Teen sexual health: a persistent blind spot

Neerja Singh

The only way to stay one step ahead of India’s breakneck teen sexual revolution is to acknowledge the phenomenon. The stakes here are so high, generational gaps could become life threatening.

The blind siding is on every front.

Adolescents make up about 21 per cent of the Indian population as per data from the National Centre for Biotechnology Information. And there are major issues and challenges with their Sexual and Reproductive Health and Rights (SRHRs) that are routinely swept under the carpet. This despite the fact that United National Population Fund states clearly that good sexual and reproductive health is an indispensable part of universal human rights and that it implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.

Take the simplest aspect of menstrual health. How many schools provide adequate support, information and accessibility to menstrual health products?

Sunil Mehra, executive director of MAMTA, a Delhi-based non-profit working on adolescent and reproductive health issues says, “Our social and policy barriers do not allow the sexual and reproductive needs of adolescents (10 to 19 years) to be addressed because many of those who have sex are unmarried and below the age of consent.”

There are other worrisome statistics. India has 253 million adolescents, more than any other country and equivalent to the combined populations of Japan, Germany and Spain, but the country is not doing enough to ensure that they become productive adults. A population council report says that, “No more than 20.3 per cent of unmarried boys and 8.2 per cent of unmarried girls used a condom consistently.”

Spurred by concerns of HIV-AIDS, the Indian government in association with United Nations agencies introduced an adolescence-education programme (AEP) in 2005. Adolescent health featured for the first time as a national programme in 2006 under the National Adolescent Reproductive and Sexual Health Strategy (NARSHS), which included health clinics that offered preventive, promotive, curative and referral services for adolescents (10-19 years) and youth (19-24 years). Within two years of inception, the AEP was banned in 12 states, including Maharashtra, Karnataka, Kerala and Uttar Pradesh. The Madhya Pradesh chief minister found the illustrations too graphic; he wanted adolescent education focused on “yoga and Indian cultural values”. The National Aids Control Organisation (NACO) removed contentious illustrations and words considered explicit, such as ‘intercourse’, ‘condoms’ and ‘masturbate’. In April 2009, a Rajya Sabha committee chaired by M Venkaiah Naidu, now Vice President of India and then member of Rajya Sabha (Upper House of Parliament), said the adolescent-education programme would “promote promiscuity of the worst kind, strike at the root of the cultural fabric, corrupt Indian youth and lead to the collapse of the education system and the decrease of virginity age.”

Illustration: Shreya Sen

The government has programmes, but the adults don’t want to know and the teens do not know. Despite the fact that in October 2014, the government started the Rashtriya Kishor Swasthya Karyakram (RKSK) or National Adolescent Health Programme, independent studies reveal widespread ignorance. Reproductive health services ought to include counselling on menstrual disorders, menstrual hygiene, use of sanitary napkins, use of contraceptives, sexual concerns, sexual abuse and gender violence. While there has been a recent uptake in activities around menstrual hygiene and iron folic supplements through schools and immunization through anganwadi (day care centre) workers, sexual and reproductive health is “completely neglected.”

The effort is now to engage adolescents through peer educators who would speak about various life skills, including nutrition, mental health, non-communicable diseases, gender and sexual and reproductive health. There is also the sensitizing of auxiliary nurse midwives, anganwadi workers, counsellors and medical officers to offer “non-judgmental services” for adolescent sexual and reproductive needs. Without sex education and counselling, adolescents are also at a high risk of acquiring sexually transmitted infections (STI) and even HIV.

In late January 2020, the Union Cabinet amended the 1971 Medical Termination of Pregnancy (MTP) Act allowing women to seek abortions as part of their reproductive rights and gender justice. The important amendment placed India in the top league of countries serving women who wish to make individual choices from their perspectives and predicaments.“India will now stand amongst nations with a highly progressive law which allows legal abortions on a broad range of therapeutic, humanitarian and social grounds. It is a milestone which will further empower women, especially those who are vulnerable and victims of rape,” Union Cabinet Minister for Textiles and Women and Child Development, Smriti Irani wrote on her blog.

Awareness and knowledge about SRHRs not just benefit the person, but also strengthen societies and nations. Schools are the perfect places to start with so as to achieve these health goals. A revised curriculum that addresses all aspects of human sexuality is the need of the hour. It ought to include information on biological processes, along with the emotional and psychological aspects involved. This alone is not enough. A proper orientation on consent, gender identity, interpersonal relationships need to happen. The final step would be to implement the curriculum across states. Where necessary, a contextualized sex-education would facilitate societal acceptance as also its effectiveness.

The digital era carries an inherent advantage of propagating verified and reliable information through online platforms. Comprehensive coverage of these issues in developed countries has helped young people make informed choices. The open conversations and progressive policies have helped normalize topics that have been considered ‘taboo’ and ‘shameful’ until now. Introducing these topics in a staggered manner from a young age reduces misconceptions and stigmas, especially regarding STDs, HIV/AIDS, sexuality spectrum (asexual, bisexuals, gays, lesbians, etc.), knowledge about contraceptive methods, and gender spectrum and many more.

With an upfront, wholesome and respectful sex/sexuality education, we empower people in their adolescent years. It is the right way to bolster self-identities and inculcate authentic individuality. Sex education moreover, nurtures a robust mental health among adolescents. The time is ripe to talk about emotions and feelings so that young people have permission to breathe and live their lives untainted by a sense of shame.

The author is a former teacher/journalist, published author and professional speaker on generational diversity with a background and training in media, having worked in advertising, public relations, documentary film making, and feature journalism. She can be reached at
neerja@neerjasingh.com and https://neerjasingh.com.

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