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When you hear the phrase “sexual health,” what comes to mind?
For many people, the topic of sexually transmitted infections (STIs) springs to mind—preventing, testing for, and treating them. No doubt, STIs are an important factor in our sexual health! But just like when we look at overall wellness, the idea of “health” encompasses so much more than the absence or presence of disease.
The World Health Organization (WHO) defines sexual health as “… a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled.”
This broad definition encourages us to look not simply at the status and performance of our genitals and reproductive organs as the sole markers of our sexual health, but also at how we are valued in our intimate relationships, how we experience our bodies and self-image, and especially our location within the cultural dynamics and institutions of our communities. Moreover, we should note that the factors outlined by WHO interact with one another—our physical and mental health is deeply impacted by the structural health of our communities, and vice versa.
What supports our sexual health?
Let’s return to STIs as an example. Imagine you are a sexually active person who wishes to prevent contracting or transmitting a sexually transmitted infection. Where do you begin? Have you received accurate information about ways to reduce your risks? Was the information offered to you in a way that made you feel shame about your body, your desires, your identity, or who your sexual partner(s) are? Is the information applicable to the types of sexual behavior that you engage in?
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Imagine you got the information that you need. Is there a convenient and safe location nearby where you can access medications and/or barrier methods (condoms or dams) that are appropriate for your situation? If there is no source nearby, do you have access to transportation or delivery? Will you be treated with respect by the providers who offer these services? If you are trying to prevent pregnancy in addition to reducing STI risk, are the methods you’d like to use legal and accessible where you live?
Let’s say you need medical advice or a prescription to navigate your options. Is medical care accessible to you? Can you afford costs associated with your care? Will your provider be comfortable talking about sex—and will you be comfortable talking with them? Will it be okay to talk openly about the type of sexual expression that you enjoy, or the partner(s) you have sex with?
Okay, so imagine you’ve managed to get all the tools and help you need to reduce your risks. Is your partner on board with using them? Are you able to communicate openly with your partner? Do they treat your body, your boundaries, and your efforts to care for yourself with respect? Are you free from coercion or harm in your relationships? Do you live in a community that values the health and safety of all people?
On top of all the previous factors, the accumulation of messages we’ve received throughout our lives about our bodies and sexuality will impact our overall comfort and self-esteem. This in turn impacts whether we feel our bodies are worthy of pleasure, respect, and protection from harm. It even impacts the type of sex we believe we can have (and with whom), or what we imagine pleasurable and fulfilling sexual relationships might look like! In our STIs example, these experiences might impact how empowered we feel about advocating for our own sexual well-being—or how well we can truly hear others when they are advocating for themselves.
Sexual health requires healthy communities
When you think about it, how we experience and maintain sexual health is truly holistic. It involves not just the body and mind, but how the body and mind intertwine with the people and structures around us, right down to the cultural air that we breathe.
Too often, the health and wellness industry pressures us toward individual solutions to any of our bodily concerns. We’re encouraged to purchase supplements, fancy water, diet plans, and any other number of products to feel better, or to be the “best version of ourselves.”
But while products aimed at the individual can be beneficial in some cases, we might be better off taking a closer look at the cultural and institutional systems that play a huge part in determining whether we can fully enjoy and embrace our sexual health. We should do this for two reasons. First, because we need to stop thinking that we are somehow broken or at fault because of the negative impacts of systems that are failing many of us. Second, because if we can see how and when our systems are failing us, we’ve got a shot at building a better world where we call can flourish.
