Year: 2014
Type: article
Abstract: The World Health Organization (WHO) convened a meeting on sexual health in 2002 to clarify definitions of healthy sexual development and concluded with a powerful statement testifying to the central and multifaceted role of sexuality in human health and well-being [World Health Organization, 2004]. According to their model, sexuality incorporates eroticism, intimacy, pleasure, reproduction, and one's own gender identity, and it is manifested in sexual behaviors, wishes, desires, fantasies, attitudes, roles, and relationships. The WHO also views sexuality as inherently multidimensional, integrating biological, cultural, social, economic, psychological, ethical, and spiritual factors. Positive or healthy sexuality, then, requires that individuals have adequate freedom and knowledge to pursue safe and satisfying sexuality. In the compelling words of the WHO [2004]:Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. (p. 3)A decade after the publication of this powerful statement, the study of adolescent sexuality remains more focused on negative than positive experiences. Although a number of scholars have advocated for positively-oriented conceptualizations of adolescent sexuality [Russell, 2005; Tolman & McClelland, 2011], the majority of developmental research continues to view adolescent sexuality through a lens of danger and threat, overemphasizing the timing and frequency of risky sexual acts and their negative implications for future health and adjustment. We remain woefully uninformed about youths' total psychological and physical experience of erotic and affectional desires, cognitions, and behaviors from childhood to adulthood and their potentially positive developmental implications for notions of self, identity, and relationships.For these reasons, Miriam Arbeit's [this issue] skill-based model for promoting adolescent sexual development is a welcome addition to contemporary theorizing about adolescent sexuality. It draws productively from existing strains of research on positive adolescent sexual development [Bay-Cheng, 2012; Fine & McClelland, 2006; Impett, Muise, & Breines, 2013; Lamb, 2010; Russell, 2005; Tolman, 2012; Tolman & McClelland, 2011] but breaks new ground in its more specific and process-oriented approach. Whereas previous scholars have effectively outlined the need for and the promise of positive developmental models of adolescent sexuality, Arbeit has taken on the thorny details, outlining a vision of the fundamental components of positive adolescent sexuality (sexual selfhood, sexual negotiation, and sexual empowerment) and the psychosocial skills that they require. A particular strength of the model is the proactive role that it grants to adolescents themselves as drivers of their own development. In contrast to the hundreds of studies that focus on how adolescent sexuality is shaped by outside forces (such as parents, peers, teachers, school, their church, the media, the Internet, and the culture at large), Arbeit's model casts adolescents themselves as the central characters in their own emerging sexual selfhood. In her conceptualization, youths are not simply passive actors, consuming conflicting messages from parents, peers and the media, and moving back and forth with changing cultural tides, but active shapers of their own sexual-developmental trajectories. This allows researchers to ask far more sophisticated questions about the dynamic interchanges between youths and their environments that produce variability in sexual-developmental pathways and outcomes.I am enthusiastic about Arbeit's model and its potential to generate important new questions and answers about adolescent sexual development. Nonetheless, there are “soft spots” in the model that could benefit from greater attention, clarification, and expansion. My discussion of these areas below is intended to enhance and improve the impact and generativity of Arbeit's model rather than to challenge it. She has charted a new course in the study of adolescent sexuality, and working to test and refine this new course should be the work of all scholars of adolescent sexuality.Arbeit grounds her model in relational developmental systems theory [Lerner, Lerner, Almerigi, & Theokas, 2006; Overton, 2013], which views human development as the evolving product of an ongoing series of dynamic person-context relations. Yet this perspective raises an inevitable question: why restrict a model of sexual development to adolescence? Although the developmental transitions of adolescence arguably make it a “critical period” for sexual development, sexuality is obviously a lifelong experience. Furthermore, a growing body of theoretical models related to developmental systems theory have called for “cascade” models of human development [Lansford, Malone, Dodge, Pettit, & Bates, 2010; Masten & Cicchetti, 2010; Ryff, Singer, & Seltzer, 2002; Ryff, Singer, Wing, & Love, 2001], in which each developmental phenomenon is conceptualized as both the output of prior developmental processes and the input for forthcoming processes. Hence, from this perspective it may be impossible to study positive adolescent sexual development without beginning with a focus on childhood sexual experiences, cognitions, and skills. Arbeit is clearly aware of the relevance of childhood processes and indicates that sexual skill development begins with children's own bodily exploration and early childhood interactions, but these childhood experiences receive little explicit attention in her model, nor do the potential sexual-developmental implications of early childhood adversity, neglect, or abuse. More comprehensive integration of childhood sexual development into Arbeit's model would substantially expand its reach.Similarly, it would appear to be impossible to differentiate positive versus negative trajectories of sexual development during adolescence without extending the time frame