What is sexuality?

Sexuality is often mistaken with sexual behaviour or the sexual act, as if it were affected only by biological and physiological attributes. A more comprehensive definition of sexuality encompasses not only biological, but also social and cultural factors:

Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships.  While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical and religious and spiritual factors.

Physical and emotional aspects, attitudes, meanings, practices, behaviours, identities and knowledge all affect sexuality. All these factors are socially defined and mediated by class or cast, ethnicity, gender and age. Sexuality is a multidimensional and dynamic concept whose meaning and expression change over time, and vary across cultures and for different people in different contexts. An individual experiences sexuality differently at different stages of life. The social construction of sexuality incorporates individual and collective beliefs, thoughts and conditions about the nature of the human body, about sexual practices, about sexual meanings and sexual orientation that are conceived as suitable or unsuitable for men and women.

Gender roles and power imbalances play a major role in mediating sexuality, sexual relations, as well as sexual health and ill-health. In some countries, societal beliefs about sexuality underline male aggression and sexual arousal, in contrast to female passivity and resistance. Men are seen as the ones performing and dominating sexual intercourse, while women are denied sexual pleasure. These prescribed gender roles and constructions can inhibit women's and men's ability to enjoy a healthy sexual life. For example, in some countries, socially constructed roles have been shown to have kept women uninformed about their bodies, subjected to discrimination and abuse, and with low self-esteem. Conversely, prescribed gender roles for men have, in some settings, led to a sense of uselessness and impotence when they can not fulfil their economic role as provider for their families, and in the extreme case – when men are not able to provide financially for their children – they are not welcomed into the home as the father or sexual partner.

The family as promoter of sexual health?

In many societies, decisions related to sexuality, such as when to first engage in sexual activity and when to have children, are influenced by the family and community, as well as the individual. In most cases, the views of older people are particularly influential.

Optimally, the family can and should play a protective, safe and supportive role in the lives of young people as they come to face these early important decisions about their sexual lives. Evidence suggests, however, that parents themselves often do not feel comfortable discussing sexuality with their children for a variety of reasons ranging from cultural or social shame associated with discussion of sexuality and sexual practices, to fear and lack of knowledge about their own bodies and its functions. As a result, parents are unfortunately often a barrier – perceived or real – to the adolescent's sexual decision-making process.

In addition to lack of comfort and knowledge, parents often struggle to understand and adapt to external forces that are reshaping the way people are living and working. Globalisation has entered into the lives of people everywhere, with profound effects on family structure, social cohesion, and cultural and social norms. Where families once lived collectively in Southeast Asia or Southern Africa, economic imperative now leads younger members to migrate to urban areas or trade zones for jobs and perceived better futures. In Eastern Europe and Latin America, strong community ties have given way to more individualistic lifestyles with individuals and nuclear families trying to make it on their own. Without the continued influence of the extended family and community, and traditional patterns of socialisation and acculturation, people – particularly young people – often find themselves in circumstances where what they had been taught regarding how to organise their social and sexual life no longer applies. Television images, radio messages and internet chat rooms create new sexual expectations and desires. As a result, people often find themselves in, or are seeking relationships that may increase risk-taking behaviour by putting themselves in circumstances where they are socially and sexually vulnerable. Managing these competing forces requires various strategies with often multiple entry points.

Given the competing forces and changing environment, how can we expect family members – most of whom suffer similar social and cultural constraints related to their own sexuality – to pave the way for the foundation of healthy sexual expressions, behaviours and experiences of their children? However, family members, as a dominant force in most people's lives, must be brought into the process of change if sexual health is to be promoted or maintained. There are numerous examples of efforts to promote sexual behaviour change among young people through sex education that have failed because they did not adequately bring on board the familial guardians and gatekeepers of sexual and social mores.

What we have learned is that promoting sexual health requires discussing sexuality. Affecting sexual decision-making and behaviours requires breaking down social and cultural barriers. Families and communities as the custodians of societal values systems, however challenging, are in as much need and must be targeted as well if we are to build sexually healthier societies.