to each patient attending the clinic to fill out at the end of the clinic. The form included a space for feedback for each speciality involved. The feedback forms were reviewed by 2 individual researchers and entries were assessed using an adapted Likert scale (0 – 5). Clinicians involved in the clinic were also encouraged to attend and rate the other specialties, the effectiveness of the pre and post clinic MDTs and to describe achievements derived from KSMDT clinic team-working. Results All the patients (n = 72) took the questionnaire reported that the clinic was beneficial to their understanding of KS & its management and had enough time during consultations. In terms of scoring 86% were very satisfied (score = 5) about genetic consultation compared to 92%, 82%, 82% and 88% in endocrine, fertility, psychosexual and urology consultation, respectively. Key factors influencing these positive results included the presence of an MDT, the access to a patient liaison and knowledge of support groups during the consult, digitized patient information sheets and a cohesive approach between endocrine and fertility teams. Clinician feedback was positive with all members agreeing that the pre and post clinic MDTs allowed effective pinpointing of often missed issues (e.g. hormone induction, social issues). Key milestones for the clinic included the reduction in waiting times by almost 80%, securing funding for costly hormone medication and assisted reproduction, improving sperm retrieval rates (from 11 – 29%) and a thrombo-embolism awareness programme. Conclusion The overall patient and clinician feedback for the adult KSMDT clinic was uniformly positive, with the multispecialty approach allowing communication with and between all relevant specialities on the same day, avoiding the need to come for multiple separate appointments across different sites (especially relevant during the COVID-19 era). The feedback has also been useful in developing patient information tools such as digital resources and has led to the development of a supportive community group for newly diagnosed KS men. More research is underway to investigate the complex issues affecting KS men long term, after fertility management. Disclosure Work supported by industry: no.

Workshop Compiled

Sex therapy is one of the oldest surviving treatment modality in sexual medicine. It has been found effective in diverse range of sexual disorders in both the men and women and has a good evidence base also. In last few decades, various pharmacological and somatic interventions are found useful in sexual disorders. However the existing pharmacological agents have certain limitations and non-pharmacological interventions still remains relevant for a significant number of clinical situations in sexual medicine. Classical Sex Therapy (CST) as proposed by Masters and Johnson, however, have certain requirements like trained experts of both the genders working together and distinctive set-up which may be restrictive in application for most of the practitioners of sexual medicine. Required kind of set up and availability of both male and female therapist which although can provide privacy to the patients is rare in most resource constrained countries and restricted mainly to only certain parts of the world. There has been a leap in research in psychosexual medicine in recent decade involving classification, new medicines and improved emphasis on female sexuality also. The advancements have also affected sex therapy and it has gone through several modifications to suit the need of current times and resources. CST is modified in context of increasing knowledge and evidence base of cognitive behavior therapy, mindfulness based therapies and couple therapy etc. Approaches to combine sex therapy with pharmacotherapeutic interventions, other physical therapies like vacuum devices and surgical interventions is also advancing. This symposium is planned to update recent developments in sex therapy including 1. Current understandings of sex therapy2. Its modification and blending with other form of psychological therapies3. Its use along with other pharmacological, somatic and surgical treatment modalities4. Future prospects and updates

Raymond Emmanuel Goodman

Raymond Emmanuel Goodman was a GP in Gorton for 22 years. He then moved into psychosexual medicine and pioneered a clinic in Salford, which was named after him and flourished...

