It was perhaps a very chilly morning in the winter of 2007—one of those days when you do not want to come out of your bed as the very bare skin of your toe feels frozen when it contacts the air outside. But she was squirming in her bed, her legs writhing in pain, and her abdomen as if someone was crushing it with an axe. She was wet and felt something swollen between her legs. Once in the bathroom, she was frozen to death when she noticed scarlet red blood and quickly washed and put toilet rolls in her underwear. Something had gone wrong with her, but what was more horrible was how she felt at that moment: scared, embarrassed, shameful, sinful, dying, and in pain. Today, she’s almost in her 30s, and a tear flickers down her cheek as she pens down a poignant and uncomfortable memory about a moment that could have been lived better.
A UNICEF poll launched via the U-Report platform (a U-Report is a social messaging tool) on the 9th of March 2017 in Pakistan showed that 49% of the women did not know about menstruation before their first period (Lihemo & Hafeez-Ur-Rehman, 2017). Despite the limited number of women who could use such a social messaging tool, such a percentage is not surprising but should be concerning. The human body experiences several natural processes, and each of these processes is what makes us human. But even then, many of the topics related to sexual and reproductive phenomena are considered taboo, and when it comes to “sex education,” many of us get alarmed.
In most conservative societies, adolescents become sexually active without knowing their reproductive and sexual health since it remains a taboo topic that dwells on a misunderstanding that sex education is about telling children to have sex. Silenced by cultural practices, societal norms, patriarchal structure, and lack of government support, knowledge about sexual and reproductive health and rights (SRHR) in reality creates awareness about one’s health, hygiene, personal relations or relationship needs, family planning, and human dignity. In this article, I argue that the pervasive practice of not providing sex education prevents children from resorting to healthy life choices and protecting the rights of others and how community-based interventions through sexual and reproductive health and rights curricula can help cater to the myths and taboos around sexual education.
Repercussions for lack of sex education:
When parents find it hard to discuss sexuality with their children and young people are experiencing natural body changes, they seek answers to their bodily curiosities by talking to their peers and friends, who often offer nonscientific information which increases the chances of engaging in dangerous behaviours (Bilal & Leygraf, 2024). Svanemyr, Baig, & Chandra-Mouli (2015) highlighted that due to a lack of knowledge of sexual and reproductive health (SRH), there emerge challenges such as unplanned pregnancies, low use of contraception, use of unsafe abortion, and increase of STDs (sexually transmitted diseases) and HIV. Thus, lack of sex education influences and has repercussions for both men and women.
Boys consider masturbation as sinful, while poor menstrual hygiene is common among women. For instance, a study done in Pakistan with 188 young men showed that 32% of the respondents felt guilt about nocturnal emissions, and 31% felt masturbation could lead to physical illness (Bilal & Leygraf, 2024). Another study showed that contraception among young adults is regarded as an issue of child spacing, pregnant women’s health, and population growth, and not as an issue related to sexuality or safer sex among couples (Svanemyr et al., 2015). Moreover, the lack of sex education was cited as the biggest etiological reason for the development of nonorganic sexual dysfunctions in Pakistani young adults (Bilal & Leygraf, 2024). Imran’s (2023) work showed that urologists and male general physicians in Pakistan said there had been an increase in depression and suicide among men due to a lack of awareness about infertility, other male reproductive dysfunctions, and sexually transmitted diseases (STDs). Given the immense amount of shame and fear associated with these ailments, men remain reluctant to seek medical treatments.
Women also experience similar issues. A research study conducted by Imran (2023) involved medical professionals, midwives, married women, married men, unmarried men, and pharmacists in Pakistan. One of the groups (comprising women) Imran (2023) interviewed mentioned that no sex education was given to them by their mothers, friends, or another female guardian; instead, they were taught about sexual intercourse on their wedding night by their husbands, mothers-in-law, or an older female relative. They were instructed to relax as a bride and not to say ‘no‘ to their men as it’s his right. Women, already a marginalised group in Pakistan, are often killed for not bleeding during the first sexual intercourse. Thus, such ‘crash courses‘ deprive women of basic knowledge about their bodies and the complications they might face. Knowing sexual and reproductive health and rights can make people aware of the rights they have over their bodies, recognise injustice, and make healthy choices instead of feeling ashamed about their bodies.
Role of Sexualized Media in Perpetuating Violence Against Women: The Impact of a Lack of Sex Education
In this age of technology, the ideas of sex are shaped by internet pornography, which has a known tendency to include pictures of violence (Gul, 2020). Returning to pornography to fill the void of lack of sex education can emerge as a dangerous substitute and lead to harmful outcomes. It creates exaggerated and unattainable standards for sexual performances and sexual pleasures, causing body issues and dissatisfaction in real-life relationships. This eventually leads to sexual violence and women being objectified. Though there remains a debate if pornography can be considered the sole reason for violence or victimization, there remain valid concerns about the possible consequences of sexualised media and information coming from such sources. For instance, the Sexual Scripting Theory proposes that “individuals learn how to engage in sexual behaviour through observing messages (or sexual scripts) perpetuated within the media content we consume” (Maas, Gal, Cary, & Greer, 2022).
