Be Positive

Core to all The Pleasure Principles is being sex-positive.
Remember, when you feel safe and are safe, sex can be very good for you.

Our starting point is a sex positive position where pleasure is seen as essential and central to sexual, physical and mental well-being. This is critical as sexual pleasure remains one of the most important motivations to have sex.

However, many of us have learnt about sex and our sexuality through negative messages that focused on fear and shame. We might have also been told that we will never have a loving relationship if we have a sexual identity that is outside the norm of our community. This has led to many of us feeling deep shame and sadness when we think about our futures. Building a pleasure-inclusive world means turning these negative messages into sex positive ones. 

Until recently, Sexual and Reproductive Health and Rights [SRHR] interventions and sex education mainly focused on preventing unintended pregnancy and sexually transmitted infections, including HIV [STI/HIV]. In addition, health education and services portrayed sex (especially outside marriage) as dangerous and risky. The risks associated with disease and unintended pregnancy were emphasised, but the health benefits of sex rarely mentioned.

Research shows that safe sex can improve your health, physical and mental well-being. So while prevention remains vital, we at The Pleasure Project believe that managing risks is not the only way to talk about sex. Also important are the enjoyment of sex and the values of gender equity or being fair to women, men and those who have other gender expressions; and social justice where everyone has equal economic, political and social rights and opportunities. The goals of decreasing discrimination and stigma, promoting critical thinking in recognizing agency over and enjoyment of sexuality should be part of all sexual health and sex education interventions.

To become more sex-positive in our approach, we can purposely reflect and adjust our lens and move away from thinking that has been influenced by a dominantly sex-negative culture. The World Association of Sexual Health issued a Declaration of Sexual Pleasure in 2021 highlighting the significance of sexual pleasure for health, education, advocacy, and human rights. This is important to raise awareness of how pleasure needs to be promoted as core to our sexual expression, identity, and health.

What is a sex-positive and pleasure-based approach in SRHR programmes?

The definitions of sex-positivity emphasise different concepts. For example, some definitions highlight the importance of consent in sexual relationships while others focus on the importance of sexual expression. 

Here are three definitions of how to use a sex-positive approach moving from a sex positive approach to a pleasure-based one.

Sex-positive approaches strive to achieve ideal experiences rather than solely working to prevent negative experiences. At the same time, sex-positive approaches acknowledge and tackle the various concerns and risks associated with sexuality without reinforcing fear, shame or taboo of sexuality and gender inequality”. International Planned Parenthood Federation, 2016

“A positive approach to sexuality and reproduction should recognise the part played by pleasurable sexual relationships, trust, and communication in the promotion of self-esteem and overall well-being.” The Guttmacher-Lancet Commission on SRHR. 2018   (Starrs et al, )

A pleasure-based approach is one that celebrates sex, sexuality and the joy and wellbeing that can be derived from these, and creates a vision of good sex built on sexual rights. It focuses on sensory, mental, physical and sensual pleasure to enable individuals to understand, consent to, and gain control over their own bodies and multi-faceted desires. Well-being, safety, pleasure, desire and joy are the objectives of a programme with a pleasure-based approach. This approach measures empowerment, agency, and self-efficacy by whether or not an individual is enabled to know what they want, can ask for it, and request this of others, in relation to their sexuality, desires and pleasure.” The Pleasure Project, 2019

Concepts, values and benefits associated with sex-positive approaches to SRHR programmes

  • Sex-positivity is not the same as sexual pleasure. In its broadest sense, sex-positivity is the idea that sex can be positive as long as it is consensual and safe. Sexual pleasure is the physical and/or psychological satisfaction and enjoyment derived from shared or solitary erotic experiences, including thoughts, fantasies, dreams, emotions, and feelings.
  • Looking at sexuality through a sex-positive, rights-based lens can help break traditional power relationships and can be gender transformative. For example, by highlighting that women or female identified people can enjoy sex, or that men or male identified people can show vulnerability or want emotional intimacy, we challenge damaging gender stereotypes.
  • People can negotiate the quality of their sexual relationships to demand other (sexual) rights
  • A sex-positive approach aims to help everyone find their way to feeling confident and safe so they can enjoy sex.
  • A pleasure inclusive approach to sexual health and sex education has been shown to lead to more condom use and better sexual health outcomes. See this recent evidence review The Pleasure Project did in partnership with WHO.
  • A sex-positive approach recognises the importance of pleasure for social change. For example, it promotes solidarity for people who historically have less or no sexual rights such as people with disabilities.
  • A pleasure inclusive approach can increase people’s sexual confidence and use of contraception and condoms. It can support learners and clients in achieving sexual well-being for themselves and recognising the sexual rights of others. For example, if you are confident as a female to tell your partner what you like or dislike in sex, you can discuss other issues as well, such as contraceptives and condom use. You can see this resource which looked at Why Do People have Sex
  • A sex-positive approach does not replace the discussion of the possible negative outcomes of sex. Rather, it seeks to bring balance and represent the range of possible sexual experiences.
  • A sex-positive approach is critical of how sexual pleasure is often shown in sexist ways. Additionally, it is critical of how sexual pleasure is positioned as permissible only for certain groups of people [young, non-disabled, male, white] or used to promote and market a wide range of products [from cars to foods to toothpaste] but rarely used to promote ‘good safe sex’.

