What you don’t know about your sexual health can hurt you
Plus: What’s Long COVID? + How is mentorship connected to well-being? + What it costs to produce a vial of insulin
Welcome to Doing Well. Today:
An interview on how to talk about sexual health
Resources to learn more about the history of sex education
Health news we’ve found useful this week
Word(s) of the week: Long COVID
Thanks for being here—let’s dive in.
We Asked: How can we have better conversations about sexual health?
Sexual health is profoundly important, and profoundly neglected. Doctors rarely ask about it, patients feel unable to discuss it, and policymakers shove it into a corner.
In a recent article for Issues in Science and Technology, a partnership between ASU and the National Academy of Sciences, Jewel Kling, a professor of medicine and dean at the Mayo Clinic Alix School of Medicine Arizona Campus; Sara Collina, a professor of women’s and gender studies at Georgetown; and Lindy Elkins-Tanton, a regents professor at ASU’s School of Earth and Space Exploration, outlined a bold case for investing in research, education, and patient care focused on sexual health. They approach the issue from different perspectives—Jewel as a doctor, Sara as an educator, and Lindy as a patient.
I spoke to Jewel, Sara, and Lindy about where our health care system has led us astray when it comes to our sexual health, and what we can do to get back on track. Our conversation has been edited for length and clarity.
Mia Armstrong-Lopez: I want to start with a basic question: What is sexual health, and what are the components of sexual health care?
Jewel Kling: Sexual health is health—it's hard to define it. Our sexual functioning is a part of our global functioning. Oftentimes, we think about sexual parts—as a women's health practitioner, I'm thinking about, for a cisgender woman, the vagina, vulva, breast. But that may look different for somebody depending on their gender identity, and how they participate in sexual activity.
Sexual health is sexual well-being. Oftentimes, I'm seeing patients because they're coming in with sexual dysfunction—when we define it as a dysfunction, it's a sexual problem that's also accompanied by distress.
MAL: How does sexual health influence other aspects of our health?
JK: When folks are having sexual dysfunction, it's associated with things like poor quality of life, depression, and it can have negative consequences for their relationships—not just their sexual relationships, their relationships with their partners and their family members and their communities. And so sexual dysfunction can have compounding factors, and that's where it raises this concern of being relevant to everything we do in health care.
MAL: Sara, in the article the three of you wrote for Issues, you talk about how almost no one is getting the education about their sexual health that they deserve—not in classrooms, not in doctor's offices. You point to the need for a really big structural rethink of policy and education programs around sexual education.
There are also a lot of people who are sitting back now and thinking, “I didn't get the sexual education that I wish that I would have. I have a lot of questions. But I'm not even sure how I might go about improving my own personal sexual education.” Where would you suggest that they start?
Sara Collina: Well, each other. We all have lived experience, and that's a form of expertise. So one thing we can do is be a little braver when we talk to our friends, when we talk to our parents, when we talk to our children. Being able to awkwardly say, “I don't really even know how to talk about sex”—that would be a great way to start right in the doctor's office. In the doctor's office, we’re used to being asked questions, right? You may not have a sexual health doctor, but many cis women and non-binary people have access to an OB/GYN, and you can say, “Can you ask me about my sex life?”
You can be embarrassed, but then they switch gears—almost all of them will say, “Of course. Tell me.” I want as a culture for us to be a little bit braver about talking and sharing our authentic experience.
MAL: The taboo that you're talking about affects the ability to have these conversations on both sides, for patients and providers. Lindy, in the Issues article you write about how, after being diagnosed with ovarian cancer, you underwent a complete hysterectomy and removal of ovaries, and in the process of preparing for that surgery, and what you should expect, health care providers never broached the topic of sexual health or sexual pleasure in any way.
Having gone through that situation, is there anything that you learned as a patient that you might pass on to others?
Lindy Elkins-Tanton: I thought about that a lot, and I only have a few ideas about what I would do differently. The constellating moment for me was finding myself in sexual distress after the surgery, and with the strangest symptoms that I'd never heard of before, and no one had talked to me about.
I love my doctors—they're amazing. My surgeon and my oncologist saved my life, and I can't say enough good things about them. But I couldn't help thinking, according to some studies, [a significant] percent of women who've been through the surgery are not able to have orgasms again, or at least not orgasms that resemble their previous orgasms. It seemed to me that if this was the case for a male surgery, it would have been the headline—and it was never brought up at all, no discussion of sexual consequences were brought up. I don't at all lay the blame to my doctors; I think this is a huge societal issue. And it's one of the starkest examples of gender bias that I've experienced. I'd never heard anyone describe the kind of symptoms I had afterward.
I wish I tried harder to explain what was happening to me to my doctors. I ran out of words too soon, when I had an expression shown back to me on the doctor's face of just incomprehension, or what I felt like was irrelevance. I'm sure it's my own internal mirroring. But I did not feel welcomed to go on talking about this thing, which seemed incomprehensible and completely out of the conversation we were having at the moment. Even if I didn't have the words, I wish I would have known to say, “Is there an expert in women's health you can refer me to? Help me find someone who can answer these questions—because this is a real problem, even if I can't describe it well.” I think the willingness to say that to your doctor would be such a good starting point.
MAL: It requires a lot of courage even to say that, to advocate for oneself. Jewel, what tools should patients have around self advocacy? One of the studies you cited in the Issues article documented that many OB/GYN residents agreed that sexual health was important, but didn't have the education to be able to properly provide care to their patients. Given those limitations, what would you recommend to patients?
JK: I'm having an emotional response to Lindy sharing her story, and how brave she is to share it. It's breaking the silence—because probably what you were seeing on those doctors’ faces is they didn't know what to do. And so it translates as discomfort. There's a systematic lack of education because of lack of research. If doctors aren't trained in sexual education, how are they going to talk about it in the exam room with their patients?
