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What Determines Healthy Sexuality

Lorraine Benuto, Ph.D., edited by C. E. Zupanick, Psy.D.

Across time, shame and taboo have been associated with sexuality. This has perhaps contributed to its mystery. Whatever the reasons, sexuality remains a topic that is not often discussed. The purpose of this center is to provide general information about what healthy sexuality is and what is a sexual problem or disorder.

figure standing in bright sun A commonly-used saying by many is that Variety is the Spice of Life. Sexuality often involves variety. When we speak of "normal" sexuality, it may be useful to keep this saying in mind. People often wonder what is normal, healthy sexuality. When it comes to sexuality, defining what is normal, and what is not, is complicated because there is a great deal of variety in sexuality.

Defining "normal" sexuality is complicated because we often use the words, "normal" and "healthy" to mean the same thing. While "normal" and "healthy" may often refer to the same thing, their meanings are somewhat different. In science, when we say something is "normal" we mean it is average. "Healthy" refers to what is adaptive. As we will soon see, sometimes what is considered average or "normal" is not necessarily considered adaptive or "healthy" by some people. Sexuality is so diverse, and what determines normal sexuality depends on many different things. It is easy to understand the difficulty in answering the question, "Am I normal?" This is because there are many variables that make up healthy sexuality.

Because of this, it is very common for us to wonder whether our sexual needs, interests, and desires are normal. In fact, couples who participate in couples' therapy almost always ask questions about what is normal, and what is not. To determine whether one's sexuality is normal or not, it is important to consider the definition of both sexuality and abnormality. The definition of sexuality includes many pieces including (but not limited to) sexual:

  • attitudes
  • desires
  • behaviors engaged in
  • preferences
  • identification
  • function.

In psychology, abnormality is defined using three different perspectives:

  • the frequency perspective considers a behavior abnormal when it happens rarely or infrequently in the general population.
  • from a social norms perspective, behavior may be considered abnormal if it is not socially acceptable.
  • a maladaptive perspective considers behavior abnormal when it causes problems in the person's life or to society (Getzfeld, 2006).

From a frequency perspective, a sexual behavior is considered abnormal when it is infrequently reported. The frequency perspective defines "abnormal" by first determining what is average, or normal. When we consider the idea of frequency, we may want to keep in mind that what we know about sexuality is only as good as what people are willing to tell us. A large portion of sexuality research is based on self-report. When people are asked questions of a sensitive nature (and certainly questions about sex are of a sensitive nature), they may not tell the truth. Therefore, what we know about the frequency of sexual behaviors may be an underestimation, or overestimation of the truth. For example, when we ask women how many sexual partners they have had over the course of their life, they tend to round down, whereas men tend to round up. Therefore, if you hear that the average adult has had 10 sexual partners, it is important to keep in mind this could be more or less than the true number.

From a social norms perspective, it becomes clear that culture (i.e., ancestry, religion, politics, society) largely determines what is considered "normal sexuality." It is important to recognize that what is considered normal, natural, or moral in one society or culture may very well be abnormal, unnatural, or deviant in another. Even within the same culture, social norms may change over time. Social norms include a historical perspective because what was once considered abnormal may very well be considered normal today (Firestone, Firestone, & Catlett, 2006). For example, in the 1950s a woman who had sex before marriage may have been considered very promiscuous whereas today, sex outside of marriage is much more acceptable in many societies.

Finally, from a maladaptive perspective, normal sexuality is defined from a healthy perspective, not an average one. A maladaptive perspective would consider whether the sexual behavior is causing problems, or is harmful to the individual, or to society. Frequency involves an objective look at "normal" or average consideration., "Adaptive" determinations of abnormality involve a subjective evaluation about whether the behavior interferes with someone's life.

Clearly, all of this makes defining "normal" sexuality quite difficult! Because of these issues, using terms such as "natural" and "healthy" may be a more complete approach when we are discussing sexuality. When we discuss healthy sexual practices good questions to ask ourselves are:

  • Is there consent - Are both partners freely agreeing to this?
  • Is the behavior exploitive, coercive, manipulative, and/or self-destructive? (Firestone, Firestone, & Catlett, 2006)
  • Does the behavior cause problems or harm to any of the participants, or to society?


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