Posted by Maria Codina on December 19, 2018 at 10:30 am
Globally, within the domain of Sexual and Reproductive Health and Rights (SRHR), sexual health
seems to be the neglected component. Health and development initiatives typically focus on
particular components of SRHR: contraception, maternal & new-born health, and HIV/AIDS (Starrs
et al., 2018). It was believed that the only purpose of sexual activity was post-marital reproduction
and hence healthcare interventions ignored a large population of sexually active unmarried
population, including those with varied sexual preferences. As it is being increasingly
acknowledged now, sexual health and reproductive health, although intertwined, have unique
individual aspects and should be given equal importance as they play a central role in the survival
and overall well-being of people.
The WHO provides a comprehensive definition of Sexual Health, where SH is
defined as “….a state of physical, emotional, mental and social well-being in
relation to sexuality; it is not merely the absence of disease, dysfunction or
infirmity. Sexual health 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. For sexual
health to be attained and maintained, the sexual rights of all persons must be
respected, protected and fulfilled.” (WHO, 2017)
As Gagnon and Simon (1973) points out, managing one’s sexual behaviour includes managing of
interpersonal relationship/s. In other words, interpersonal intimate relationships are a major
contributor and determinant of sexual choices, decisions and behaviour. Hence, we include
relational aspect of health as an additional aspect of sexual health. Each aspect (i.e. physical, social,
mental, and relational) has different challenges attached to it, which need to be looked at
separately. Therefore, a slightly modified, operational definition of sexual health could be “….a
state of physical, mental, relational and social well-being in relation to sexuality
and not merely the absence of disease…” where the idea of emotional health is included in
both mental and relational aspects of sexual health.
Realization of sexual and reproductive rights is essential to achieve sexual and reproductive health.
These rights ensure that individuals can:
1) have their bodily integrity, privacy, and personal autonomy respected; 2) freely define their own
sexuality, including sexual orientation, gender identity and expression; 3) decide whether and when
to be sexually active; 4) choose their sexual partners; 5) have safe and pleasurable sexual
experiences; 6) decide whether, when, and whom to marry; 7) decide whether, when, and by what
means to have a child or children; and 8) have access over their lifetime to the information,
resources, services, and support necessary to achieve all the above, free from discrimination,
coercion, exploitation, and violence. While these rights must universally apply, the path to achieve
these rights is fraught with diverse set of challenges depending on the social, cultural, political,
economic and legal context in which people’s lives are embedded.
Certain social conditions act to aid or inhibit certain behaviour. For instance, every individual is a
part of multiple social systems, such as the family, peer groups, formal and informal institutions,
neighbourhood; these comprise certain structured and semi-structured rules, norms and modes of
conduct, that are considered appropriate and desirable. Along with this, there are enforceable code
of conduct such as national laws, state laws and local laws, and geographical, political and
economic factors. All these have a cumulative effect on the sexual health of a single individual.
Strict abortion laws in several countries, for example, violate some basic human rights and compel
a number of women to opt for unsafe abortion which has serious health implications. Similarly, laws
related to sex education determines the nature of sex education provided and whether it is
provided at all. Even if the state mandates sex education, several schools restrict provisions for sex
education due to the existing cultural, social and religious norms. Thus laws of the government and
basic societal norms seep into several formal institutions (organizations, schools, healthcare etc.)
and informal institutions (family, religious groups, peer groups etc.) which altogether contribute to
the existing status of sexual health of every single individual.
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