Sexual Health Framing Sexual Medicine: Toward a More Humanistic Framework

An editorial argues clinical sexual medicine neglects justice, rights, and pleasure — proposing a shift from fixing dysfunction to enabling well-being

Journal: Sexual Medicine Reviews | Published: 2026-04-02 | Type: Editorial | PMID: 41926205 Authors: El Kak Faysal (American University, WISH Program); Giraldi Annamaria (Psychiatric Centre Copenhagen) Funding/COI: Not listed

Summary

Two senior sexual health clinicians argue that sexual medicine's biomedical orientation — focused on pharmacological, hormonal, and surgical restoration of function — is insufficient. Drawing on the WHO's multidimensional definition of sexual health, they propose expanding clinical goals to include justice (equitable care across identity and socioeconomic status), rights (sexuality as human dignity), and pleasure (a legitimate, measurable health outcome). No data is presented; this is opinion.

Claims

• Sexual medicine's dominant paradigm is biomedical, privileging physiological restoration over holistic well-being
• The WHO definition of sexual health encompasses well-being, not merely absence of dysfunction
• "Pleasure" has been systematically marginalized in clinical discourse and should be a measurable health outcome
• Current care fails to be equitable across gender, orientation, identity, and socioeconomic contexts
• Clinical metrics, education, and practice standards need restructuring to incorporate these three dimensions

Study Quality

This is an editorial — no original data, no systematic review, no methods section. The argument draws on "transdisciplinary scholarship" without specifying search strategy, inclusion criteria, or effect sizes. The WHO definition cited is real and established; the clinical implications drawn from it are the authors' normative position.

As opinion pieces go, the argument is internally coherent. But it cannot be evaluated by standards applied to empirical research, and shouldn't be cited as evidence that any intervention or framework produces better outcomes.

Red Flags

• No data. This is advocacy, not evidence synthesis.
• "Pleasure as a measurable health outcome" is asserted without specifying validated instruments, endpoints, or thresholds
• The proposed "flourishing model" is unoperationalized: no clinical metrics, no implementation pathway, no pilot data
• No funding or COI declared — less concerning for an editorial than a trial, but noted

Strengths

• Clear argument with a defined tripartite framework (justice + rights + pleasure)
• Grounds the proposal in the WHO's established sexual health definition, not invented criteria
• Authors hold relevant credentials in clinical sexual medicine and public health
• Identifies a real and documented gap: most sexual dysfunction trials measure function, not satisfaction or well-being

Verdict

A competent editorial making a reasonable argument that sexual medicine routinely measures the wrong things. The "pleasure as clinical outcome" claim is the most provocative piece, and also the least developed — the authors don't specify how you'd measure it, what instrument you'd use, or what constitutes success. Worth reading if you're interested in how clinical endpoints get defined and who gets to define them; not citable as evidence that any practice or framework improves outcomes.