Friday, December 7, 2007

Creating Sexual Health

Integrated into my treatment philosophy is an explicit goal of helping the client clarify his or her appropriate sexual behaviors. Toward this goal, it is important to understand what sexual health is. The definition of sexual health that I liked the most was published by the World Health Organization. They define sexual health as a . . .

“. . . state of physical, emotional, mental and social well-being related 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” (WHO, 2002).

The definition is very complex and represents nearly 30 years of scholarship and development.(For those desiring an understanding o f the history of defining sexual health please see one of the papers that came out of my dissertation [ Edwards & Coleman, 2004]). Sexual health is more a process than a dichotomy answered by a yes or no. As treatment continues, the key is to help the client develop and improve their sexual health. I found another article helpful in framing the process toward sexual health. Robinson et al (2002), provides a model which consists of 10 components which are briefly summarized.

The Ten Components of the Sexual Health Model.

1. Talking About Sex is a cornerstone of the Sexual Health Model. This includes talking about one’s own sexual values, preferences, attractions, history, and behaviors. As you can see, the first exercise is about evaluating your ability to talk about sex.

2. Culture and Sexual Identity are instrumental to understanding one’s sense of sexual self. It is important that individuals examine the impact of their particular cultural heritage on their sexual identities, attitudes, behaviors, and health.

3. Sexual Anatomy and Functioning assumes a basic knowledge, understanding, and acceptance of one’s sexual anatomy, sexual response, and sexual functioning. Sexual health includes freedom from sexual dysfunction and other sexual problems.

4. Sexual Health Care and Safer Sex covers a broad perspective encompasses knowing one’s body, regular self-exams and responding to physical changes with appropriate medical intervention. Examination of one’s safer sex behaviors is critical.

5. Challenges and Barriers to Sexual Health include the major areas of as sexual abuse, substance abuse and compulsive sexual behavior. Other challenges might include sex work, harassment, and discrimination. Treatment must address these areas.

6. Body Image requires challenging the notion of one narrow standard of beauty and encouraging self-acceptance. Sexual health requires a development of a realistic positive body image.

7. Masturbation and Fantasy can be a healthy expression of sexuality. It is important for individuals to clarify their values on masturbation and fantasy. Too often, masturbation and fantasy are linked with shame because of the historical myths associated with sin, illness, and immaturity.

8. Positive Sexuality recognizes that all human beings need to explore their sexuality in order to develop and nurture who they are within a positive and self-affirming environment. Positive sexuality includes appropriate experimentation, sensuality, sexual competence developed through the ability to get and give sexual pleasure and setting sexual boundaries.

9. Intimacy and Relationships. Intimacy can take many forms and is a universal need that people meet through relationships. Sexual health requires knowing which intimacy needs are important for the individual and appropriate ways to meet these needs.

10. Spirituality and sexual health assumes congruence between one’s ethical, spiritual, and moral beliefs and one’s sexual behaviors. Spirituality may or may not include identification with formal religions, but always addresses moral and ethical concerns and deeper values in order to integrate a person’s sexual and spiritual selves.

The exercises and assignments in this blog and in my treatment work are designed to help an individual in their process toward improved sexual health as presented in the sexual health model. The process is extensive, requires significant work and effort. In my opinion, sexual health can be reduced to a process of integrity toward one’s behaviors and one’s values. Hence, the previous conversation on integrity takes one a new level of importance. I cannot define for the individual what is “sexual health.” Only the individual can do so. My commitment is to you express your sexuality with integrity.


Edwards, W. M., & Coleman E. (2004). Defining sexual health: A descriptive overview. Archives of Sexual Behavior, 33(3), 189-195.

Robinson, B. E., Uhl G., Miner, M., Bockting, W. O., Scheltema, K. E., Rosser, B. R. S., & Westover, B. (2002). Evaluation of a sexual health approach to prevent HIV among low income, urban, primarily African American women: Results of a randomized controlled trial. AIDS Education and Prevention, 14(Suppl. A), 81-96.

World Health Organization (2002). Gender and Reproductive Rights, Glossary, Sexual Health,

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