Sexual health education in the West has often focused on physical aspects of health and disease (UBC Learning Circle, 2018). However, sexual health goes beyond anatomical information and physiological facts. It includes pleasure, healthy relationships, expectations, consent, and boundary setting.
One model that utilizes a holistic approach to sexual health is the Sexual Wellbeing Learning Model. This model is rooted in traditional Indigenous knowledge and grounded in the belief that sexual wellbeing is a key component of holistic health and wellbeing. It acknowledges that stigma and judgement around sex is a colonial concept and includes the following four Indigenous values:
- protecting communities (safe sex)
- healthy relationships (communication, boundaries, and consent)
- identity (gender identity, expression and inclusion)
- and adulthood/ rites of passage (holistic health, nonjudgement).
To learn more about the Sexual Wellbeing Learning Model, visit UBC’s Learning Circle.
Barriers to Sexual Wellbeing: Stress & Sex
We often talk about how exercise, sleep, and nutrition impact our stress levels and wellbeing but what about sex?
When we are experiencing high levels of stress or even chronic stress, we are operating in “survival mode”, often referred to as flight, flight, freeze or fawn. This focus on survival can block both sexual pleasure and sexual interest (Nagoski, 2015). Research suggests that more than half of women report that stress, depression, and anxiety decrease their desire for sex, as well as their ability to become aroused and experience pleasure. Chronic stress can also impact the menstrual cycle and fertility (Nagoski, 2015).
Although the stressors themselves may be out of our control, managing our response to those stressors can allow us to control some aspects of our context, potentially improving our sexual wellbeing.
According to Nagoski (2015), completing the stress cycle is a key strategy and can look like the following: sleep, movement, meditation, affection, crying, creativity and expression to name a few. Sexual health research conducted by UBC’s Department of Obstetrics and Gynaecology also demonstrates the role that mindfulness can play in improving sexual functioning and satisfaction in women (Velten and Brotto, 2017).
Learn more about Dr. Brotto’s research
Communicating Pleasure
Not only is sexual pleasure contextual, it also differs from person to person. When discussing sexual needs and wants with a partner or partners, identifying and celebrating similarities and small experiences of pleasure is a great place to start (Rademacher, L., & Hoskins, L., 2017). Understanding where wants and expectations differ can be more challenging to navigate. However, no one is a mind reader and clear communication is an important piece of sexual health and wellbeing in a partnership or partnerships.
Some strategies from the Principles of Pleasure for having effective and positive conversations about pleasure and sex include:
- Using humour or a light-hearted tone. There are many layers of stigma and negative connotations around prioritizing your own pleasure. Approaching the conversation in a relaxed way might allow your partner to relax and feel less pressure as well.
- Set expectations prior to the conversation. If you are looking to discuss a need or want that you are feeling embarrassed or ashamed about, open with honesty. For example, “I feel embarrassed to share this and am hoping you can listen first.”
- Present your needs and wants in a positive light. Due to portrayals of sex in the mainstream media, we may feel “abnormal” if something doesn’t work for us or bring us pleasure. Thinking about experiences of pleasure as normal or abnormal creates a dichotomy around sexual health and wellbeing that simply doesn’t exist. Normalize checking in with your partner(s) about expectations on pleasure and sexual well-being (Rademacher, L., & Hoskins, L., 2017).
Embracing Pleasure
A pleasure-positive culture is tied to the belief that sexual wellbeing is a key component of health. Sexual health and wellbeing education, which includes education about pleasure, is connected to increased physical and mental health outcomes, self-esteem and relationship satisfaction (Rademacher, L., & Hoskins, L., 2017). This education is an important part of addressing the stigma around sex that adversely impacts 2SLGBTQ+ folks and often contributes to rape culture and prevents victims/ survivors of sexual violence from speaking out (GLSEN 2014), (Rademacher, L., & Hoskins, L., 2017).
Living in a pleasure-positive culture does not look like seeking out pleasure that is detrimental to your health or the health of others but involves developing agency and empowerment when it comes to your sexual health and wellbeing (Rademacher, L., & Hoskins, L., 2017).
What’s one thing you could do this month to support your sexual health and wellbeing? The resources listed below are a great place to start formulating your ideas for fostering your own pleasure-positive world.
Resources:
- https://www.optionsforsexualhealth.org
- http://qmunity.ca
- https://www.wavaw.ca/
- https://svpro.ubc.ca/faculty-and-staff/
- https://brottolab.med.ubc.ca/
Take care and be well,
Erica Altomare, Workplace Wellbeing Learning Specialist
References
Brotto, Lori A. et al. (2008). Mindfulness-Based Group Psychoeducational Intervention Targeting Sexual Arousal Disorder in Women. The Journal of Sexual Medicine, Volume 5, Issue 7, 1646 – 1659.
Iulia Dascalu & Lori A. Brotto (2018). Sexual Functioning in Experienced Meditators, Journal of Sex & Marital Therapy, 44:5, 459-467. https://med-fom-brotto.sites.olt.ubc.ca/files/2019/03/Iulia-Dascalu-Lori-A.-Brotto-2018-Sexual-Functioning.pdf
Kosciw, J. G., Greytak, E. A., Palmer, N. A., & Boesen, M. J. (2014). The 2013 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York: GLSEN. https://www.glsen.org/sites/default/files/2020-03/GLSEN-2013-National-School-Climate-Survey-Full-Report.pdf
Rademacher, L., & Hoskins, L. (2017). The Principles of Pleasure: Working with the Good Stuff as Sex Therapists and Educators (1st ed.). Routledge. https://doi.org/10.4324/9781315715872
UBC Learning Circle. (2018). Indigenous Perspectives on Healthy Sexuality with FNHA Indigenous Wellness Team. Faculty of Medicine. https://learningcircle.ubc.ca/2018/02/27/indigenous-perspectives-on-healthy-sexuality/
Velten J, Brotto LA (2017) Interoception and sexual response in women with low sexual desire. PLoS ONE 12(10): e0185979. https://med-fom-brotto.sites.olt.ubc.ca/files/2014/11/Velten-Brotto-2017-Interoception-sexual-response-in-women-with-low-sexual-desire-.pdf
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