On World Sexual Health Day, WHO celebrates every person’s right to sexual wellbeing
How does the World Health Organization (WHO) define sexual health – and what do we bring to this annual, global celebration of sexual health, well-being and rights for all?
From the absence of disease to well-being: the continuum of sexual health
Sexual health is relevant throughout a person’s life, through to adolescence and into older age – not only during their reproductive years.
It is determined by the quality and safety of people’s relationships: with oneself and other individuals, with family and friends, and the society in which we live, including the gender norms that shape our experiences. These relationships are themselves dependent on whether everyone’s human rights related to their sexuality are realised and protected.
WHO’s working definition of sexual health emphasises a positive and respectful approach to sexuality and sexual relationships, one that cannot be separated from sexual well-being:
“Sexual health is a state of physical, emotional, mental and social well-being related 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.”
What is WHO doing to promote sexual health and well-being?
Enabling all people to achieve sexual health and well-being requires tailoring normative guidance and national programming to meet their specific needs and lived experience: welcoming and inclusive of people with diverse sexual orientations, gender identities and gender expressions, sexual characteristics, people living with HIV, and with disability.
“Sexual health is not a fixed state of being, and every person’s needs will change across the life course,” said Ian Askew, Director of the WHO Sexual and Reproductive Health and Research department, including the United Nations Special Research Programme HRP.
“This is why it is crucial for WHO, together with HRP, to undertake a range of activities across this continuum: from support of sexual well-being, to prevention and management of disease.”
WHO and HRP activities include:
education, counselling and care related to sexuality, sexual identity, and sexual relationships
addressing sexual function and psychosexual counselling
promoting positive sexual and psychosocial development
prevention and control of sexually transmitted infections (STIs), including HIV
prevention and management of cervical and other cancers of the reproductive system.
Sexual well-being can be conceptualised in various ways, including sexual respect, sexual pleasure, sexual self-esteem and self-determination in one’s sexual life.
Robust, transparent and comparable sexual health-related data are needed to ensure adequate services. WHO and HRP are coordinating a global research programme to better understand people’s sexual practices, behaviours and health outcomes and inform national programming to achieve sexual well-being. WHO and HRP are also exploring whether sexual and reproductive health interventions which incorporate sexual pleasure considerations improve relevant health outcomes.
What next for sexual health and well-being?
Interventions specifically intended to improve sexual well-being are gradually emerging.
A major milestone is the new edition of the International Classification of Diseases (ICD) which has a chapter on sexual health for the first time. By providing the latest evidence-based definitions, WHO is facilitating the diagnosis and appropriate management for a wide variety of conditions related to sexual health. Countries will begin using this chapter from January 2022.
Comprehensive sexuality education (CSE) is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. WHO recently collaborated with partners, including HRP, to develop guidance for out-of-school CSE programmes that are appropriate and safe for different groups of children and young people. This complements the guidance developed by the United Nations on school-based sexuality education. Both these guidance documents reiterated that sexual activity part of normal and healthy living, as is giving and receiving sexual pleasure.
Another recommendation is for policy-makers to integrate brief sexuality-related communication when possible, a clinical tool for behaviour change which takes a holistic and positive understanding of sexual health and sexuality.
Sadly, this is not everyone’s reality. Many women, girls and gender-diverse persons experience non-consensual and violent sexual activity. WHO and HRP are supporting national efforts around the world to prevent and manage the consequences of all forms of sexual violence.
To eliminate diseases that affect sexual health, WHO is developing new global strategies to address STIs, including HIV – while taking into account the current pandemic-induced health system disruptions.
Addressing challenges in sexual health and well-being
To eliminate diseases that affect sexual health, WHO is developing new global strategies to address sexually transmitted infections (STIs), including HIV, while taking into account the current pandemic-induced health system disruptions.
Given the many evidence gaps for achieving universal access to STI/HIV services, WHO is currently prioritising a research agenda for improving the implementation of national STI programmes. This agenda will complement WHO’s leadership in developing innovative point of care tests (POTCs) for quicker and more accurate diagnostic testing, and in specifying the “Global STI Vaccine Roadmap” to guide research and development for new vaccines against STIs.
One particularly pernicious disease associated with sexual activity is cervical cancer. WHO has launched a global strategy to accelerate the elimination of cervical cancer, and most recently issued a guideline for screening and treatment of cervical pre-cancer lesions, a key intervention for cancer prevention and control.
A central aspect of being human
Good sexual health is fundamental to the overall health and well-being of individuals, couples and families, and to the social and economic development of communities and countries.
While sexual health and rights and reproductive health and rights are closely linked, crucial aspects of sexual health can be overlooked when grouped under the domain of reproductive health. WHO is committed to identifying and promoting sexual health itself, so that everyone, everywhere is able to fulfil their human rights related to their sexuality and sexual well-being.
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