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Yesterday, I attended a lovely workshop titled "Operationalizing Sexual Health," which generated discussion around what exactly we mean by this term. It was an interesting discussion, prompted first by a group activity where participants were forced to stand on either side of the room to indicate whether or not they thought a given activity or idea was part of sexual health. One side was labelled "THIS IS NOT SEXUAL HEALTH," the other "THIS IS SEXUAL HEALTH."
Then they called out activities like "mutual masturbation" or "douching" and we were forced to pick a side, and then discuss. I was one of the few defenders of douching as part of sexual health, arguing that -- for me -- douching can give me anal confidence, which can promote pleasure in my sexual life. But most folks of course were thinking strictly in terms of the public health / STD transmission / risk model of sexual health.
We then broke up into groups to come up with our own definitions of sexual health. After a lengthy and complicated discussion, our group came up with this definition:
Sexual health is more than just the absence of sexually transmitted diseases. It is first and foremost individually and culturally contextual, but generally includes: 1) The ability for people and their partners to set boundaries and make informed consensual sexual decisions; 2) The ability to feel good about those decisions, without fear or stigma; 3) A claim to pleasure and/or intimacy in whatever way people see fit; and 4) The access to communities and institutions that support and promote healthy sexual lives.
I edited that last bit just a tad to say "healthy sexual lives" instead of "those decisions" -- I think it's a bit stronger that way. What do folks think? A good start? Is something radically missing?
I'm starting to wonder if maximalist definitions of sexual health are the right way to go, because they support the extension of HIV biopolitics into almost every corner of gay life - under the rubric that it's all context. Maybe it would be better to say 'sexual health promotes the absence of sexually transmitted infections' and deal with mental health, sexual racism, alcohol and other drugs, as gay men's health issues in their own right, rather than tying everything back to HIV via risk - and risk thinking kinda haunts the definition you've quoted here, via the focus on 'decisions' rather than practices or dispositions.
I'm not sure I agree. Where is the HIV risk in that definition? I mean decisions in terms of who you have sex with, what kind of sex you have, and the pleasure you get from that sex. Can you rewrite it to perhaps be less focused on risk? I just can't see it at the moment...