In 2000, the Pan-American Health Organization, in collaboration with the World Health Organization and the World Association of Sexual Health, published the Promotion of sexual health: Recommendations for action, which included a description of responsible sexual behavior:
“Responsible sexual behavior is expressed at individual, interpersonal and community levels. It is characterized by autonomy, mutuality, honesty, respectfulness, consent, protection, pursuit of pleasure, and wellness. The person exhibiting responsible sexual behavior does not intend to cause harm, and refrains from exploitation, harassments, manipulation and discrimination (PAHO/WHO/WAS, 2000, p.8).
From this description, Mr. Doug Braun-Harvey (a sexual health author, trainer, and psychotherapist) harvested components that became the sexual health principles. First published in Mr. Braun-Harvey’s texts integrating sexual health into drug and alcohol treatment. The sexual health principles were further developed with Michael Vigorito by applying them to out of control sexual behavior treatment. Mr. Braun-Harvey identified the need to facilitate conversations about sexual health that could balance the person’s autonomy, while helping prevent harm to themselves and others.
The six sexual health principles ethical framework applies for positive, responsible, and pleasurable sexual interactions. The principles build off each other, but are equally important. For sexual health to be attained and maintained, all of the principles must be acknowledged by the individual and be discussed with the partners. The sexual health principles, Mr. Braun-Harvey says, “provide a map to balance couples and family conversations about sexual activity, sexual functioning, and sexual relationships before it is a problem or hurts someone”.
Consensual:
The most universal sexual health principle on the planet is consent. Healthy and positive sexual experiences require “voluntary cooperation” as Harvey says in an interview with Vivian Baruch. “Safe, consensual sex is a human right” (Wertheimer, 2003). Consent transforms the act of sex from “an invasion, intrusion or violation” into one of mutual pleasure. Brush up on your knowledge of consent with this video.
Non-exploitative:
Healthy sex cannot be exploitative sex. Exploitation is when a person leverages their “power and control to receive sexual gratification from another person, which compromises the person’s ability to consent” (Braun-Harvey & Vigorito, 2016, p. 47). The #MeToo movement is a reckoning related to sexual exploitation and assault.
Exploitation can also occur within romantic relationships. A misuse of power, at the center of a couple, presents problems often involving the consequences from one partner’s decision to unilateral change the couple’s sexual agreement. Commonly referred to as an affair, cheating, the cover-up, denial, or gaslighting was exploiting the partner’s trust, which allowed the individual to continue the affair while remaining in their primary relationship.
Protection from STIs and unintended pregnancy:
“This sexual health principle is evident when those involved in the sexual activity are capable of protecting themselves and their partners from an STI (including HIV) and unintended or unwanted pregnancy. This includes access to testing and medical care and to scientifically accurate information regarding disease transmission, reproductive health, and contraception resources” (Braun-Harvey & Vigorito, 2016, p. 47).
Honesty:
The honesty principle is twofold: open and direct communication not only between partners but with oneself too. Being honest with oneself involves a process of self-awareness about sexual pleasure, education, and values. Honesty is being aware of one’s physical and emotional needs—acknowledging when something feels good, indifferent or hurts. Is this pleasurable? Am I enjoying this? Am I doing this for the right reasons? Do we, as a sexual partnership, have an agreement in place already? Without honesty and effective communication, sexual rights, satisfaction, and agreements cannot be attained or maintained.
Shared Values:
Sexual relations require the clarification of motives, sexual standards, and the meaning of specific sexual acts for each person. As Mr. Vigorito discussed in our Sexual Health Alliance weekend OCSB training, “the meaning of touch changes depending on who is doing the touching, why they’re touching, where they touch, and with what part of the body they touch”. Shared values as a principle promote conversations between partners to acknowledge and clarify their personal biases and intentions when engaging in sexual activity. Not sure where to get started with identifying your values? Use this Sexual Value System to find your foundation.
Mutual Pleasure:
The sixth and final principle prioritizes the giving and receiving of pleasure. Pleasure is the main reason people have sex, both solo-sexual activity, like masturbation, or partnered sex. Pleasure is most likely to be attained and maintained when the other five sexual health principles are successfully met. Sexual health conversations are inadequate without valuing and promoting sexual pleasure.