Sexual, Reproductive Health & Rights
To define the terms
- reproductive health,
- sexual health,
- reproductive rights,
- sexual rights
- Sex is part of sexuality
- Sex is NOT the same and sexuality
- Refers to one’s biological characterstics – anatomical (breast, vagina, penis, testes), physiological (menstrual cycle, spermatogenesis) and genetics (XX, XY) as male or female
- Also a synonym for Sexual Intercourse, which includes Penile-Vaginal Sex, Oral Sex and Anal Sex
- Expression of who we are as human beings – a total sensory experience involving the mind and the body
- Includes all the feelings, thoughts, and behaviours of being male or female, being attractive and being in love, as well as being in relationships that include intimacy and physical sexual activity
Aspects of Sexuality
- Intimacy and relationships
- Sexual Identity
- Biological sex
- Gender identity
- Gender roles
- Sexual orientation
Sexual Feelings & Behaviour
- Attracted to same sex but not act on it
- Having same sex practices but attracted to opposite sex
- Feel attracted to same sex and having same sex practices
Case Study 1
- Kim is a 19 year old man. He has always had attractions to members of the same sex.
- Currently he is not sexually active, but he is planning to start a relationship with a 33 year old man he met online.
Sexual Feelings & Identity
- ¨Attracted to person of same sex but does not identify as homosexual
- Attracted to person of same sex and identifies as homosexual
Case Study 2
- Eric is 15 years old and is currently sitting for his PMR exams.
- Of late, his teachers have started to notice the drop in performance at school and are concerned that he misses his classes regularly.
- This is not usual as he has always been attentive in his studies previously.
- When questioned, he reveals that, “I feel like a woman trapped in a man’s body”
“a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes”
- People are able to have a responsible, satisfying and safe sex life
- Have they capability to reproduce and the freedom to decide if, when and how often to do so
Case Study 3
- Raju is celebrating his 5th wedding anniversary next year.
- He and his wife have been happily married but they constantly receive pressures from their family and friends on not having any children.
Implicit to this are the rights of men and women to be informed of and have access to safe, effective, affordable, and acceptable me methods of fertility regulation of their choice, and to appropriate health services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chances of having a healthy infant (WHO)
Healthy Parents and Children
•Safe motherhood – choice of methods for family planning (but by choosing when to have children)
•STI/HIV diagnosis and treatment
•Choose when to have children, i.e. spacing and number
•Absence of STIs and HIV
•Prompt treatment of STIs and HIV
•Prevention of HIV transmission to baby
- Sexual health is a personal sense of sexual well-being, as well as the absence of disease, infections or illness associated with sexual behaviour.
- It includes issues of self-esteem, self-expression, caring for others and cultural values.
Implies a positive approach to human sexuality and the purpose of sexual healthcare should be the enhancement of life and personal relations as well as counselling and care related to reproduction and sexually transmitted diseases (adapted, UN)
Involves our behaviours related to producing chidren, enjoying sexual behaviours, and maintaining our sexual and reproductive organs.
Includes issues such as:
- Sexual Intercourse
- Sexual transmitted infections (STIs)
- Urologic & Gynaecologic Organ & Function health
•Condoms, lubricants and contraceptive choice
•Express sexuality and gender without shame, stigma or fear
•No violence or force
•Early diagnosis and treatment of STIs and HIV
•Protected from STIs, HIV and unintended pregnancy
- Najwa a 24 year old newlywed discovered that she had syphilis recently when she went for a blood donation campaign.
- She has never had sex with anyone apart from her husband. She plans to start a family.
- Embrace human rights that are already recognised in national laws, international human rights documents and other consensus documents
- Include the right of all persons, free of coercion, discrimination and violence, to the highest attainable standard of health in relation to sexuality
Sexual Rights Includes
- access to sexual and reproductive health care services, seek receive and impart information in relation to sexuality;
- sexuality education;
- respect to bodily integrity
- choice of partner;
- decide to be sexually active or not;
- consensual sexual relations;
- consensual children;
- and pursue a satisfying, safe and pleasurable sexual life (WHO working definition)
Case Study 5
- Felicia is a 39 year old mother of two children and married to Ricky, who is 43.
- She is the sole breadwinner of the family
- Her husband is a known injecting drug user and has been diagnosed with Hepatitis C
- She is always nervous whenever they have sex.
- She fears that he does not want to put on a Condom
- Embrace certain human rights that are already recognised by national laws, international human rights documents and other consensus documents
- Rest on the recognition of freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.
- Also includes their rights to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights document (ICPD)
Using sexuality to control others
- Many people use sexuality to violate someone else or get something from another person
- Sexual Abuse
- Transactional sex
- Even advertising often sends messages of sex in order to get people to buy products
Case Study 6
- Fiza is a 16 year old girl who is deeply in love with her boyfriend.
- Her boyfriend, who is 19 keeps on asking her for sex, stating that he is madly in love with her and that by having sex, it will reaffirm the love.
- She is thinking of giving in because he has told her that he’ll leave her if she doesn’t.
Case Study 7
- Sheila is a 43 year old lawyer and is married for 3 years to a 37 year old engineer.
- She suspects her husband has another woman
- They sometimes break up in heated arguments, which does result in her getting beaten
- Her husband has also attempted on several occasions to force himself on her
- She feels that she does not want to have any children, but her husband insists on her conceiving.
Case Study 8
- Nora is a 36 year old widow with 4 children
- She has very little job skills and low social support. She always has very little money and is always struggling to make ends meet.
- Occasionally, she turns to selling sex to supplement her income
- She has recently missed her period and is concerned that she may be pregnant.
Sexuality and Reproductive Health
Sexuality is an essential part of reproductive health
- Individuals make decisions about their sex lives and reproduction within the context of sexuality, gender inequities, and economic and social power
- Individual’s attitudes about sexuality influence their choices of contraception method, how effectively the method is used, and their satisfaction with the method
- Helping women and men develop a better understanding of their sexuality, the context of their sexual relationships, and the motivations behind their sexual behaviour is an important step toward helping clients achieve sexual and reproductive health
- By making assumptions about client’s sexual behaviours, service providers may provide inappropriate services