Michael Guyton, MD
Sexual health is about so much more than birth control and STI protection (even though both are still very important!). Sex is still a taboo subject, so information on it is often confusing and contradictory. September is Sexual Health Awareness Month so we asked, “What does it mean to be sexually healthy?” Broadly, being sexually healthy means that you are aware of your own comfort level with sex, know how to create a safe relationship with sex itself, and understand its risks and benefits.
But what does that actually look like?
You take care of your body.
First things first: It’s impossible to be sexually healthy if you are putting yourself in danger. Use condoms to prevent pregnancy and protect against STIs, including HIV. If you’re having sex, make STI testing a routine part of your life, just like you get your blood pressure checked at each doctor’s appointment.
If you or your partner is capable of getting pregnant, use birth control. There are a range of options available. Make an appointment to talk to your doctor about what option is best for you as soon as you start considering having sex. Condoms are a great, effective way to prevent pregnancy, but accidents can happen. Have a backup.
And remember: Sex shouldn’t hurt. If you’re bleeding or in pain, stop! Have a different type of sex that feels good. Try using lube. Talk to your doctor if it’s not getting better.
You understand what sex is.
When people talk about sex, they often mean PIV (penis in vagina) sex. But sex is actually a whole spectrum of activities. Sex includes oral sex, anal sex, and even masturbation. It may include toys! It might involve fingers!
If you’re engaging in any of these activities, you’re having sex. Tell your doctor. Each type of sex comes with its own pluses and potential risks, and it’s important to be aware of them. (Pro tip: Did you know that you can still get STIs from sex toys?) Keep in mind that masturbation is a healthy, safe way for everyone to explore their sexuality.
You are comfortable with sex.
Say the word “sex” out loud. How do you feel? Excited? Uncomfortable? Awkward because everyone on the bus is shooting you weird looks now? It may seem silly, but this should help you figure out how comfortable you are with sex, and how ready for it you are.
Part of being comfortable with sex is not shaming yourself or others, whether it’s for how much sex someone has, who they have sex with, what kind of sex they have, or their sexual identity.
You communicate about sex.
Communication means really listening and responding to your partner. You also need to be able to talk to your partner about STIs, birth control, boundaries, and desires. You need to be honest with your doctor so they know how to best treat you.
Plus: Sex is fun! How are you supposed to get what you want in the bedroom if you can’t ask for it?
You understand that sex is powerful.
Sex can be a fun, fulfilling addition to a relationship, and a great way to get to know yourself better. But it can also destroy relationships, cause distress, and harm your body. To be sexually healthy, you need to understand both the benefits of healthy sex, and the potential consequences of unsafe or unwanted touch. If you’ve had a bad experience with sex, it’s ok to talk about it. Your feelings surrounding sex and relationships are probably particularly complicated. Talk to your doctor.
If you don’t understand that sex is powerful, you may unintentionally violate your partner’s consent. Consent is crucial for every step leading up to sex. Ask your partner not only what they’re ok and not ok with, but what they’re excited about! If their yes is not a “hell yes!”, then it’s a no. Don’t ask for a sex act repeatedly, don’t keep trying to “get away with” something once your partner has expressed hesitation, and don’t make your partner feel bad for saying no, even if they’ve said yes in the past. Remember: Consent can be withdrawn at any time. Never, ever, force anyone to have sex.
Because sex is powerful, it’s important to feel comfortable turning it down. You don’t need a reason, so don’t let anybody make you feel like you do. If you’re feeling uncomfortable (or just aren’t in the mood! Or don’t find someone attractive! Or smell something a little weird down there!), you owe it to yourself to say no.
You know why you’re having (or want to have) sex.
Having sex is a personal choice led by personal motivations: curiosity, desire, love and intimacy. Countless other reasons may also come into play, including the desire to please your partner and pressure from friends. While this is a personal choice, there are some situations where sex can be illegal (like prostitution or having sex with someone very young). Know the difference, and if you don’t know, ask!
You don’t have to be having sex or even be interested in sex to be sexually healthy. It’s completely normal to not want to have sex, or to think it’s gross. Maybe you’ll become interested over time, or maybe you won’t—either is totally fine!
Dr. Michael Guyton is currently serving as an Adolescent Medicine Fellow at MSAHC after earning his M.D. from the University of South Carolina. His areas of clinical interest include preventative screening tools for adolescents in the primary care setting, mental health services for LGBT youth, and health education with particular focus on college-aged youth. Michael is also a member of the Girlology/Guyology Team, providing age-appropriate health and sexuality education for grade- and high school-aged boys.
The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.