In Bangladesh, the first time my mother heard about sexual intercourse was on her wedding night. “It’s something married women must do to bear kids,” is what she recalls being told in June of 1990. Before this vague explanation, “sex” had been a mystical and taboo subject.
When I attended high school in New York City from 2014 to 2017, my sex education teacher was also the assistant principal. He referred to sex as the “s-word,” as if the word itself was inappropriate to speak out loud. The lack of quality sex ed I received in school, in addition to cultural stigmas associated with sexuality, cultivated in me a sense of shame about my own body and identity.
Though they happened over 24 years and 7,000 miles apart, my mom’s and my experiences with inadequate sex education are not unique. Currently in the United States, only 29 states and the District of Columbia mandate sex ed be taught in schools. Of those 29 states, only 13 states require sex ed to be scientifically accurate, and only one state requires that consent be integrated into the curriculum. This deficit in accurate, well-rounded sex ed leaves adolescents in the dark about their sexual health, rights, and identity.
Comprehensive sexuality education (CSE) is a vital component of sexual and reproductive health and rights (SRHR). SRHR is defined by the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights as “a state of physical, emotional, mental, and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction, or infirmity.” CSE explores a wide variety of topics related to sexual identity, managing one’s health, and sexual and reproductive autonomy. The information and skills provided by CSE are essential to helping all people, especially young people, to form equitable relationships and have autonomy over their sexual and reproductive health and well-being.
Although CSE programs alone cannot combat rape culture, they provide young people with information on how to recognize and respond to sexual violence.
There is an overwhelming need for the inclusion of CSE in SRHR programming in the United States and globally. Sexual violence, primarily against women and girls, is one of the most widespread human rights violations in the world: One in three women and girls have experienced physical and/or sexual abuse. In the United States, 81% of women have experienced sexual assault in their lifetime. In Malawi, where the US government funds SRHR-focused development programs, more than half of girls between the ages of 13 and 17 have experienced forced sexual initiation, which increases their risk of HIV/AIDS, sexually transmitted infections, and unintended pregnancy.
Conversations about sexuality should not only occur after instances of sexual violence; CSE may be used as a preventative measure against sexual assault by initiating conversations about SRHR, promoting sexual well-being, and addressing sexual violence early on. Although CSE programs alone cannot combat rape culture, they reinforce our human right to autonomy, teach youth that sexual violence is not ok, and provide young people with information about how to recognize and respond to sexual violence.
THE BENEFITS OF EVIDENCE-BASED INTERVENTIONS
The benefits of implementing CSE in international SRHR programs have been observed through various evidence-based interventions, like the DREAMS partnership. The DREAMS partnership, supported by the President’s Emergency Plan for AIDS Relief (PEPFAR), conducts evidence-based HIV prevention and treatment programming for adolescent girls and young women in countries with high HIV incidence. The DREAMS Core Package of services includes school-based HIV education through CSE, community mobilization, gender norm change programs, and violence prevention education based on a review of available data. Data show that school-based HIV and violence prevention workshops that socialize equitable gender norms correlates with lower rates of STIs and unintended pregnancies. Data in DREAMS’ community mobilization efforts have also been shown to engage boys in conversations about HIV, gender norms, sexuality, and navigating relationships which have influenced norms change and decreased violent perpetration.
Another notable feature of PEPFAR’s DREAMS program is that abstinence-only education is not used in its programming. A 2016 study by Stanford University found that abstinence-only sex education had no effect on sexual behavior or decreasing HIV infections. Instead, abstinence-only education promotes gender stereotypes that put the burden of consent almost exclusively on women and girls, creating a culture of shame and blame that prevents youth from seeking help regarding their sexual health.
While federally funded global health programs like DREAMS avoid abstinence-only education, this cannot be said for many states across the United States. Indeed, 19 US states require that only abstinence is taught in schools. Interestingly enough, among the states with the highest rates of births among teenagers, five are states that either do not teach sex education or promote abstinence-only education: Arizona, Mississippi, Texas, Florida, and Arkansas. While some advancements have been made in global health programming funded by the US government, legislation regarding CSE in several US states remains extremely outdated and detrimental to the sexual and reproductive health and well-being of people across the United States.
THE POWER OF BEING INFORMED
CSE provides the necessary tools for people to make informed decisions regarding their sexual well-being, develop healthy identities, and advocate for themselves when facing gender-based violence. It is vital that we advocate for the US government to include and expand CSE programs that are accessible and culturally sensitive, both domestically via federal and state legislation, and globally via international development funding and programs that address SRHR.
At the Generation Equality Forum this past July — organized by UN Women, co-hosted by Mexico and France, and attended by progressive governments — several civil society organizations, including International Planned Parenthood Federation Western Hemisphere Region (IPPFWHR), made a five-year funding commitment to support quality and inclusive CSE in Latin America and the Caribbean. The commitment includes CSE curricula in formal and non-formal settings, partnerships with local service providers, and increased access to sexual and reproductive health services. Along with expanding CSE globally, the US government must commit to CSE in domestic and foreign health policies and programs.
A commitment to CSE throughout the United States, and globally, should be included in the US Gender Policy that is being developed by the White House Gender Policy Council, which pledges to promote SRHR domestically and globally. Continued advocacy on this important issue is required to ensure the integration of quality CSE in all US and global health policies and programs in order to promote the sexual well-being of young people across the country and throughout the world.
Hamida Chumpa is a South Asian feminist and activist who interned at the Change Unit at International Planned Parenthood Federation Western Hemisphere Region (IPPFWHR) through the Jeannette K. Watson fellowship.