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We looked at different definitions and discussed what we agreed with, as well as what we felt might be missing.

We also considered specific populations to better understand how sexual health can vary depending on individual experiences. For example, sexual health might look different for a trans* person compared to a cisgender heterosexual male.

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Our definition of sexual health is outlined by a variety of important factors:

the understanding that sexuality is a healthy and natural part of life

respecting sexual differences between individuals and groups

access to sexual and reproductive health care

access to accurate information about the risks of sexual activity, especially for vulnerable populations

being able to communicate about sexual health with others (e.g. partners, healthcare providers)

living in an environment that affirms and promotes sexual health

being able to experience sexual pleasure, satisfaction, and intimacy in a safe environment when desired

embrace and celebrate sexuality throughout our lives!

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Our Case: A husband and wife agree that he can enjoy cross-dressing when she travels out of town on business. When she is home, they agree they have an enjoyable sex life.

How it Aligns with our Sexual Health Definition:

From these few sentences, it seems as though the couple came to a compromise that they are both satisfied with.

They explicitly state they are fulfilled with their sexual experiences regarding each other.

They seem to be very considerate of each other's preferences and feelings.

Area's of Consideration for Sexual Health Improvement:

Does the husband ever feel limited in regards to self-expression? (Agree is not equivalent to happy).

The wife might be avoiding seeing her husband cross-dress. If this is the case, avoidance implies that there is some level of discomfort. If this is the case, a goal might be to get to a level where both partners feel comfortable and fulfilled.

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Sexual health is the ability to embrace and enjoy our sexuality throughout our lives. It is an important part of our physical and emotional health. Learn more about what being sexually healthy means.

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Aspects of sexual health could be:

Communication

agreement between parties

openness to discuss wants, needs, likes/dislikes

Is there openness to relationship?

in this case: testing, care, discussion, honesty

consent, respect and boundaries

Body language, physical touch, verbally communicating

Non-sexual intimacy

Care

Self-care strategies

Couple centered care strategies (before and aftercare)

Affirmative environment

Access to resources

medical care

information

counseling services

Cultural & Social Influence

Does the husband feel impacted by society or social norms in this aspect?

Gender roles & power imbalances

Learning the client's sexual identity and orientation

What messages have both clients received about sex and sex roles

Expressive

satisfying to both parties

promotes mental, social, physical, and emotional health

collaborative effort

Intertwining of connection and intimacy

Exploration

Ideas of role-play and expression for the husband

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Everything you need to know, from birth control to healthy relationships, identity, and more.

For Teens

Questions about sex, your body, or relationships? We've got you. Here's your ultimate guide to getting through high school and beyond.

Learn More

For Parents

From talking about sex and relationships to online bullying to supporting your LGBT kid: how to guide your children into making healthy decisions.

Learn More

Many STDs are no big deal, and can be treated easily. But sometimes STDs can be dangerous. Luckily, it's easy to get tested. Here's how you can prevent getting or passing on an STD. Take the first step to a healthier, safer sex life.

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Sexual Health Topics | Get the Facts about Sexual Health

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Planned Parenthood provides information and services concerning sexual and reproductive health as well as offering testing and treatment for STDs.

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Whatever works for them. If both partners are happy with the arrangement, then it’s totally fine. As counselors, we have to respect our client’s wishes. For example, if crossdressing more often might lead to their partner leaving them, we need to explore that with the client. We can ask if that’s something they’re willing to risk, and if not, that’s okay too. Our job is to support their well-being. Even though we may want our client to live authentically, we also have to respect their personal choices and timing.

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The counselor could consider what the couple needs in order to properly help them support, respect, and feel comfortable with each other's sexual desires and preferences. For example, after a few initial sessions building rapport I would start to ask more deep questions about avoidant behaviors and limited self-expression. However, if the couple reports to feel content with their current arrangement, then the deeper questions are not necessary. In order for these conversations to be productive it's necessary to create a safe and genuine environment for the couple to freely share.

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As Sofia said, whatever works for them! I would be curious to explore the specific parameters and dynamics of this couple's relationship in more detail. However, given the fact that both partners seem comfortable with their situation/agreement, I would avoid placing any unnecessary emphasis on trying to "fix" their relationship if they are both content with this arrangement. I would be interested in gently exploring the topic of cross-dressing with the husband: How does cross-dressing serve him? Does he feel a level of gender dysphoria which cross-dressing relieves, or is cross-dressing simply something he enjoys? I would avoid pathologizing him---I would only ask to ensure that both partners' well-being is fully respected and supported. All in all, I would like to more thoroughly understand the dynamics of this couple's relationship and their goals for counseling.

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I think as long as the agreement is truly mutually beneficial and nothing is left off the table this is can be sexually healthy. I am curious to see how the husband feels in regards to his dressing as I know many influences may impact someone (social, emotional, psychological, and emotional).