The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior
July 9, 2001
I. IntroductionSexuality is an integral part of human life. It carries the awesome potential to create new life. It can foster intimacy and bonding as well as shared pleasure in our relationships. It fulfills a number of personal and social needs, and we value the sexual part of our being for the pleasures and benefits it affords us. Yet when exercised irresponsibly it can also have negative aspects such as sexually transmitted diseases -- including HIV/AIDS -- unintended pregnancy, and coercive or violent behavior. To enjoy the important benefits of sexuality, while avoiding negative consequences, some of which may have long term or even life time implications, it is necessary for individuals to be sexually healthy, to behave responsibly, and to have a supportive environment -- to protect their own sexual health, as well as that of others.
Sexual health is inextricably bound to both physical and mental health. Just as physical and mental health problems can contribute to sexual dysfunction and diseases, those dysfunctions and diseases can contribute to physical and mental health problems. Sexual health is not limited to the absence of disease or dysfunction, nor is its importance confined to just the reproductive years. It includes the ability to understand and weigh the risks, responsibilities, outcomes and impacts of sexual actions and to practice abstinence when appropriate. It includes freedom from sexual abuse and discrimination and the ability of individuals to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose.
Sexual responsibility should be understood in its broadest sense. While personal responsibility is crucial to any individual's health status, communities also have important responsibilities. Individual responsibility includes: understanding and awareness of one's sexuality and sexual development; respect for oneself and one's partner; avoidance of physical or emotional harm to either oneself or one's partner; ensuring that pregnancy occurs only when welcomed; and recognition and tolerance of the diversity of sexual values within any community. Community responsibility includes assurance that its members have: access to developmentally and culturally appropriate sexuality education, as well as sexual and reproductive health care and counseling; the latitude to make appropriate sexual and reproductive choices; respect for diversity; and freedom from stigmatization and violence on the basis of gender, race, ethnicity, religion, or sexual orientation.
Sexual health and responsible sexual behavior are both linked to the Surgeon General's Public Health Priorities and the Department of Health and Human Services' Healthy People 2010 initiative and the Guide to Community Preventive Services. These are, in turn, based on the scientific evidence and on principles of health promotion and disease prevention, and provide a basis for approaching these challenges.
The Surgeon General's Public Health Priorities include: (1) a balanced community health system, grounded at the community level and encompassing the promotion of healthy lifestyles, including responsible sexual behavior, and provision of equitable access to health care services; (2) the elimination of racial and ethnic disparities in health; and (3) a global approach to public health and the exchange of information and technology with other nations to improve world health.
Healthy People 2010 identifies national public health priorities and objectives to be achieved over the next decade. Its two overarching goals are to improve years and quality of healthy life and to eliminate disparities in health including those related to HIV/AIDS, sexually transmitted diseases, domestic violence and unintended pregnancy. The document also includes a set of 10 Leading Health Indicators for the nation, one of which is responsible sexual behavior. Two other leading health indicators are also relevant to this Call to Action -- reducing substance abuse and improving access to health care.
The Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations represents a significant national effort in encouraging evidence-based public health practice. It is being developed to make recommendations regarding public health interventions in a variety of areas, including mental health, violence prevention and sexual behavior. It is intended to provide an independent and scientifically rigorous road map to help reach the goals of improved health envisioned in Healthy People 2010.
This Call to Action focuses on the need to promote sexual health and responsible sexual behavior throughout the lifespan. Its primary goal is to stimulate respectful, thoughtful, and mature discussion in our communities and in our homes. While sexuality may be difficult to discuss for some, and there are certainly many different views and beliefs regarding it, we cannot afford the consequences of continued or selective silence. It is necessary to find common ground -- balancing diversity of opinion with the best available scientific evidence and best practice models -- to improve the health of our nation. This Call to Action is also the first step toward the development of guidelines to assist parents, clergy, teachers, and others in their work of improving sexual health and responsible sexual behavior.
This article was provided by U.S. Department of Health and Human Services.