The Pleasuremeter: exploring the links between sexual health, sexual rights and sexual pleasure in sexual history-taking, SRHR counselling and education

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02/12/2019 12:00 am

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Health professionals do not generally receive adequate training to address the sexual concerns of their clients,1 provide sexual and reproductive health and rights (SRHR) counselling and education or conduct comprehensive sexual history-taking. Many of them talk about sexuality with clients through a risk-based approach, addressing the negative consequences of sexual relationships, such as HIV, sexually transmitted infections (STIs) and unwanted pregnancies, as a way of influencing people to practice safer sex.2

Without underestimating the importance of discussing the risks associated with sexual relationships, health professionals should address sexual pleasure and well-being in sexual history-taking, SRHR counselling and education. Research has shown that ignoring sexual well-being in counselling with clients has a negative effect on safer sex practices and may confound contraceptive consultations.3,4

There is a growing movement of SRHR organisations and professionals that recognise the importance of sexual pleasure to effectively promote sexual health. The Pleasure Project, created in 2004, is one of the first groups of public health professionals that have advocated for the inclusion of sexual pleasure in sexuality education and safer sex programmes.2 The International Planned Parenthood Federation (IPPF) and the World Association for Sexual Health have included sexual pleasure as a dimension of sexual health and sexual rights in their respective Declarations of Sexual Rights.5,6 The working definition of sexual health of the World Health Organization (WHO) incorporates the “possibility of having pleasurable and safe sexual experiences.”7

Most recently, the Global Advisory Board for Sexual Health and Wellbeing (GAB) proposed the “triangle approach” as an innovative conceptual framework linking sexual health, sexual rights and sexual pleasure to strengthen SRHR policy and programming.8 In 2018, the GAB released a toolkit to train future health professionals entitled “Sexual pleasure: The forgotten link in sexual and reproductive health and rights.”9 The toolkit was piloted in a two-day workshop at the 2017 World Congress for Sexual Health with a group of 18 medical students from the International Federation of Medical Students Associations and received positive feedback. It was then reviewed by a panel of international SRHR experts (including professionals who have worked with organisations such as IPPF and WHO, sexologists and medical students involved in SRHR advocacy), edited, finalised and is now available online at


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