(879) Pleasure as Medicine: Exploring Pathways to Sexual Well-Being and Restoration Among Black Women

Introduction Sexual medicine has historically focused on dysfunction, risk, and pathology, leaving the role of pleasure in sexual health underexplored. Across many marginalized populations, pleasure may carry restorative or reparative meaning when experienced within contexts of social constraint and cumulative stress. For Black women, whose sexualities are often shaped by intersecting structural, relational, and cultural inequities, pleasure may serve functions beyond physical enjoyment. Understanding how pleasure operates within these contexts can inform more equitable models of sexual well-being. Objective This qualitative study explored how Black women define, pursue, and experience sexual pleasure, with the goal of developing a conceptual model describing pleasure’s potential restorative and regulatory functions in daily life. Methods Nine semi-structured focus groups were conducted with 57 self-identified Black women aged 18–35 in two urban regions of the United States. Participants were heterosexually active within the past three months. Guided discussions examined definitions of satisfying sexual experiences, barriers and facilitators to pleasure, and the perceived relationship between pleasure, safety, and self-care. Transcripts were analyzed using reflexive thematic analysis informed by a constructivist approach. Codes were iteratively clustered to generate higher-order themes and map interrelationships among structural, interpersonal, and psychological dimensions of sexual experience. Results Participants located sexual pleasure within environments of fatigue, relational inequity, and cultural stigma. Against this backdrop, three interrelated thematic domains described a cyclical process through which pleasure emerged as a form of regulation and restoration: Contextual Constraints: Persistent structural and interpersonal barriers, including limited time, emotional depletion, gendered expectations, and stigma restricted opportunities for desire and intimacy. Regulatory Practices: Women described intentional actions to create conditions conducive to pleasure, including self- and environmental preparation, communication about needs, and cultivating trust. These behaviors mirrored broader wellness strategies oriented toward safety and emotional equilibrium. Restorative Outcomes: When these conditions aligned, pleasurable experiences yielded feelings of calm, validation, and reconnection with self and partner. Pleasure was described as “healing,” “balancing,” and “a release,” functioning as an antidote to chronic stress and the devaluation of Black women’s bodies. Synthesizing these findings, a Pleasure-as-Medicine conceptual model was developed in which pleasure operates as a psychosocial regulatory process. Contextual stressors generate emotional imbalance; intentional regulatory practices facilitate safety and embodiment; and pleasurable experiences restore or enhance equilibrium, offering transient but meaningful relief and self-affirmation. Conclusions Findings suggest that for many Black women, sexual pleasure functions as a restorative practice, a psychosocial form of medicine that counters everyday depletion and reaffirms agency and worth. This model challenges sexual medicine’s deficit focus by positioning pleasure as integral to health rather than ancillary to it. Incorporating assessments of pleasure, emotional safety, and relational confidence into sexual-health research and clinical practice could advance a more holistic and equitable understanding of women’s sexual well-being. Future work should test the model empirically and examine its implications for intervention design across diverse populations. Disclosure No