Hesperian Health Guides

Communicating for healthier relationships

In this chapter:

Differences in sexuality mean different people like and need different things in a relationship. For relationships to be healthy — especially sexual relationships — people need to be able to communicate what they need or want, and trust that the other person will understand. For example, a woman needs to be able to communicate to her partner whether she wants to have sex or not, what she is comfortable doing or not, what gives her pleasure, whether she wants to use a condom or other protection, and anything else that helps her feel OK about the relationship. Together they then make a decision about having sex. This is called negotiating. One person does not decide for both!

2 women having a conversation.
If I were brave enough, I’d tell him that licking me down there feels better than having his penis inside me.
I think my partner was relieved when I guided his hand to where I wanted it. And he could definitely tell when he found the rhythm that worked for me! And all that happened without me saying a word!

Group discussion helps women and men understand differences in sexuality

An organization called Strategies for Hope leads "Time to Talk" workshops to help groups of women and men talk honestly with each other about their expectations in relationships. First, the men and women meet in separate groups and discuss preferences and desires that are important to them in their sexual relationships. Then the groups come together to exchange their ideas and work toward a better understanding of their differences.

a man speaking in a group of men while a woman speaks in a group of women nearby.
We wish our wives would act sexy but we are embarrassed to ask. So we go to sex workers. They know how to make us feel like real men.
We are the experts on women. What would we like men to know about women? What do we hope for, fear, and actually experience in relationships?

One person in each group writes down the ideas as the men and women talk separately. After each group presents its ideas, the women can comment on the men’s views and the men can comment on the women’s. These are some of the things women and men told each other in workshops held in Malawi and Zambia:

Men want women to know:

  • Good sex comes first. Love of a caring, friendly kind is less important.
  • A husband wants to be welcomed when he comes home. He also wants to be praised and thanked for what he does right.
  • Men like women to keep themselves and their house clean.
  • Men want to be able to keep secrets from their wives, including their income and other personal relationships.
  • Men fear impotence and other men having sex with "their" women.
  • Men fear appearing weak if a woman has a strong role or is assertive.


Women want men to know:

  • Love of a caring, friendly kind is most important.
  • Women want husbands to be reliable providers.
  • Women wish for a husband who comes home in the evenings and who will talk with them about things that matter to him.
  • Women fear beatings and abandonment. They fear their husbands taking second wives, disgracing them in front of other people, or making unreasonable rules.


In the large group discussions, men learned that women are aroused more by touch than by sight, and that women’s sexual arousal takes longer than men’s does — they did not know these things before. Men said they had never felt much responsibility for women’s arousal and pleasure, but they were willing to learn.

Both men and women saw that sex can be better for both partners when women’s and men’s rights and responsibilities are evenly balanced. They would like to be able to discuss things that would give both partners pleasure. But men and women both fear being shamed for violating cultural expectations or being accused of adultery. This workshop also showed that women are able to get support from their friends. Men said they felt alone and unsupported in comparison, with no one to confide in about problems.

Gain confidence to talk about sex with a partner

Girls are often taught from an early age to accept what they are given and not ask for what they want — whether it is a preference for food, a desire to attend school, or the chores they are assigned. Girls and women are often not supposed to know about sex at all, making it more difficult for them to ask for what they want when talking about sex with a partner. If a young unmarried woman wants to have sex, she may feel she has to pretend that it "just happened" without planning, which makes it difficult for her to negotiate.

Learning and practicing assertive communication can help women negotiate what they need or want, especially in their sexual relationships. See below for information about ways for women to better express what they want. The following section offer some ideas to prepare to talk more confidently about sex with a partner.

Activity Practice talking about sex with a partner

This role-playing activity can help women be more comfortable saying what they want or need. It can also help them negotiate more respect for their rights to health and pleasure. (See role play instructions.)

  1. Ask the group to think of situations in which partners might communicate about different needs or expectations in their relationship. For example:
    • The woman wants intercourse to last longer, and the man does not want to do anything other than what feels natural to him.
    • A woman wants to have sex to get pregnant, but the man wants to use a condom.
    You can also use one of the story ideas from the activity Changing stories, changing lives or create your own.
  2. Have the group role-play one or more of these situations or stories.
  3. a man and a woman in a role-playing conversation.
    When I come home from work, I want to have sex right away.
    Remember when we used to spend hours just kissing? I miss that.

  4. After all the role plays, you can lead a discussion about how the couples in each situation communicated about sex. Here are some possible discussion questions:
    • Were the role plays realistic? Is this how a couple would negotiate in real life?
    • What felt uncomfortable to talk about? Why?
    • What was different about the ways the women and men negotiated?
    • How did gender roles influence the way the women and men negotiated?
    • Did gender, age, race, ethnicity, or disability matter? Why?
  5. To end, ask what the group has learned from this activity, and if there is anything they think they will try to change in their own relationships.

Women build each other’s confidence to discuss sex

Rahnuma, a holistic family health organization in Pakistan, organized a project in the city of Lahore to help married women reflect on their sexual experiences and gender roles, and how these might affect their ability to negotiate about sex.

