The 24th World Congress of Sexual Health issued a "Declaration of Sexual Pleasure" on October 15, 2019. The purpose of this blog is to help to contextualize this declaration. Part of my interpretation of the context is that there has been a shift by professionals towards emphasizing sexual pleasure as an important component of sexual health, which is evident by this declaration at this time. That’s interesting because the emphasis in the past was more on sexual function, which is why Masters and Johnson’s model of human sexual response similarly emphasized functioning and gave rise to DSM diagnoses. With the growing emphasis on pleasure, it makes me curious about why. Is that where we “should” be going in terms of emphasis? Or is it just a part of the acceptance of “other” reasons to have sex, finally.
On one hand, pleasure is absolutely an important part of sexual health but why are we only now recognizing pleasure as central to sexual experience? Pleasure shouldn’t be a new concept when it comes to sex. It’s a built-in part of the human sexual experience for as long as sex has existed – after all, pleasure and reproduction have been paired by evolution to promote the survival of the species. Is the study of human sexuality that far behind the experience of individuals? Yes, it is. It took until the early 2000s for sexual health professionals to finally recognize that sexual distress was an important concept when diagnosing sexual disorders! Until then, you could have been diagnosed with a sexual disorder based solely on how your sexual responses (desire, arousal, action, orgasm, and refractory period) aligned with Masters and Johnson’s model. Even if your sexual responses did not cause you distress, it didn’t matter, sexual health professionals with influence had decided that there was still something wrong with you that indicated attempts to change. That ridiculousness should sufficiently demonstrate the degree to which sexual function was positioned as THE most important part of sex in the past.
So, on the other hand, might the emphasis on pleasure nowadays merely be a reflection of what society believes is most important about sex? Have we shifted from a belief that sex is about reproduction to a belief that sex is about pleasure? And does that also reflect our changing beliefs about how we make meaning out of our lives? Abrahamic religions have typically emphasized guidelines that reinforce the belief that sex is more about reproduction than hedonistic pleasure. Without these religious beliefs shaping as many individuals’ sexual beliefs, it appears that society has developed a more individualistic and egocentric view of sexuality (and an understanding of those factors would be crucial to understanding the reasons for that shift over the last few hundred years, which for the purposes of this blog, I am merely referencing the fact that less individuals turn to religion to answer the questions they have posed about life). I imagine that one’s opinion on whether this shift is positive or negative is dependent on one’s beliefs about religion. However, that’s not the topic I’m interested in for the purposes of this blog. I’m interested in thinking about the context in which this declaration of sexual pleasure was made. Sexual pleasure is pretty obviously an important element of sexuality when individuals are having sex because they want to feel good either through the pleasure gained by connecting to a partner(s) which may or may not include orgasm, or through the pleasure gained via the 5 senses which likely includes orgasm. But, I also regularly see clients who are primarily interested in the functionality of sex for reproduction. They want to have a baby so they are focused on what they believe is the function of their sexual encounter – male orgasm via penetration. And that’s not something that is just a given for all couples. Research has shown that couples who are sexually satisfied in their relationship do not meet their sexual goals in about 15% of their sexual encounters. That’s a number that couples need to know because it is very normal for even couples with happy sex lives to not always get the sex they want, and those couples still consider their sex lives to be happy.
My point is that what individuals consider important about sex is unique and cannot be assumed. We must be respectful of the differences that exist about what is important about sex because what is important is in the eye of the beholder. Sex for reproductive purposes is just as valid as sex for pleasure purposes. We may be witnessing a shift in society’s beliefs about what is important in sexuality, but maybe this shift merely reflects some increased acceptance and advocacy for sexual pleasure as a contrast to society’s previous emphasis on sexual function. Let’s listen to each other to understand what is important to all of us about sex, and put it all on an equally valid level. For now, this declaration celebrates sexual pleasure, so consider it as one of the reasons for your sexuality, but remember that there are many, many, many reasons to have sex and one person’s reasons are not better than others (unless we start talking about sexual offending, which I am not trying to discuss here).
The participants of the Congress of the World Association for Sexual Health in Mexico City declared that they:
Sexual pleasure is the physical and/or psychological satisfaction and enjoyment derived from shared or solitary erotic experiences, including thoughts, fantasies, dreams, emotions, and feelings.
Self-determination, consent, safety, privacy, confidence and the ability to communicate and negotiate sexual relations are key enabling factors for pleasure to contribute to sexual health and well-being. Sexual pleasure should be exercised within the context of sexual rights, particularly the rights to equality and non-discrimination, autonomy and bodily integrity, the right to the highest attainable standard of health and freedom of expression. The experiences of human sexual pleasure are diverse and sexual rights ensure that pleasure is a positive experience for all concerned and not obtained by violating other people’s human rights and well-being.
1. The possibility of having pleasurable and safe sexual experiences free of discrimination, coercion, and violence is a fundamental part of sexual health and well-being for all;
2. Access to sources of sexual pleasure is part of human experience and subjective well-being;
3. Sexual pleasure is a fundamental part of sexual rights as a matter of human rights;
4. Sexual pleasure includes the possibility of diverse sexual experiences;
5. Sexual pleasure shall be integrated into education, health promotion and service delivery, research and advocacy in all parts of the world;
6. The programmatic inclusion of sexual pleasure to meet individuals’ needs, aspirations, and realities ultimately contributes to global health and sustainable development and it should require comprehensive, immediate and sustainable action.
URGE all governments, international intergovernmental and non-governmental organizations, academic institutions, health and education authorities, the media, private sector actors, and society at large, and particularly, all member organizations of the World Association for Sexual Health to:
A. Promote sexual pleasure in law and policy as a fundamental part of sexual health and well-being, grounded in the principles of sexual rights as human rights, including self-determination, non-discrimination, privacy, bodily integrity, and equality;
B. Ensure that comprehensive sexuality education addresses sexual pleasure in an inclusive, evidence-informed and rights-based manner tailored to people’s diverse capacities and needs across the life span, in order to allow experiences of informed, self-determined, respectful, and safe sexual pleasure;
C. Guarantee that sexual pleasure is integral to sexual health care services provision, and that sexual health services are accessible, affordable, acceptable, and free from stigma, discrimination, and prosecution;
D. Enhance the development of rights-based, evidence-informed knowledge of the benefits of sexual pleasure as part of well-being, including rights-based funding resources, research methodologies, and dissemination of knowledge to address the role of sexual pleasure in individual and public health;
E. Reaffirm the global, national, community, interpersonal, and individual commitments to recognition of the diversity in sexual pleasure experiences respecting human rights of all people and supported by consistent, evidence-informed policy and practices, interpersonal behavior, and collective action.