Most of the time, the people who ask how you’re doing will be satisfied by the rote, two-word reply: I’m fine. I’m good. Really, it was the question that mattered, not the answer. Every so often, though, you’ll encounter someone who truly wants to know about the state of your emotional/physical/spiritual existence, who puts a hard emphasis on the last word to show that they’re trying to go deep: No, really, how are you doing?
It’s a question that sex researchers, too, would love to be able to ask, explains Kristen Mark, a professor of health promotion at the University of Kentucky and a sexuality researcher at the Kinsey Institute. The problem is that the vocabulary for it doesn’t really exist: Scientists have tools to measure various facets of our sex lives, from pain and dysfunction to communication and overall satisfaction, but they don’t have a tool to holistically assess all of those things together. Sexually, how are you doing? We don’t really know.
The Cut spoke to Mark about the concept of “sexual well-being,” why researchers don’t yet have a way to measure it, and why, without one, we’re missing out on a trove of information about what makes for good sex, bad sex, happy and unhappy couples, and fulfilling individual sex lives. Below is a lightly edited and condensed version of our conversation.
How do you define sexual well-being?
Sexual well-being involves the absence of sexual problems, but to me, that’s kind of neutral. That’s baseline. My colleagues and I think about sexual well-being as going beyond risk reduction to the point where one is in a state of feeling safe, feeling trusting of their partner, feeling satisfied, fulfillment, attachment — especially in the current climate that we’re in, the safety and trust piece, I think, is quite important. Sexual well-being really plays a huge role in people’s overall sex lives, their romantic lives, and also their overall well-being. And it’s really quite crucial for the success of long-term relationships.
But it’s beyond each of those alone. And the reason it’s kind of complicated is because we do have definitions of all the constructs that I mentioned, but there’s no gold standard measure of sexual well-being, which would encompass all those things and would take this in sort of a holistic way.
Is this something that only applies in the context of relationships?
It definitely can be something you have as a single person. This is not reliant on relationships. A couple may have a higher or lower sexual well-being based on how their relationship is going — certainly, if you’re in a relationship, that’s going to contribute to your sexual well-being. But being single and being happy about that, and feeling like you are sexually satisfied by being alone — you can reach a state of sexual well-being by single as well.
So what are we missing out on by not having this standardized definition?
So much of the work that we do in the sexual-health world, or really just generally in society, looks at sexuality as being this thing that one either shouldn’t talk about, or should only talk about in the context of disease avoidance and risk reduction. And it’s quite important to our overall well-being that we go beyond that risk-reduction model, because what sort of level of satisfaction, or level of security, are we getting when we’re just looking to avoid getting pregnant or getting an STI? If you think about Maslow’s hierarchy of needs, sexual well-being is kind of that self-actualization piece, but within the context of sex.
Practically speaking, how would this be applied in research?
The idea would be to create some sort of scale to measure these things, and there are people looking to try and figure this out. If we create a comprehensive measurement tool, we have a better ability to figure out, what variables are related to this? And how can we improve well-being in individuals and couples? I would love to see an increase in the number of people using sexual well-being as an outcome measure in a variety of clinical-type uses. That could be therapeutic techniques, or it could be pharmaceutical drug development.
A lot of the research that I do looks at happy couples, well-adjusted couples — we like to be able to study them in order to learn what’s working, because we can learn a lot from these couples who are really thriving. And so if we could come up with a measurement tool, we could standardize this so that we could all be studying sexual well-being in a way that’s consistent. And then we can draw cross-cultural comparisons related to sexual well-being.
And it just improves our knowledge in this area that’s so under-studied. Sex is seen as such a taboo topic in our society, and all the funding for sexuality research goes toward risk reduction, HIV, unintended pregnancy. It’s never focused on, how do we optimize people’s sex lives? We’re not seeing any research grants go out to improve sexual well-being. But I would argue that if our society at large could become more sexually healthy through sexual well-being, and through improving pleasure and satisfaction and communication, then we would see a larger and more population-level change in some of these sexual-health outcomes that are being funded, like STIs and unintended pregnancy.
And outside of research, is there a way that people can be applying the concept of sexual well-being in everyday life?
I think the measurement stuff is less relevant to the general public as opposed to the general idea that sexual well-being is quite multifaceted, and having people realize that sexual well-being is important. Our society doesn’t really acknowledge that, and doesn’t really place an emphasis on that, especially for women. When we look at statistics of the level of sexual pain than women experience, that alone is so much higher than what we would hope for women’s sexuality. Women have always been taught not to prioritize a sex life, not to really make pleasure a priority, and sexual well-being provides a framework within which women can prioritize their sex lives. And men as well, but women have so regularly and historically been told, Pleasure is not part of sex for you.
So I think just acknowledging sexual well-being is a really important piece, and that sexual well-being is beyond just feeling satisfied. It’s not about that. It’s about this fulfillment, and feeling you’re in a relationship where you feel safe and feel like you can express yourself in a meaningful way that enriches your life. So it’s about going beyond, Okay, let’s get rid of the pain during sex. It’s going beyond that and going into the fulfillment and excitement and really valuing sex as a part of your life. I feel like people don’t think about sex in this way, and I wish they would more.