The Six Pillars of Sexual Health


Editor’s Note: This article is part of a series developed by the American Social Health Association (ASHA) in celebration of Sexual Health Month (September) 2012. See the ASHA articles published by RHRC here and visit ASHA online for updates. Cross-posted with permission from the American Social Health Association (ASHA).

Sexual Health. Two words that conjure up images of a gym teacher in front of a blackboard, rows of foil-wrapped condoms, and PSAs about preventing HIV and other sexually transmitted infections (STIs).

Are all those visions included in the world of sexual health? Sure. But there’s a lot more to it. I’ve spent the majority of my life getting people not only to broaden their definition of sexual health, but to understand that sexual health is part of their overall health. It’s hard to have one without the other.

Sexual health is the foundation for who we are and how we operate in our lives. When I heard that my friends at the American Social Health Association were going to devote an entire month to providing fact-based and personal perspectives on sexual health, I was in.

My goal as a sexuality educator has always been to get students to redefine the concept of sexual health. In my lectures, I like to frame it as a larger concept with six pillars: physical, emotional, intellectual and cognitive, relational, political (yes, political), and cultural. If that doesn’t make sense (and it may not right away), consider the following:

Physical sexual health includes taking care of your overall health, using protection (condoms, dams, or other barriers) regularly, using contraception until you want to become pregnant, having pleasure or the potential for pleasure, getting tested regularly for STIs, and treating or curing an STI that you may currently have.

Emotional sexual health includes feeling comfortable with your decisions to engage or not to engage in sexual activities; feeling good about your sexual orientation; owning your sense of gender and gender identity; having self-confidence; feeling good about your body; feeling fulfilled (not just in a relationship but on your own); and feeling comfortable talking about your sexuality and sexual health to partners and health-care providers.

Intellectual and cognitive sexual health includes being familiar with how your body works (including your genitals and reproductive systems); knowing about the outcomes (positive and potentially negative) of various sexual behaviors; knowing how to use condoms correctly; knowing where to access reproductive-health services; knowing about different contraceptive methods and how they work; and having the information to make smart decisions about all sex behaviors. 

Relational sexual health includes assessing the health of your relationship or partnership by asking these questions: Do you have a voice in your relationship? Can you speak up about pleasure? Can you ask about protection? Can you share your emotional and physical needs? Does your partner respect your needs and or boundaries? Is there balance, equality, and mutual respect? Can you talk to your partner about STIs and your personal sexual health status? Do you communicate well?  

Political sexual health includes having access to tools, sites, and services. Okay, so a little personal monologue here. While I would love people of all ages to be concerned with how they approach their sexuality, sexual health, and relationships, we are severely challenged in the political arena. Sexual health isn’t just about what we do. It’s about what is done to us. Which means that it is impossible to be sexually healthy if our cultural and political structure puts up physical or metaphorical barriers to accessing the tools for sexual health. So while you may have different values than I, the following issues all affect our ability to be sexually healthy: sexuality education, access to emergency contraception, affordable contraception, reproductive health services, preventive care, and abortion care, to name a few. 

Cultural sexual health includes good media and cultural messages. Every culture has its own standards and belief systems when it comes to sex and sexuality. In a perfect world, those standards enhance our sexual health, but in many cases, these systems hinder it. Consider the effects of perpetuating the sexual double standard or the sexualization of women and girls. Think about how treatment of same-sex couples or our transgender population affects sexual health. 

In a perfect world, we are empowered by all these sexual-health pillars. At any age we have the ability to be sexually healthy and to do better for our young people and for ourselves. 

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