Thursday, September 25, 2008

Sexual Wellness at the PFLAG Conference

PFLAG Presentation: On Saturday 9/28, I'm presenting at the Northern Plains Regional PFLAG Conference. Their web site is:

As part of the submission/clarification process, I was asked to integrate a sexual health approach that could apply to everyone, and not just those who struggle with sexual compulsivity, sexual addiction and/or sexual anorexia. I've included the basics of this workshop here. If you have read other blog entries, you'll see similarity between this post and previous posts. The biggest similarity is with the blog "creating your personal definition of sexual health." This post reflects some further development in the past few months.

Toward a Personal Definition of Sexual Health.

To start with, it is important to define sexual health. The definition of sexual health that I like is 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 complex and represents nearly 30 years of scholarship and development. Sexual health is more a process than a dichotomy answered by a yes/no response. As treatment continues, the key is to help the client develop and improve his or her sexual health. The theoretical model within this workbook is based on Robinson et al (2002) who provides a model consisting of 10 components and highlights the necessary components of defining healthy sexual behaviors. Integrated into the treatment philosophy is an explicit goal of helping the client clarify his or her appropriate sexual behaviors.

1. Talking About Sex
I ask people to identify (or develop) 5 confidants. This means selecting individuals where they understand all aspects of your responses to the questions below. A common theme is the struggle to be open and honest with the important people in your life. I consistently see how people avoid talking with others, disclosing their sex history, or reaching out for help, or breaking the isolation because of fear and shame. A relevant 12-step tradition is "Our secrets keep us sick." Anything you're not talking with these individuals about is an issue to be addressed.

2. Culture and Sexual Identity

• What are my values I learned about sexuality from my culture, be it in a religious tradition, racial culture, social economic status, or sexual minority culture
• To what degree have these values shaped my thoughts about men and women?
• Do I agree with these values?
• In what way do I disagree?
• When values from different cultures are in conflict, how do I resolve this conflict?
• The five primary values that shape my behavior are?

3. Sexual Anatomy and Functioning
• What questions do I have about sexual anatomy and functioning?
• As I age, I have the following sexual functioning concerns?
• What do I need to learn about my primary partner to help him or her experience sexual health?

4. Sexual Health Care and Safer Sex
• Who is my primary physician? Do I have a relationship with my medical provider where I can talk with him/her regarding my sexual behaviors and questions regarding health issues?
• Identify your safer sex rules?
• Why do I have these boundaries?
• Think about your safer sex behaviors and risky sex behaviors. If I engage in unsafe sexual behaviors or if I place myself at risk for HIV, STD and/or pregnancy risk, my plans to address this are:
• If you are HIV+ what are your rules regarding disclosure of your status to your sexual partners?

5. Challenges and Barriers to Sexual Health
• Chemical Use
• Mental Health
• History of Abuse

6. Body Image
• What are three messages you have about your body?
• What are your plans to create a healthy body image?

7. Masturbation and Fantasy
• Identify three favorite fantasies. Write these out and be as detailed and specific as possible.
• What are my unhealthy fantasies, or fantasies I want to avoid?
• What are my current values toward masturbation and fantasy?
• What are my current appropriate masturbation behaviors? (Where, when how often?)
• What are my rules toward disclosure to my partner of my masturbation behaviors?
• What are my rules toward disclosure of fantasies to your partner?
• Have you reviewed these with your partner? Does he/she agree with these values? If there is disagreement, what is your plan to address the disagreement?
• What are my current values toward sexually explicit material?
• What sexually explicit material is acceptable? Why?
• What sexually explicit material is not acceptable? Why?
• What are the rules in your relationship regarding disclosure of your use of sexually explicit material?

8. Positive Sexuality
• Sexuality is a major focus of energy in your life. The following questions reflect that your sexual energy is healthy and when channeled in healthy ways can bring new life, energy and strengthen relationships both with your partner and with others in your life. The following questions are designed to be integrative. You should have a sense of harmony in your definition within these responses.
• How do you develop new ways of sexual expression?
• How do you express sensuality?
• Who is an appropriate sexual partner? (Age, sex, relationship, etc.)
• What types of sexual behaviors are healthy?
• What types of sexual behavior should be avoided?
• When is it appropriate to be sexually active?
• Where is it appropriate to be sexually active?
• What are healthy reasons to engage in sexual behavior?
• What are unhealthy reasons to engage in sexual behavior?
• What is the preferred level of physical touch?
• What kind of touch is acceptable?
• How will I ask to have my sexual needs met?

9. Intimacy and Relationships
• Identify the top three types of intimacy that are the most important for you.
• Identify 3–5 people who can help you meet those intimacy needs
• How satisfied are you with your level of intimacy in these three areas. If you aren’t satisfied, identify a plan to increase your level of satisfaction.

10. Spirituality
• Is anything listed in the previous 10 areas in conflict with your spiritual values? If so, reexamine and resolve this conflict. Are you living the life you love? To the degree that you are not, why not?
• What are your plans to resolve these differences?

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