Queering Sexual Health – a non pathological approach to sexual health advocacy

In September 2020, I attended a Sexual Attitudes Reassessment (SAR) course hosted by Sex Coach University, the institution through which I was completing my sex coaching qualification. As a baby in the industry, I was overwhelmed and honoured to meet medical doctors, psychotherapists, lawyers, pastors, teachers and sex workers who were just as invested in understanding sexual identity and expression in ways that could heal and help others live their lives as authentically as possible, and from an empowered place. For two days, 23 people from different countries and backgrounds had the opportunity to discuss the theories we had been exposed to through our studies and research, and to reflect and share on how it applies in our unique contexts or specific professions.

My biggest take away from that conference is that there is a big shift happening in the way industries are trying to help people with their sexual health. I like to think of it as a process of ‘queering’ sexual health. Initially, especially when it came to female and queer sexualities, the studies were very scientific, pathological, and medicalised. It was, and sometimes still is, about diagnosing a problem and finding a treatment for it. The medicalisation of sexology creates boxes of what is acceptable and unacceptable, normal and abnormal, almost never leaving room for the uniqueness we all possess as humans, and inevitably, in how we could express ourselves sexually. Not so long ago in history, a sexually frustrated woman was thought to have a medical condition called hysteria that could only be cured by frequent visits to her doctor who would rub her clitoris or use a vibrator on her to give her release. This release was still not considered an orgasm, or something related to pleasure and sexuality, and for many years after that, female sexuality still remained a myth. A great step for medicine, but still a roadblock for a broader understanding of sexual health and human sexuality. The research and focus was too preoccupied with medicalisation, pathologizing women, that it left no room to study the female body and the woman as a complex human being with sexual agency.

It sounds so absurd when we think about it now, but the truth is, so much of our current studying and understanding of sexuality still borrows from the pathologizing of sexuality. Not all our healthcare providers and psychotherapists are able to think of, and treat, sexual health-related issues outside of mere diagnoses and prescriptions. Some are not adequately equipped considering the anti-sex positive environments most of us come from, and most wouldn’t know how to start and facilitate conversations about sexual health even if they genuinely wanted to. What I am excited to see though is that professionals are starting to embrace a broader approach to the counselling and medical services being offered in the sexual health industries. While there will always be a place for facts, research, therapy and medical intervention, it is thrilling to know that we are broadening the possibilities of how people can be supported and empowered when it comes to sexual health and identity. We’re queering sexual health.

The main difference between traditional forms of sexual healthcare and the options that are now available to the public, is this move away from pathology and how professionals can help their clients or patients. Counseling, for example, offers space for a person to look into past events to understand and heal who they are now. There are often strict rules and conditions one must satisfy to get to a diagnosis and often, the treatments will be the same for cases with the same symptoms. The non-pathological approach looks to understand who a person is today and compiles results-driven and measurable action plans that will get them to where they want to be in future. While the medical world does a good job in helping someone figure out what is wrong with them, in a non-pathological approach, the focus is more on empowering the person, showing what is right with them currently, and how it can be used to further their hopes of who they want to be. There is more of a focus on the “what now” that we often get after completing therapy and doing the healing work. While it may sound like these two approaches are working in opposite directions, personally, I believe the offering to society is more holistic when both these sectors exist and work together. The reason why we see so many counselors, doctors et cetera, embracing the art, not science, of non-pathology, is because professionals realize that pathology will not work for every patient. There are so many opportunities where professionals from both sectors need to work together, and more often, learn from each other, to better serve our communities.

Queering sexual health also means bringing pleasure back as a pivotal part of sexual health. It is understanding that a person being comfortable and confident in their sexuality and having access to resources that enable them to experience pleasure, and to lead healthy, active sex lives is just as important as the medical aspects that come with sexual health. Permission is also the foundation of this non-pathological approach. It aims to validate and accept people and be that consistent advocate for their pleasure and wellness. The queering of sexual health also opens up possibilities of how to help clients. Medical professionals are bound by strict rules and ethics on how they relate with their clients while professionals like those of us who are part of the World Association of Sex Coaches have license to touch their clients if it is for their benefit. Suddenly, hugging a client during an emotional session or inviting them to a kinky BDSM event, or actually touching them to help them better understand their own bodies, become possibilities. Sex work then also becomes validated as something that can aid in our sexual health and pleasure journeys. Sometimes supporting someone in their sexual health is as simple as giving a person specific information, like where to access sex positive Muslims in your city. A therapist may not be able to engage in the outside world with their client, but a sex coach, for example, could easily use different physical spaces as a way to confront traumas or desires. Sometimes, queering sexual health is about dispelling myths and misinformation about how our bodies and minds function when it comes to sex. It really is about using the wealth of knowledge gathered by science and medical researchers and merging it with ideas of how things could be. It is about taking the same freedom and creativity we embrace in queer identity politics and applying it to how we can help people. So instead of having generic, one-size-fits-all ways to support people, non-pathology forces us to take into account the many contributing factors that make the person and circumstance unique.

The holistic approach of non-pathology and queering sexual health makes us think about how the mind, energy, body, emotions, and spirit of a person influence their sexual expression. It makes us no longer see sexuality as an isolated part of a human being, and there exists room for the client to bring along any and all other parts of themselves they think are relevant to the concern they may have. Apart from helping people with their physical sexual health concerns, non-pathology also creates room to form practical support for people in other areas of their lives that intersect with sexuality. How to transition healthily from monogamy to non-monogamy for example, talking to kids and minors about sex and consent or embracing the intersection between pleasure and spirituality. The list is endless and there is no uncharted territory.

When I attended that conference in September, I got the sense that, finally, people are going to feel less lonely and less weird. People are going to be supported! With so many people from different sectors and parts of society embracing the permission-emphasizing, non-pathological approach to sexual health, it means that more patients and clients will come across help and resources that validate and empower them, instead of alienating them. There will be something for everyone.

Personally, I am not only excited about what this could mean for sexual health. I am hoping that with every professional who gets to help or support a patient or a client enough for them to be healthy, empowered individuals who get to live out their sexual identity and expression authentically, those same people will inevitably defend someone else’s right to do the same. The permission that queering sexual health gives you is the same permission you should give others to be who they are. I am hoping that with this ‘new’ and different way of approaching sexual health, we will slowly start to see communities of people who move away from problematizing that which they may not understand, but are rather more interested in giving others the permission to simply explore and be themselves, because that’s what they would want for themselves too. I really am hoping that by helping one individual, one couple or family with the many options we now have outside of pathology, we will be creating a positive ripple effect into our larger communities. That is what really gets me excited about the idea of queering sexual health.

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