forward substantially into middle and late adulthood. After all, research has shown that many adult sexual problems and dysfunctions are related to interpersonal and situational stressors occurring at all stages of the life course [Laumann, Paik, & Rosen, 1999]. Hence, there is no particular age at which we can confidently establish that a youth has succeeded in developing a healthy, positive, sexual self. Rather, positive sexual development is a life span task which requires a life span research frame and an investigative approach capable of attending to the cumulative, cascading processes that give rise to dynamic changes in sexual selfhood across different ages and contexts.Arbeit's model is well-suited to take this approach: she indicates that the hypothesized developmental processes outlined in figure 1 are likely to recur many times over, resulting in the development and refinement of different sets of skills across an expanding range of contexts. Surely, these recurrences may occur over the entire life span, as developmental and contextual changes create new needs and challenges. Consider, for example, the skills required for effective sexual negotiation. As Arbeit indicates, the development of skills related to verbalizing one's needs and boundaries, establishing and negotiating consent, and successfully seeking and providing pleasure are critically important during the adolescent years, but they may require substantial refinement and elaboration at many different stages of the life span as individuals encounter new sexual partners with different expectations, different bodies, different patterns of communication, and different sexual tastes. Aging, too, creates new challenges: consider two individuals in their 70s dating for the first time, struggling to find an artful way to describe and work around potential physical and/or health limitations to their sexual behavior. No matter how successfully they might have mastered sexual negotiation in previous decades, the new developmental challenges accompanying later stages of life create new challenges and the need for new sets of skills. Similarly, imagine a married couple coping with the reestablishment of sexual intimacy after one partner's infidelity. The challenges of this novel context might tax their skills of sexual negotiation in new and unexpected ways.Hence, as long as individuals undergo lifelong psychosocial, biological, emotional, cognitive, and ideological changes, and as long as they move into and out of different relationships and contexts, they will inevitably repeat and revisit Arbeit's hypothesized processes of sexual development. Accordingly, one of the most generative implications of Arbeit's perspective is that it could be used as the foundation for a truly life span model of sexual development. Although adolescence might prove to be a particularly critical period for the development of sexual skills and sexual selfhood, it is clearly not the only one. Rather, adolescent sexuality represents one stage in a cascade model - sexual feelings, experiences, skills, and identities during the adolescent years are both the outcome of childhood feelings, experiences, skills, and identities, and also the drivers of feelings, experiences, skills, and identities during early, middle, and late adulthood. Although Arbeit does not substantively integrate this cascade perspective into her model, it is fully consistent with her emphasis on relational developmental systems theory.Another area of Arbeit's model which would profit from expansion and elaboration concerns the role of biological processes. Although Arbeit makes several references to the influence of biological factors on adolescent sexual development, these references are relatively vague, and the overall role of biological processes in her model is underdeveloped. If, as she states, her goal is to draw greater attention to the systematic relations involved in promoting positive sexual development, then biology deserves a larger and more specific role. Furthermore, greater focus on the biological body would enhance Arbeit's commendable emphasis on embodiment as a critical component of sexual development. As Arbeit reviews, the concept of embodiment encapsulates the fact that youths' sexual development, their sense of sexual selfhood, and their development as sexual citizens is negotiated by, with, and through their bodies following the influential work of Overton [2008] and Tolman, Bowman, and Fahs [2014]. Although research on embodiment typically focuses on the subjective phenomenology of bodily experience, it can and should include a focus on the many systems within the body which undergo change before, during, and after sexual maturation. Arbeit highlights that the development of sexuality-related skills occurs within young people's bodies and in relation to “past and future bodies.” During a time of such incredible physical change, these past and future bodies might be astoundingly different, both in obvious and not-so-obvious ways. Although an adolescent (and his or her peers, parents, and potential sexual partners) might be acutely aware of bodily changes signaling sexual maturation (height, hair growth, breast size, hip size, muscular development), they are probably less aware of invisible changes such as those related to brain structure and function and to autonomic and neuroendocrine functioning. Yet these changes undoubtedly interact in critical with social and sexual and their implications for youths' sense of sexuality greater Hence, one and potentially for Arbeit's model would a more of in all of its systems and to a more specific of sexual for example, the role of factors. 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Source: Human Development
DOI: 10.1159/000368280
Author: Lisa M. Diamond
Institutions: University of Utah, Karger Publishers (Switzerland)
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2143096354