Alumni Association Home > Past Issues > 2009 > January-February 2009	Print View

Eli Coleman. To see his faculty page, click the image.

The shelves and window ledges in Eli Coleman’s office on the West Bank of the Minneapolis campus are a glorious mess. They’re cluttered with hundreds of items—ceramic houses, animals, divinity figures, coffee mugs, and stuffed toys, to name a few—that Coleman (Ph.D. ’78) has collected in his years of crisscrossing the globe as director of the Program in Human Sexuality (PHS) at the University of Minnesota Medical School. “They’re a memory of all the different places in the world where I’ve met wonderful people and maintained friendships,” Coleman says.  But these are not just the baubles of an inveterate traveler. Rather, they tell a tale about the distances that Coleman has traveled in a career devoted to advancing healthy attitudes, practices, and policies toward human sexuality.

In his 30 years at PHS, almost 20 of them as director, Coleman has become one of the world’s most highly regarded experts in human sexuality, and the program he directs has achieved international stature as the premier center for sexual health. In 2007, the same year that he received the prestigious Gold Medal from the World Association for Sexual Health (WAS) and was elected president of the International Academy of Sex Research, Coleman was named the holder of the world’s first academic chair in sexual health, established at the U with a $4 million endowment. A psychologist by training, Coleman has devoted his life to helping people struggle with problems in the most intimate aspect of their lives: unfulfilling sex lives, compulsive sexual behaviors, confusion about gender and sexual identity, and myriad other issues. “The constant refrain we hear from people who were so troubled and despairing is ‘you saved my life, I don’t know what I would have done without PHS,’?” Coleman says.

But it would be a mistake to view Coleman’s work as essentially private. On the contrary, the untold number of hours he has spent listening to clients’ personal torments has led him to conclude that sexual health fundamentally has a public as well as a private component. “People are very much influenced by the environment they’re in. That has led me from working with clients to wanting to change the social climate,” Coleman says. Thus has Coleman sometimes waded into the treacherous waters of public policy debates on hot-button issues such as sex education and HIV/AIDS. He considers his work, whether it’s conducted in his office, the classroom, or the halls of government, a seamless whole that begins and ends with compassion.

The next frontier, he says, is to raise awareness about every person’s sexual rights. It’s a conviction shared by WAS, which calls sexual rights “universal human rights based on the inherent freedom, dignity, and equality of all human beings.”

The meaning of “sexual health” is elusive, even for those who work in the field. “We’ve wrestled with defining sexual health and establishing measures of it,” Coleman says. “There are lots of people who simply view sexual health as the absence of sexually transmitted disease. But when you define sexuality in the broad sense and recognize that it involves not only what we do with our genitals but also gender roles, our need for touch, human bonding, and eroticism, then sexual health encompasses a broad arena,” Coleman says.

Walter Bockting, associate professor of family medicine and community health who works at PHS, says that it is crucial to consider sexuality an integral part of being human. “There’s financial, mental, physical, and spiritual health. And then there’s sexual health, though we haven’t looked at it that way,” Bockting says.

Indeed, that sort of holistic approach toward sexuality is new. Sexology, the study of sex, is a relatively young field of study that took root in Germany at the turn of the last century. Early sexologists, most of them physicians who were influenced greatly by the psychoanalytic theories of Sigmund Freud, were more inclined to focus on sexual disorders (understood to be any behavior outside of socially acceptable norms) than they were to nurture their clients’ sense of sexual well-being.

A significant shift in how sexuality was understood occurred in the 1950s, when the locus of sex research moved from Europe to the United States. During World War II, many sexologists had been forced to flee Germany, and Nazis had destroyed whatever work they left behind. But in 1948 and 1953, biologist Alfred Kinsey of Indiana University almost single-handedly resurrected the field with the release of two groundbreaking reports, “Sexual Behavior in the Human Male” and “Sexual Behavior in the Human Female.” Kinsey’s carefully documented scientific research challenged conventional beliefs about sexual orientation and sexual behavior, both inside and outside of marriage. He posited, for example, that a certain amount of attraction to other men was a normal phenomenon in all men, not just those who identified as homosexual. In sum, the Kinsey reports suggested that normal human sexuality was much more complex and variable than previously believed.

Kinsey’s work provoked a public uproar. But it also cracked open a door to the possibility that human sexuality was less a fearsome force that required strict regulation than it was a little-understood aspect of human experience that deserved respect and warranted further study. The sexual revolution of the 1960s threw the door open wide to an all-out questioning of established norms related to sexuality, gender, and marriage and family life.

