Never Shy: M. Joycelyn Elders, MD, on Sexual Health

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A pediatrician. A university professor. Arkansas state health director. The 15th Surgeon General of the United States. An outspoken champion of “bringing sexuality out of the dark ages.”

Ladies and gentlemen, I give you M. Joycelyn Elders, MD.

M Jocelyn Elder, MDDr. Elders has devoted her life to science in the pursuit of public health and social justice. Now retired but very active, her projects include developing a sexual health education chair at the University of Minnesota that will bear her name. As part of Sexual Health Month 2012, Dr. Elders chatted with us to offer her perspective on where we’ve been with sexual health, and where she hopes we’ll go.

The prescription is straight-talk and sanity. The good doctor is in.

Sexual health touches on many things: relationships, sexually transmitted infections, and matters of social justice. What should our sexual health priorities be?

I think our first priority should be that every person is allowed to enjoy their sexuality to the greatest extent possible, as long as it doesn’t come at the expense of another.

To me sex is about the three P’s: procreation, prevention, and pleasure. We have to procreate (but every sperm is not a baby meant to be!) but we want to be healthy and protect ourselves and others from infections. Of course, pleasure is one of the most important aspects of our sexuality.

Why are we so squeamish about sex? It’s easier to show graphic violence on screen than two caring adults making love.

I don’t think we’ve ever really learned to appreciate our sexuality, and it’s hard for me to understand why we don’t. We’re so secretive about sex; we’ve crammed it down in a hole and don’t like to bring it out. We need to get over our silence and be open and honest about our sexuality. Everyone should be aware of how important sex and sexuality are but more than that, we need to learn to value our sexuality. It’s important that we do that for ourselves, for others, and our children, too.

Keeping with the idea of valuing others and their sexuality, I’d like to ask about sexual minorities such as lesbian, gay, bisexual, and transgender (LGBT) individuals. How do we bring them more into the mainstream, especially with regard to healthcare?

It starts with education. There is a great deal of misinformation and stereotypes and we need to start early; we do far too little, too late. People just don’t have an understanding of what it means to be LGBT, so they live believing all the myths.

Outreach to healthcare professionals is critical, as they have to be educated so they understand LGBT issues. It should start during their training: I was shocked to learn our medical schools spend an average of five hours of talking about, not just transgender, but all of GLBT. Think about that, all of five hours. When you consider we spend almost 30% of our healthcare dollars on problems related to sexual and reproductive health, we really have to address it better in medical schools.

You mentioned that education about sexual health should start early. Thinking of young people:  what should school-based sexual education programs cover, and when do we start?

I’m always talking about the need comprehensive sexuality education, which we often say should begin in kindergarten and last through 12th grade. However, I’d say it should start at birth and last until death! We need to educate our children early, so why wait until kindergarten? As soon as they can understand we need to tell them about their body parts, and we need to be honest with what we tell them. Children can learn; they might as well learn the right words as the wrong ones!

It’s not like sexuality has a switch that’s suddenly flipped at some magical age that is turned off somewhere down the road…

That’s right, it lasts a lifetime!

Masturbation: it’s something everyone does, it’s pleasurable, and doesn’t lead to any harm. Why would your comments on the subject be controversial at all?

That’s exactly my feeling. Nobody’s ever gotten a sexually transmitted infection or become pregnant because of masturbation.  It won’t make hair grow on our hands; it won’t make us go blind or crazy. Some of that probably has root in the fact many mental patients are seen masturbating (speaking of which, that’s another group that’s ignored when it comes to sexual health education). It really makes no sense at all to me, especially when the data suggest something like 90% of the people will have masturbated at some time during their life.

I mean, if everybody who ever masturbated turned green, we’d be a green society!

The University of Minnesota is establishing the Joycelyn Elders Chair in Sexual Health Education. Tell us what that will involve.

The Joycelyn Elders Sexual Health Chair will be in the department of sexual health and family medicine to really provide further education, starting with healthcare professionals we’ll seek grants so faculty will have funds to do the kinds of studies we need to bring sexuality out of the dark ages.

It’s also important that we educate parents. I think parents would do a good job if we gave them the tools; they don’t want to make a mistake with their children and are so scared of doing something wrong they often just don’t do anything!

So it’s about educating healthcare professionals, parents, and children. If we do all that, we’ll educate our community!