Ask an Expert: Sexual Health with Candice Hargons

By Shelby Crosier

The phrase “sexual health” often brings to mind STI checks, pregnancy prevention, or annual gynecologist visits. But some sexual health experts want to change that narrative by taking a sex-positive approach to sexual health and wellness.

Candice Hargons, PhD, is an associate professor of behavioral, social, and health education sciences at Emory University’s Rollins School of Public Health and is a leading expert in sexual wellness and liberation. She shared information that everyone needs to know to improve their sexual wellness.

How does sexual health relate to public health?

The type of sexual health that most interests me is sexual functioning, which includes sexual satisfaction, arousal, orgasm, desire, and pain. It’s a highly prevalent disease category. For instance, erectile dysfunction can affect up to 80% of men at some point in their lives, while various sexual dysfunctions impact 40-50% of women.

Public health focuses on prevention and health promotion, and addressing sexual dysfunction aligns with this goal. By improving sexual functioning, we can enhance quality of life, reduce suffering, and even contribute to better overall health through improved mood, better sleep, and reduced incidence of some cancers and reproductive disorders. 

What does it mean to have a sex-positive approach in public health?

Typically, public health research has defined sexual health from a deficit lens, focusing on STIs, HIV, or unplanned pregnancy. A sex-positive approach examines what enriches sex, which according to my research may include passion, intimacy, love, pleasure, and communication. From a public health perspective, ensuring equitable access to the factors that enable good sex for everyone is a crucial aspect of health equity.

What is the greatest challenge in achieving good sexual health?

The taboo surrounding sex is the greatest challenge, because it hinders open conversations about sexual health. People are afraid to discuss sex with children, health care providers, and partners, even though developmentally appropriate, transparent, evidence-based communication is crucial.

This taboo is fueled by moral judgments, leading to social consequences for some people perceived as too sexual or not sexual in the “right” way. Without comprehensive sex education, people struggle to understand what is sexually healthy. Attempts to provide scientifically sound education through popular channels can even be censored due to this stigma.

How do you navigate communicating about a taboo topic like sexual health?

I listen, and I don’t judge. Because I’ve been talking about sex for so long, it doesn’t feel taboo to me. I know how normal sex is, so I speak about it in a way that normalizes it for others. I invite people to think about their sex lives more intentionally, but I don’t push a specific way to be sexual.

I also don’t mind using a bit of levity and fun. People often leave workshops I’ve facilitated saying they didn’t expect to share so much, but they are happy they did. It’s important, because they often feel empowered to extend the conversation with their peers and partners. 

What is an easy first step that people can take toward feeling more empowered in their sexual health?

Identify what you like and don’t like, sexually. An easy way to do this is creating a “yes, no, maybe so” list. Create three columns, one for yes, no, and maybe so. In the yes column, write all the things you enjoy and want to keep doing sexually, as well as things you have not tried yet that you want to try. In the no column, write all the things you don’t enjoy and do not want to do anymore. It can also include things you haven’t tried that you’re uninterested in trying. Finally, in the maybe so column, write all the things you’re curious about but are only willing to try in specific settings or circumstances.

You can share this list with your partner, but even if you are not ready to do that, you will have enhanced your sexual self-awareness and be better positioned to ask your sexual partner for what you want.