Out of this ferment emerged the Program in Human Sexuality at the University. In some ways, it was born of desperation: In 1970, Twin Cities–area clergy approached officials at the University medical school and pleaded for the school’s help in training ministers to counsel congregants on sexual and relationship issues. Could the medical school offer its expertise and guidance, they asked? The request resonated with leaders at the medical school, who recognized that religious professionals weren’t the only ones who needed training. Medical students did, too.

So in 1971 the medical school created PHS and assigned to it the tasks of teaching and conducting research in human sexuality. Thus did Minnesota become one of the first medical schools in the country to require students to take a course in human sexuality. A cornerstone of the PHS curriculum was the Sexual Attitude Reassessment Seminar (SAR), an intensive program that utilized lectures, media, and small group discussions to explore myths about sexuality, sexual practices, sexual identity, sex roles, adolescent sexuality, and related topics. The seminars were hugely successful; students devoured the opportunity to learn and talk about sex in a knowledgeable, nonjudgmental setting. In 1973, recognizing that a plethora of people were wrestling with sexual problems, PHS established a clinic that offered therapeutic services in addition to education. In 1977, PHS became a unit within the Department of Family Medicine and Community Health, where it remains today.

“Residency directors will tell you that they can tell the difference between students who have graduated from the University of Minnesota Medical School and those who have not in terms of the comfort and skill in addressing sexual issues as part of their medical practice,” says Beverly Whipple, professor emerita at Rutgers University and secretary general of WAS.

June LaValleur (M.D. ’87), who trained under Coleman and now helps teach the course, credits PHS with helping her become comfortable talking to patients about sexual issues. “I ask patients, are you in a sexual relationship? With men, with women, or both? Are you or you and your partner having any sexual difficulties? Physicians will have a million reasons for not asking these kinds of questions, but people look to physicians to have knowledge about sexual health. We want to train medical students to be “askable” physicians. In order to be askable, physicians need to be comfortable with their own sexuality.”

The requirement that sexual health professionals be comfortable with their own sexuality was one of the first lessons that Coleman learned when he arrived at the University in 1976 to pursue a doctoral degree in psychology. As an intern at PHS, he helped teach the course at the medical school, including the SAR, and he also saw clients

To visit the Program in Human Sexuality Web site, click the logo above.

individually, as couples, families, and in group. The problems he encountered were legion, and they were often crippling for those who struggled. Sex offenders, men and women who were questioning their sexual identity, people attempting to work through sexual abuse, those suffering with compulsive sexual disorders, and myriad other psychosexual problems were the stuff of Coleman’s everyday world. Coleman personally knew plenty about torment. When he began his graduate studies in 1970, the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s official guide to mental disorders, classified homosexuality as a mental illness—and Coleman is gay. Though homosexuality was delisted as a mental illness in 1973, Coleman nonetheless had to wrestle with reconciling his sexual identity to his professional aspirations.

“How could you be mentally ill and a psychologist? I thought there was no way I could live as a gay person and be a psychologist, so I felt I needed to put that part of myself behind me,” Coleman says. While he resolved that issue before he arrived at the University, PHS provided an affirming environment like no other. Coleman is convinced that his own coming out process enhanced his capacity to help his clients. “As someone with a stigmatized identity you can very much appreciate the struggles and shame that people have with their sexual secrets. You have a special sensitivity in understanding that in others. That sensitivity translates into my work,” he says. Coleman joined the faculty of the medical school in 1978, and was appointed director of PHS in 1991. PHS has flourished under his leadership, training close to 10,000 University of Minnesota and Mayo medical students and tens of thousands of physicians, psychologists, clergy, and other professionals in sexual health. The Center for Sexual Health, PHS’s clinic, treats close to 500 individuals and couples per year with approximately 1,200 patient visits per month. The faculty and clinical staff, which numbers 23, represent a variety of disciplines, including psychology, family medicine, psychiatry, marital and family therapy, and education. Twenty other research assistants and support staff make the Program one of the largest of its kind in the world. It is one of the few programs in the country training sexual therapists and researchers through a post-doctoral program. “PHS is probably the most influential entity in sexual health around the world,” says Chris Kraft, director of clinical services for the sexual behaviors consultation unit at Johns Hopkins Medical School and a former postdoctoral fellow of Coleman’s. The program’s stature is due in no small measure to its rare longevity—it has weathered vicissitudes in funding levels, public opinion, and institutional support that have sunk dozens of other academic programs in human sexuality. The reason, colleagues say, is Coleman. “One of his incredible strengths, his ability to network, is totally based on his personality and enthusiasm for the profession,” Kraft says. “Eli has a worldwide network. I went with him to a conference in Hong Kong and I watched him interact with people and they just adore him. He’s a big teddy bear. From that he can motivate people to do things, inspire them to do their work, facilitate people to work together. He is brilliant with handling different types of personalities; he knows how to work with people and policy.” Bockting, who has worked with Coleman at PHS for 23 years, puts it this way: “Eli is like an artist doing a painting or an actor in a movie constantly trying to figure out how to do things better.” Coleman has thought deeply about the concept of “sexual citizenship,” a term that has been recently coined to describe the status of people who have been given a full complement of fundamental sexual rights as part of the rights of any citizen. “Fifty years ago if someone were divorced, they were shunned. They lost their sexual citizenship,” Coleman says. “We understand more and more that sexual health is linked to stigma. Those who fit into societal expectations have an edge in gaining sexual health because they have sexual rights. We really have to wrestle with the fact that sexuality is part of life and it isn’t always expressed in a way that society says is ideal.”

