Name: 醫生來了！看我如何學會談論性愛 | Lauren Bull | TEDxNHS (How I finally learned to talk about sex, as a doctor | Lauren Bull | TEDxNHS)
Uploaded: 2026-03-06T21:44:08.000Z
Duration: 16 min 55 s

I've taught sex ed to thousands of young people over the years, and

我多年來教了數千位年輕人關於性教育，

between that and my job, I've been asked every question under the sun.

加上我的工作，我被問過各種各樣的問題。

情態副詞

Literally nothing shocks or surprises me anymore.

真的沒有什麼能讓我感到震驚或驚訝了。

But there is one word that comes up again and again.

但有一個詞，總是會不斷出現。

But of course, when it comes to sex, there is only one should.

但當然，說到性教育，只有一個「應該」。

You should communicate your wants, needs, boundaries, consent.

你應該溝通你的期望、需求、界線、同意。

But how well are we really taught to do that?

但我們真的有好好被教導怎麼做嗎？

We are, by every metric, the most connected generation in history.

我們是史上連結最緊密的世代，從各方面來看都是。

Texts snaps DMs 24,7 access to anyone, anywhere, anytime.

簡訊、Snapchat、私訊，24小時全年無休，隨時隨地都能聯繫任何人。

Here's the thing about that kind of communication.

It is fast, it's efficient, but it's impersonal, ambiguous, disconnected.

它快速、有效率，但卻不親近、模糊不清、疏離。

And the same thing is happening with sex.

而性教育也正在發生同樣的事情。

When was the last time you saw anything sex related online?

上次你看到跟性教育相關的內容是什麼時候？

And when was the last time you had an open, honest, vulnerable conversation with another human being about sex?

上次你跟另一個人就性教育坦誠、誠實、毫無保留地聊過是什麼時候？

Because that gap, that gap between digital, hyper connection, hyper sexualisation and real life disconnection and silence, that's the crisis I want to talk about.

因為這種數位、超連結、超性化的連結，以及現實生活中的疏離和沉默之間的差距，這就是我想談的危機。

This is not just an inconvenience, it's a communication breakdown with devastating consequences.

這不只是個不方便，而是個後果嚴重的溝通斷層。

We are surrounded by sex, but for the most part, we ain't any better at talking about it.

我們被性包圍著，但大部分時間，我們在談論這件事上並沒有變得更好。

And for all the sex positivity you see online in real life, confusion, awkwardness, silence.

儘管網路上到處都是性愛正向的內容，現實生活中卻充斥著困惑、尷尬和沉默。

These days, young people are taught to look sexy before they even know what consent is.

現在，年輕人甚至還沒搞懂什麼是同意，就被教導要看起來性感。

Because we live in a world saturated with sexualised media, explicit content, formative pressure.

因為我們活在一個充斥著性化媒體、露骨內容、形成壓力的世界裡。

But let's be clear, there is a big difference between exposure and education.

但我們要說清楚，接觸和教育之間有很大的差別。

I can't tell you how many patients I've met who never even looked at their own bits, let alone be able to name all the parts.

我遇過太多病人，她們甚至沒看過自己的身體，更別說能說出所有部位的名稱了。

Just because we see more sex, it doesn't mean we understand it any better.

我們看到更多性，並不代表我們就更瞭解它。

Being bombarded with porn doesn't teach you how to have a conversation about sex, it teaches you how to perform sex, how to copy what you've seen, meet unrealistic expectations, how to fake confidence instead of building connection.

被色情內容轟炸，不會教你怎麼談論性，它教你怎麼表現性，怎麼模仿你看到的，滿足不切實際的期望，怎麼假裝自信而不是建立連結。

A culture that sexualises before it educates, if it ever does.

一個在教育之前就先性化的文化，如果有的話。

The Children's Commissioner released a report just last month, and

兒童委員上個月才發布一份報告，

I quote, this report should read as a map of what rock bottom looks like.

我引用，這份報告應該像一張地圖，顯示了谷底的樣子。

Not only is it now normal for children to see pornography before they leave primary school, it is normal for that porn to be the most violent and extreme content online.

不只現在小孩在小學畢業前看到色情內容是常態，就連這些色情內容是網路上最暴力、最極端的內容，也成了常態。

Primary school and the effects we see in clinic.

小學以及我們在診間看到的影響。

I had a 16 year old girl say to me she wasn't very good at sex.

我曾有個16歲的女孩告訴我，她性方面表現得不太好。

Well, my boyfriend says I don't make enough noise and I don't look like I enjoy it when he chokes me.

嗯，我男朋友說我不夠叫，而且他掐我脖子時，我看起來不像很享受。

I asked her if she'd ever had a conversation with him about this.

我問她有沒有跟他談論過這件事。

Had she ever even said she wanted to be choked?

I've had teenage boys ask me if it's okay that they don't want to choke someone.

我遇過青少年男生問我，他們不想掐別人脖子這樣可以嗎？

A young woman in tears because her vulva is wrong, because it doesn't look like the ones in porn.

一位年輕女子哭著說她的外陰部長得不對，因為它不像色情片裡的那樣。

Had a young guy devastated he couldn't make his girlfriend orgasm.

有個年輕男生很沮喪，因為他沒辦法讓他的女朋友高潮。

She just wasn't squirting, so he didn't think it counted.

她只是沒有噴水，所以他覺得不算。

So many patients doing things they didn't want to do.

