Comprehensive Sexuality Education: Informed choice — Syirin Junisya

JULY 8 — This is in response to Dr Rafidah Hanim Mokhtar’s letters published in Malaysiakini and The Star “Sex education should not disregard abstinence”.

Various arguments on the approach to empower young people about their sexual and reproductive health inevitably include personal and moral compass. There is no doubt that the notion of abstinence would be serve as one of the solutions to the social issues young people are facing but when it comes to interventions, it must be based on one that are evidence-based rather than moral judgment which is often subject to personal bias.

The Comprehensive Sexuality Education introduced by Unesco, International Technical Guideline of Sexuality Education: An Evidence Based Approach (Women, UN and Unicef, 2018) and IPPF Framework for Comprehensive Sexuality Education (International Planned Parenthood Federation; IPPF, 2013) are two of the most credible and widely used guideline in guiding educator in the world to provide non-judgmental and youth-friendly sexuality education which are based on the scientific evidence and consultation from many stakeholders and lessons learnt from the ground in regards of its practicality.

Both modules have similar definition of CSE which incorporated the concept of Gender, sexual and reproductive health and HIV, citizenship, sexual behaviour, violence, diversity, relationship, skills for health and well-being which can be delivered in formal and non-formal settings that are scientifically accurate, incremental, human-right based, and gender transformative based (IPPF, 2013; Unesco, 2016; UNFPA, 2014).

The perception that these guidelines are amoral and culturally insensitive that would undermine young people’s ability to understand the conundrum of sexual behaviour is hardly justified by any scientific evidence and depicted the lack of awareness and understanding of its curriculum and delivery approach. Both of the guidelines are culturally relevant and context appropriate as CSE fosters respect and responsibility within relationships, supporting learners as they examine, understand, and challenge the ways in which cultural structures, norms, and behaviours affect people’s choices and relationships within a specific setting.

This is where CSE plays a vital role, in creating conversations and interactions among young people, to reflect on social norms, cultural roles and values, and traditional beliefs — for them to understand and better manage their relationships with friends, parents, teachers, and other members of society, through developing their life skills that are needed to support healthy choices that include the ability to reflect and make informed decisions, communicate and negotiate effectively and demonstrate assertiveness.

An empowering attitude

The framework of both manuals underpins that CSE should be an informed choice-based approach as it believes the ability of young people in making their decision over their body with adequate education and information on their sexual and reproductive health. It provides children with the opportunity to develop confidence by learning about their emotions, self-management (hygiene, emotions, behaviour), social awareness (empathy), relationship skills (positive relationship, dealing with conflicts) and responsible decision-making (constructive and ethical choices). These topics are introduced gradually, in line with the age and evolving capacities of the child.

Apart of that, the guidance lays the foundation for healthy childhood by providing children with a safe environment to learn the correct names for parts of the body; understand principles and facts of human reproduction: explore family and interpersonal relationships; learn about safety, prevention and reporting of sexual abuse etc.

We applaud the efforts made by Ministry of Women, Family and Community Development in educating children about safe and unsafe touch, but it would be irrational to acknowledge that the social issue faced by the children can be solved by abstinence because it does not. Our national curriculum is an abstinence-based, restricted and rigid framework that does not take into consideration of the fact that we are all from a variety of backgrounds living a diverse set of circumstances. How do we explain in Malaysia the rising numbers of sexual violence, sexual exploitation, high teenage pregnancy, child marriage, when the education framework employs abstinence-only focus as suggested by Dr Rafidah and which clearly disregards the interlinkage of informed choice (inclusive of abstinence) with that of protection and promotion of young people’s health and well-being?

CSE is key to the solution

The recently launched Country Monitoring Report by Federation of Reproductive Health Associations, Malaysia (FRHAM) presented at a National Policy Dialogue with Ministry of Women, Family, and Community Development and the Education Ministry showed the ineffective of abstinence approach in the school curriculum and testimonies from respondents including young people, teachers, parents, stakeholders in agreeing that abstinence-based approach is not enough to empower young people about their safety, security, boundaries, and consent.

The results also found that despite the milestones achieved by Malaysia in the area of sexual and reproductive health, adolescents and CSE, there were still a multitude of issues surrounding adolescents today like teenage pregnancies, sexual violence, child grooming and sexual grooming that need to be better addressed. A curriculum that is based on abstinence instead of informed-choice, the lack of parental and family support, compounded by lack of a robust monitoring and evaluation mechanism, untrained teachers and the lack of political willpower have also decelerated the progress of CSE. This has been hugely supported by research (Haberland & Rogow, 2015).

Collaboration with various parties is needed to ensure the gaps of existing sexuality education are able to be fulfilled and a youth-friendly, age-appropriate, evidence-based, and informed choice CSE could be able to deliver to the young people. Besides, the regional study done by Asia Pacific Research and Resource Centre for Women (ARROW) 2018, illustrated that CSE is not a “western value” but widely accepted by Asian countries due to its relevance to Asian culture and values.

Evidence of CSE

Comprehensive Sexuality Education is a guideline that is based on extensive empirical evidences collected across the globe. The evidence reaffirms that curriculum-based sexuality education programmes contribute to delay of initiation of sexual intercourse, decrease in the frequency of sexual intercourse, decrease number of sexual partners, reduced risk taking (Unesco, 2009; Fonner et al., 2014; Shepherd et al., 2010), increased use of condoms (Lopez et al., 2016), and increased use of contraception (Unesco, 2016c).

Researchers studied the National Survey of Family Growth in the US to determine the impact of sexuality education on youth sexual risk-taking for young people ages 15-19, and found that teens who received comprehensive sex education were 50 per cent less likely to experience pregnancy than those who received abstinence-only education.

In conclusion, the guidelines of both IPPF and Unesco on Comprehensive Sexuality Education is voluntary and non-mandatory, based on universal evidence and practice, and recognises the diversity of different national contexts in which sexuality education is taking place. As to where Malaysia is right now, young people need an education that is effective in empowering them based on informed choices, for them to make better choices for themselves now, and in the future when they become adults.

* Syirin Junisya is executive director of the Federation of Reproductive Health Associations Malaysia (FRHAM)

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.  

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