Sexual and reproductive health has largely been shaped by perspectives from wealthier developed nations in the Global North. To correct this imbalance, public health experts call for centering Global South knowledge, lived experience, and culturally grounded understandings of sexuality—including sexual pleasure.
Jessie Ford , PhD, assistant professor of sociomedical sciences , and co-authors draw on examples from Māori communities and West Africa to show how these perspectives can broaden the way we think about sexual health research, policy, and practice. The commentary article is published in the journal Culture, Health & Sexuality .
"So long as Global North frameworks continue to dictate what counts as sexual freedom, pleasure, or health, programs and interventions may remain partial, exclusionary, and at times harmful," the authors write.
The article observes that a disproportionate share of research originates in the Global North, leaving Global South perspectives marginalized. In many Global South contexts, sexual and reproductive health interventions are focused on disease prevention and family planning, often sidelining considerations of pleasure or holistic health. Agendas shaped in the Global North are often implemented through external financing structures that attach conditions to funding and prioritize externally defined goals.
For example, in Sierra Leone, an influx of international HIV-related funding reshaped national health priorities despite the country's relatively low HIV prevalence, limiting the ability to prioritize other urgent health concerns. More recently, there has been a rise in funding from U.S.-based pro-family conservative groups to political campaigns that support anti-abortion and anti-LGBTQ policies.
The researchers draw on perspectives from the Global South to imagine a new path for sexual and reproductive health and rights (SRHR). For example, Māori researcher Ngāhuia Murphy draws on Māori cosmologies and the lived experiences of people who menstruate to challenge colonial narratives that frame menstruation as dirty or shameful and justify women's inferiority. Likewise, Yoruba traditions in West Africa frame knowledge as experiential and somatic as well as rational. In practice, this orientation suggests that SRHR interventions can move beyond risk-focused messaging and survey-based measures to incorporate sensory and embodied approaches—such as guided body awareness or facilitated conversations about touch and feeling.
"The future of sexual health will be defined not by a universalized Global North narrative but by all the voices that insist on liberation as a collective, culturally grounded, and intersectional project. This future will build on existing scientific and quantitative advances while also drawing on lived experience—how things feel, what people remember, and how individuals connect with their communities," they conclude.
Authors include Madison Moore, an MPH student at Columbia Mailman School; Laura Gemmell-Sinnott, a PhD candidate at the University of Otago and Fulbright fellow at Columbia Mailman; and Jessie Ford.
The authors report no potential conflict of interest.
Funding was provided by the National Institute on Alcohol Abuse and Alcoholism (grant AA028532-01A1).