Eleven Sexual Rights The World Association for Sexual Health calls sexual rights "universal human rights based on the inherent freedom, dignity, and equality of all human beings." The association establishes 11 rights that must be recognized, promoted, respected, and defended in order to have a healthy society: 1. The right to sexual freedom. This excludes all forms of sexual coercion, exploitation, and abuse at any time and situation. 2. The right to sexual autonomy, sexual integrity, and safety of the sexual body within the context of one’s own personal and social ethics. 3. The right to sexual privacy. 4. The right to sexual equity, which refers to freedom from all forms of discrimination regardless of sex, gender, sexual orientation, age, race, social class, religion, or physical and emotional disability. 5. The right to sexual pleasure. 6. The right to emotional sexual expression through communication, touch, emotional expression, and love. 7. The right to sexually associate freely. This means the right to marry or not, to divorce, and to establish other types of responsible sexual associations. 8. The right to make free and responsible reproductive choices. 9. The right to sexual information based upon scientific inquiry. 10. The right to comprehensive sexuality education—a lifelong process that should involve all social institutions. 11. The right to sexual health care for the prevention and treatment of all sexual concerns, problems, and disorders. See a Minnesota Broadcaster's Association interview with Eli Coleman here.

Last year, Coleman served as project coordinator and senior editor of Sexual Health for the Millennium, a far-reaching WAS document that asserts that promoting sexual health and sexual rights is central to wellness and sustainable development worldwide. It makes the case for including sexual health and sexual rights in the Millennium Development Goals, a United Nations initiative that outlines eight approaches to addressing global problems such as poverty, illiteracy, and the spread of HIV/AIDS (see sidebar). Situating sexual rights within the context of sustainable global development is an ambitious undertaking, but Coleman is unfazed. “Sexual health is essential to meeting these goals. If we address the sexual needs and rights of everyone in society, society will be enriched. When you deny people full education—for example, abstinence-only education that does not help in any meaningful way—you deny them citizenship and human rights,” Coleman says.

Fear, he maintains, drives the controversy about sexual rights. “The fears are no different than those in the evolution of human rights,” Coleman says. “The worry is that the whole structure of society will suffer. That is, if we give sexual rights—domestic partner benefits, letting people marry whoever they want—somehow our society is going to crumble. But there’s also a greater understanding that if you give everyone their basic rights, everyone becomes more productive. And that’s sexual citizenship. People have come to realize that citizenship is a basic human right. I don’t think we’ve realized that with sexual rights, but we’re working on that.”

Coleman, who turned 60 this past year, recently bequeathed his estate to the program. And the endowed chair that was established in 2007 ensures that the work will continue. Coleman reflects that perhaps it is fitting that the endowment was raised in an unorthodox manner: 300 people contributed the first $1 million, and an anonymous donor stepped forward with $3 million more. “It’s an unheard of way to fund an endowed chair. Sexuality is still rather stigmatized, so who wants to put their name to it?” Coleman asks. Like the trinkets that populate the window ledge in Coleman’s office, the endowment speaks to the expansive community that inspires and informs Coleman’s work.

Cynthia Scott (M.A. ’89) is the managing editor of Minnesota.

Comment on this story.