Are We Talking Enough About Sex?

Eli Coleman in front of a mountain range

October, 2014

Providing infrastructure support for the Director of the Program in Human Sexuality is one of the major roles of the Chair in Sexual Health. Just as important is to advocate for sound sexual health policy based upon the best available science. As many of you know, I was involved in the public policy debate while I was Senior Advisor and Scientific Editor for the US Surgeon Generals Call to Action to Promote Sexual Health and Responsible Sexual Behavior (2001). While that report continues to have tremendous impact and is regularly cited 15 years later, the U.S. Government has not built an adequate national strategy as was recommended in that Report.

In 2009, the effort was picked up by the Centers for Disease Control and Prevention (CDC) and they attempted to resuscitate that work. I worked closely with CDC leaders to articulate a framework for sexual health promotion within the CDC with the hopes that it would unify and amplify efforts across their many divisions. At that time, the hope was that such a report would stimulate new national strategies in the Department of Health and Human Services and at the National Institutes of Health. Unfortunately, that report never saw the light of day due to philosophical and political differences, illustrating America’s deep discomfort with and divide over sexuality!  

Fortunately, Former US Surgeon General David Satcher, Edward Hook III and I were able to rescue some of the work at CDC. We published an article in the Journal of the American Medical Association this past summer, outlining a basic approach and a call for a national strategy to promote sexual health.  

We noted that since the Surgeons General report in 2001, reproductive and sexual health morbidity in America continues to escalate and far exceeds that of other developed nations.  We noted that this is costing taxpayers almost 40 billion dollars, not to mention the implications of the emotional toil this was taking in terms of interpersonal relationships, self-image, and mental health.   

While not a new method to some, we advocated for a sexual health concept that emphasized a positive, holistic, flexible, and comprehensive approach to disease prevention and health promotion. This involved five key principles: address the underlying socio-cultural and social determinants of health, emphasize wellness, focus on positive and respectful relationships, acknowledge the impact of sexual health on overall health, and an integrated approach to prevention.

This journal article explained that this was not just a good idea but that there are evidence-based sexual health interventions that embody these principles and should be more widely utilized and further developed.

In moving the agenda forward, we recognized that this country has to put more effort into normalizing our conversations regarding sexual health and to do everything we can to reduce stigma, fear, and discrimination regarding sexuality and sexual expression. Our article emphasized that sexual health issues exist across the lifespan. The sexual health framework we outlined would improve a range of outcomes important to health across a lifetime. The framework would increase knowledge, communication, and respectful attitudes. It would support healthy, responsible, and respectful sexual behaviors and relationships. Ultimately, this framework would lead to a reduction in central public health outcomes including HIV/AIDS, STDs, viral hepatitis, unintended pregnancy, and sexual violence. But just as important, it would lead to a sexually healthier nation - sexually satisfying and enjoyable sexual expression as well as increased joy in people’s lives.

The challenge has once again been put forth. Will politicians and policy makers accept the call and embrace these changes? We will continue to advocate for this sexual health framework. There is still much to be done but we continue to plant these seeds of change. Your continued support is always greatly appreciated!

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