Sexual practices are something that are not often spoken about freely and are still considered a taboo. It’s important to curb the stigma in order to prevent certain STDs, teenage pregnancies and promote use of contraception. Sex positivity is all about promoting and inculcating healthy sexual practices and much more which the teenagers should be aware of, let’s do our part as medical students to slowly inculcate them and to not shun them!
The term Sex positivity can be interpreted as having a positive attitude about sex and feeling comfortable about one’s own sexual identity and with the sexual behaviors of others.
Sex positivity is not an openly and widely discussed topic in India. Sex positivity is a still a taboo as many are ashamed to talk about it or think it’s guilty to have such thoughts. Sex positivity has many aspects to it, it’s inclusive of sexual education, wide range of sexual experiences, expressions, consensual activities and identities. Sex positivity is an important ideology which should be inculcated into the public from an appropriate age where they can begin to understand the gravity of such issues. Mainly we could start by targeting the adolescent group, as this is the age where curiosity and exploration begins.
Firstly, self-pleasure shouldn’t be something that should be shunned on, masturbation should be considered as something normal and healthy. Let me share an anecdote with you all, it’s a story about a friend’s brother. He was caught masturbating by his mother and obviously his mother was shocked and immediately said “God will punish you for this.” I was really surprised listening to what happened, I didn’t understand why God had anything to do with it. It is understandable that his mother was shocked but considering his age, it is something common. Our parents didn’t not have any means of sex education or sex positivity back then and that is why most of them don’t have a wider sense of approach to these topics. I really don’t think religion should be brought here, how is pleasure related to your religious beliefs? How are we disobeying god by doing something we have the right to? So, we must urge the elders not to force their opinion onto their kids. It can tend to narrow down their approach as well. No one talks about the pleasures of women; it’s considered a serious taboo. She is human and has the right to her needs and choices. They are narrowed down to just being mothers and wives, their needs and desires are somewhere lost unless their partner is considerate enough to talk about it.
Consensual sexual practices should be normalized. Mainly here the importance of consent should be discussed. Both the individuals should be able to talk to each other regarding their preferences and boundaries. Healthy sex is important and equality is crucial and well. Both the partners need to climax and experience an orgasm. It is important to understand how it works differently for males and females. In a survey conducted it was found that only 26% of the women orgasm every time they have sex, it’s unacceptable as everyone has their right to experience it. Both men and women should understand how it works so that no one has to feel the burden to satisfy their partner, rather it should be a natural process.
Next is each individual understanding their sexuality. It is of prime importance that one shouldn’t succumb to the societal pressures but rather explore and identify their sexuality. Attraction to another individual be it of the same or opposite gender should be considered common. Being open about one’s sexuality and gender should be laid emphasis on or otherwise it can affect the individual’s mental health, provided it’s safe to do so in their current circumstances. The individual’s process of coming out will not be easy and that we provide a friendly and comfortable environment for them is necessary. It is necessary that we don’t over react or have a negative approach to their feelings, this might impact them mentally. We need to encourage and support them.
If encouraging and supporting is the first step, the next step is helping them be aware of the problems involved in practicing same gender sex.
We shouldn’t only focus on the positive aspects, but should also keep in mind the aspects like Sexually transmitted diseases. Like any other ailment or disease, these are also important to understand and be aware of. STD’s can include HIV, syphilis, genital warts, HPV infections, chlamydia infections, gonorrhea, trichomoniasis etc. We must not shy away in discussing these diseases with non-medical students or students still in school, we should always try to expand their knowledge to help them be aware of everything.
Contraception is mainly used for protection against unplanned pregnancy but use of contraception can prevent the transmission of STDs to some extent. We need to prioritize the use of contraception to prevent STDs. It is said that the Male condoms do provide protection against STIs including HIV, however due to lack of proper research it is not proven that female condoms do offer to protect against STDs. According to the citation published by U.S centers for Disease Control and Prevention, latex condoms if used correctly and consistently while practicing sex, it can prevent the transmission of HIV, in addition to this, it also prevents the diseases transmitted by genital secretions. Condom usage can prevent the transmission of HPV associated infections as well. Contraception doesn’t necessarily only cover condoms; there’s a variety of options and one can choose accordingly. Diaphragms, combined pills, progesterone only pills, IUDs, hormonal patches, contraceptive implants, vaginal ring, spermicides, cervical cap and sterilization are the available options.
After contraception another sensitive topic is teenage pregnancy. Teenage pregnancies are a global problem and mainly prevalent in the developing countries. It is a major problem seen in the poorer, rural and underprivileged communities due to their lack of education and blind trust on age-old rituals and superstitions. Poor socio-economic conditions, cultural practices, lack of literacy and awareness are the risk factors. What we need to understand is not only the impact it will have on the fetus but the effect it will have on the mental health of the mother. There are a lot of complications associated with teenage pregnancies. Preterm delivery, risk of anemia, development of hypertension, risk of delivering low birth weight babies are some of the complications involved in teenage pregnancies. Researchers from the University of Washington found that adolescents who receive comprehensive sex education are significantly less likely to become pregnant and also led to a decrease in STIs.
