Women's Health Surveillance Report
Sexual Health
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Lisa Hansen, MSc, MHSc; Janice Mann, MD; Mike Barrett,
PhD; Sharon McMahon, MA; and Tom Wong, MD, MPH, FRCPC (Health
Canada)
Health Issue
Health Canada's 1999, Report from Consultations on a
Framework for Sexual and Reproductive Health, has asserted as a
guiding principle that all individuals are sexual beings throughout
their lives. This is the broad approach we have taken in
considering issues related to the sexual health of Canadian women.
In both biological and behavioural aspects, Canadian women
experience important variations in their sexual health throughout
the life cycle, from before puberty to after menopause. We pay
particular attention to the often overlooked formative and mature
stages of women's sexual lives, including the development of
healthy sexuality before puberty and the maintenance of healthy
sexuality after the reproductive years. We have analyzed
cross-sectional data from the "Sexual Behaviour" module
of the 2000-2001 Canadian Community Health Survey (CCHS), and have
reviewed the literature and other available indicators of the
sexual health of Canadian women.
Key Findings
- Contemporary Canadian adolescents are becoming sexually active
at younger ages than in previous generations.
- The "gender gap" between young males and females in
age at first intercourse has virtually disappeared. Among those
15-24 years old, the mean age at first intercourse was 16.7 years
for males and 16.8 for females.
- Canadian-born females and males are significantly younger at
first intercourse than respondents who were not born in
Canada.
- In focused research, female and male adolescents demonstrate a
poor knowledge of sexual and reproductive health. Despite a
reasonable awareness of HIV/AIDS, few adolescents recognize the
behaviours and infections that pose the greatest threats to their
sexual health. In this aspect, Canadian youth are similar to their
international peers.
- Among all CCHS respondents who had one or more sexual
relationships lasting less than 12 months in the previous year,
only about half report that they "always" used a
condom.
- Among older adults, the medical model of sexuality often fails
to recognize that normal aging does not necessarily compromise
sexual expression. Canadians in mid-life and beyond are sexually
active, and find emotional and physical satisfaction in their
sexual relationships. Healthy sexuality is an essential aspect of
quality of life for older adults.
Data Gaps and Recommendations
The authors identified the following data gaps and made the
following recommendations:
- At the national level, we rely on periodic population health
surveys for a limited set of sexual health measures. Both surveys
and targeted research need to employ a broader understanding of
"sexuality," to encompass psychological as well as
behavioural and biological measures. Ongoing indicators are needed
to measure important changes in the sexual health of Canadians
throughout the life cycle as well as better measures of the
upstream determinants of sexual health.
- Although unintended pregnancies, contraceptive use, and
sexually transmitted infections among adolescents have been
extensively researched, sexual behaviour and knowledge have not
been given the same degree of attention. There is reluctance to
direct questions about sexual issues to younger Canadians, even
though increased knowledge of sexual health topics is associated
with delayed onset of sexual intercourse.
- Among adults, resources directed at sexual health are needed to
address psychological aspects of aging and sexuality, rather than
focusing on physiologic sexual dysfunction.
- Age and gender-appropriate sexual health care, education, and
knowledge is not only important for women of reproductive age, but
for all Canadians at all stages of life.
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