Definition of sexual health
The general practice management of sexual health covers physical, emotional, mental and social wellbeing in relation to sexuality, and 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. According to the World Health Organization working definition, for sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.1 2
As community based health practitioners, general practitioners are vital to the maintenance of individual sexual health.
The definition of sexual health has progressed since the World Health
Organization (WHO) published its original definition in 1975. It is
expected that the definition will continue to develop further as the
cultural conversation continues to evolve. It is important to remember
that any attempts to establish “norms” and an objective definition of
sexual health is dangerous in that they could be used to exclude or
label people as unhealthy or abnormal.
Sexual health is 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.
Robinson et al. (2002):
Sexual health is defined as an approach to sexuality founded in accurate knowledge, personal awareness, and self-acceptance, where one’s behavior, values and emotions are congruent and integrated within a person’s wider personality structure and self-definition. Sexual health involves an ability to be intimate with a partner, to communicate explicitly about sexual needs and desires, to be sexually functional (to have desire, become aroused, and obtain sexual fulfillment), to act intentionally and responsibly, and to set appropriate sexual boundaries. Sexual health has a communal aspect, reflecting not only self-acceptance and respect, but also respect and appreciation for individual differences and diversity, and a feeling of belonging to and involvement in one’s sexual culture(s). Sexual health includes a sense of self-esteem, personal attractiveness and competence, as well as freedom from sexual dysfunction, sexually transmitted diseases and sexual assault/coercion. Sexual health affirms sexuality as a positive force, enhancing other dimensions of one’s life.
The National Strategy for Sexual Health and HIV (2001):
Sexual health is an important part of physical and mental health. It is a key part of our identity as human beings together with the fundamental human rights to privacy, a family life, and living free from discrimination. Essential elements of good sexual health are equitable relationships and sexual fulfillment with access to information and services to avoid the risk of unintended pregnancy, illness or disease.
Satcher, Surgeon General's Report (2001):
Sexual health is inextricably bound to both physical and mental health. Just as physical and mental health problems can contribute to sexual dysfunction and diseases, those dysfunctions and diseases can contribute to physical and mental health problems. Sexual health is not limited to the absence of disease or dysfunction, nor is its important confined to just the reproductive years. It includes the ability to understand and weigh the risks, responsibilities, outcomes and impacts of sexual actions and to the practice abstinence when appropriate. It includes freedom from sexual abuse and discrimination and the ability to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose.
Lottes (2000):
Sexual health is the ability of women and men to enjoy and express their sexuality and to do so free from risk of sexually transmitted diseases, unwanted pregnancy, coercion, violence and discrimination. In order to be sexually healthy, one must be able to have informed, enjoyable and safe sex, based on self-esteem, a positive approach to human sexuality, and mutual respect in sexual relations. Sexually health experiences enhance life quality and pleasure, personal relationships and communication, and the expression of one’s identity.
SIECUS (1995):
Sexual health encompasses sexual development and reproductive health, as well as such characteristics as the ability to develop and maintain meaningful interpersonal relationships, appreciate one’s own body, interact with both genders in respectful ways, and express affection, love and intimacy in ways consistent with one’s own values.
Pan American Health Organization, World Association of Sexology (1991):
Sexual health is the experience of the ongoing process of physical, psychological and social-cultural well-being related to sexuality. Sexual health is evidenced in the free and responsible expressions of sexual capabilities that foster harmonious personal and social wellness, enriching individual and social life. It is not merely the absence of dysfunction, disease and/or infirmity. For sexual health to be attained and maintained it is necessary that the sexual rights of all people to be recognized and upheld.
Langfeldt and Porter (1986):
Sexuality is an integral part of the personality in everyone: man, woman and child. It is a basic need and an aspect of being human that cannot be separated from other aspects of life. Sexuality is not synonymous with sexual intercourse; it is not about whether we have orgasms or not, and it is not the sum total of our erotic lives. These may be part of our sexuality but equally they may not. Sexuality is so much more: it is in the energy that motivates us to find love, contact, warmth and intimacy. It is expressed in the way we feel, move, touch, and are touched. It is about being sensual as well as being sexual. Sexuality influences thoughts, feelings, actions and interactions and thereby our mental and physical health.
World Health Organization (1975):
Sexual health is the integration of the somatic, emotional, intellectual and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication and love.
In unhealthy relationships, there are barriers instead of intimacy, where people are often fearful of self-disclosure. These barriers between partners:
Chronological History of Definitions of Sexual Health:
World Health Organization (2002):Sexual health is 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.
