Before I get to discussing some of the revelations from the Journal of Sexual Medicine's supplemental issue on findings from the National Survey of Sexual Health and Behavior (NSSHB) published yesterday, here's one startling stat, from commentary in the issue by former Surgeon General M. Joycelyn Elders, MD:
"Thirty percent of our healthcare cost is related to sexuality"
Think about that for a moment... thirty percent? When I meet people and tell them that I write about sex, sexuality, sex education, and sexual health professionally, these are sometimes dismissed as fringe topics. But they shouldn't be: As Dr. Elders points out in her commentary, "Sex for Health and Pleasure Throughout a Lifetime," these are topics that should and must be at the forefront of our national conversation and particularly at the center of any discussion or debate about healthcare reform. She doesn't go into any detail about that thirty percent figure, but we can assume that it includes costs related to gynecological exams, contraception, pregnancy (both planned and unplanned), sexual dysfunction, sexually transmitted infection, and treatment of sexually transmitted diseases including HIV/AIDS, all costs which, I might add, could be significantly reduced through improved sex and sexual health education.
Dr. Elders, as you may recall, is best known for being the first African American appointee to the office of Surgeon General of the United States (during the Clinton administration) and for being subsequently run out of town for daring to suggest that masturbation "is part of human sexuality, and perhaps it should be taught" in sex education curriculum. Of course we've always known, anecdotally, or at least assumed, that nearly everyone masturbates, but data from the National Survey of Sexual Health and Behavior confirms it: Nearly everyone masturbates regularly, and they do so throughout their lifetime, from adolescence through to at least their 70s. Among men, solo masturbation was more commonly reported than most partnered sexual behaviors for ages 14 through 24 and among those aged 50 years or older, with as much as 68.6 percent of men reporting solo masturbation during the past month. Among women, solo masturbation was reported by more than 40 percent of all women under 70 within the past year, and a greater proportion of those ages 14 to 17 reported lifetime solo masturbation compared with any other sexual behavior. Again, this is information worth knowing and worth discussing: We're not talking about fringe behavior or cultural taboo here: Masturbation is perfectly normal human sexual behavior, and we've done ourselves a disservice to treat it as anything else.
As Elders notes in her introduction,
"Sex is for far more than procreation once or twice in life; sex is also for a lifetime of pleasure. While this is not news to anone, it is not part of our national conversation... now it is time to include sex and sexuality as pleasurable and natural in open frank conversation about the human condition. Knowledge and open discussion are the paths to social change that lead us away from viewing sexuality primarily in negative terms and towards viewing sexuality as a part of life that is wholesome and pleasurable."
Elders references the three key strategies outlined in the 2001 Surgeon General's Call to Action to Promote Sexual Health and Responsible Behavior -- "1) increasing public awareness of issues relating to sexual health and responsible sexual behaviors; 2) providing the health and social interventions necessary to promote and enhance sexual health and responsible sexual behavior; and 3) investing in research related to sexual health and dissemenitating findings widely" -- and argues that we live in a sexually dysfunctional society.
Elders advocates for age-appropriate, science-based comprehensive health education in grades K-12 encouraging abstinence and counseling to reduce risky sexual behaviors without withholding critical information, if we are to achieve a sexually healthy society. Her full commentary is worth a read, as is the rest of the research and commentary on findings from the National Survey of Sexual Health and Behavior (Download the supplemental Issue of Journal of Sexual Medicine here), which I'll be examining in subsequent articles this week. For now, I'll leave you with Elders' conclusion:
"We have both a moral and ethical responsibility to protect all children and adolescents in our community. We cannot withhold information from children, adolescents, or adults, live in silence about this taboo subject and expect everything to turn out all right. We have tried ignorance and it does not work."
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