When project organizers asked women why they could not discuss sex with their husbands, the women said it was because of modesty, lack of confidence, and not having enough to say. Women also worried about what would happen to them if they tried to ask their husbands to use condoms. They were afraid their husbands would be angry, or think they were having sex with others, or deny support in some way.

a man and a woman talking in bed.


However, these women worked together using discussions and role plays, and were able to develop many possible arguments and things to say in negotiating about sex. This had seemed impossible to many of them, but after 2 months of meeting together, they were more knowledgeable about their bodies and more comfortable discussing sex with their husbands. They had become confident enough to negotiate in a friendly way things such as when to have sex, or using a condom.

Before participating in the workshops, many women thought that sex was an obligation. After seeing how much they were able to discuss sexual matters with their husbands, they began to feel their relationships should be based on mutual pleasure and respect, and they saw that this might actually be possible.

Since then, many women have reported that their sexual relationships are more satisfying for both them and their husbands, their marriages are happier, and their families closer.

Activity Want, Willing, and Won't: Exploring our desires and boundaries

This activity encourages people to think and then talk about sexual desires and boundaries. Exploring these topics is an important way to strengthen a girl’s or woman’s ability to negotiate in a sexual relationship.

This activity works best with a group of young women who know and trust each other. Before beginning the activity, establish a group agreement that nothing anyone says will be shared with others (see more on group agreements).

To prepare: Give 3 squares of paper for each participant: 1 square with a smiley face (Want), 1 square with a serious or undecided face (Willing) and 1 square with a frown (Won’t). Give a handful of dried beans to each participant.

illustration of the above: 3 squares of paper with faces drawn on them.
Want
Willing
Won't
  1. Explain that everyone is going to think about what they Want, are Willing to do, and Won’t do. A good way to introduce this is to ask the group to say out loud a few foods they really like to eat, a few foods they are willing to eat, and a few things they absolutely will not eat. (You can use some humorous examples to get the group laughing.)
  2. Form small groups of 3 to 4 participants. Explain that everyone is going to think about sexual activities — whether they have experienced them or not does not matter. They will be thinking about sexual activities that:
    • they want, or think they would enjoy.
    • they would be willing to do, if their partner were interested.
    • they would not do, and would want to refuse if a partner asked.
  3. Then ask each participant to work on her own for a few minutes. Have each woman put the 3 squares in front of her and think of different sexual activities. For each one, she will place a bean on the paper that matches the category of something she would enjoy, would be willing to do, or would not do.
  4. illustration of the above: 4 women working alone with beans and squares of paper.
  5. Ask that each person share with the others in their small group something from each of their squares. They should just choose what they are comfortable sharing with the others. Give the groups a few minutes to share.
  6. Then ask each small group to discuss questions such as these:
    • Was it hard to be specific, even just with yourself, about what you want in a sexual relationship and what you do not want? What was it like to do this?
    • What would make it easier to ask for what you want?
    • What would make it easier to set a boundary and let a partner know you won’t do something?
    • How do you feel about the things on your "willing" list? How do you want to balance "wants" and "willings" in a relationship?
  7. Then bring everyone back together in one large group. Ask questions such as:
    • How does knowing more about your own desires and boundaries help you be a healthier or more empowered person?
    • How would talking about desires and boundaries with your partner (current or a future one) help to make a healthier relationship?
    Be sure to remind everyone about the group agreements before ending the workshop.

Stepping Stones method makes lasting changes in relationships

Stepping Stones is a training program that helps health promoters lead community workshops on problems in personal lives and relationships. The workshops help community members discuss questions about gender and sexuality, and how belief systems and values affect relationships. The training program takes about 10 to 12 weeks, and helps women and men of all ages change how they act and what they expect in relationships — individually and together.

For the first session, organizers lead an open discussion with the whole community about relationships between women and men. People who want to discuss the issues further then form smaller peer groups of 10 to 20 people. Peer groups could be older women, young women, older men, and young men. Being in peer groups helps most people talk more honestly than they could in a group with both sexes or with both older and younger people.

a group of 12 women having a discussion.


The peer groups meet several times. With the help of trained facilitators, each group discusses problems they experience in relationships with the other sex, and possible causes. Then a full meeting of all the peer groups is held. Each peer group presents the most important ideas and conclusions they have come to so far.

This process continues 2 or 3 more times, and each peer group comes to a deeper understanding of the issues that are important to them. They also explore ways to communicate about these issues with their partners and with the other groups. Each time all the groups come together, more information and ideas are exchanged. At these large meetings, people learn things they never knew about the feelings and experiences of people in the other groups. Finally, everyone in the community is invited to a meeting where each peer group presents the problem they think is most important for them to resolve in their relationships. They also present a request to the community for help with this problem.

Because of the time and care that go into this process, many groups have been able to get strong community support for real and lasting changes in the ways men and women treat each other.

Stepping Stones is used in many countries around the world, and more than 1,000 people in 100 countries belong to a network of facilitators and supporters, the Stepping Stones Community of Practice.

2 women and 2 men speaking.
Before we participated, we did not even know we had the right to decide about some of the issues that were most important to us in life.
I never imagined I would be willing to talk with a group about sexual relationships.
We started a Youth Council and participate in community meetings.
Now we teach about sexual and reproductive health in schools.


This page was updated:05 Jan 2024