You say sexual health, we say pleasure- positive and inclusive sexuality and health programmes
Sexual pleasure remains a highly significant, if not primary, motivating factor for sexual behaviour (
World Association for Sexual Health (WAS), 2008).
There are as many definitions of sexual pleasure as there are people in the world – it is hard to define, is understood in diverse ways, and often has a culturally distinct basis for each of us; however, it is still associated with shame, and the pursuit of sexual pleasure is usually positioned as a cause of, or contributor to, disease (
Anne Philpott, Arushi Singh, et al. 2017).
We are usually educated only about what to avoid, like disease or death, rather than what we could aim for.
Understanding this diversity is crucial for pleasure-focused programmes. Sexual health programmes tend to focus on delivering safer sex messaging with an aim to reduce ‘risk taking’, assuming individuals make ‘rational’ sexual decisions based only on health considerations. However, there are other factors affecting sexual decision-making, including gender, culture, notions of intimacy and/or authenticity, and desire (Knerr, W and Philpott, A; 2012). Overall, the public health sector has dealt with the concept of sex – or more specifically sexual activity – largely in the context of penis-in-vagina penetration for the purpose of procreation, or penis in anus or mouth, while ignoring the wide range of other activities that people find sexual or stimulating.
What is clear is that sexual pleasure is not always directly linked to arousal or orgasm. While the diverse ways that people define sexual pleasure is under-researched and under-reported, it is clear that cultural notions of what constitutes sex and what is pleasurable have massive implications for effective sexual health programmes, and prevention work must open up a dialogue about how the regulation of sexual pleasure is understood in different cultures. It is important to consider conceptions of sexual pleasure if we are to have pleasure-focused sexual health programmes.
The Pleasure Project is an initiative of Taking Action for Sexual Health. Photo: © The Pleasure Project
Since it was established in 2004, The Pleasure Project has been bridging between the public health world and the sex industry and has been putting the sexy back into safer sex. It is an international organisation that envisions a world where sex is satisfying and safe with a mission is to ensure that ‘Safe, pleasurable sex is an essential part of sexual health programmes’. The Pleasure Project provides training, consultancy, research and publications for sexual health counsellors, NGOs and others who want to take a more sex-positive, pleasure-based approach to their work. Our training toolkit on the Secrets of Mixing Pleasure with Prevention is available for use from our website. We have also built a body of evidence around using pleasure-based messaging to promote safer sex and prevent HIV, and have global recognition as ‘the agency’ that championed putting pleasure into sexual health programmes. The Pleasure Project is currently working with the World Association of Sexual Health on a declaration of pleasure and health to be launched in October 2019 at their global congress. Given this history, and the recent recognition among several sexual health organisations of the importance and need for sex-positive, pleasure-based programmes, The Pleasure Project developed a working definition of a pleasure-based approach.
A pleasure-based approach is one that celebrates sex, sexuality and the joy and wellbeing that can be derived from these, and creates a vision of good sex built on sexual rights. It focuses on sensory, mental, physical and sensual pleasure to enable individuals to understand, consent to, and gain control over their own bodies and multi-faceted desires. Well-being, safety, pleasure, desire and joy are the objectives of a programme with a pleasure-based approach. This approach measures empowerment, agency, and self-efficacy by whether or not an individual has been enabled to know what they want, and can ask for it, and request this of others, in relation to their sexuality, desires and pleasure.
This definition goes further than a sex-positive approach, which has been defined as ‘an attitude that celebrates sexuality as a part of life that can enhance happiness, bringing energy and celebration. Sex-positive approaches strive to achieve ideal experiences, rather than solely working to prevent negative experiences. At the same time, sex-positive approaches acknowledge and tackle the various risks associated with sexuality, without reinforcing fear, shame or taboo surrounding the sexualities of young people (IPPF 2016). While, this is an important approach for sexual health programmes, The Pleasure Project advocates for larger goals and objectives of these programmes to be focused on pleasure as a measure of sexual agency and empowerment.
Photo: © The Pleasure Project
Rights, pleasure, action!
