What it means to have good sexual health

Analysis: Sexual health is not just about preventing infection, but about ensuring all sexual interactions are safe, respectful and consensual

By John Gilmore, UCD

Sexual health is often reduced to a conversation about preventing sexually transmitted infections (STIs),. While this is an important aspect, it is not the whole picture. The rise in STI rates in Ireland and globally highlights the need for a more comprehensive approach to sexual health, one that considers reproductive health, sexual identity, consent, education and overall well-being.

According to the Health Protection Surveillance Centre (HPSC), STI cases in Ireland increased by 31% in 2023, with chlamydia and gonorrhoea leading the surge. This statistic is a stark reminder of the need for greater awareness and education.

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From RTÉ Radio 1's Ray D'Arcy Show, sexual health consultant Dr Aisling Loy on why home STI testing kits are proving so popular

The World Health Organization (WHO) defines sexual health as "a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity." This underscores the fact that sexual health is multi-dimensional and cannot be achieved simply through medical intervention, but requires informed choices, positive relationships, respect, and open communication.

How to prevent STIs

STI prevention is a cornerstone of public health, but it must be part of a broader strategy that includes access to contraception, reproductive health services and education about bodily autonomy. Safe sex practices, including condom use and regular testing, are fundamental to reducing the spread of infections. However, sexual health also involves being able to make informed decisions about contraception and family planning.

In Ireland, access to contraception has improved in recent years, with free contraception schemes being introduced for younger people. However, barriers remain, including stigma and misinformation. A holistic approach to sexual health ensures that people have the knowledge and resources to make the best choices for themselves, whether that involves pregnancy prevention, STI screening, or other aspects of reproductive well-being.

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More than just biology

Changes in sex drive, erection frequency and other changes in sexual functioning can be a sign of something biological, but can also be related to stress, tiredness, ageing or many other factors. Open conversations with healthcare providers and access to credible resources can help individuals navigate these concerns.

Sexual identity is another key component of sexual health. Feeling safe and accepted in one’s gender and sexual orientation is vital to overall well-being. In Ireland, significant progress has been made toward LGBTQ+ inclusion, but challenges remain, particularly for those in more conservative or rural areas. Ensuring that sexual health services and education are inclusive of all identities helps to foster a more accepting society and improve health outcomes for marginalised communities.

From RTÉ News, a new consent module will be in schools from 2027

What about consent?

Consent is fundamental to all aspects of sexual health. Despite widespread advocacy for better consent education, recent research highlights ongoing misunderstandings. A 2024 survey found a significant gap between men and women’s views on sexual consent in Ireland, with 46% of men believing that false accusations of non-consensual sex are common, compared to just 27% of women. These findings point to the urgent need for better education on what constitutes clear, enthusiastic, and ongoing consent.

Misconceptions about consent contribute to harmful societal attitudes and can lead to serious consequences for individuals and communities. The emphasis on teaching consent should start early, be reinforced across all levels of education, and be included in public health campaigns. Sexual health is not just about preventing infections; it is also about ensuring that all sexual interactions are safe, respectful, and fully consensual.

What's the role of healthcare professionals?

Healthcare professionals play a key role in promoting sexual health. This includes not only providing STI screenings and contraceptive advice but also offering holistic support for issues such as sexual dysfunction, identity exploration and trauma-informed care. Training healthcare providers to approach sexual health with sensitivity and inclusivity ensures that all patients receive the care they need.

From RTÉ 2fm's Jennifer Zamparelli Show, sexual health consultant Dr Aisling Loy on the rise of STIs

In Ireland, initiatives are underway to make sexual health services more inclusive, but gaps remain. For example, transgender individuals often report difficulties accessing gender-affirming care, while migrant populations may face language and cultural barriers. A truly comprehensive approach to sexual health must address these disparities and work toward equitable access for all.

Sexual health education in schools

One of the most effective ways to improve sexual health outcomes is through comprehensive education. Ireland has taken steps to enhance sexual health education by reviewing its Social, Personal and Health Education (SPHE) curriculum. The updated programme, set to be implemented in schools nationwide, aims to provide students with accurate, age-appropriate, and inclusive information about relationships, sexuality, and personal well-being.

Sexual health education should go beyond biology and risk reduction and the new curriculum provides a real opportunity to do this. Research has consistently shown that comprehensive sex education leads to better health outcomes, including lower rates of STIs, unintended pregnancies and sexual violence. It also empowers young people to make informed choices and engage in healthier relationships.

From RTÉ Radio 1's Morning Ireland, Temple Carrig School assistant principal Eoghan Cleary on the new and revised Leaving Certificate SPHE curriculum

The key to sexual well-being? Open communication

Sexual health is best supported through open, judgment-free communication. Conversations about sex, sexuality, and relationships should not be taboo. Whether between partners, parents and children, or healthcare providers and patients, honest dialogue helps individuals feel informed and supported.

Stigma around sexual health issues can discourage people from seeking help. Many individuals, particularly young people and those from marginalised groups, avoid discussing sexual concerns due to fear of judgment. Ensuring that sexual health services are accessible, confidential, and affirming is crucial to breaking down these barriers.

