The proliferation of sexual health: Diverse social problems and the legitimation of sexuality

Especially since the 1990s, the term sexual health has flourished in professional, commercial, and lay domains. Yet the more the phrase has become visible, the greater the mutability in its meanings. These developments matter for an understanding of healthism—the idea that modern individuals are enjoined to recognize a moral obligation to maximize their health. Theorists of healthism have paid relatively little attention to sexuality and its frequent rendering as controversial, illegitimate, or stigmatizing. We argue that because pairing “sexual” with “health” serves to legitimize and sanitize sexuality, the framing of sexual issues as matters of sexual health is widely appealing across multiple social arenas, and this appeal helps to explain both the proliferation of the term and the diversification of its uses. Secondly, we argue that while the polysemy of sexual health might suggest that the phrase lacks a clear meaning, in another sense the term is quite meaningful: content analysis of journal articles, newspaper articles, and websites shows that the semantics of sexual health can be categorized into six social problem niches, within which sexuality and health are construed in distinctive ways. For each social problem framing, we identify the implied meanings of both sexuality and health, the “opposite” of sexual health, the institutional action plans, the individual injunctions, and the presumed ontologies of bodies and selves. By focusing on how the conjoining of “sexual” and “health” changes the meanings of both terms, our analysis adds nuance to discussions of healthism: it challenges a singular conception of healthism and points to the need for clearer consideration of its different forms. At the same time, we call attention to the significance of “sexual healthism” as a particular example of the “will to health” while also highlighting implications of characterizing sexual issues as matters of health.