What Determines Healthy Sexuality: Variance is the Spice of Life

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Across time, shame and taboo have been associated with sexuality, perhaps contributing its mystery. Whatever the reasons, sexuality remains a topic that is under-discussed. The purpose of this paper is to provide general information about what constitutes healthy sexuality vs. what constitutes disordered sexuality.

In 1785 William Cowper wrote a poem entitled "The Task." From this poem emerged a commonly-used saying: Variety is the Spice of Life. Sexuality is no stranger to variety and when we speak of "normal" sexuality, it may be useful to keep this saying in mind. People often wonder what constitutes normal, healthy sexuality. When it comes to sexuality, defining what is normal, and what is not, is quite complicated because there is such tremendous variety in sexuality.


Defining "normal" sexuality is further complicated because we often use the words, "normal" and "healthy" to mean the same thing. While "normal" and "healthy" may often refer to the same thing, their meanings are somewhat different. Normal refers to what is average. In science, when we say something is "normal" we mean it is average. On the other hand, "healthy" refers to what is adaptive. As we will soon see, sometimes what is considered average or "normal" is not necessarily considered adaptive or "healthy" by some people. Because sexuality is so incredibly diverse, and because what determines normal sexuality is dependent upon many different things, it is easy to understand the difficulty in answering the question, "Am I normal?" This is because what constitutes healthy sexuality is quite variable.

Because sexuality is so variable, it is quite common for us to wonder whether or not our sexual needs, interests, and desires are normal. In fact, couples who participate in couples' therapy almost always ask questions about what is normal, and what is not. In order to determine whether one's sexuality is normal or not, it is important to consider the definition of both sexuality and abnormality. The definition of sexuality includes many components including (but not limited to): sexual attitudes, sexual desires, sexual behaviors engaged in, sexual preferences, sexual identification, and sexual function. In psychology, abnormality is defined using three different perspectives: 1) The frequency perspective considers a behavior abnormal when it occurs rarely or infrequently in the general population. 2) From a social norms perspective, behavior may be considered abnormal if it is not socially acceptable. 3) Finally, a maladaptive perspective considers behavior abnormal when it causes problems in the person's life or to society as a whole (Getzfeld, 2006).

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From a frequency perspective, a sexual behavior is considered abnormal when it is infrequently reported. Thus, the frequency perspective defines "abnormal" by first determining what is average, or normal. Also, when we consider the concept of frequency, we may want to keep in mind that what we know about sexuality is only as good as what people are willing to tell us. A large portion of sexuality research is based on self-report. When people are asked questions of a sensitive nature (and certainly questions about sex are of a sensitive nature), people may distort the truth. Therefore, what we know about the frequency of sexual behaviors may be an underestimation, or overestimation of the truth. For example, when we ask women how many sexual partners they have had over the course of their life, they tend to round down, whereas men tend to round up. Therefore, if you hear that the average adult has had 10 sexual partners, it is important to keep in mind this could be an under- or over-representation of the truth.

From a social norms perspective, it becomes quite apparent that culture (i.e., ancestry, religion, politics, society) largely determines what is considered "normal sexuality." But it is important to recognize that what is considered normal, natural, or moral in one society or culture may very well be abnormal, unnatural, or deviant in another. Also, even within the same culture, social norms may change over time. Thus, social norms include a historical perspective: what was once considered abnormal may very well be considered normal today (Firestone, Firestone, & Catlett, 2006). For example, in the 1950s a woman who had sex before marriage may have been considered very promiscuous whereas today, sex outside of marriage is much more acceptable.

Finally, from a maladaptive perspective, normal sexuality is defined from a healthy perspective, not an average one. Therefore, a maladaptive perspective would consider whether or not the sexual behavior is causing problems, or is harmful to the individual, or to society as a whole. Unlike the objective "normal" or average considerations such as frequency, "adaptive" determinations of abnormality reflect a subjective evaluation about whether the behavior interferes with someone's life.

Clearly, all of this makes defining "normal" sexuality quite difficult! Thus, perhaps using terms such as "natural" and "healthy" may be a more holistic approach when we are discussing sexuality. When we discuss healthy sexual practices good questions to ask ourselves are: 1) Is there consent (i.e., Are both partners freely agreeing to this?), 2) Is the behavior exploitive, coercive, manipulative, and/or self-destructive? (Firestone, Firestone, & Catlett, 2006), and 3) Does the behavior cause problems or harm to any of the participants, or to society as a whole?

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