Spotlight on… mental health

Spotlight on… mental health

Setting Up Psychosexual Medicine Unit: Insights From a Private University-Based Medical College Hospital

Introduction: Sexual health issues are highly prevalent but are underdiagnosed and underrecognized in day-to-day clinical practice. The lack of awareness of the specific health care needs of the patients with sexual dysfunctions and resource limitations might be certain reasons why many hospitals are not been equipped with the sexual health care units. There is paucity of specialized psychosexual health care services across the country. Trained interdisciplinary team with prepared environment in sexual medicine is the need of the hour. We started this psychosexual medicine unit with an emphasis on sexual wellness to deliver comprehensive sexual health care which will be a primary care linkage to patients presenting with symptoms of sexual disorders, so also treatment emergent sexual dysfunction in psychiatry and other medical and surgical branches.Aim: To portray the methods, opportunities, and challenges that we experienced in establishing a specialty psychosexual medicine facility as a different unit in a private university-based medical college and hospital in Mysuru, India.Methods: This triweekly psychosexual medicine unit is situated in the Outpatient Division of Psychiatry and is staffed with a multidisciplinary group of health care professionals. Structured survey tools and proforma are utilized to assess all patients. Case conclusions are made according to International Classification of Diseases, Tenth Revision, symptomatic/clinical explanations and diagnostic recommendations, and furthermore Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) when required. Patient care included interventions in the form of psychotherapy and pharmacotherapy.Results: It is possible to set up a functional psychosexual medicine facility as a different unit with a trained interdisciplinary group of professionals. Patient-centered approach is vital in our care plan and management. Postgraduate students and internees posted in psychiatry division have been undertaking rotations respectively as per their duty rota. There is also a robust academic program that includes once-weekly seminars pertaining to topics of psychosexual health and monthly journal club gatherings interchanging with seminars on sexual health and well-being appraisal devices.Conclusion: By investing on improving infrastructure and available human resources, the specialty psychosexual medicine unit was established. The psychosexual medicine unit not only gave chances for a more comprehensive assessment of individuals with sexual disorders but also improved training and education for residents with focused interdisciplinary research in the field of sexual medicine. It portrays a versatile model that can be replicated in settings of similar type.

MP44-04 IDENTIFYING PATHWAY DELAYS AND PATIENT NEEDS TO OPTIMIZE THE MANAGEMENT OF MEN WITH ADULT KLINFELTER SYNDROME

INTRODUCTION AND OBJECTIVE: Men with Klinefelter Syndrome (KS) often present with infertility. However, the optimal management of this condition can involve many different specialties. Unfortunately, this often results in major gaps and delays to the patient pathway, often with a lack of coordination in areas such as genetic & psychosexual counselling. Based on this, a national survey was carried out to assess the needs of adult Klinefelter Syndrome patients with the aim of setting up a one-stop multidisciplinary team (MDT) clinic model for KS. METHODS: Men with KS over age 18 who were members of the Klinefelter Association of the UK as well as current KS patients in three large teaching hospitals were invited to participate in the study. A detailed, anonymised online questionnaire was used to collect data on initial presentation, delays and gaps in management and outcomes. Separately, an expert panel involving 7 specialties (Urology, Endocrinology, Genetics, Radiology, Reproductive Medicine, Embryology, Psychosexual Medicine), patient representatives and allied specialties (pharmacy & nursing) was set up to identify the feasibility and benefits of an MDT clinic. Ethics approval was obtained from our local NHS board. RESULTS: 92 patients in total completed the online questionnaire. 65% presented with infertility. Almost half had noticed signs of KS by the age of 16 but the median age of diagnosis was 26-30 with more than 20% diagnosed after 35. 45% waited a year or more in primary care before eventually being referred to a urologist, with definitive fertility management starting 1-2 years after. Only 39% had formal genetic counselling, and 35% had no long-term endocrine input. Although 87% were aware of surgical sperm retrieval, only 30% were offered MicroTESE. 89% felt they would have benefited from seeing an endocrinologist (and 61% for psychology) at diagnosis, with 86% strongly supporting an MDT clinic approach. The MDT clinic would also decrease visits, ensure a standard of care and potentially reduce delays to definitive fertility management from 18 to 3 months. CONCLUSIONS: The valuable information gathered about the delays and issues faced by adult men with Klinefelter Syndrome have led to the setting up of a one-stop MDT clinic encompassing 7 specialties with pharmacy & patient liaison services. The clinic itself and its positive clinician and patient feedback are presented separately. The need for more awareness of KS in the community remains a widespread issue. Source of Funding: None

