Adolescent Sexual Health: Parents, Teachers Need To Break The Cycle Of Silence Around Sex And Sexuality, Say Experts

New Delhi: According to the World Health Organization (WHO), sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality. It further says that sexual health is not merely about diseases but requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. However, in many societies, sexual health is still a very confidential topic. When it comes to children and teenagers, talking about sexuality and sexual health is nothing less than a taboo.

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Dr Veena Aggarwal, Gynaecologist, Consultant Women’s Health, Medtalks.in says that sexuality in children is natural and it is normal for them to be curious about sex and their sexual organs. She said,

Given the highly conservative attitudes towards sexual behaviour in India, adolescent sexual and reproductive health has been overlooked historically. Most children are not even taught the anatomically correct names for body parts. But, studies have shown that even in our traditional society, both rural and urban adolescents are engaging themselves in sexual activities. So why are we still keeping them ill-informed about the most natural aspect of life?

She further said that the low social and economic status of women and girls in the country and high rates of illiteracy and ignorance about sex among them make them particularly vulnerable to abuse, sexually transmitted diseases (STDs) and Reproductive Tract Infections (RTIs).

According to data from the National Family Health Survey (NFHS)- 4, the average age at which women in India have their first sex encounter is lower than that for men. The data shows, men are most likely to have had their first sexual intercourse at the age of 20-24, while for women, the peak age of first sex is at 15-19 years. The responses of men and women in the age group 25-49 years reveal that 11 per cent of women in this age group had sex before the age of 15 years while only 1 per cent of men in this age group had sexual intercourse before the age of 15. NFHS-4 report suggests that this difference is primarily on account of the difference in the ages at which they tend to get married. Thus, women tend to have sex at an earlier age because they get married at a younger age, as per NHFS-4.

Radhika Sharma, Director, Jeevan Ashram Sanstha (JAS) who has been working on raising awareness among teenagers on sexual health since last 10 years, highlighted that many men even as adults feel awkward talking about periods or female hygiene and many women feel ashamed about their bodies and bodily functions almost all of their lives. She added that both girls and boys face sexual and reproductive health issues as teenagers and as adults due to the stigma attached to it, they hesitate from seeking help. She said that sex education is a tool that can be used to ensure safe and healthy life for girls and boys.

Talking about the importance of sex education, Ms. Sharma said that while girls still get some information from their mothers during puberty and before marriage, boys don’t have anyone to get their queries answered.

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Education About Sex And Sexual Health Should Go Beyond Preaching Abstinence: Experts

According to Dr. Aggarwal, parents and children should have mutually respectful dialogues about sex and equip them with the knowledge to make informed and responsible decisions on the matters of sexuality. She said,

It can feel like an emotional rollercoaster at first, but being respectful and frank with children and teenagers could go a long way when it comes to the ‘Bird and Bees’ talk. It is the responsibility of the trusted adults to teach children about personal safety and how they can protect themselves from abuse and exploitation. Instead of telling them that sex is bad, empower them with understanding about their and their partner’s safety and about consequences of their actions. The teenagers should be counselled on how to manage peer influence because this is the age when their self-esteem is fragile and their ‘image’ is everything to them.

Sex Education May Prevent Teen Pregnancy

According to a report published by WHO in December 2018, in developing countries, approximately 16 million girls aged 15-19 years and 2.5 million girls under the age of 16 give birth each year. It also says that annually, nearly 3.9 million girls aged 15-19 years undergo unsafe abortions that ultimately end their lives. An adolescent mother (aged 10-19 years) faces a higher risk of various kinds of complications and infections than those in the age of 20 years and above, says WHO.

Dr. Aggarwal asserts that imparting information about sex to teenagers well before their first sexual encounter would help ensure sexual health of the young women and men and may prevent teen pregnancy. She said,

Studies have shown that early, frank and age-appropriate conversations about safe sex can result in fewer unwanted pregnancies. Boys and girls should be explained about early child bearing, safe abortions and how teenage pregnancy affects themselves, their families and their futures.

Access To Sexual Healthcare And Sexually Transmitted Disease

Ms. Sharma highlighted that teenagers, especially in rural areas and in families with low income, lack the access to sexual healthcare. Due to lack of information, teenagers are usually more concerned about pregnancy than Sexually Transmitted Diseases (STDs) and do not practice safe sex, she said. She further added that if, in case they do get an infection, fear and stigma among teenagers may result in delays in seeking treatment for STDs.

According to Srijana Bagaria, Co-founder, Pee Safe, in the recent years, the teenagers are increasingly becoming prey to STDs and HIV/AIDS.

Dr. Aggarwal said that there is ample evidence from various researches to support the fact that sex education and awareness programmes have significantly reduced HIV risk in adolescents. She said,

According to the International Institute of Population Science data base, 45 per cent of women in India marry before 18 years of age and 22 per cent of them give birth to their first child even before they attain the legal age for marriage. The same report also shows that modern contraceptive usage is abysmally low ranging from a mere 12 per cent in Delhi to 2 per cent in Bihar in the age group of 15-19 years. This is further complicated by the rising cases of HIV/AIDS with the adolescent and young population comprising 34 per cent of the total AIDS burden. Poor infrastructure and lack of human resources to deal with adolescent specific reproductive health issues make the issue of sex education not only relevant but also important from a human rights perspective.

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Sexting And Interaction With Strangers Online

Exchanging explicit pictures with people is becoming an increasingly common phenomenon among teenagers, said Dr. Aggarwal. Therefore, lessons on cyber safety are very important, she said. She further added that children must use the internet under the supervision of an adult and should be taught not to engage with strangers online. She said,

Teenagers should be equipped with the information about online risks and dangers of social networking. They should practise sound judgement both online and offline. IT is important for their physical as well as mental health.

Gender And Consent Need To Be Taught During Early Childhood Itself

Parents and teachers should discuss consent with the children from a very young age, said Dr. Aggarwal. She further said that children from very young age should be taught to respect the word ‘no’ and use it without hesitation when they need to use it themselves. She further said,

Children from the age of 2 years should be taught about what parts of their body need to be kept private and to differentiate between good touch and bad touch.

She further said that children should be taught about respecting boundaries and about asking for permission.
Gender, is another concept that cannot be missed and needs to be explained to the youngsters from the very beginning, said Ms. Sharma. She said,

They should be taught about inclusiveness, body positivity and celebrating diversity. About gender identity, gender sensitivity and LGBTQ+ – lesbian, gay, bisexual, transgender, queer, intersexual, asexual and others on the spectrum.

Ms. Bagaria said that all parents and teachers should also be provided with gender-sensitive trainings and lessons on sexuality and sexual health so that they can be armed with the right knowledge that they can further impart to their children and teenagers, as per their age. She said,

Accept that your adolescents are discovering a whole new world. Empower them with right information and let them know that you are there when they need you.

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NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.