The mainstream and free internet pornography that is readily available for teenagers has sexual scripts comprising of sexual violence and a lack of respect for women’s sexual consent and bodily comfort. When exposed to such violent forms of sexualised media, adolescents can unintentionally develop their sexual scripts in their minds to guide their own sexual expectations and decision-making (Maas et al., 2022). Thus, information coming from inaccurate, aggressive, and violent sources further reinforces the need to discuss sexual and reproductive health and rights (SRHR). We must realise that sex education is not about having sex; instead, it is about providing safe and accurate information to teenagers for a responsible, secure, and fulfilling adulthood.
Returning to community-based interventions:
The most conventional disagreement around the provision of sexual and reproductive health rights is that imparting such knowledge to young people will encourage them to participate in inappropriate behaviours. Furthermore, the cultural barriers in our societies find sex education in conflict with the local, traditional, and religious norms of the society. Therefore, to cater to such disagreements and concerns, there is a need to develop community-based interventions relying on curriculum and training manuals that are culturally sensitive. For instance, in a conservative country like Pakistan, an intervention was done by the Rutgers WFP (formerly known as the World Population Foundation [WPF]) in collaboration with national and local partners to introduce a rights-based program for comprehensive sex education using life skills-based education (LSBE) approach. World Health Organization (WHO) defines life skills as the ‘abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life’ (Svanemyr et al., 2015).
Rutgers WFP kept modifying its curriculum based on the needs of target groups and feedback from stakeholders. A four-year program (2009-2012) in three cities of Pakistan, evaluated in 2013 with a survey of 300 students, showed that 52% of the students deemed it very beneficial, 87% reported an increase in awareness of their rights, and 91% expressed they could discuss SRHR issues with their parents (Svanemyr et al., 2015). These percentages are significant for a country where discussion on SRH largely remains taboo. Thus, Svanemyr et al.’s (2015) work on SRH interventions in different cities of Pakistan and how continuously modifying LSBE-based curriculum showed that by reaching a wide range of stakeholders (such as religious leaders, community-based organisations, and school authorities), LSBE programs in Pakistan were able to deal with the potential social backlash and unsettle myths around sexuality.
Way Forward:
There is a need to comprehend the fact that there is no shame in knowing your body, and sexual and reproductive health and rights (SRHR) education should be normalised for all. Keeping SRHR education shrouded in stigma perpetuates ignorance, violence, and health crises. SRHR education not only reduces health risks but is also pivotal in dismantling patriarchal norms that restrict women’s rights and autonomy over their bodies. Allowing SRHR education gives women constructive knowledge about the menstrual cycle, menopause, pap smear tests, and pre-menopause treatments, among other health concerns. This can eventually allow them to make effective choices for each case. Similarly, men can be made more aware of their bodies and how they need to respect women’s bodies as well. In a culturally sensitive setting, engaging with religious and community leaders and local organisations and a tailored curriculum can ensure a scientific and accurate knowledge transfer. By normalising SRHR education, we can foster a healthier and more equitable society that empowers individuals to make healthy choices about contraception, family planning, and consensual relationships. More so, it can prevent any girl from experiencing what this girl felt when she reached menarche in the cold winter of 2007.
Bibliography:
Bilal, A., & Leygraf, B. (2024). The State of Sex Education in Pakistan: The Way Forward. Journal of Psychosexual Health. https://doi.org/10.1177/26318318241265834
Gul, M. (2020, April). What sex education is really about. D+C Development and Cooperation. https://www.dandc.eu/en/article/pakistan-shows-why-comprehensive-sex-education-would-improve-young-peoples-lives
Imran, K. (2023, December 17). Sex education, lies and Pakistan. DAWN.COM. https://www.dawn.com/news/1798340
Lihemo, G., & Hafeez-Ur-Rehman, H. (2017, April 17). Breaking silence on menstrual hygiene. UNICEF Office of Innovation. https://www.unicef.org/innovation/U-Report/menstrual-hygiene-polls-pakistan
Maas, M. K., Gal, T., Cary, K. M., & Greer, K. (2022). Popular Culture and Pornography Education to Improve the Efficacy of Secondary School Staff Response to Student Sexual Harassment. American Journal of Sexuality Education, 17(4), 435. https://doi.org/10.1080/15546128.2022.2076757
Svanemyr, J., Baig, Q., & Chandra-Mouli, V. (2015). Scaling up of Life Skills Based Education in Pakistan: a case study. Sex Education, 15(3), 249–262. https://doi.org/10.1080/14681811.2014.1000454
