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The Quest for Sexual Health

How an Elusive Ideal Has Transformed Science, Politics, and Everyday Life

The Quest for Sexual Health

How an Elusive Ideal Has Transformed Science, Politics, and Everyday Life

Publication supported by the Susan Elizabeth Abrams Fund in History of Science

Offering an entryway into the distinctive worlds of sexual health and a window onto their spillover effects, sociologist Steven Epstein traces the development of the concept and parses the debates that swirl around it.

Since the 1970s, health professionals, researchers, governments, advocacy groups, and commercial interests have invested in the pursuit of something called "sexual health." Under this expansive banner, a wide array of programs have been launched, organizations founded, initiatives funded, products sold—and yet, no book before this one asks: What does it mean to be sexually healthy? When did people conceive of a form of health called sexual health? And how did it become the gateway to addressing a host of social harms and the reimagining of private desires and public dreams? 

Conjoining "sexual" with "health" changes both terms: it alters how we conceive of sexuality and transforms what it means to be healthy, prompting new expectations of what medicine can provide. Yet the ideal of achieving sexual health remains elusive and open-ended, and the benefits and costs of promoting it are unevenly distributed across genders, races, and sexual identities. Rather than a thing apart, sexual health is intertwined with nearly every conceivable topical debate—from sexual dysfunction to sexual violence, from reproductive freedom to the practicalities of sexual contact in a pandemic. In this book Steven Epstein analyzes the rise, proliferation, uptake, and sprawling consequences of sexual health activities, offering critical tools to assess those consequences, expand capacities for collective decision making, and identify pathways that promote social justice.

Download the Bibliography. An audiobook version is available.

400 pages | 7 halftones, 4 line drawings, 2 tables | 6 x 9 | © 2022

Gender and Sexuality

History of Science


Sociology: General Sociology, Medical Sociology


“Epstein’s magisterial analysis is thorough and nuanced. . . . The Quest for Sexual Health will prove to be a field defining work for scholars who work at the intersections of sexuality, science, and medicine, but Epstein’s masterful analysis of ‘sexual health’ as an object of knowledge will be very useful for historians of science generally.”


The Quest for Sexual Health is impressive in its scope, scholarship and depth of analysis, its appeal going well beyond the field of sexual health itself: I would in fact be happy to defy any medical sociologist to claim they could not find an interesting or relevant topic in this book.”

Sociology of Health and Illness

“An erudite, groundbreaking book.” 


“The pinnacle of a body of work deftly tracing the politics of knowledge surrounding sexuality, in this book Epstein offers a kaleidoscopic analysis of what happens when ‘sexual’ and ‘health’ are conjoined. Epstein has no unitary ‘take’ on what sexual health is or what it does, nor is he making a judgment call as to whether it’s ‘good’ or ‘bad’; rather, he follows its effects across a wide variety of social institutions. This ‘ethnography of a discourse’ sketches a genealogy of sexual health that resists neat, tidy, linear explanations. Using scholarly journals, government and nongovernmental agency documents, news media, key informant interviews, and participant observation, The Quest for Sexual Health demonstrates that sexual health’s flexibility is what makes it so useful.”

Social History of Medicine

"This book is rich, thought provoking, and timely. Epstein provides an insightful and meticulous analysis that brings together the multiple layers of social, cultural, political, and institutional processes that shape the amorphous and ubiquitous term of sexual health."

Jennifer Reich, University of Colorado Denver

"A major work. The Quest for Sexual Health is likely to change the way we think about the field of sexual health for years to come. This is the kind of critical scholarship that is truly a pleasure to read. I am convinced that it will quickly come to be recognized as the definitive study on the field of 'sexual health.'"

Richard G. Parker, Columbia University

Table of Contents

List of Abbreviations
List of Illustrations

Introduction: Catching Sexual Health

Part One: Making Sexual Health: Invention, Dispersion, and Reassembly
Chapter 1: A New Definition and the Backstory: Inventing Sexual Health
Chapter 2: Proliferation and Ambiguity: The Buzzwording of Sexual Health
Chapter 3: New Projects of Health, Rights, and Pleasure: Recombining Sexual Health

Part Two: Operationalizing Sexual Health: Enabling Science, Medicine, and Health Care
Chapter 4: Sexuality in the Medical Encounter: Standardizing Sexual Health
Chapter 5: Diagnostic Reform and Human Rights in the ICD: Classifying Sexual Health
Chapter 6: Surveys and the Quantification of Normality: Enumerating Sexual Health
Chapter 7: The New Sexual Health Experts: Evaluating Sexual Health

Part Three: Under the Sign of Sexual Health: Beyond the Worlds of Science and Medicine
Chapter 8: The Pursuit of Wellness: Optimizing Sexual Health
Chapter 9: Social Risks, Rights, and Duties: Governing via Sexual Health
Chapter 10: Bridges to the Future: Repoliticizing Sexual Health

Conclusion: Whither Sexual Health?


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