Sex

Forbidden Words: Sexual Health

It is time to change our culture of shame

Posted Jan 20, 2018

"When it comes to sex, the most uncomfortable people in the room have all the power" Doug Braun-Harvey, Certified Sex Therapist

Few topics in our culture are as fraught with problems than sex and sexuality—especially sexual pleasure. Ironic, isn’t it, that something so central to our very existence and our happiness is so infected with shame and misunderstanding that so many of us feel uncomfortable even seeing the word in print?

This was dramatically illustrated by a recent experience I had while in the process of moving my office to a new location. My practice operates under the name, “The Center for Relationship and Sexual Health.” But when the name was listed on the building directory, I got a call from the building’s owner.

“We want to have a neutral building that doesn’t have any words that are upsetting to people,” he said. A pediatrician in the building had filed a complaint, concerned that her clients—parents and children—who saw the sign would be offended and take their business elsewhere. The owner asked others what they thought “sexual health” implied, and he reported that most thought it meant there would be sexual offenders in the building. It never occurred to me that these two words could be so widely misconstrued.

In some ways, I shouldn’t have been surprised. After all, we are living at a time in which the words “sex” and “sexual” are daily in the public forum—nearly all in the negative context of harassment and assault (#MeToo; #TimesUp; a President who brags about sexually assaulting women; politicians, pastors, and priests preying upon minors). At times when I have mentioned “sexual health” in conversations, I have been asked, “Are you having sex with your clients?” Or, “Is sex therapy just supporting the idea that ‘anything goes?’” We are sometimes confused with sexual surrogates, and we find that that the misnomer of “sex addiction” is widely seen as something common to child molesters, which is patently untrue.

None of this is part of “sexual health.”

istock by Getty Images
Source: istock by Getty Images

What really caught me by surprise, though, was that a doctor, someone from a profession that employs supposedly some of the most educated and trusted citizens, would project such irrational fears onto the name of a therapist’s practice who promotes sexual health. But gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health. Often, for doctors who hold conservative sexual beliefs, or have been raised with certain cultural biases around sexuality, talking about such subjects is anathema. It is sad when the sexual health of children, youth, and their families is erroneously confused with sexual non-consent by a pediatrician. Instead, it seems to me a perfect “teachable moment,” an opportunity for the doctor to educate their clients and help dispel the prevalence of negative and shameful attitudes about sex. In fact, the American Academy of Pediatrics has committed significant resources to the topic, and urges pediatricians to find time to meet individually with teenaged patients in order to confidentially ask them about sexual and reproductive matters, including STI prevention and HIV testing. The Society for Adolescent Health and Medicine also has an organizational commitment to sexual health, reproductive health, and relationship issues of adolescents.

Sex isn’t dirty, nor should people feel ashamed about talking about it. It can and should be one of the most central pleasures in life. Instead, people project their fears and naiveté onto the word, victims of misinformation and millennia of misinformation and sexual suppression. At my talks, people will even bring up such horrific and unrelated subjects as human trafficking in an attempt to sabotage an uncomfortable conversation about the positive aspects of our sexuality.

The aversion even extends to social media. I give talks and workshops around the nation on these subjects, and yet I find that when I am trying to promote events I have named “Smart Sex-Smart Love,” Facebook only allows me to promote “Smart Love.” Paradoxically, the term “sexual health” is commonly used by respected international health organizations. Even the U.S. Surgeon General has issued a report to the nation on sexual health. Research shows that about 40 percent of American women experience at least one period of sexual difficulty in a given year, perfectly demonstrating the need for this kind of therapy.

In trying to set the record straight, I find myself explaining that sexual-health therapy is “talk therapy,” not having sex in the office, and deals with such things as:

* helping couples with discrepancies in their erotic desires and fantasies

* problems related to painful intercourse or erectile disorders

* sexual difficulties following cancer treatment or childbirth

* breaking of relationship contracts and infidelity

* problems underlying the cessation of sex in a relationship

* religion-based shame around sexuality

* fighting over the use of porn by one or the other partner

* failure to have an orgasm

* helping parents to have conversations with their children or teenagers about sex

It is time we begin to have more open dialogue about something so important to our well-being and happiness, especially now when the subject

of sex is everywhere in the public space? It’s been reported that a third of all diseases among women of reproductive age are directly related to sexual and reproductive health. Doesn’t this emphasize the importance of speaking more openly about these things? Isn’t it time to educate our children about sex, not just about the mechanics and the problems of STIs, as does most school-based sex education, but about the proper and joyful ways in which sex can enhance our lives and relationships?

To my way of thinking, it should be obvious that there is a pressing need for such conversations in today’s world, and well worth the discomfort some may feel to begin to address the negative consequences of sexual ignorance and shame. 

References

1. https://www.cdc.gov/Healthyyouth/about/index.htm

2. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/adolescent-sexual-health/Pages/default.aspx

3. http://www.adolescenthealth.org/Resources/Clinical-Care-Resources/Sexual-Reproductive-Health/Sexual-Reproductive-Health-Resources-For-Adolesc.aspx

4. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180250 ​