How can we be sex-positive in our work?

Let’s start by flipping the narrative and embracing education practice and health programming which start from the idea that sex and sexuality are positive, healthy, human experiences that can improve well-being and life. We shall recognize that sexuality and sexual expression can be life-affirming and fun; it can make you happy and help you bond with others. Sex and pleasure positivity recognize that sex can feel good. You can start a conversation by exploring and affirming freedom of sexual expression, sexual consent, sexual diversity, bodily autonomy and integrity, pleasure and privacy.

 

Be transparent and explain how to communicatepositively about sex and sexual health. Have fun and be clear when presenting the facts and evidence that support sex-positive approaches or the consequences of sexual activity. (see The Pleasure Principle Talk Sexy(link) You can also promote the fact that solo-sex [masturbation], sexual relationships and the freedom to express sexual identity can bring fulfillment, joy, pleasure, intimacy, and closeness.

We can ensure that pleasure is addressed in a similar way for girls and women as for other genders. Masculine sexuality is presented as nuanced and complex as is feminine sexuality. For example, you can look at the work by Love Matters, Body is Not an ApologyDoing so can move people away from linking sex and sexuality with death, danger, and disease. Research already shows that fear-based messages do not work. We know that when people think positively about sex, it improves their self-esteem and safer sex practices. You can look at some case studies of people who have done just that.

Tips and Actions

If you are a sex educator, you could try:

  • Telling learners they are sexual beings with the right to make their own choices. They have the right to experience desire and pleasure in their daily lives. They have control and agency over their bodies – whether they are sexually active or not. This is particularly important for people whose rights and sexualities are socially stigmatised or denied such as gay, lesbian, bisexual and trans people, and people with disabilities.
  • Focus on pleasurable, positive sexual experiences as the aim of sexuality education. This will help to open discussions towards safer sexual behaviours and stronger negotiation skills in sexual relationships.
  • Be clear. Explain how sex works. Young people have a lot of questions when it comes to sex. Be clear when explaining the biological and physical aspects of sex. For example, when talking about female genitalia, explain the different parts (vulva, clitoris, labia, etc.) rather than just lumping together all the parts as “vagina”. 
  • Open discussions on the different ways to experience pleasure. Allow learners to explore and discover how to have pleasure. You can talk about how orgasm does not have to be the only goal and sex is not a performance. Sex can be amazing. But it can also be messy, awkward and disappointing. Highlight that reality. When you judge sex like a performance that you can fail, you disempower your learners and increase feelings of self-doubt. 
  • Conversations around pleasure can emphasise the diverse forms that pleasure can take such as being close to someone, sleeping with them, and cuddling. By not focusing on penetrative sex, we can offer people a safe space to discover what pleasure looks like for them. 
  • We at The Pleasure Project have found it helpful to ensure that all discussions in sexuality education start with a conversation about boundaries for the group. Establish ground rules that ensure members of the group don’t allow comments that stigmatise or discriminate people because of their sexual identity and desires. We use these ‘ice breaker’ exercises to allow us to talk about fears or what will make us feel safe in conversations about pleasure. We have found these exercises to be really helpful in reminding ourselves to listen and understand that the members of the group have different comfort levels when it comes to discussing sex and pleasure. 
  • Work to develop media literacy to critically evaluate media content, especially in relation to porn, and guides on safe use of social media including sexting and sharing explicit materials.

