Intended for healthcare professionals

Education And Debate

Sexual behaviour and its medicalisation: in sickness and in health

BMJ 2002; 324 doi: (Published 13 April 2002) Cite this as: BMJ 2002;324:896
  1. Graham Hart, professor (,
  2. Kaye Wellings, directorb
  1. a MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow G12 8RZ
  2. b Centre for Sexual Health Research, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: G Hart

    Religion used to define morally acceptable conduct, then doctors became interested in sexual behaviour. Now we live in a world where celibacy is the new deviance, and surgery and drugs are used to enhance sexual pleasure. Graham Hart and Kaye Wellings reflect on the extent and consequences of the medicalisation of sexual behaviour

    “Sex survey ruined our wedding,” screamed the front page of the Sun.1 The newspaper reported how a “couple had a furious row and called off their wedding after the bride-to-be revealed their sex secrets in a university survey.” This could be a routine example of how the press uses research on sex to sell papers. This case is more interesting, however, because the groom to be was clearly unhappy with the extent of sexual surveillance, which arguably is a feature of the medicalisation of sexual behaviour in British society. To what extent has there been a medicalisation of sex, and what are the consequences of this?

    Summary points

    Medical authority over sexual behaviour has a long history

    In the 19th century, labels distinguished “perversions” from “acceptable behaviour,” and some doctors invented adverse outcomes of sexual acts to deter the practice of these acts

    In the 20th century, disorders previously seen as morally inadmissible became “treatable”

    The late 20th century saw major changes in sexual attitudes and mores as therapeutic advances removed adverse outcomes of sexual behaviour

    Our obsession with sexual gratification increases expectations and feelings of inadequacy

    The medicalisation of sex has resulted in surgery and drugs being used to enhance sexual pleasure

    Overly medical approaches to sex ignore the social and interpersonal dynamics of relationships


    Medical authority and sexual behaviour

    The exercise of medical authority over sexual behaviour has a long history. Religion once defined morally acceptable sexual conduct, but in an increasingly secular society, this task fell to medical science. …

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