Why Psychosexual Disorders Equally Important in India

Human sexuality is a complex with multidimensional aspects such as biological, psychological, social, and cultural. Cultural factors influence their development as prevalence rates of these disorders vary in different communities. The nature of problems and their psychological consequences make it difficult to assess the exact prevalence of these dysfunctions, even more difficult in developing countries like India. In India, care for people is not proper as large number of patients suffering from psychosexual problems visit unauthorized “sex clinics” rather than an authorized hospital setting. Specialists like dermatologists are often consulted for these problems in their routine practice as common belief shared by them is that these problems are caused by dysfunctions in their sex organs. So they are hesitant to go to sexual clinics and psychiatrists for the same in the first place. The question that arises is where does sexual medicine stand, as asked by many in the past too but remains unanswered in terms of general medicine and psychiatry. Thus, the need of the hour is to identify these cases in early stages, which can prevent a lot of other disorders occurring due to them such as homicide, suicide, domestic violence, battered wife syndrome, etc. in society. The advance in psychosexual medicine is much needed. Despite the importance of these disorders and sensitivity, in India, there is scarcity of data about the burden of sexual health disorders from community-based studies, unlike Western countries.

Evaluation of psychiatry training in India: A survey of young psychiatrists under the aegis of research, education, and training foundation of Indian Psychiatric Society.

Aim:The aim of this study is to assess the perception of the young psychiatrists (aged ≤45 years) about their training received during the postgraduate training period.Methodology:An online E-mail survey using Survey Monkey electronic platform evaluated the perception of 451 psychiatrists about their own perception of training received during the postgraduation period.Results:About two-third (n = 308; 68.3%) of the respondents reported that their overall training was ‘good’ or ’very good’. However, training was rated as poor/very poor in subspecialties of child and adolescent psychiatry and geriatric psychiatry by 26.2% and 26.9% of the participants, respectively. Exposure/training was rated as “poor/very poor” by more than one-fifth of the participants in areas of repetitive transcranial magnetic stimulation and deep brain stimulation (69.9%), rehabilitation psychiatry (47%), forensic psychiatry (45.5%), psychodynamics (40.5%), neuroimaging (38.1%), psychotherapy (34.8%), orientation to private practice (26.9%), statistics (34.1%), writing skills (24.4%), ethical principles of research (23.5%), women mental health (23.3%), psychosexual medicine (22.7%), and research methodology (21.5%). Regarding academic activities involving writing skills, although majority (72.5%) of the participants reported being involved in writing case reports and half (50.3%) reported involvement in writing original articles, but exposure to writing other types of article was quite low. Training in different types psychotherapies in the form of adequate exposure, carrying out and supervision to different types of psychotherapy was inadequate/low for psychodynamic psychotherapies, rational emotive therapy, dialectical behavior therapy, eclectic psychotherapy, and other kind of therapies. A high proportion of respondents reported having good competence in the administration of modified electroconvulsive therapy and making presentation in academic fora just after passing degree from their institutes and at the time of survey (current competence). When comparisons were done between the different groups of institutes, significant difference was noted across all aspects of training.Conclusions:The present survey reflects that there is a variation in the psychiatry training in India. Accordingly, it can be said that there is a need to develop a model for competency-based training program at the level of the Indian Psychiatric Society in consonance with training regulatory bodies like the Medical Council of India, which can be implemented across the country to harmonize the training.

In Memoriam: Dr Graham Jackson, 1947-2016.

In Memoriam: Dr Graham Jackson, 1947-2016.

