sexual health education

POV: Sexual Pleasure Should Be Integrated into Scientific Research on Sexual Health

Aside from disease prevention, elements of sexual health, including pleasure and orgasm, don’t receive much research funding, limiting what’s known, writes alum Julia Bond (SPH’24) in a new POV for BU Today.

This commentary originally appeared in BU Today.

In a splashy piece in 2022, the New York Times detailed what many doctors and medical researchers know, but rarely talk about: we really do not know enough about the clitoris. This component of female anatomy has been routinely overlooked and ignored by the medical establishment, despite its substantial role in sexual pleasure for many people. When asked why, the medical experts interviewed in the piece shared the same sentiment: female sexual pleasure has long been viewed as secondary to male sexual pleasure. Unnecessary, even frivolous. Why, then, would this organ, perceived by many to play no role beyond orgasm, be suitable for serious scientific research? I believe the deep-rooted ignorance of the clitoris is a good example of the consequences of a larger, pervasive problem in the field of medical research: the routine dismissal of sexual pleasure as something worth studying.

This year, the National Institutes of Health (NIH), the largest funder of scientific research in the United States, will allocate an estimated $388 million towards the study of sexually transmitted diseases. This is a critical effort, particularly as cases of some sexually transmitted infections have increased in recent years. But the risk of sexually transmitted infections is just one component of sexual health. In 2022, the World Health Organization published an updated definition of sexual health, defining it as more than just the absence of disease. Their definition includes the “possibility of having pleasurable and safe sexual experiences.” Elements of sexual health beyond disease prevention, including pleasure, orgasm, or even pain, do not receive much research funding, which limits what is known.

In addition to little funding, sexual health research is also curtailed by scientists themselves. Researchers are impacted by cultural influences. Across different cultures, it is common for sex and sexual pleasure to be considered a taboo topic. Researchers’ discomfort with topics related to sexual pleasure poses real barriers to the meaningful study of sexual health. If someone is uncomfortable even saying the word “orgasm,” how can they effectively research the full range of human sexual experience?

The lack of scientific research focused on the positive elements of sexual behavior, including pleasure and orgasm, has real consequences. Beyond the ignorance of female sexual anatomy, research also suggests that public health programs that incorporate sexual pleasure might work better. Downplaying or ignoring pleasure may result in less successful efforts to promote sexual health. A narrow research focus on the risk of sexually transmitted infections can also obscure other important issues that are deeply relevant to people, including sexual dysfunction, which is estimated to affect 40 percent of women and 30 percent of men in the United States. The stigma against discussing sexual pleasure and pain also pervades medical care. Research shows that people experiencing sexual health issues often do not discuss them with their providers and providers do not routinely ask about them. This contributes to the often years-long wait that many people experiencing chronic pelvic pain conditions, like endometriosis, experience before receiving a diagnosis.

I believe that scientific and medical research that aims to improve sexual health should incorporate a sex-positive lens. By this, I mean taking into consideration the many reasons people may have sex, including interpersonal connection, pleasure, and joy. This is the focus of a recent commentary I published in the American Journal of Epidemiology, alongside Dr. Jessie Ford of Columbia Mailman School of Public Health. We emphasize that sexual pleasure is important to many people, and therefore should be integrated into scientific research on sexual health. This could help public health research be more aligned with people’s lived experiences, in which pleasure and connection are often central to sexual experiences. In an era where humans have gone to the moon, the intricacies of the clitoris should not be a mystery. Scientific researchers have the potential, and, I would argue, the responsibility, to help bring sexual pleasure out of the darkness, and into the light.