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Approached with an idea for a book on erotic photographs, Madonna expanded on the idea and conceived the book and its content.Shot in early 1992 in New York City and Miami, the locations ranged from hotels and burlesque theaters, to the streets of Miami.

According to Giselle Benatar of Entertainment Weekly, there are two versions of how Madonna came up with the idea for the book.

It was received negatively by both critics and fans of the singer, who felt she had "gone too far." Through the years, however, critical reception towards Sex has become more positive, with academics deeming it a defining phase in Madonna's career.

Sex is noted for its impact on society and culture as well as on Madonna herself, and is considered a bold, post-feminist work of art.

Sex has photographs that feature adult content and softcore pornographic as well as simulations of sexual acts, including sadomasochism.

Madonna wrote the book as a character named "Mistress Dita", inspired by 1930s film actress Dita Parlo.

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