A Mind-Body Model for Educating Men with Sexual Dysfunction Post Prostate Cancer

Objective: An educational and clinical tool used to assist patients, and their partners, in understanding the importance of the Mind-Body connection in relation to sexual difficulties following Prostate cancer. Design and Method: This Mind/Body model was developed over 20 years working in Psychosexual Medicine and Therapy. It has been used in helping men with desire and arousal problems, erectile dysfunction and ejaculatory concerns. It helps couples think about contributing factors and barriers to a satisfying sexual relationship, and helps them identify factors, which are getting in the way or missing, in order to maintain intimacy. It has been applied in outpatient hospital clinics, private practice settings, and in education of health professionals. Clinically, it is adapted to each individual or couple with regards to their presenting complaint, past history, current circumstances, and the dynamics operating in their relationship. Results: Patients have reported that the use of this model: 1) Demonstrates that the clinician understands their experience. 2) Provides a framework for understanding their specific biopsychosociocultural factors, which need to be addressed in order to treat the sexual difficulties. 3) Helps them recognize repetitive vicious cycles contributing to the exacerbation and maintenance of their difficulties. 4) Provides practical stepping stones to creating the kind of intimate / sexual connection they would like. Conclusions: This Mind/Body Model provides a clear educational tool for developing practical therapeutic interventions for men with Prostate cancer and their partners. It is used in conjunction with medical penile rehabilitation.

Psychosexual medicine: Why me?

This article describes how a particular approach to sexual difficulties allows a useful therapeutic relationship with patients to be developed. Combined with an understanding of the dynamics encountered in the genital examination, it is possible for any interested GP to engage in psychosexual work. The Institute of Psychosexual Medicine has been training GPs and other doctors for over 40 years.

The Leeds Psychosexual Medicine Service: an NHS service for sexual dysfunction – review period 2

ABSTRACTNational health service (NHS) psychosexual clinics are key providers of services for sexual problems in the UK. This report is the second in a series of three which describes the Leeds Psychosexual Medicine Service. It covers a three-year period (2009–2012), presenting information relating to 1085 patients referred to the service during that time. The majority of patients were in the age range 18–40 years and 54% were male. In 76% of cases the referral was from primary care and a broad range of sexual problems were referred. Only 31% of the total referrals were found to have completed all planned sessions of their treatment. Of those who did, 82.99% showed an improvement in their condition (42.71% major, 22.92% moderate, and 17.36% minor improvement), with no change in 15.97% and a deterioration in 1.04%. In common with the results of the first in this series of reports, our data suggest that brief therapy lasting six to eight sessions is beneficial in most patients and that, with minimisation of patient non-attendance, the brief interventions which we are finding to be effective could be made more so. This review series remains relevant in the current context of severe financial constraints and pressures on the NHS.

P127 Special interest clinic: a novel genitourinary medicine service initiative providing continuity of care and educational opportunities

Introduction External referral to dermatology and psychosexual services from genitourinary medicine (GUM) can cause delays in patient care. To counter this within our service an experienced consultant has established a Special Interest Clinic (SIC) reviewing dermatology, erectile dysfunction and complex GUM cases. Written educational feedback is offered to internal referrers. We reviewed the impact of SIC. Aims To evaluate the service offered by SIC. Methods Data was collated from randomly selected patient records who attended SIC between April 2012 and April 2013. Results A total of 100 records were reviewed. 67 patients were male, 25 of whom were MSM. Patients were ethnically diverse, White British (52) being the most common ethnicity. Median age was 33 years (range 19–70). 12 patients were HIV-infected. Internal referrals predominated (96) and average waiting time from referral was 6.2 weeks (range 0.14–28). Broadly stratifying referrals 40 patients were complex GUM, 35 psychosexual medicine, 25 dermatology. The most prevalent diagnoses were erectile dysfunction (23) and lichen sclerosus (9). 9 patients required skin biopsy, 8 of which were performed within SIC. Ongoing follow up was recommended to 60 patients, of which 43 (71.7%) were retained. 27 patients were discharged after first attendance. 77 referrers requested feedback, all received it. Conclusion Keeping patients within our service provided continuity of care. The availability of formal feedback increases educational opportunities for referrers. We recommend experienced clinicians consider establishing similar SICs in other services. A challenge services will encounter is the lack of specific SHHAPT coding for prevalent SIC diagnoses.

