Sexual health is relevant throughout a person’s lifethrough to adolescence and into older age – not only during their reproductive years.
It is determined by the quality and safety of people’s relationships: with oneself and other individualswith family and friendsand the society in which we liveincluding the gender norms that shape our experiences. These relationships are themselves dependent on whether everyone’s human rights related to their sexuality are realized and protected.
WHO’s working definition of sexual health emphasizes a positive and respectful approach to sexuality and sexual relationshipsthat is much more than just physical - one that cannot be separated from sexual well-being:
Sexual health is a state of physicalemotionalmental and social well-being related to sexuality; it is not merely the absence of diseasedysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationshipsas well as the possibility of having pleasurable and safe sexual experiencesfree of coerciondiscrimination and violence. For sexual health to be attained and maintainedthe sexual rights of all persons must be respectedprotected and fulfilled. |
“Sexual health is not a fixed state of beingand every person’s needs will change across the life course,”said
Ian Askewformer Director of the WHO Sexual and Reproductive Health and Researchincluding the United Nations Special Research Programme HRP. “This is why it is crucial to undertake a range of activities across this continuum: from support of sexual well-beingto prevention and management of disease.”
Pleasure as a consideration for the success of sexual health interventions
Ahead of Valentine’s Day (14th February2022)a new analysis was published in the open-access journal PLOS ONE on the need to consider sexual pleasurenot only risk of diseasein designing sexual health programmes.
What is the added value of incorporating pleasure in sexual health interventions? A systematic review and meta-analysis shows this can be an important success factor for improving knowledge around sex and uptake of safer sex practices such as condom use.
Looking at outcomes from various initiativesthe research recommends redesigning sexual education and health interventions to incorporate sexual pleasure considerationsincluding when promoting safer sex. This means acknowledging the reasons why people have sex – and recognizing that sexual experiences can and should be pleasurable.
“Sexual health education and services have traditionally promoted safer sex practices by focusing on risk reduction and preventing diseasewithout acknowledging how safer sex can also promote intimacypleasureconsentand wellbeing,” said Dr Lianne GonsalvesWorld Health Organizationpaper co-author. “This review provides a simple message: programmes which better reflect the reasons people have sex – including for pleasure – see better health outcomes. The hope is that these results galvanize the sexual and reproductive health and rights community to promote services that educate and equip users to engage in sex that is safeconsensualand pleasurable.’
What next for sexual health and well-being?
Interventions specifically intended to improve sexual well-being are gradually emerging.
A major milestone is the new edition of the International Classification of Diseases (ICD) which has a chapter on sexual health for the first time. By providing the latest evidence-based definitionsWHO is facilitating the diagnosis and appropriate management for a wide variety of conditions related to sexual health. Countries began using this chapter from January 2022.
Comprehensive sexuality education (CSE) is a curriculum-based process of teaching and learning about the cognitiveemotionalphysical and social aspects of sexuality. WHO recently collaborated with partnersincluding HRPto develop guidance for out-of-school CSE programmes that are appropriate and safe for different groups of children and young people. This complements the guidance developed by the United Nations on school-based sexuality education. Both these guidance documents reiterated that sexual activity is part of normal and healthy livingas is giving and receiving sexual pleasure.
Another recommendation is for policy-makers to integrate brief sexuality-related communication when possiblea clinical tool for behaviour change which takes a holistic and positive understanding of sexual health and sexuality.
Sadlythis is not everyone’s reality. Many womengirls and gender-diverse persons experience non-consensual and violent sexual activity. WHO and HRP are supporting national efforts around the world to prevent and manage the consequences of all forms of sexual violence.
To eliminate diseases that affect sexual healthWHO is developing new global strategies to address STIsincluding HIV – while taking into account the current pandemic-induced health system disruptions.
Given the many evidence gaps for achieving universal access to STI/HIV servicesWHO is currently prioritizing a research agenda for improving the implementation of national STI programmes. This agenda will complement WHO’s leadership in developing innovative point of care tests for quicker and more accurate diagnostic testingand in specifying the “Global STI Vaccine Roadmap” to guide research and development for new vaccines against STIs.
A central aspect of being human
Good sexual health is fundamental to the overall health and well-being of individualscouples and familiesand to the social and economic development of communities and countries.
WHO is committed to identifying and promoting sexual health itselfso that everyoneeverywhere is able to fulfil their human rights related to their sexuality and sexual well-being.