Sexual Dysfunction in Sex Ed

Sexual Dysfunction in Sex Ed

By Holly Ponton and Blaire Ward
December 14, 2016

In recent weeks we’ve discussed teaching pleasure in sex ed, how to frame that conversation with asexuality in mind, and we tackled difficulties with discussing pleasure in one of our recent TRUST blogs. But in doing some research, our evaluation coordinator, Blaire Ward, discovered that there’s yet another piece missing to this conversation: what about youth who are experiencing sexual dysfunction?

Sexual dysfunction isn’t a topic often discussed in sex ed curricula, so why worry about it? First, it’s important to clarify what sexual dysfunction actually is.

Sexual Dysfunction: The Basics

In a nutshell, sexual dysfunction disrupts the full sexual response cycle (how human beings experience sexual pleasure). This can mean that people experiencing sexual dysfunction can find it difficult to orgasm, experience pain during sex, or have a lack of sexual desire or sexual pleasure. Sometimes sexual dysfunction is situational and sometimes it’s long-term, and the cause can be physical, psychological, or both. It’s important to note that sexual dysfunction is NOT the same thing as asexuality. Asexuality is a sexual orientation, whereas sexual dysfunction is a physical and/or psychological disruption in the sexual response cycle.

There isn’t a large body of research available looking into adolescent sexual dysfunction. What is available, unfortunately, is focused primarily on male experiences, excluding female or trans experiences from the discussion. However, current research indicates that youth sexual dysfunction (in the age range of 15-24) might be a more widespread experience than we may have expected. One 2016 study of over 2,000 15-24 year olds found that 48% of females and 23% of males had at least one sexual dysfunction in the last 12 months.

Advertisers, academics, and our society at large have long treated sexual dysfunction as something that’s exclusive to adults, particularly older adults. However, this does an enormous disservice to young people who may also experience these symptoms but don’t have the vocabulary or resources to articulate their experiences. A young person who has trouble maintaining an erection or self-lubricating may feel shamed by our culture’s pervasive assumptions about how sexual organs 'should' function. When we educate young people about their bodies, it is easiest to talk about what ‘typically’ happens to ‘typical’ genitals during sex acts. Particularly in a classroom environment, this is often the most convenient way to convey general information to a broad audience. However, this lack of nuance can be inadvertently damaging to young people who may feel inadequate if they do not fit the ‘norm’ being presented.

One of the primary principles behind comprehensive sex ed is that it provides complete information in a values-neutral manner – and we know that this method works. When youth can make fully informed decisions about their sexual health with access to the most complete and accurate information, research shows that there is a delay in the onset of sexual activity, a reduction in the amount of sexual partners, and the rates of unintended teen pregnancy go down. In other words, when youth have the best information, they make the best choices. And when they are misinformed, their choices and their lives can be negatively impacted. Sex ed shouldn’t treat sexual dysfunction any differently: we need to provide youth with the full spectrum of information on how bodies can react during sex. Failing to do so can impact youth in their physical, emotional, and mental health.

Risks and Challenges

Sexual dysfunction that goes unresolved can be incredibly damaging to a young person’s development. For one, sexual dysfunction can be symptomatic of serious medical or psychological conditions that require treatment, including heart and vascular disease, neurological disorders, and chronic diseases such as kidney or liver failure. Sexual dysfunction can also be caused by antidepressant drugs, leading youth to stop taking medications critical to their mental health without discussing it with their doctor. Furthermore, sexual dysfunction can greatly impact sexual self-confidence at a critical period, resulting in a sense of shame, embarrassment, or feeling broken or abnormal. As a result, youth may develop a deep anxiety around sexual activity, preventing them from eventually having fulfilling sexual relationships. In fact, many adults who experience sexual dysfunction first encountered difficulties in their adolescence.

So it’s clear that early intervention is critical, but asking youth to advocate for themselves in this capacity is a tall order. A 2013 study found that most doctors avoid discussing sex with adolescent patients, and teens are extremely bashful when it comes to bringing up sex with their doctor. The same study also found that it can be difficult to get parents out of the room when a doctor tries to have a confidential conversation with a teen about sex, making it less likely for teens to be honest with their doctor. Add in the stigma surrounding sexual dysfunction, and it’s unlikely to say the least that youth will feel comfortable bringing up sexual dysfunction with their doctor, preventing them from receiving the care and information they need.

Solutions in Sex Ed and Doctor’s Offices

There are two arenas where we need to improve the way we approach sexual dysfunction. The first is in sex ed. Sex education should be providing youth with age-appropriate information about how to deal with sexual challenges, as well as removing some of the stigma surrounding sexual dysfunction. In a sex-ed class, that might entail telling students that lots of people have performance difficulties. Opportunities for this discussion can come up with lessons on the sexual response cycle, where you can simply mention briefly that while many people want to and do experience the sexual response cycle without issue, some people can experience sexual dysfunction. In the interest of increasing school-to-clinic linkages, you can also refer students to their local clinic as a great resource for working through sexual issues.

The second arena is in doctor’s offices, which must work to create a welcoming safe space to foster these discussions. Too few doctors are proactively starting conversations about sex, let alone sexual dysfunction, with their patients. Research shows that young people are ready to talk to their doctor about their sexual and reproductive health, but the doctor needs to be the one to initiate the conversation. In other words, medical providers need to actively promote these conversations rather than wait for patients to bring the topic up themselves.

Sexual dysfunction can sometimes be extremely distressing, sometimes only slightly so. And sometimes people with sexual dysfunction don’t see it as an issue at all. What’s important is that youth have access to accurate information about their bodies, and potential experiences they may have as they begin to enter sexual relationships. In this sense, we shouldn’t treat sexual dysfunction any differently than we treat other sexual health topics – and that means talking about it.

Looking to make your sex ed curriculum inclusive of sexual dysfunction? Contact Holly Ponton at This email address is being protected from spambots. You need JavaScript enabled to view it. for support.

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