Management of common disorders in psychosexual medicine

Key content Over 20% of women attending gynaecology clinics have psychosexual dysfunction and yet training for medical students, trainees, and consultants is inadequate and in some regions non‐existent. Common problems include sexual pain disorders, protracted pelvic or vulval pain, hypoactive sexual desire disorder and repeated requests for gynaecological surgery where no pathology has been found. National provision of specialist psychosexual clinics is patchy and yet the Tomorrow's Specialist report from the RCOG includes psychosexual services as a service expected by patients. Learning objectives This article outlines the management of psychosexual dysfunction in the gynaecology outpatient department (GOPD). After reading we would expect clinicians to have a basic understanding allowing the majority of such cases to be managed in the GOPD. The principles of psychosexual medicine are that the patient is the expert but clinicians can allow them to see their problems more clearly through enhanced consultation skills. Ethical issues There are very few trained doctors and specialists in psychosexual medicine despite it being a commonly requested service.

Editorial

Editorial

Vulvodynia: integrating current knowledge into clinical practice

Key content Vulvodynia is a chronic gynaecological condition that results in significant distress to women and management can be challenging to the clinician. The 2003 International Society for the Study of Vulvovaginal Disease (ISSVD) defines vulvodynia as vulval discomfort that is described as burning, stinging or irritation, in the absence of relevant visible findings or specific signs of a clinically identifiable neurological condition. The condition can be localised (vestibule) or generalised and the discomfort can be spontaneous or provoked by physical contact. The diagnosis of vulvodynia is one of exclusion after inflammatory, infectious, dermatological, neoplastic, neurological and psychosexual conditions have been ruled out. A multidisciplinary approach to tackle the different components of vulvodynia is required that includes a lead clinician with clinical psychologist, physiotherapist, psychosexual medicine clinician and pain management specialist. Owing to the heterogeneity in the aetiology of the condition, multimodal therapy is recommended in most cases. Learning objectives To review the current classification and pathophysiology of vulvodynia. To review the clinical manifestation and diagnosis of a patient with generalised and localised vulvodynia. To critically appraise the currently available treatments options for vulvodynia. Ethical issues Psychosexual dysfunction related to this disorder raises the sensitive issue of open communication with the individual or couple on varying degrees of sexual and psychological counselling. Ethical issues that are realised in determining the cause of vulvodynia include sexual orientation and history of sexual abuse. How does evidence‐based medicine direct health professionals in the treatment of this condition?

EPA-0125 – Integrating sexology education into psychiatry residency training: Perspectives from the USA

The presentation will focus on how psychosexual medicine and sexology education can be integrated into psychiatry residency training. The Psychosexual Medicine Program currently being implemented at Beth Israel Medical Center, Department of Psychiatry and Behavioral Sciences in New York, NY will be described. The positive impact on the training program and overwhelming support from faculty and residents of the program will be discussed. An argument will be made why it is important to teach sexual medicine in psychiatry residency training and how psychiatrists are uniquely positioned to be good sexologists. It will be recommended that sexual medicine education become an integrated part of psychiatry residency training everywhere in the USA.

The Leeds Psychosexual Medicine Service: evaluation of an NHS service for sexual dysfunction

Sexual problems are common and patients seek treatment from various clinicians. Specialist psychosexual clinics within the NHS in the UK are one of the key providers of sexual medicine services. This retrospective service evaluation covers a population of 846 patients referred over a three-year period to the Leeds Psychosexual Medicine Service. Of patients referred, 65% were males and the majority of patients were in the age range of 18–40 years. Of referrals, 70% were from primary care physicians, with complaints of a broad range of sexual problems. Around half of the referred patients failed to attend either their first or subsequent appointments. A third of the total referrals completed all planned sessions of their treatment. Of these, 70% showed major improvement and only a small proportion (6.5%) either showed no change or worsening of their problems. Our data suggests that brief therapy lasting four to eight sessions is beneficial in most patients. This evaluation is timely as there are financial constraints on the NHS currently and with improved service delivery models, which aim to minimise patient non-attendance, brief interventions can be effective.