Background Sexual health and its determinants are central to overall well-being and development. Thus, sexual health should be considered by public health as a critical element not only of the population's health, but also as an essential component of the health generated by the population. Regrettably, strict social norms and traditions in LAC have maintained the public discussions about sexuality in secretive and private domains. Moreover, rigid and stereotyped gender roles and social mores and values regarding sexuality have limited the incorporation of this area in the public health agendas, with the only exception of issues related to reproduction.

Methods With the purpose to initiate a process aimed at incorporated the notion of sexual health into the public agenda, in May 2000, the Pan American Health Organization, in association with the World Association for Sexology/WAS (which has since changed its name to World Association for Sexual Health), held a consultation in Guatemala in which a definition of sexual health was coined: a state of physical, psychological, and socio-cultural well-being related to sexuality. The sexual health and the quality of sexual life of individuals, families and communities and the various factors that can affect them were also discussed and avenues for action were proposed.

Since then PAHO has also been engaged in several processes to further advance the sexual health agenda in the Americas, among which the collaboration with WAS in their initiative “Sexual Health for the Millennium”, the explicit incorporation of indicators on sexual health in PAHO's Strategic Plan for the Region, active support to the Mexico City Declaration, and several others intended to improve the health of members of sexual minorities and to rekindling of STI programs in LAC.

Results Preliminary empirical evidence seems to indicate that the use of a public health rationale contributes to create convergence in an open debate that would be impossible to hold if other approaches were to be used (eg, based on moral, tradition or assumptions and beliefs). The discussion should lead to the realisation of sexual health, which means adoption of healthy lifestyles and the creation of supportive environments conducive to well-being for all. It would also contribute to the reorientation of the health services to better respond to the sexual needs of individuals through the life cycle, families, and communities.