We have so many opportunities to do better. There are some really incredible organizations that are small, but are getting bigger, and are full of very passionate people that are out there trying to spread the good word. The International Society for the Study of Women's Sexual Health has a patient-facing website called Prosayla. Emily Nagoski wrote a great book called Come As You Are. My colleague Dr. Denise Millstine uses narrative and medicine in a podcast to help close gaps in lots of women's health areas, it's called Read. Talk. Grow.
The need for a focus in this area is going to be even more important moving forward. Making sure we're creating a space for people to be authentic, speak up for themselves, and educate health care practitioners is going to get even more challenging.
SC: Yeah—there has never been a better time for all of us to have bodily autonomy and agency. This is your body, and you get to learn about it. You get to enjoy it. There's never been a better time to work on our sexual well-being.
When I talk about people talking to each other, some of it is about practicing before you go to a specialist or an expert. You start with one word, you come to another, and you don't have to be good at it. You don't have to be good at talking about sex in order to be an advocate for yourself and others. You just have to try a little bit.
Well-Informed: Related stories from the ASU Media Enterprise archives
Why do social media companies allow ads for products used to treat erectile dysfunction, but not those used to promote women’s sexual health? In this 2022 article for Future Tense, Hallie Lieberman examined policies for social media ads related to sexual health.
Plus: For Leonardo, authors Emanuela Corti, Ivan Parati, and Christian Dils explore a collaborative art-science project meant to make sexual pleasure more accessible for people with motor impairments. The article describes the stigma of disability and sexuality, and how wearable technology could give people “autonomy to explore their own bodies.”
Well-Versed: Learning resources to go deeper
Want to learn more about the history of sexual health? Visit the sexual health listing within ASU’s Embryo Project Encyclopedia—a free online library that records and contextualizes the science of embryos, development, and reproduction. You can read about everything from a comic developed to fight taboos around menstruation to the surgeon general who fought to promote sexual health education.
Well-Read: News we’ve found useful this week
“The Market For Menopause Products Is Booming—But There's An Easy Way To Find What Actually Works,” by Courtney Rubin, April 16, 2025, Women’s Health
“Parents Need to Talk to Their Tweens Sooner About Puberty,” by Riane Lumer, April 21, 2025, CNN
“Can You Stop an Outbreak of a Contagious Disease?” by Aatish Bhatia and Francesca Paris, April 12, 2025, the New York Times
“Get Ahead of Allergy Season This Year,” by Allie Volpe, March 31, 2025, Vox
Well-Engaged: Your turn!
Insulin is a hormone that is naturally produced in the body. Synthetic insulin is used by people with Type 1 and some people with Type 2 diabetes to help regulate blood sugar levels. For people with Type 1 diabetes, manufactured insulin is essential for survival.
In 1921, scientists at the University of Toronto discovered a way to create synthetic insulin. In 1923, they sold the patent—the copyright to the scientific and medical formula—for $1 each to the University of Toronto. In order to increase production (and help patients with diabetes), the university partnered with pharmaceutical companies to manufacture, sell, and distribute the drug.
Today, treatment for Type 1 and Type 2 diabetes has become incredibly expensive, and in the 100 years since the medicine’s discovery, insulin prices rose to disastrous levels for many people who need it.
In an effort to address these high prices, the Inflation Reduction Act of 2022 capped the monthly out-of-pocket cost for insulin at $35 for Medicare recipients. Before this legislation was passed, the average out-of-pocket cost for a 30-day supply of insulin was around $58, with the average cost for uninsured patients around $123. Since then, major drug manufacturers have also implemented changes to bring monthly costs down to $35 for a larger group of patients.
-Mel Moore, health communication assistant
Well-Defined: Word of the week
Have you heard the term “Long COVID”? It refers to a phenomenon in which people who had COVID-19 experience long-term effects from the virus, which can be debilitating and are still being studied. The National Academies defines Long COVID as an “an infection-associated chronic condition” that is present for at least three months after the original infection. Although symptoms vary and can affect any organ system, some to look out for include fatigue, shortness of breath, trouble concentrating, and recurring headaches or migraines. According to the World Health Organization, recent studies have shown that between 10 and 20 percent of people infected by SARS-CoV-2 have developed lasting symptoms. The best way to prevent Long COVID is to try to avoid getting COVID in the first place—and the COVID vaccine is a safe and effective tool to do so.
-Mel Moore, health communication assistant
Well-Advised: One thing that’s improving our health
Cristina Baciu, assistant director of research at the W. P. Carey School of Business and the cofounder and codirector of the Arizona Cancer Evolution Center Scholars Program, shares the important connection between mentoring and well-being:
Mentoring isn’t just about career growth—it’s a powerful tool for well-being. Whether as a mentor or mentee, engaging in meaningful mentoring relationships fosters connection, reduces stress, and provides a sense of purpose. Research shows that strong social ties improve mental and physical health, while giving and receiving guidance enhances resilience and self-efficacy. I’ve found that mentoring builds community, offers perspective during challenges, and reminds us we’re not alone.
If you’d like a mentor but aren’t sure where to start, begin by identifying someone you admire and reaching out for an informal conversation. Many organizations also offer formal mentoring programs—check with your workplace, university, or professional networks. And if you’re interested in becoming a mentor, start by offering support to someone in your field, even informally. A simple conversation can be the first step toward a meaningful and mutually beneficial relationship. Prioritizing mentorship isn’t just good for professional success—it’s a small but transformative act of self-care and collective well-being.
Question: How much does it cost to make one vial of insulin?
Answer: Around $3. The number of vials needed per month varies by patient.
Do you have a question or topic you’d like us to tackle? Would you like to share your experience? Reach out at any time—we’d love to hear from you.