Chapter 2

2. A Closer Look at Sexual Wellness

In the past five years, I’ve spoken to thousands of students at colleges and universities across the country, from massive auditoriums at state schools to small, intimate gatherings at liberal arts colleges. I’ve spoken at tech conferences, like TED Unplugged in Vancouver, SXSW in Austin, and the UN Commission on the Status of Women in New York City. And, of course, I’ve hosted livestreamed classes on O.school. No matter what the venue, the reaction I get when we talk about pleasure and sex education is incredible. When we’re able to solve a problem, the results can be life-changing.

But it’s not just in formal settings. Whenever I talk about what I do, people confide in me.

I’ll never forget a fifty-six-year-old woman at a business networking event telling me that she finally had her very first orgasm—after learning how to use a Hitachi Magic Wand, a mass-market massager beloved by multiple generations.

Or the Lyft driver in 2016 who burst into tears trying to communicate to me the shame she felt around sex. She’d had four children, she told me, but her husband didn’t care about her pleasure. Desperate to have someone to talk to, she finally asked me through tears if it was okay to buy her fifteen-year-old a vibrator—she wanted a different life for her daughters.

Or the law school student at an Ivy League university who came up after a talk who told me she had no idea that women could really experience sexual pleasure. She’d seen it on TV, of course, but assumed it was a myth because it had never happened to her.

Or the disabled veteran in Kansas City who cried to me about his inability to please his wife due to post-traumatic stress disorder that affected his marriage and relationship to intimacy.

Or the sorority member in Los Angeles who thought she was broken. She’d had sex with many men but never had an orgasm.

Or the Muslim trans man seeking help about coming out to his family. His older sister had been kicked out of their house for coming out as a lesbian, and he was desperate for insight as to how I managed to reconcile with my own religious parents.

We tend to internalize our sexual shame. I’ve had women in their fifties—CEOs and leaders in their fields—approach me after a business meeting to confess that they fear they’re failing their husbands, because they feel disconnected from their bodies.

The unifying thread in all of these stories is shame. Shame can have many causes, but I frequently find religious upbringing, sexual trauma, miseducation, and lack of education to be the key drivers. People are very often ashamed about their lack of knowledge, despite the fact that we as a society have failed to educate them. In place of education, we’ve created an ideal of a sexually-realized woman from Sex and the City to Broad City to Cosmopolitan to porn, we’ve created an ideal—progressive in some ways—that can paradoxically leave women feeling like sexual failures.

So when I talk about sexual wellness to strangers, when I talk about the ways in which we’ve failed to educate, and how the path to pleasure is different for each person, it can be hugely validating and start a process of healing for these deep wounds.

People think sexual wellness is about sex, when it’s really about wellness.

We’re going to talk a lot about sexual wellness as we get into sextech, so here is what I believe are the core principles:

Sex is natural and normal. Sex, masturbation, and sexual pleasure are regular functions of the human body. Pleasure is not dirty or shameful, indulgent or harmful, nor to be shrouded in mystery.

It is okay not to have sex, too. For some people, sexual wellness means not being sexual. Celibacy and abstinence can be valid, healthy choices, especially for individuals who identify as asexual, about one percent of the human population.13

Sexual wellness is part of health and wellness. As such, it should be in the domain of evidence-based public health—not religious, political, or morality-based institutions.

Sexual wellness is not “sexy.” We should be able to address it without sensationalism or “hot” models. You don’t need to act sexy to educate people about sex.

Sexual wellness is holistic. It uses mental health, spiritual health, physical health, and sexual health to connect people to their own sexuality.

Sexual wellness is not about performance. There’s not one way to be a sexual being. We don’t have to meet others’ expectations about what a fulfilled sex life looks like.

Sexual wellness products are not “novelty” or “niche” products. Vibrators, cock rings, lubricant, and other products should be treated the same way as a leg brace or a back massage.

Sexual wellness is about access. We deserve education and the freedom to make informed choices about the sex life that is right for each of us.

Sexual Pleasure Is Good Health

As we will explore in the next chapter, most of us are taught about sex in negative terms—dangerous STIs and unwanted pregnancies, ruined reputations, and legal liabilities. As kids, we’re taught the “why not” of sex, but rarely the “why.” Not only is that confusing, but for many of us, it has lasting impact on how we approach sex as adults. After all, most of the sex that people have is not for reproduction, but because it feels good. Because we’re attracted to someone, or because we want a more personal connection, or because our body is craving sexual release. But it has a host of other benefits as well.

For most people, sex reduces stress. In addition to just feeling good, pleasurable, consensual sexual activity releases oxytocin, a hormone which creates feelings of well-being, facilitates social bonding, and helps block certain stress reactions in the body.14

Sexual pleasure also releases endorphins—the same hormones that kick-in with exercise. Sex helps with sleep, which can in turn affect everything from mental health to longevity.15 It has even been shown to strengthen immunity.16

We face an epidemic of stress-related illnesses, from anxiety to heart disease, and have become used to doctors scolding us about what we eat and if we work out—but when was the last time a doctor asked about your sex life, or if you masturbated regularly? In most cases, such a discussion about sex—one of the key drivers of human behavior—would be entirely off the table.

Sexual wellness challenges that model. Sexual wellness seeks to strip away the prescribed versions of sex that society has given us—what we should or shouldn’t do, who we should or shouldn’t be—and to integrate it back into our everyday lives.

Sexual wellness companies understand sex is a source of energy, power, and self-care. A sexual wellness company incorporates sexual health, mental health, and general wellness in order to help someone feel at home in their body, free of psychological and physiological issues around sexuality.

We celebrate finding out the diet that works for you and doing the exercise that’s right for you. We remind each other to get our water intake in order and to sleep eight hours. But how often has the medical establishment told us to get your sex life and sexual identity in order?

That’s what sexual wellness calls for. It’s bringing sexuality back into the experience of being human.

Erectile Visibility, Vaginal Shame

Turn on the Superbowl, and you’ll see ads for Viagra, Cialis, and Levitra, all drugs treating erectile dysfunction (ED). Ever since former Senator Bob Dole appeared in a Viagra ad, it’s been acceptable to talk about ED on television.

In general, this is a good thing. All sexual problems are valid and should be respected, and I’ve seen firsthand how people struggle with ED and the emotional toll it can take. We want more discussion about sexual problems, not less.

However, the near-singular focus on ED is representative of how the medical industry addresses sex: in terms of performance, rather than pleasure or satisfaction.

With the generic form of Viagra now available, ED advertising has exploded seemingly overnight. And with it, the idea that erectile performance is a performance sport.17 Erectile dysfunction is a serious condition, but the barrage of ads—on radio, on bus stops, on social media—not only focus entirely on one gender, and one form of sex, they focus only on one solution.

We’ve all heard it in ads: “Call your doctor for an erection lasting more than four hours.” In a culture that pushes men to last longer and perform better, even the warning of “side effects” is a form of marketing.

But many doctors and sexual health experts recognize that ED is often more complicated than a lack of blood flow to the penis.

Stress and anxiety, and other mental health concerns, are a big factor...