Promoting sexual health is about more than access to care

My time in sex ed class as a student in the Maritimes was pretty typical. Our curriculum consisted mostly of creating grisly poster boards of untreated STIs that were posted in the bathrooms to strike fear into the hearts of anyone who dared to even dream of a sexual partner, and whispered stories of the social purgatory that awaited if you became pregnant.

Later, sitting in a university classroom I was introduced to the idea that health isn’t just about the absence of an ailment or disease. Rather, health is a complex set of factors that lead to overall wellbeing for the individual and the community. These ideas, created by women of colour and Indigenous women who saw the ways in which a pro-choice movement based only on access to care failed marginalized people and failed to address the root causes of inequity, were light-years away from the ideas of sexual health I had been taught in grade school.

Sexual health is not simply the absence of an unwanted pregnancy or STI. Promoting sexual health means cultivating a space where people are able to access the information they need to make decisions about their bodies, where social determinants of health are the basis of policy, and where friends, family, medical professionals, and service providers recognize and advocate for social justice that will allow people to make those decisions in a safe environment.

Sexual health, or a space where we can truly Heart Our Parts, is a space where not only do people have access to quality healthcare, but have access to evidence-based comprehensive sexual health education, affordable birth control, services close to their communities, medical professionals who understand queer and trans health, and an approach to services and education that addresses the ways that racism, colonialism and transphobia continue to impact the sexual health of individuals and communities.

For sexual health educators working in communities, it doesn’t take long to realize that effectively working towards building sexual health doesn’t just depend on having free condoms available (although that certainly helps!), it is a multifaceted fight.

While I worked as a sexual health educator in Nova Scotia, I met many young people who were desperate to find affordable birth control. With few options at the time, they were often not able to find what they needed. These young people were often at the intersection of poverty, rural isolation and youth. Unfortunately rather than seeing their health as a complex set of social factors, people in positions of power often judged them on the basis of whether or not they managed to avoid pregnancy, despite the barriers.

While being able to provide affordable birth control through programs like The Compassionate Contraceptive Assistance Program (CCAP) were critically important, it was necessary to simultaneously work alongside those activists and advocates working to address the factors that marginalized these young people.

At its best, sexual health education is an important tool of reproductive justice. Going beyond the birds and the bees or rushed condom demonstration, comprehensive sexuality health education can illuminate the broader social context of sex, sexuality and gender, and give young people the tools they need to grapple with power structures, gate keepers and the social context of their future sexual and romantic relationships.

It’s important to recognize that the majority of people working in sexual health or teaching it in schools in the Maritimes (including myself) are white. Racism and colonialism heavily impact sexual health. The experiences that people of colour and Indigenous peoples have at school, in the doctor’s office, and within the justice system, demonstrates that a sexual health strategy or program that fails to include the voices of people of colour or Indigenous peoples is insufficient.

Advocating for comprehensive sexuality education that includes discussion about social factors as well as access to services gives young people a chance to begin to learn about their bodies in a social context, and is a critical step in achieving sexual health for our communities.