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The older age groups may also be reluctant to reveal their sexual activity to their regular medical attendants (or their staff), but for slightly different reasons. They may not wish to bother their doctors – who they view as caring for ill people – with their contraceptive needs which they feel are less important. They may fear that their sexuality is not acceptable to their doctors, to the staff or to other patients whom they encounter in the surgery and who may enquire why they are attending. One woman in her 40s travelled many miles to attend a clinic far from her home. Married to the minister of a strict religious sect, she could not risk revealing to her husband’s flock that she was sexually active and needed to use a diaphragm to prevent pregnancy. She could not refuse him intercourse, nor did she wish to do so, although she felt it was somehow wrong and sinful not to be above such base human emotions. She feared further pregnancy with advancing years, but saw her need for contraception as a betrayal of her husband’s teaching which had to be concealed from his congregation. Her ambivalent attitudes had made her an unpopular patient at the family planning clinic she attended; she had managed to make most of the staff feel that they were somehow dealing in something unsavoury and undesirable.


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