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Sexual Health
Lisa Hansen, MSc, MHSc; Janice Mann, MD; Mike Barrett, PhD; Sharon McMahon, MA;
and Tom Wong, MD, MPH, FRCPC (Health Canada)
Health Issue
Health Canada's 1999, Report from Consultations on a Framework for Sexual and
Reproductive Health, has asserted as a guiding principle that all individuals are sexual
beings throughout their lives. This is the broad approach we have taken in considering
issues related to the sexual health of Canadian women. In both biological and behavioural
aspects, Canadian women experience important variations in their sexual health
throughout the life cycle, from before puberty to after menopause. We pay particular
attention to the often overlooked formative and mature stages of women's sexual lives,
including the development of healthy sexuality before puberty and the maintenance
of healthy sexuality after the reproductive years. We have analyzed cross-sectional
data from the "Sexual Behaviour" module of the 2000-2001 Canadian Community
Health Survey (CCHS), and have reviewed the literature and other available indicators
of the sexual health of Canadian women.
Key Findings
- Contemporary Canadian adolescents are becoming sexually active at younger ages than in previous generations.
- The "gender gap" between young males and females in age at first intercourse has virtually disappeared. Among those 15-24 years old, the mean age at first intercourse was 16.7 years for males and 16.8 for females.
- Canadian-born females and males are significantly younger at first intercourse than respondents who were not born in Canada.
- In focused research, female and male adolescents demonstrate a poor knowledge of sexual and reproductive health. Despite a reasonable awareness of HIV/AIDS, few adolescents recognize the behaviours and infections that pose the greatest threats to their sexual health. In this aspect, Canadian youth are similar to their international peers.
- Among all CCHS respondents who had one or more sexual relationships lasting less than 12 months in the previous year, only about half report that they "always" used a condom.
- Among older adults, the medical model of sexuality often fails to recognize that normal aging does not necessarily compromise sexual expression. Canadians in mid-life and beyond are sexually active, and find emotional and physical satisfaction in their sexual relationships. Healthy sexuality is an essential aspect of quality of life for older adults.
Data Gaps and Recommendations
The authors identified the following data gaps and made the following recommendations:
- At the national level, we rely on periodic population health surveys for a limited set of sexual health measures. Both surveys and targeted research need to employ a broader understanding of "sexuality," to encompass psychological as well as behavioural and biological measures. Ongoing indicators are needed to measure important changes in the sexual health of Canadians throughout the life cycle as well as better measures of the upstream determinants of sexual health.
- Although unintended pregnancies, contraceptive use, and sexually transmitted infections among adolescents have been extensively researched, sexual behaviour and knowledge have not been given the same degree of attention. There is reluctance to direct questions about sexual issues to younger Canadians, even though increased knowledge of sexual health topics is associated with delayed onset of sexual intercourse.
- Among adults, resources directed at sexual health are needed to address psychological aspects of aging and sexuality, rather than focusing on physiologic sexual dysfunction.
- Age and gender-appropriate sexual health care, education, and knowledge is not only important for women of reproductive age, but for all Canadians at all stages of life.
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