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Dr John Gilmore is Subject Head for Adult General Nursing and Assistant Professor in Nursing at UCD.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ

Beyond the Basics: What It Really Means to Have Good Sexual Health

Sexual health is often reduced to a conversation about preventing sexually transmitted infections (STIs), and while this is an important aspect, it is not the whole picture. The rise in STI rates in Ireland and globally highlights the need for a more comprehensive approach to sexual health—one that considers reproductive health, sexual identity, consent, education, and overall well-being. According to the Health Protection Surveillance Centre (HPSC), STI cases in Ireland increased by 31% in 2023, with chlamydia and gonorrhoea leading the surge [RTE News https://www.rte.ie/news/2024/0326/1440144-sti-hspc/ ]. This statistic is a stark reminder of the need for greater awareness and education. However, focusing solely on STI prevention and treatment risks overlooking other vital elements of sexual health.

The World Health Organization (WHO) defines sexual health as "a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity." This definition underscores the fact that sexual health is multi-dimensional and cannot be achieved simply through medical intervention. It requires informed choices, positive relationships, respect, and open communication.

The Importance of STI Prevention and Reproductive Health

STI prevention is a cornerstone of public health, but it must be part of a broader strategy that includes access to contraception, reproductive health services, and education about bodily autonomy. Safe sex practices, including condom use and regular testing, are fundamental to reducing the spread of infections. However, sexual health also involves being able to make informed decisions about contraception and family planning.

In Ireland, access to contraception has improved in recent years, with free contraception schemes being introduced for younger people (RTE News on contraception https://www.rte.ie/news/ireland/2024/0603/1452718-contraception-health/ ). However, barriers remain, including stigma and misinformation. A holistic approach to sexual health ensures that people have the knowledge and resources to make the best choices for themselves, whether that involves pregnancy prevention, STI screening, or other aspects of reproductive well-being.

Sexual Functioning and Identity: More Than Just Biology

Sexual health is also about understanding and accepting one's sexual functioning and identity. Many people experience concerns about their sexual response, performance, or orientation at some point in their lives. Misinformation about what is "normal" can lead to anxiety and distress. Changes in sex drive, erection frequency and other changes in sexual functioning can be a sign of something biological, but can also be related to stress, tiredness, ageing, or many other factors. Open conversations with healthcare providers and access to credible resources can help individuals navigate these concerns.

Sexual identity is another key component of sexual health. Feeling safe and accepted in one's gender and sexual orientation is vital to overall well-being. In Ireland, significant progress has been made toward LGBTQ+ inclusion, but challenges remain, particularly for those in more conservative or rural areas. Ensuring that sexual health services and education are inclusive of all identities helps to foster a more accepting society and improve health outcomes for marginalised communities.

Consent: A Crucial and Often Overlooked Element

Consent is fundamental to all aspects of sexual health. Despite widespread advocacy for better consent education, recent research highlights ongoing misunderstandings. A 2024 survey found a significant gap between men and women's views on sexual consent in Ireland, with 46% of men believing that false accusations of non-consensual sex are common, compared to just 27% of women [DRCC research for we consent https://www.drcc.ie/policy-advocacy/research-statistics/we-consent-research-2024/ ]. These findings point to the urgent need for better education on what constitutes clear, enthusiastic, and ongoing consent.

Enhancing Sexual Health Education in Schools

Sexual health education should go beyond biology and risk reduction. It should cover topics like healthy relationships, boundaries, pleasure, gender identity, and emotional well-being; the new SPHE curriculum provides a real opportunity to do this. Research has consistently shown that comprehensive sex education leads to better health outcomes, including lower rates of STIs, unintended pregnancies, and sexual violence. It also empowers young people to make informed choices and engage in healthier relationships.

Open Communication: The Key to Sexual Well-Being

The Role of Healthcare Professionals

Healthcare professionals play a key role in promoting sexual health. This includes not only providing STI screenings and contraceptive advice but also offering holistic support for issues such as sexual dysfunction, identity exploration, and trauma-informed care. Training healthcare providers to approach sexual health with sensitivity and inclusivity ensures that all patients receive the care they need.

Conclusion: A Holistic Approach to Sexual Health

Good sexual health is about more than just preventing STIs. It encompasses informed decision-making, reproductive autonomy, a healthy sense of sexual identity, clear understandings of consent, and access to comprehensive education. By broadening our approach to sexual health beyond risk reduction, we can empower individuals to enjoy safe, fulfilling, and respectful sexual experiences.

The rise in STIs in Ireland highlights the need for continued investment in public health strategies, but these strategies must be multi-faceted. Consent education, LGBTQ+ inclusion, improved access to reproductive healthcare, and open conversations about sexuality are all critical components of a holistic approach. By addressing these factors, we can move toward a society where everyone has the knowledge, resources, and confidence to maintain good sexual health throughout their lives.

Dr John P Gilmore RGN FHEA

Assistant Professor

Head of Subject - Adult General Nursing

Fulbright HRB Ireland Health Impact Scholar 22/23

UCD School of Nursing, Midwifery and Health Systems

B307, UCD Health Sciences Centre,

University College Dublin,

Belfield, Dublin 4,

Ireland.

D04 V1W8

Tel: +353 1 716 6482 Web: www.nmhs.ucd.ie

Profile: https://people.ucd.ie/john.gilmore

Twitter: @GilmoreJNurse

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