What is healthy sex?

Sex is a topic that is talked about a lot. If you go online, you can read thousands and thousands of articles about sex, one of the most popular headlines being: what is healthy sex?

Sex is also a topic which most people have strong opinions about. Naturally, we bring our own morals and values when talking about sex: I hear people talk about what is right, what is wrong, what is healthy or unhealthy, even what is normal and abnormal. I also hear professionals in the psychology field having the same rhetoric. When we start to think about sex with 'what is' we already go down a difficult path of debates. People asking the 'what is' imply that the focus should be on the sexual act. Thinking about sex from an act-centred framework opens the thinking to judgments, opinions, moralistic views. This idea of what is healthy sex is likely to be preached to the rest of us in the form of an article from an 'expert'. Well, the truth is that there is no agreed upon definition of what 'healthy sex' is.

Let's suspend our judgments and morals on sexual acts for a moment, and instead I am inviting you to look at sexual health. Unlike 'healthy sexuality', there is an agreed definition of sexual health (Pan America Health Organisation). The definition of sexual health is based on six principles. I believe that looking at sex with a defined principle-centred thinking is much more helpful than an act-centred thinking.

The six principles of sexual health are:

1- Consent. This should not need any explanation, but unfortunately many people seem to have difficulties with this. Consent can only be expressed from a person aged 16 or over, with a fully functioning brain. And 'no' means 'no'. Consent cannot be expressed from a person who has impaired thinking: under the influence of drugs or alcohol, for example. Anybody under the age of 16 cannot give consent in the UK.

2- Non-exploitation. This means to do what you and your partner(s) have agreed to do. For example, if you are in a monogamous relationship but decide to have an affair, you are exploiting your relationship. It causes great distress to your partner (often it is experienced as a traumatic experience). People in polyamorous relationships can also exploit their relationships if they deviate from what is agreed between them.

3- Protection from HIV, STIs and unwanted pregnancy. In the UK, there is still 45% of unplanned pregnancy despite having the best contraception technology. It is important to take your responsibility with contraception when you engage sexually with your partner. It is also your responsibility to make sure that you are at low risk of contracting a sexually transmitted infection. Often it requires an honest conversation with your partner, and an explicit agreement on how you are going to protect each other. If you have a STI that is infectious, it is your responsibility to disclose this to your partner or to put protection in place that won't knowingly infect your partner. The advances in HIV treatment has improved a lot over the last few years. It has now been shown that a HIV+ person on regular medication whose viral load is undetectable isn't at risk of infecting others.

4- Honesty. Being honest and upfront with your sexual desires and sexual needs is important. Everybody is different, and human sexuality is diverse. It is likely that your partner may not know all of what you like, need or want sexually. In fact, some people are not in touch with their own sexual landscape and all the parts of their body that is erogenous. Being able to express to your partner what you want or need is important. It can be difficult and it is a courageous conversation to have, because you can risk hearing your partner saying that they don't like what you like. When couples stay in a place of honesty and truth, often they can work some things out between them to achieve a fulfilling sex life.

5- Shared values. It is important that you and your sexual partner are 'on the same page' about what is acceptable and what is not. Our values are what we hold dear and it is difficult to compromise on those. If you decide to engage in a sexual practice that is against your own values, you are breaching an important part of yourself. Equally, do express your values to your partner. For example, for some couples, it is ok to play with a third person occasionally. But for other couples, it is unacceptable. Values can also be cultural or religious as those often play an important part in sex.

6- Mutual pleasure. Pleasure is one of the most important component of sex. For good sexual health, it is crucial that you make sure that what you do bring you pleasure and at the same time, to be able to hear what your partner finds pleasurable. It is a good idea to talk about it with your partner because it is not possible to assume. What one finds pleasurable can feel horrible to another person. Some people find pleasure in BDSM, others find it painful. We usually feel good when we bring pleasure to our partners and we also feel good when we feel pleasure ourselves.

We have sex for fun, entertainment, pleasure and also for procreation. Whatever purpose sex serves in your life at the moment, and whatever sexual activity you decide to engage in, it is all good sexual health as long as you can make sure that all six principles are being addressed. Most of my clients find this a really helpful guide to help them navigate through their sexuality and wondering what is healthy and not healthy.

Enjoy!