If you work in health services, you can:

  • Respect clients’ choices. The enjoyment of sexuality is based on recognising their autonomy and individuality within the boundaries of sexual rights and consensual sexual relations. 
  • Work to feel comfortable as a provider to discuss sex and sexuality, pleasure, and desires. If needed, you can organise a staff training to better understand a pleasure-based approach using these exercises.
  • Before talking about sex and pleasure with others, think about your own boundaries and what you are comfortable sharing or not. Speak to trusted friends/colleagues about how much your past and present may be affecting your work.
  • Create a safe and non-judgemental environment by being clear on the services you provide. Tell people upfront that you respect a range of sexual identities and relationships. You can put up a poster in your waiting room or provide information on your website to make this clear.
  • Be open to listening to clients’ concerns, needs, and realities and what they need to practise good safe sex. Ask them to tell you what words they are comfortable using when talking about their intimate lives.
  • Explain that you can provide health care information about the benefits and risks of sex so they can make informed choices. Emphasise that clients’ choices about their sex lives are theirs alone. Clients may not always make the choice that you would make if you were in their position, but you should respect their choices if they are based on sexual rights of all. 
  • Explain ways to experience and give pleasure without assigning a value to one kind of way over another. For example, penetrative vaginal sex should not be positioned as better or more pleasurable than non- penetrative, anal, or oral sex. Doing so will help avoid creating feelings of shame about bodies or sexual choices.
  • Recognise and express that there are unintended and harmful consequences of sex, but that these should not overpower the positive benefits of sexual well-being and pleasure.
  • Remind yourself that we don’t all come from the same place in terms of sexual joy and well-being. Some people will have suffered sexual trauma or a history of sexual abuse or deep sexual shame and will need sex-positive trauma support to overcome this. Avoid making clients feel shame if they do not feel sexual joy in or enthusiasm in their sexual relationships. 
  • The bottom line is that your clients should leave an interaction with you feeling confident and positive about their choices rather than ashamed or afraid.
  • Learners and clients have (sexual) rights; this should be the basis of all our interactions with them.
  • Promoting, explaining and giving information about sexual pleasure is not the same as sexualizing or over-presentation of sexuality, especially the bodies of women and girls and to a lesser extent of boys and men
  • It is more helpful to point out that sexualization, for example in the media, often presents as an aspiration for girls and women to be sexual in a certain way. As such it reinforces gender hierarchy, heterosexuality and the gender gap. 

When you develop programmes and design evaluations you can:

  • Include goals and indicators in your programme that measure and aim for sexual well-being or enhancement of safe sexual satisfaction rather than reducing disease. (See Pleasure Principle: Embrace Learning)
  • Include goals that stimulate reflection and spark discussions on how sexual pleasure and wellbeing can be (more) integrated into SRHR programmes. 
  • Ensure that in monitoring and evaluating SRHR programmes and comprehensive sexuality education (CSE) curricula, emotional and mental elements of sexual wellbeing are included.
  • Give more emphasis on the positive and healthy aspects of (the development of young people’s) sexuality and sexual experiences.
  • During the development of programmes, build consensus on how to improve the integration of sexual pleasure, and understand the different possible perspectives which will help to operationalise programmes in different contexts.

Examples of work / initiatives / programmes 

Further resources you might find useful

Boydell, V., Wright, K.Q., Smith, R.D. (2021) A Rapid Review of Sexual Pleasure in First Sexual Experience(s). The Journal of Sex Research 58:7 pages 850-862. https://www.tandfonline.com/doi/full/10.1080/00224499.2021.1904810

Eastham, R., & Hanbury, A. (2020) Education from sexual pleasure workshops with self-defining women: a commentary https://www.tandfonline.com/doi/abs/10.1080/14681811.2020.1801408

Fava N.m., & Fortenberry. J.D. (2021) Trauma-Informed Sex Positive Approaches to Sexual Pleasure, International Journal of Sexual Health, DOI:10.1080/19317611.2021.1961965

Ford, J.V., Vargas, E.C., Finotelli, I.J., Fortenberry, D., Kismödi, E., Philpott, A., Rubio-Aurioles, E., & Coleman, E. (2019). Why Pleasure Matters: Its Global Relevance for Sexual Health, Sexual Rights and Wellbeing. International Journal of Sexual Health, 31(3), 217-230. DOI:   10.1080/19317611.2019.1654587 

Haberland , N., Rogow, D., (2015) Sexuality education: emerging trends in evidence and practice 

Hanbury, A., & Eastham, R. (2016). Keep calm and contracept! Addressing young women’s pleasure in sexual health and contraception consultations. Sex Education, 16(3), 255–265. https://doi.org/10.1080/14681811.2015.1093925 

Higgins, J.A., & Hirsch, J.S. (2008). Pleasure, Power, and Inequality: Incorporating Sexuality into Research on Contraceptive Use. American Journal of Public Health, 98, 1803-1813. https://doi.org/10.2105/AJPH.2007.115790

International Planned Parenthood Federation (2016). Fulfil! Guidance document for the implementation of young people’s sexual rights (IPPF-WAS) https://bit.ly/37kozUD

IPPF (2016) Putting sexuality back into Comprehensive Sexuality Education https://bit.ly/3w8rPNa

Ivansk, C., Kohut, T., (2017) Exploring definitions of sex positivity through thematic analysis, The Canadian Journal of Human Sexuality 26:3, 216-225 https://utpjournals.press/doi/10.3138/cjhs.2017-0017

