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Breaking the Cycle: Toward a More Holistic Treatment of Sexuality

March 01, 2012

(Colleen Hoff is director of the Center for Research & Education on Gender and Sexuality at San Francisco State University. Her ongoing HIV prevention study on gay couples is the largest ever in the U.S. Justin Keller is the center's development director.)

Icon_gender_logoSexuality remains a largely taboo topic in the world of philanthropy. Culturally speaking, it tends to make us uncomfortable, and controversy is not something foundations tend to seek out. To avoid potential conflicts, private funders interested in the subject tend to narrow their focus to specific needs-based issues: reproductive rights and health, HIV/AIDS, sexually transmitted infections (STIs), intimate partner violence, women's rights and social justice, and marriage equality. Unfortunately, these needs-based labels can restrict our thinking about sexuality and its connection to health and well-being.

Among other things, this narrow view forces researchers and educators in the field to frame their work in the context of disease or other negative consequences of sex, such as unintended pregnancy. Without question, these issues need to be addressed. But by defining sexuality in terms of the negative outcomes associated with it, we are painting an incomplete picture. More devastatingly, it prevents important research questions from even being asked.

Both the White House and the Center for Disease Control and Prevention have recently started to recognize the importance of sexuality as a vital component of the human experience. As early as 2001, former United States Surgeon General David Satcher stated "that sexuality encompasses more than sexual behavior, that the many aspects of sexuality include not only the physical, but the mental and the spiritual as well...." Despite this acknowledgment, federal funds dedicated to this area of research are almost completely devoted to HIV/AIDS and STIs. What little research has been done on the positive impact of sex clearly indicates that healthy sexuality contributes greatly to overall health and well-being. Framing adverse sexual health outcomes within the larger context of sexuality may allow for the development of more holistic, effective programmatic approaches to these issues.

Here is a small sample of areas that have been virtually ignored:

Gay and Lesbian Parents

According to a 2011 report by the Evan B. Donaldson Adoption Institute, over 50 percent of lesbian and gay parents adopted children from the welfare system, while 60 percent adopted trans-racially (i.e., a child of a different race). Fourteen thousand of the one hundred thousand foster children in the U.S. currently live in homes headed by gay or lesbian parents. And approximately 57 percent of children adopted by gay and lesbian parents have one or more special needs (e.g., developmental disabilities, complex medical issues, and emotional/behavioral disturbances). Despite these figures, little is known about this important and growing population of caregivers, and some literature suggests that gay and lesbian parents and their families receive disparate treatment from schools, healthcare providers, and federal and state entitlement programs. Clearly, there is an immediate need to better understand these experiences so that policies and service providers are able to adapt to this unique and growing population and provide these families with the resources they need.

Sexuality and Disability

As noted above, sexuality tends to be a taboo subject, and discussing it in the context of disability complicates things further. Sexuality can be very confusing for youth with intellectual and developmental disabilities who are developing physically at the same rate as their peers without disabilities. Everyone involved in their lives -- parents, schools, community -- wants to include these youth in conversations about sexuality but also wants to protect them from abuse and exploitation. Research in this area can be critical to informing best practices, programs, and policies that acknowledge that youth with disabilities often are just as curious and confused about sexuality as their peers without disabilities.


Despite the increased visibility of LGBT people in society over the last several decades, gay and non-gender conforming teens are still often bullied, with some driven to suicide. The tragic and highly publicized deaths of gay teens such as Jamey Rodemeyer, Jamie Hubley, and Kameron Jacobsen have created a national discourse on the plight of LGBT teens in public school. In 2010, a Mississippi high school canceled its senior prom when a lesbian teen expressed her intention to bring her girlfriend. Such actions demonstrate to LGBT teens that they are less valued than their straight peers. With foundations and popular celebrities such as Lady Gaga engaging in advocacy related to this important social issue, it is critical that we spend the time and resources to understand the unique social environment of schools and the support needed by marginalized teens from a social science perspective.

Diversity in Research

Research is an increasingly difficult market for young researchers of color. A recent study published in Science magazine showed that African Americans are significantly less likely to receive National Institutes of Health grants than white researchers. Mentorship and professional opportunities are critical for students of color currently in the academic pipeline. Diversity of experience plays an important role in the formation of scientific hypotheses. The lack of diversity in the field of sexual health is especially disturbing in light of significant disparities in communities of color with respect to HIV/AIDS, STIs, and unintended pregnancy. Research is needed to examine why these barriers and disparities exist for both researchers of color and communities at risk.

In sum, as our understanding of sexuality grows in the academic realm, we believe the controversy and negative associations tied to it will diminish. The private philanthropic sector's participation is critical if this is to happen sooner rather than later. It would be wonderful, in the near future, to see funders treat sexuality holistically, the way they do other important social and cultural issues such as the arts, education, and economic development. This work will not only improve and save lives, it also will provide an opportunity to promote wellness and acceptance in society. That is something we can all embrace.

(Image: Selina Anttinen)

-- Colleen Hoff and Justin Keller

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