好多病人在做他們不想做的事。

Gagging, slapping, anal, but felt expected to do because that's what they'd seen.

被掐脖子、巴掌、肛交，但覺得應該要這麼做，因為那是他們看過的。

Countless guys unable to get erections in real life scenarios because compulsive porn viewing has completely rewired their arousal pathways.

無數的男生在真實情境中無法勃起，因為強迫性色情觀看已經完全重塑了他們的性興奮路徑。

A world where the line between pleasure and performance is completely blurred.

一個快感和表現的界線完全模糊的世界。

So much confusion about how desire, arousal, and pleasure actually work, because real sex is not performance.

對於慾望、喚起和快感如何運作有這麼多困惑，因為真正的性不是表現。

It's messier, funnier, emotionally complex, but we don't teach any of that.

它更混亂、更有趣、情感更複雜，但我們卻沒有教這些。

We have a generation of people who could fake an orgasm but can't say the word orgasm to their partner, can't say orgasm to a doctor.

我們這一代人可以假裝高潮，卻無法對伴侶說出「高潮」這個詞，也無法對醫生說出「高潮」。

Even worse, doctors who can't say orgasm.

更糟的是，醫生也說不出「高潮」。

So what of the role of the healthcare professional?

那麼，醫療專業人員的角色是什麼呢？

Well, as a sexual health consultant doctor, I can care for some of society's most vulnerable and stigmatised people.

嗯，身為性健康顧問醫生，我可以照顧社會上一些最脆弱、最受汙名化的人。

Asylum seekers, sex workers, people who use drugs, members of the LGBTQIA community.

尋求庇護者、性工作者、藥物使用者、LGBTQIA 社群成員。

And in these rooms, we're not just talking about symptoms.

在這些診間裡，我們不只談論症狀。

We can be dealing with some of the most taboo, often traumatic parts of someone's life.

我們可能在處理一個人生命中最禁忌、常是創傷的部分。

We have to earn trust, build rapport, create safety fast.

我們必須贏得信任、建立關係、快速創造安全感。

Now, one of the things I love about my specialty, we don't do hierarchy.

現在，我喜歡我的專科其中一點，我們不做階級制度。

事實上，我們會積極地瓦解它。

We are the medics who swapped stethoscopes for lube, the white coats for a lot of us, tattoos and piercings, that outdated model, doctor knows best.

我們是那些把聽診器換成潤滑液的醫護人員，脫下白袍，對我們許多人來說，身上有刺青和穿環，打破那種過時的「醫生什麼都懂」的模式。

那種模式教我們要臨床、要超然。

不行，不行，不行，不行，不行，不行，不行。

If I want someone to open up to me about the most private parts of their lives, then I have to meet them as my full, authentic self.

如果我希望有人對我敞開心房，聊他們生命中最私密的部分，那我必須展現我最真實、最完整的自我去面對他們。

I'm also a mum, a professional bikini model, an acupuncturist, an aspiring pilot.

我同時也是一位媽媽、一位專業比基尼模特兒、一位針灸師，還是一位有抱負的飛行員。

I am ridiculously passionate and over excitable.

我對事情充滿了極大的熱情，而且很容易興奮。

And that's who you'll get when you sit in front of me.

這就是當你坐在我面前時，你會看到真實的我。

We sense inauthenticity and we don't trust it.

我們能感覺到不真實，而且我們不會信任它。

And in a clinical space, trust is everything.

Our patients don't just listen to what we say.

我們的病患不只聽我們說的話。

They feel whether they're safe, whether we care.

他們能感覺到自己是否安全，是否被關心。

It is the thing that no algorithm, chatbot or machine will ever replicate.

這是任何演算法、哈拉機器人或機器永遠無法複製的東西。

Because it's not just what our patients say, it's what they don't say.

因為不只是病患說了什麼，還有他們沒說什麼。

Flicker change in facial microexpression, the slight glance away, change in posture.

臉部微表情的瞬間變化、眼神的些微飄移、姿勢的改變。

How often the real reason someone's in your room shows up at the end, disguised as a joke, throwaway comment.

一個人來你診間的原因，常常在最後才顯現，偽裝成一個玩笑、一句隨便說說的話。

Now, when I ask her more, her relationship's broken down.

接著，我再多問她一些，發現她的感情出了問題。

And for the record, you are never too old for sex.

順帶一提，你永遠不會太老而不能有性行為。

A young guy makes a casual joke about masturbation, which, when explored with care, actually

一個年輕男生開玩笑說自慰，但仔細探究後，其實

reveals a serious porn addiction, a deep fear of intimacy.

揭露了他嚴重的色情成癮，以及對親密關係的深層恐懼。

It is our job to notice the threat, to gently, curiously, pull, let the story unfold.

我們的職責就是察覺潛在的危機，溫柔、好奇地引導，讓故事慢慢展開。

Too often, as doctors, we're already working like algorithms.

我們常常，身為醫生，已經像演算法一樣在工作了。

We've got diagnoses to rule out, boxes to tick, KPIs to hit, and

我們要排除診斷、要打勾、要達成 KPI，然後

in that super efficient process, lose the person.

在這個超有效率的過程中，卻失去了這個人。

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醫生來了！看我如何學會談論性愛 | Lauren Bull | TEDxNHS (How I finally learned to talk about sex, as a doctor | Lauren Bull | TEDxNHS)

vulnerable

content

empathy

devastating