Even though this field remains under-researched, the evidence that does exist tells us that the inclusion of pleasure in sexual health programmes leads to more safer sex, self-efficacy, and empowerment among women (Scott-Sheldon, Lori and Johnson, Blair T. ; 2006). Programmes that include issues such as gender norms, psychological and social aspects of sexuality, sexual orientation, sexual expression and pleasure, violence, and individual rights and responsibilities, contribute to the attainment of goals on social health and development, livelihoods, gender equity, emancipation, communication and community well-being (Vanwesenbeeck, I, et al. 2016).
There are connections between pleasure and gender equity, women’s rights, and overall mental health and wellbeing. The common gender and sexuality norms of women as passive and ignorant makes it difficult for women to be informed about sex, sexuality and safer sex. In many cultures and contexts, women are at risk of violence or other negative consequences if they are seen to ‘enjoy sex too much’, because this brings into question their virginity or fidelity. The focus on ignorance and virginity as ‘feminine’ increases risks, as it keeps women uninformed about sexual health, and this is often compounded by erroneous beliefs and myths about sex, such as that men can be cured of HIV by having sex with a virgin. When women do report on their own pleasure, it is sometimes ignored because it doesn’t fit the development world stereotype of women as passive victims of sex. On the other hand, the more positive people are about sex and sexuality (and their right or ability to experience sexual pleasure), the more confident they seem to be about practicing safer sex. There is evidence that attitudes about sex and sexuality influence safer-sex practices.3
There are documented examples of organisations and individuals who have incorporated sex-positive and pleasure-based approaches in their work (The Pleasure Project; 2008). As mentioned earlier, in recent years, there are even more organisations, programmes and individuals that are adopting these approaches. The Pleasure Project has brought together these examples in its online ‘pleasure map’ to serve as a resource for the community of practice on pleasure. This map has examples from all over the world including the global south.
Other than compiling resources on pleasure-based approaches, The Pleasure Project is also developing a tool to measure how well these approaches have been implemented, their impact, and recommendations to improve them. This tool is intended to understand and unpack what is meant by an environment that is ‘positive towards sexuality’; what role ‘pleasure’ plays into this; how or if it is discussed; what are the contextual factors affecting this discussion; and how the pleasure-based, sex-positive approach can be strengthened. Efforts to use pleasure and desire as motivators for safer sexual behaviour and self-efficacy require an understanding of sexual pleasure and overall well-being crafted in a way that makes it useful in research and programs in a range of contexts. We will know more when organizations start implementing quality, pleasure-based approaches and measuring impact.
Our vision is a world where pleasure-inclusive sex education and sexual health programmes are the norm and recognised as both best practise and effective.
References
- WAS (2008) Sexual Health for the Millennium: A Declaration and Technical Document, Minneapolis MN: World Association for Sexual Health
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Philpott, A, Singh, A and Gamlin, J (2017) Blurring the Boundaries of Public Health: It’s Time to Make Safer Sex Porn and Erotic Sex Education, ‘Sex Education in the Digital Era’, IDS Bulletin Vol. 48 No. 1
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Knerr, W and Philpott, A (2012) Everything you wanted to know about pleasurable safer sex but were afraid to ask, Pathways of Women’s Empowerment Research Programme Consortium | IDS Sexuality and Development Programme, UK
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IPPF (2016) Putting sexuality back into Comprehensive Sexuality Education: making the case for a rights-based, sex-positive approach, London: IPPF
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Scott-Sheldon, Lori and Johnson, Blair T. (2006) ‘Eroticizing Creates Safer Sex: A Research Synthesis’, Journal of Primary Prevention 27.6: 619–40
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Vanwesenbeeck, I, J Westeneng, T de Boer, J Reinders & R van Zorge (2016) Lessons learned from a decade implementing Comprehensive Sexuality Education in resource poor settings: The World Starts With Me, Sex Education, 16:5, 471-486, DOI: 10.1080/14681811.2015.1111203
- The Pleasure Project (2008) The Global Mapping of Pleasure: A directory of organisations, programmes, media and people who eroticize safer sex
