Defining sexual health

Sexuality is a very broad category. It includes much more than sexual activity alone: sexual identity, sexual orientation (heterosexual, homosexual, bisexual, asexual), sexual roles (femininity, masculinity), physical health, and a whole host of other aspects of sexuality.

Sexual health is key for building a sound and informed attitude towards sexual life. At the same time, sexual health demands critical knowledge about our bodies and our reproductive systems, to protect us against sexual pathologies such as unplanned and unwanted pregnancy, venereal diseases and others. It should be remembered that sexual health is also determined by context and culture and normative order.

Sexual health, in its broadest sense, includes intimacy and closeness, and how to build and sustain a proper relationship. It includes a proper understanding of consent and respect - respect for someone else’s body, someone else’s feelings and someone else’s decisions. Importantly, it also involves respect for your own body, your own feelings, and your own desires. The World Health Organisation (2006a) defines sexual health as follows:

“…a state of physical, emotional, mental and social well-being in relation 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, 2006a)

Building on that basis, young people - and older ones, too! - can develop good relationships that offer space for safe, informed and consensual sexual activity. Relationships based on trust, understanding, a willingness and desire to accept and to be accepted.

Sexual rights
 
Any conversation about sexual health must also touch on sexual rights.  All of us should be aware of these, and young people should be taught these so that they know and understand what is and is not acceptable. 

Rights critical to the realization of sexual health include:

• the right to equality and non-discrimination
• the right to be free from torture or to cruel, inhumane or degrading treatment or punishment
• the right to privacy
• the right to the highest attainable standard of health (including sexual health) and social security
• the right to marry and to found a family and enter into marriage with the free and full consent of the intending spouses, and to equality in and at the dissolution of marriage
• the right to decide the number and spacing of one's children
• the right to information and education
• the rights to freedom of opinion and expression, and
• the right to an effective remedy for violations of fundamental rights.

The responsible exercise of our human rights requires that all persons respect the rights of others.  Sexual rights are no exception to this. 

Sexual health and LGBT

Much of what young people hear and learn about sexuality is much narrower in scope, depicting pejorative sexuality and concentrating mainly on possible pathologies.  Sex education is explored in greater detail further on in this module, but it is worth highlighting that this, too, needs to go beyond biology and a focus on pathologies.  Sexual health, in its broadest scope, must be taught and learned - it can never be ‘assumed’.  Very few countries are getting this right, meaning that the vast majority of students have no access to the ‘bigger picture’.  The UK’s Department for Education revised its sex education guidelines in November 2018 and immediately faced heavy criticism from women’s groups and Stonewall, a leading LGBT organisation, for its ‘squeamish’ focus on self-restraint and for choosing “to teach only very traditional notions of sexuality, relationships and gender norms, and is generally squeamish about sex and sexuality.”  (The Guardian, 2018). 

• What does ‘state of physical well being’ mean in relation to sexuality?
• What does ‘state of emotional well being’ mean in relation to sexuality?
• What does ‘state of mental well being’ mean in relation to sexuality?
• What does ‘ state of social well being’ mean in relation to sexuality?

I was diagnosed with hepatitis B in 1999 . . .
I’m a gay man who was diagnosed with hepatitis B in 1999. Fortunately I only experienced a short-term (or acute) infection and am fine. Hepatitis B can be really serious, though, and I know I’m fortunate. Each and every gay man should have the hepatitis B vaccine. I wish I had gotten it when I was younger. Learn from me, and get your hep B shots! Take an HIV test. Use condoms. Don’t depend just on what the medical community says to do, take control and do something!

I thought I was invincible.

Like many, I was/am pretty well educated on STDs. However, I still felt that I was “invincible” to sexual diseases and NEVER would have expected to get one. I have had three partners—all long-term serious relationships. At age seventeen, I’m not what most would expect an “HPV infected person(s)” to be. I graduated two years early, I was a cheerleader for my college, I graduated high school with a 4.0, I’ve held 2 state beauty pageant titles, and currently hold a local title on my way to state! The important thing is—NO ONE is invincible, and it can happen to ANYBODY. That’s part of the risk we take being sexually active.

In my case, knowledge is power. I discovered “skin-tag-like” warts on and around my vaginal opening. I figured it was an allergic reaction to a bubble bath or something. After a week of no improvements, I did research on genital warts on the internet. I was almost positive I had them. I told me mother and we went to the doctor, and I am now undergoing treatment.

Unlike many others, I was able to trace the source of my STD. It was my first boyfriend and first partner. He had no idea he was carrying the virus (since there are often no symptoms). Since me, he has had over 10 partners…meaning possibly infecting over 10 people. They say, “You sleep with whoever your partner has slept with.” Never has the saying affected me more. I called him and told him what I had, what he had, what he should do (regarding telling his past partners), treatment he should seek, and other key facts. Once again, knowledge is power. I also called my most recent ex and partner in addition to the first. I was screamed at, and cursed, and he even threatened to kill me. It brought out a side I had never seen.

It hurt, but I did the right thing. I now understand why STD prevention may be difficult–it is hard to tell someone, especially when you get such a harsh reaction. I can’t lie. It was embarrassing, heartbreaking, and shameful. But as I told him, STDs are just one part of the risk we take from being sexually active, especially as teens.

Now to my third partner—my fiance. I have infected him. We are going to a clinic (so his parents won’t find out) next week for him. Luckily there are many low cost and even free STD screening and treatment centers for cases just like this. It was so hard for us to get through this. He, unlike me, waited for “the one” before having sex. Being honored, I never once thought that I might be capable of transmitting a disease to him. As he put it at first, “It’s like working and working and working hard for something your whole life- and then having it blow up in your face.” Yes, I gave my love an STD. The “perfect” varsity player with perfect grades. We found out that knowledge/education and communication is key. Though my communication issues were a bit more than just between us, it was something that had to be done. Something to think about.

My first partner was angry, and so embarrassed, he refuses to tell the 10+ people he slept with. Assuming they follow a pattern, in a years span (since he started having sex with others)- they sleep with three males. That’s over 30 people infected because of someone not speaking the truth. I have HPV. So does my fiance. We are normal- perhaps even considered “exceptional”—college students. His past: 0 partners. My past: 2 partners. All protected sex. We have HPV for the rest of my life. But we get through it together.

short movies from http://www.ashasexualhealth.org/sexual-health/personal-stories/

• http://www.ashasexualhealth.org/sexual-health/
• https://www.aasect.org/how-we-define-sexual-health
• http://portalzdrowiaseksualnego.pl/
• http://www.opzs.pl/
• http://ponton.org.pl/
• Period poverty: meet the women behind the campaigns to end it
• DfE's 'squeamish' sex education plans doomed to fail – women's group