Robinson et al. (2002):
Sexual health is defined as an approach to sexuality founded in accurate knowledge, personal awareness, and self-acceptance, where one’s behavior, values and emotions are congruent and integrated within a person’s wider personality structure and self-definition. Sexual health involves an ability to be intimate with a partner, to communicate explicitly about sexual needs and desires, to be sexually functional (to have desire, become aroused, and obtain sexual fulfillment), to act intentionally and responsibly, and to set appropriate sexual boundaries. Sexual health has a communal aspect, reflecting not only self-acceptance and respect, but also respect and appreciation for individual differences and diversity, and a feeling of belonging to and involvement in one’s sexual culture(s). Sexual health includes a sense of self-esteem, personal attractiveness and competence, as well as freedom from sexual dysfunction, sexually transmitted diseases and sexual assault/coercion. Sexual health affirms sexuality as a positive force, enhancing other dimensions of one’s life.
The National Strategy for Sexual Health and HIV (2001):
Sexual health is an important part of physical and mental health. It is a key part of our identity as human beings together with the fundamental human rights to privacy, a family life, and living free from discrimination. Essential elements of good sexual health are equitable relationships and sexual fulfillment with access to information and services to avoid the risk of unintended pregnancy, illness or disease.
Satcher, Surgeon General's Report (2001):
Sexual health is inextricably bound to both physical and mental health. Just as physical and mental health problems can contribute to sexual dysfunction and diseases, those dysfunctions and diseases can contribute to physical and mental health problems. Sexual health is not limited to the absence of disease or dysfunction, nor is its important confined to just the reproductive years. It includes the ability to understand and weigh the risks, responsibilities, outcomes and impacts of sexual actions and to the practice abstinence when appropriate. It includes freedom from sexual abuse and discrimination and the ability to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose.
Lottes (2000):
Sexual health is the ability of women and men to enjoy and express their sexuality and to do so free from risk of sexually transmitted diseases, unwanted pregnancy, coercion, violence and discrimination. In order to be sexually healthy, one must be able to have informed, enjoyable and safe sex, based on self-esteem, a positive approach to human sexuality, and mutual respect in sexual relations. Sexually health experiences enhance life quality and pleasure, personal relationships and communication, and the expression of one’s identity.
SIECUS (1995):
Sexual health encompasses sexual development and reproductive health, as well as such characteristics as the ability to develop and maintain meaningful interpersonal relationships, appreciate one’s own body, interact with both genders in respectful ways, and express affection, love and intimacy in ways consistent with one’s own values.
Pan American Health Organization, World Association of Sexology (1991):
Sexual health is the experience of the ongoing process of physical, psychological and social-cultural well-being related to sexuality. Sexual health is evidenced in the free and responsible expressions of sexual capabilities that foster harmonious personal and social wellness, enriching individual and social life. It is not merely the absence of dysfunction, disease and/or infirmity. For sexual health to be attained and maintained it is necessary that the sexual rights of all people to be recognized and upheld.
Langfeldt and Porter (1986):
Sexuality is an integral part of the personality in everyone: man, woman and child. It is a basic need and an aspect of being human that cannot be separated from other aspects of life. Sexuality is not synonymous with sexual intercourse; it is not about whether we have orgasms or not, and it is not the sum total of our erotic lives. These may be part of our sexuality but equally they may not. Sexuality is so much more: it is in the energy that motivates us to find love, contact, warmth and intimacy. It is expressed in the way we feel, move, touch, and are touched. It is about being sensual as well as being sexual. Sexuality influences thoughts, feelings, actions and interactions and thereby our mental and physical health.
World Health Organization (1975):
Sexual health is the integration of the somatic, emotional, intellectual and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication and love.
- Compiled by Candy Hadsall and Kathy Chinn for MOAPPP conference 2010 from “Defining Sexual Health: A Descriptive Overview” by Edwards and Coleman published in the Archives of Sexual Behavior, Vol. 33, No. 3, June 2004, pp. 189-195.
In unhealthy relationships, there are barriers instead of intimacy, where people are often fearful of self-disclosure. These barriers between partners:
- Indicates distrust
- Lowers self-worth
- Builds defensiveness
- Increases isolation within the relationship
- Denies personal responsibility
- Prevents efforts to work on common problems
- Intensifies an addictive system
- Indicates trust
- Builds self-worth
- Affirms the other person
- Increases connectedness within the relationship
- Takes responsibility for one’s own actions and feelings
- Shares common problems
- Interrupts unhealthy behaviors
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