In many contexts, particularly in the United States, “sexual health” is used synonymously with the treatment and prevention of undesirable sexuality-related outcomes–––such as STI/STDs, unintended pregnancies, maternal mortality, sexual violence, and discrimination against/stigmatization of those who are not heterosexual, cisgender, and white. However, according to the World Health Organization’s (WHO), sexual health is actually so much more:
“…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).
The American Sexual Health Association adds that “having a sexually transmitted infection or unwanted pregnancy does not prevent someone from being or becoming sexually healthy.” Having sexual experiences that are not only physically safe, but also pleasurable, is therefore the critical benchmark to achieving optimal sexual health.
Pleasure plays an important role in the health benefits of sex. Beyond getting the heart pumping and blood flowing, the neuro-chemicals released during orgasm also function as an analgesic (pain reliever). As early as 1961 researchers have observed the effects of masturbation as a way to reduce pain. Sexual arousal - especially when it includes an orgasm - can reduce lower back pain, as well as increase pain tolerance for cis women.
In addition to the physical health benefits, sexual pleasure (and strong sexual connections) have shown to support healthier relationships, increased self-esteem, and improved mental health outcomes. Masturbation helps us learn about bodies, making it easier to communicate what does and does not feel good with our sexual partners. When we understand our pleasure, we are better equipped to communicate our boundaries and advocate for our desires. It is easier to say “no” to unwanted behaviors when one feels empowered to say ‘yes’ to what they do want.
Unfortunately, pleasure is rarely presented as a meaningful and necessary component of sexual health. In fact, more often those who dare to present pleasure as a positive and healthy component of sexual health are often vilified, censored, and/or experience retribution.
Take the incident that served as a catalyst for the first National Masturbation Day (which later evolved and expanded to Masturbation Month) as an example. In 1994 at a United Nations conference on AIDS, the US Surgeon General, Dr. Joycelyn Elders, was asked whether it would be appropriate to promote masturbation as a means of preventing young people from engaging in riskier forms of sexual activity. She responded, "I think that it is part of human sexuality, and perhaps it should be taught." As a result, she was forced to resign from her position as Surgeon General by then-President Bill Clinton.
Sadly, nearly 30 years later, the United States’ attitudes toward pleasure haven't changed much. Today many online communities (predominantly women, trans, nonbinary, BIPOC, plus-sized, and/or sex worker communities) have had their voices silenced as online platforms have either disappeared or rolled out anti-sex policies in response to a package of bills known as FOSTA-SESTA. In addition to the negative impact this has had on the safety of sex workers, the censorship enacted by such policies has significantly reduced - and in some cases eliminated - access to sexuality resources and pleasure-affirming sexual health information. By restricting access to medically-accurate information about our bodies, identities, and desires, we place those who are most vulnerable at greater risk of harm and silence the voices of those who already experience systemic oppression. This further compounds existing health inequities fueled by ableism, racism, classism, and sexism, in addition to homophobia and transphobia.
Sexuality is a huge part of who we are as human beings, and it is informed by our experiences and the world we exist in - including the cultural and social norms around who is permitted pleasure. We must make room in the conversation for desire and pleasure as an essential piece of sexual health.
Written by SHIP, formerly The Center for Sexual Pleasure and Health (The CSPH), is a nonprofit organization dedicated to providing medically accurate, consent based, and pleasure guided sexuality education, therapy, and professional training to adults. We provide the sex education you deserve.