What does the term “sexual health” mean to you? You may have heard it used at your doctor’s office, in sex ed, or with potential sexual partners, but have you ever wondered what it really means? This tip will provide an expanded definition of sexual health and help you with assessing where your sexual health stands.
For a long time, sexual health was thought to be simply whether a person had any STIs (sexually transmitted infections) or not, and perhaps whether they engaged in safer sex practices such as using condoms or dental dams. Some definitions of sexual health have expanded to include reproductive health, and incorporated ideas of pregnancy, birth, abortion, and contraception. While these concepts are certainly important, the above definitions fail to encompass the entirety of the potential for sexual health. Despite what your middle school sex ed class may have taught you, there is so much more to sexual health than STIs and pregnancy!
One model of sexual health comes from esteemed sex therapists Douglas Braun-Harvey and Michael Vigorito*. This model aims to be holistic and non-stigmatizing. It incorporates the following six sexual health principles:
- Consent
- Nonexploitation
- Protection from HIV/STIs and unintended pregnancy
- Honesty
- Shared values
- Mutual pleasure
Since this is a new framework for viewing sexual health, it can be beneficial to know where you stand in terms of each of these principles. The next section will define each of the principles and give you guidelines for assessing your sexual health.
Consent
Consent is the concept of freely agreeing to something. In the context of sexual health, giving consent means that you and your partners are agreeing to sexual encounters and acts within them freely and without force or coercion. This often involves lots of open communication, and consent should be obtained before and sometimes during sex. It is important to note that one instance of consent does not mean that someone is consenting to that thing forever. For example, if someone consents to being kissed by you one time, it does not mean they are consenting to being kissed by you every time you want to from there on out. Consent can also be revoked at any time. If you are ever concerned whether you have someone’s consent for a sexual (or non-sexual!) act, the best thing to do is check in with them and ask.
In order to assess your sexual health through the principle of consent, ask yourself these questions:
- Do I ask for consent before sexual encounters?
- Do I ask for consent before individual sexual acts?
- Do I communicate with partners about things we each do and do not want to do?
- Do I stop when my partner says “no” or “stop”?
- Do we have a system to communicate consent, i.e. a safe word or red/yellow/green indicators?
- Do I check in with my partner during sexual encounters?
- Do I assert my own boundaries within sexual scenarios?
Nonexploitation
Exploitation is using one’s level of power and control in order to obtain something. The idea of nonexploitation is related to consent; it means that you are obtaining consent without using power or coercion. As an example, if a boss threatened an employee’s job for refusing sex with them, that would be considered exploitation because the boss holds a level of power over the employee and is putting them in an unethical and unfair scenario.
In order to assess your sexual health through the principle of nonexploitation, ask yourself these questions:
- Do I hold power over my sexual partners? In what way?
- How is power discussed in my relationships?
- Am I using my power to obtain sex or other favors?
- Might I be putting someone in an unfair or unethical scenario by behaving sexually toward or with them? What potential harm could be caused?
Protection from HIV/STIs and unintended pregnancy
This category is what we often traditionally think of when we think about sexual health - whether or not we have HIV or STIs, and matters around reproductive health. This principle does not mean that in order to be on the path to sexual health, you cannot have STIs; it simply means that you understand your STI status, are having discussions around that with your partners, and are protecting yourself and partners from any other STIs, HIV, or pregnancy that you do not wish to have.
In order to assess your sexual health through the principle of protection from HIV/STIs and unintended pregnancy, ask yourself these questions:
- Do I know my HIV and STI status?
- What do I know about the transmission of HIV and STIs? What do I need to know? Where can I get that information?
- Do I have access to testing and medical care?
- Do I feel comfortable and know how to communicate clearly about my STI status and safer sex?
- Am I or my partners using contraceptives and/or birth control? How do we come to those agreements? Who makes the decisions?
- What does safer sex look like for my partners and me?
- Do I have an understanding of how I would proceed if I or a partner becomes pregnant unintentionally?
Honesty
Most of us understand the importance of honesty in our relationships with other people. In the context of sexual health, the principle of honesty encourages you to be truthful with yourself and with others, and to be open to communicating about sexual pleasure, experiences, and education.
In order to assess your sexual health through the principle of honesty, ask yourself these questions:
- Am I open and truthful with my partners about my sexual health, including STI and HIV status?
- Am I honoring the relationship agreements that I have made with partners?
- Am I being honest with myself about what my desires and needs are?
- Am I willing to have open conversations about my feelings, desires, pleasure, discomfort, and/or lack of knowledge around sex?
Shared values
The principle of shared values in sexual health means that you are willing to have conversations around what sexual acts, motives, and standards mean for you and your partners. It does not necessarily mean that you share every value around sex, but that you are clear on where each other stands on these issues and have come to agreements around your shared sexual relationship.
In order to assess your sexual health through the principle of shared values, ask yourself these questions:
- Am I aware of my own values around sex and relationships?
- Do I have an understanding of my partners’ values around sex and relationships?
- Do I know what specific sexual acts may mean to and for my partners?
- Do we have an agreement about the importance or meaning of sex within our relationship?
- Am I aware of my own sexual motives? Of what motives my partner has or does not have for sex?
- Am I prepared to have conversations around sexual values with partners?
Mutual pleasure
The mutual pleasure principle emphasizes both the giving and receiving of pleasure for all partners within a sexual relationship. Sometimes we think of this as “Did each of my partners and I have an orgasm in this encounter?” However, pleasure can be much more nuanced than whether or not an orgasm happens.
In order to assess your sexual health through the principle of mutual pleasure, ask yourself these questions:
- What does pleasure look like for me and for my partners?
- How do I know that my partners are experiencing pleasure during a sexual encounter?
- Do I prioritize my partners’ pleasure in sexual experiences?
- Do I prioritize my own pleasure (while alone and partnered)?
- Do my partners and I have agreements about when a sexual encounter ends (i.e. does a sexual encounter end after one partner has an orgasm, all partners have orgasms, or after we have mutually decided we are finished regardless of orgasm)?
- Do I know what sexual acts usually bring my partners pleasure?
- Am I willing to discuss new things in our sexual relationship?
- Am I willing to have open discussions about pleasure with my partners before, during, and after sex?
There is no right answer or conclusion to these questions; assessing your sexual health through this model is meant to make you more aware of the ways that you think, feel, and behave. This is merely one model that shows us that assessing your sexual health involves much more than knowing your STI status or engaging in safer sex practices. While it is a great guideline, it does not have to be your exact definition of sexual health - that is up to you. Think about what is important to you when it comes to sex, and feel free to take from and add to this model in defining what sexual health looks like in your life.
If you would like help assessing your sexual health, schedule an appointment with a sex therapist at https://www.therapyinphiladelphia.com/contact/ or call 215-922-5683.
*Braun-Harvey, D., & Vigorito, M. A. (2015). Treating out of control sexual behavior: rethinking sex compulsion. New York, NY: Springer Publishing Company.