To the Editor: Swannell's article offers a refreshing reminder of the conflicted and contested scope of sexual health medicine.1 Recent public sector changes are forcing sexual health services to revert to the “disease” paradigm that dominated for most of the 20th century. Moves towards a more holistic vision of sexual health with a focus on wellbeing, as promoted by the World Association for Sexual Health,2 are now being pursued only in the private and non-government organisation sectors.
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