Knerr, W., & Philpott, A. (2008a) Everything you wanted to know about pleasurable safer sex but were afraid to ask: Twenty questions on sex, pleasure and health. https://secureservercdn.net/160.153.137.99/91b.068.myftpupload.com/wp-content/uploads/2020/02/TPP-20-Questions_v6.pdf 

Mark, K.P., & Vowels, L.M. (2020) Sexual consent and sexual agency of women in healthy relationships following a history of sexual trauma, Psychology & Sexuality, 11:4, 315-328, DOI: 10.1080/19419899.2020.1769157

Media Literacy for youth: Let’s Talk Resources http://depts.washington.edu/sexmedia/educators/medialit/resources.php 

Mitchell, K.R., Lewis,R. O’Sullivan, L. & Fortenberry, JD (2021) What is sexual wellbeing and why does it matter for public health?, Lancet Public Health; 6: e608–13 https://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(21)00099-2.pdf 

Philpott, A., Boydell, V., Knerr, W. (2006) Pleasure and Prevention: When Good Sex Is Safer Sex, Reproductive health matters, 2006 https://bit.ly/3CJceF7

Porn Literacy: Boston Public Health Commission on porn literacy, Teen Health Source Porn Literacy, https://www.bphc.org/whatwedo/violence-prevention/start-strong/Pages/Porn-Literacy.aspx 

RNW, Love Matters Sexual Pleasure matters (Documentary) https://share-net.nl/rnw-media-pleasure-matters-full-documentary/

Rubin (1974), Thinking Sex: Notes for a Radical Theory of the Politics of Sexuality. https://sites.middlebury.edu/sexandsociety/files/2015/01/Rubin-Thinking-Sex.pdf

Santinelli and others (2017), Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact https://bit.ly/36jF8jg

Scott-Sheldon, L., & Johnson, B. (2006). Eroticizing Creates Safer Sex: A Research Synthesis. The Journal Of Primary Prevention27(6), 619-640. doi: 10.1007/s10935-006-0059-3 

Scott-Sheldon, L., Marsh, K., Johnson, B., & Glasford, D. (2006). Condoms+pleasure=safer sex? A missing addend in the safer sex message. AIDS Care18(7), 750-754. doi: 10.1080/09540120500411073

Share-Net (2020) on “Sexual Pleasure: a luxury or a right?” https://share-net.nl/share-net-report-on-sexual-pleasure-a-luxury-or-a-right/

Singh, A. Both, R., & Philpott, A. (2019) I tell them that sex is sweet at the right time’ – A qualitative review of ‘pleasure gaps and opportunities’ in sexuality education programmes in Ghana and Kenya.2019 https://www.tandfonline.com/doi/full/10.1080/17441692.2020.1809691

Singh, A. & Philpott, A (2019), Pleasure as a measure of agency and empowerment, Medicus Mundi #115 https://bit.ly/3KM5w4g

Starrs & al (2016) , Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission; The Lancet, May https://www.thelancet.com/commissions/sexual-and-reproductive-health-and-rights 

Taylor, S.R (2021); Body Is Not an Apology The Power of Radical Self-Love Paperback 9781523090990 .2nd Revised edition 2021

UNESCO (2021), The journey towards comprehensive sexuality education. Global status report https://bit.ly/3CKTK7t

Woet L. Gianotten, Jenna C. Alley & Lisa M. Diamond (2021) The Health Benefits of Sexual Expression, International Journal of Sexual Health, DOI: 10.1080/19317611.2021.1966564

Wood, R., Hirst,J., Wilson, L. & Burns-O’Connell G. (2019) The pleasure imperative? Reflecting on sexual pleasure’s inclusion in sex education and sexual health, https://www.tandfonline.com/doi/abs/10.1080/14681811.2018.1468318?journalCode=csed20

World Association for Sexual Health. (n.d). Mexico City World Congress of Sexual Health DECLARATION ON SEXUAL PLEASURE. https://worldsexualhealth.net/wp-content/uploads/2019/10/2019_WAS_Declaration_on_Sexual_Pleasure.pdf

Zaneva M, Philpott A, Singh A, Larsson G, Gonsalves L (2022) What is the added value of incorporating pleasure in sexual health interventions? A systematic review and meta-analysis. PLoS ONE 17(2): e0261034. https://doi.org/10.1371/journal.pone.0261034

Checklists/assessment guides to verify to what extent sexual pleasure and sex positivity is integrated in your programmes:

https://pleasure-checklist.share-net.nl

https://www.gab-shw.org/resources/sexual-pleasure-an-assessment-tool/