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What Healthy Sexuality Looks Like for LGBTQ+ People
Healthy sexuality isn’t about one right way to have sex. It’s about consent, pleasure, safety and feeling good about who you are.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
Many LGBTQ+ people grew up without any sex education that included them. On top of that, they may have absorbed messages that their desires were shameful. It’s no wonder that figuring out what healthy sexuality looks like can feel confusing.
The World Health Organization describes sexual health as physical, emotional, mental and social wellbeing related to sexuality, not just the absence of disease. That includes the ability to have pleasurable and safe experiences, free of coercion and discrimination.
Healthy sexuality includes
Self-acceptance: feeling okay about who you’re attracted to and how you identify.
Consent and respect: for yourself and your partners, every time.
Communication: being able to talk about desires, limits, safer sex and feelings.
Safety: using the prevention tools that make sense for you, like PrEP, condoms, doxy-PEP, vaccines and regular testing.
Pleasure: sex is allowed to be enjoyable. Pleasure is a valid part of health.
Choice: whether you have lots of sex, little sex or none at all, are monogamous or open, what matters is that it’s your choice and it fits your values.
Things that can get in the way
Internalized shame, past trauma, depression, anxiety, medication side effects, body image struggles and substance use can all affect your sexual life. For some, sex becomes tied to alcohol or drugs because sober sex feels too vulnerable.
Asexual, aromantic and questioning folks
Healthy sexuality includes people who experience little or no sexual attraction. There’s nothing to fix. What matters is that you feel free to define your relationships and intimacy in ways that feel right.
How a clinician can help
An affirming clinician can help with shame, trauma, sexual side effects of medications, anxiety around sex, or questions about identity. These conversations are a normal part of mental health care.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
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