So there are a lot of aspects to sex positivity that need to be discussed with adolescents and we need to tackle the problems mentioned above.
My idea of approach to help develop a sex positive approach in teenagers:
• Firstly, includes the audience, that it should not only be confined to the urban population but also the rural population should be taken into account. It is of utmost importance to focus on the rural community to bring them on par with the urban population.
• Secondly, we should encourage schools and colleges to conduct special classes on sex education to cover important aspects of sexual health and rights. It’s important to normalize the topic and not be awkward about it and talk about equality of all genders here. Schools and colleges must consider the option of hiring a psychologist or a professional who has immense knowledge of aspects related to sexual health and it’s rights, whom the students can approach without any hesitation. It is important to create a safe environment and should ensure confidentiality, where students can open up and clear their doubts. They should be able to communicate about STDs, contraception and sexual practices. They should also be comfortable to talk about their sexuality, it’s important to create such an atmosphere at the school level itself such that it can help broaden their views about homosexuality, bisexuality, transgender. Homophobia is also something that needs to be discussed about, teenagers should not despise them or bully them for coming out, they need to empathize and should not change their behavior towards them. Topics like masturbation, orgasm, contraception should be discussed with teenagers. Talking to parents about how to approach their children with sexual health should also be considered in order to help them build a great rapport with each other.
• Several different organizations related to AIDS or sexual health can persuade different schools or educational institutions and talk to students about their importance. Seminars can be conducted to spread awareness. The same should be done with schools in the rural areas as well.
• As teenagers are hooked to shows and series, documentaries or shows can involve topics related to sexual health in them. A show I recently watched was sex education on Netflix and was impressed by the topics they covered. Shows target a huge number of teenagers and such shows will draw their interest to know more about sexual health in a very positive way.
• STD’s should also be discussed; it can be introduced as a minor part in the curriculum to help teenagers have a basic idea of them.
• The significance of contraception should be well explained to teenagers in their respective educational institutions. As a lot of teenagers use social media, social media can also be used as a tool for promoting sexual health. A lot of doctors use social media today, if and when they find time, gynecologists can post videos or do Instagram lives regarding contraception and should emphasize its importance. They can use the platform or clear doubts people have regarding this subject. As social media has a huge reach and people find it easy and comfortable to use, it can also be considered a tool to spread awareness. More advertisements with respect to contraception should be aired. The government can also do their part in raising awareness about the methods of contraception. Various campaigns can be conducted.
• In order to control teenage pregnancies, more concentration on the rural population should be made, we must educate them about the laws in India regarding marriage and sex, also tell them about the complications involved in teenage pregnancies. We need to help them understand various government programmes and legislations. More information regarding safe and unsafe abortion should be talked out and made available. People need to be more aware about the rights regarding abortion.
• Most importantly and primarily teenagers should be taught about good and bad touch and about consent. Consensual sex should be emphasized upon. A survey conducted tells us that, most of the teenagers indulge in such practices mostly due to peer pressure, they should be taught to take things at their own pace and not because of any pressure and this might affect them in the long run.
I would like to emphasize that talking about sex positivity does not mean we are actively encouraging teenage sex, it means we are opening a window that encourages consent, and talking freely about our choices and decisions. Tackling each problem, one at a time will help us build a society which is sex positive. Mainly spreading awareness about this topic among the teenagers, is useful in broadening their views about sexual health. This is important to understand the development of adolescent sexual well-being, including the normative age tends and its impact on their psychological and physical health.
2.Harden KP. A Sex-Positive Framework for Research on Adolescent Sexuality. Perspect Psychol Sci. 2014 Sep;9(5):455-69.
3. Mahavarkar SH, Madhu CK, Mule VD. A comparative study of teenage pregnancy. J Obstet Gynaecol. 2008 Aug;28(6):604-7.
4. National Institutes of Health. What are the different types of contraception? Available at: https://www.nichd.nih.gov/health/topics/contraception/conditioninfo/types
5. Marshall Bright. Study Finds that Comprehensive Sex Education Reduces Teen Pregnancy. American Civil Liberties Union 2008.
COLLEGE: Apollo Institute of Medical Sciences and Research, Hyderabad YEAR OF STUDY: Final MBBS part 1 HOBBIES: Table tennis, photography, writing Currently a council member of Sexual and reproductive health and rights in SIMSA (South Indian Medical Students Association) I think reading and writing do help in broadening our views and spectrum of thought. Tackling each stigma at a time and enhancing everyone’s approach to stigmas is important and I believe I can start by writing.