The concept of sexual health, which was developed at a 1975 conference of the World Health Organization (WHO), is currently being used to set up nationally based public health programs in various countries. I outline the history of sexuality as a public health issue since the 19th century, analyze the history of the concept of sexual health since its emergence in 1975, and make a comparative analysis of the contemporary documents dealing with sexual health generated in the U.S. and England, and by organizations such as the WHO and the Pan American Health Organization (PAHO). The analysis of these documents gives evidence that there is no international consensus on the concept of sexual health and its implementation in public health policies. The conceptions of sexual health remain embedded in national and political contexts. Conceptions for sexual health appear to be the result of political compromises and take place in the public health culture and practice of each country. Depending on the context, these different initiatives focus either on individual responsibility or on an appropriate sexual health services organization, and sexual health may be conceived as an ideal state of well-being or as the reduction of negative consequences of sexual activity.