Why is sex and reproductive education essential for adolescents?

 Why is sex and reproductive education essential for adolescents?

Many adolescents are afraid of where to go, how to get services, whether there will be confidentiality, and whether their family will find out.

Sandhya Rai, 16, had consensual sex and was forced to have an unsafe abortion after becoming pregnant.

Unwanted pregnancies and health problems are on the rise in Nepal due to lack of access to sex education and reproductive health services for adolescents.

‘Sandhya Rai’ (name changed) was a 16-year-old student in grade 10. She fell in love with a young man in grade 11 at the same school she attended. Both dreamed of getting married after completing their studies.

One day, they went to Nagarkot to celebrate the young man’s birthday and stayed there. They had consensual sex.

A few months later, Sandhya discovered that her menstruation had stopped. After she told her mother, she was tested at the hospital. It was confirmed that she was pregnant. Legal complications arose as she had already passed 12 weeks. She was then forced to have an unsafe abortion. The impact of this has led to long-term health problems.

Sandhya's story is not just the story of one person, but a representative example of the reality that many adolescents in Nepal face when they do not have access to accurate information, counseling, and health services.

This has complicated the debate on sexual education and reproductive health rights for adolescents in Nepal.

Adolescents at risk

Due to the lack of accurate knowledge and services, adolescents are forced to face unsafe sex, unwanted pregnancies, sexually transmitted infections, rape, blackmail, and mental stress. There have been cases where such problems have led to dropping out of school.

In Sandhya's case, if she had had timely pregnancy testing, counseling, and access to safe health services, she would not have had to undergo an unsafe abortion.

Advocate Roshana Pradhan says, "When society remains silent, the risks begin to speak." She says that when families, schools, and communities do not communicate openly, adolescents are forced to make decisions alone.

In Nepal, there are countless examples of legal complications even when adolescents under the age of 18 have consensual relationships. Rights activists say that viewing non-exploitative relationships between adolescents of the same age group as criminal is automatically creating many complications.

This has legal provisions that make adolescents, in particular, afraid to seek health care, get pregnancy tests, seek counseling, or even file a complaint in case of violence. Advocate Pradhan says that laws should be formulated by distinguishing between actual exploitation and consensual relationships.

School-going adolescents receive some information from teachers, textbooks, or school programs. However, adolescents who are out of school are deprived of such opportunities. This leaves them far from proper knowledge and services related to sexual and reproductive health.

Many adolescents are forced to drop out of school due to economic problems, child labor, child marriage, family responsibilities, migration, or remote areas. Adolescents in particular are more affected by domestic work or early marriage.

Without information about body changes after being out of school, menstrual health, safe sex, contraceptives, and ways to avoid sexual violence, they may rely on the wrong sources. This increases the risk of unwanted pregnancy, sexually transmitted infections, exploitation, and violence.

Street children, orphans, children without parents, children from immigrant families, adolescents with disabilities, and adolescents from gender and sexual minorities are at even greater risk. Even when such adolescents seek health services, they often shy away due to fear of privacy, lack of funds, or uncomfortable behavior.

Therefore, community-level programs, youth clubs, health posts, mobile camps, radio, digital media, and local-level targeted campaigns are necessary to reach out to adolescents who are out of school. Even though adolescents are out of school, their rights and needs are not outside of school.

What to do now?

According to advocate Roshana Pradhan, comprehensive sexuality education is not just about teaching reproductive organs or biology. This is to inform adolescents about their bodies, emotional development, relationships, rights, and responsibilities. It also provides age-appropriate, scientific, inclusive, and practical knowledge about safe behavior.

It covers topics such as changes in the body, menstruation, hygiene, consent, privacy, gender equality, protection from sexual violence, safe sex, family planning, sexually transmitted infections, HIV, unwanted pregnancy, mental health, self-esteem, life skills, and decision-making.

“Adolescence is a time of great change in the body, emotions, and social relationships,” says Pradhan. “If the right information is not provided at such a time, they risk quenching their curiosity through the wrong sources.”

According to Advocate Pradhan, such education should start from childhood, according to age. Body safety, good and bad touch, hygiene, and self-esteem should be taught at a young age, and relationships, consent, contraceptives, rights, and responsibilities should be taught in detail during adolescence. Comprehensive sexuality education should be made mandatory in grades 9 and 10.

Advocate Pradhan says teachers need to be trained to teach in a sensitive and scientific manner. “The program should be expanded to out-of-school adolescents and confidential, respectful, and adolescent-friendly health services should be provided.”

The family should also be made dialogue-friendly and the legal system should be Pradhan suggests that the laws should be reviewed in the best interest of adolescents.

Providing adolescents with knowledge about sexual and reproductive health is not a ‘matter of shame’, but a necessity linked to life, health, rights and a secure future. Hiding information does not eliminate curiosity, but rather increases risk.

The need for sex education

According to advocate Roshana Pradhan, comprehensive sexuality education is not just about teaching reproductive organs or biology. It is the process of providing adolescents with age-appropriate, scientific, inclusive and practical education about their bodies, emotional development, relationships, rights, responsibilities and safe behavior.

It covers topics such as changes in the body, menstruation, hygiene, consent, privacy, gender equality, protection from sexual violence, safe sex, family planning, sexually transmitted infections, HIV, unwanted pregnancy, mental health, self-esteem, life skills and decision-making ability.

Pradhan says, ‘Adolescence is a time of great change in the body, emotions and social relationships. At such times, if accurate information is not provided, curiosity is satisfied from the wrong sources - friends, rumors or uncontrolled Internet content, which increases the risk.

According to him, such education should start from childhood according to age. Body safety, good and bad touch, cleanliness and self-esteem should be taught at a young age, and relationships, consent, contraceptives, rights and responsibilities should be taught in detail during adolescence.

Why is Nepal's curriculum incomplete?

In Nepal, sexual and reproductive health-related content is covered to some extent through health and physical education subjects from grades 4 to 8. But in grades 9 and 10, when this subject is optional or limited, many students do not receive complete information.

According to advocate Navin Shrestha, this age is the most sensitive and curious time. 'Adolescents studying in grades 9 and 10 undergo rapid physical and emotional changes,' says Shrestha. 'Curiosity about sexuality is also higher at this age. But the fact that essential education is not mandatory at such a crucial stage is a serious weakness.’

Shrestha says that despite the subject matter, in practice, teachers are hesitant to teach sensitive topics openly. ‘There is still an environment where students feel shy and teachers feel uncomfortable when discussing topics like condoms, contraception, sexual violence, and gender diversity,’ he says. ‘As a result, the curriculum is limited to paper.’

There is a law, no access

Article 38(2) of the Constitution of Nepal has ensured women’s reproductive health rights as a fundamental right. The Safe Motherhood and Reproductive Health Rights Act, 2075 BS, has also made provisions for adolescent-friendly services. Related guidelines have also been issued.

Advocate Shrestha says that legal provisions alone are not enough. ‘Even though services are available, many adolescents are afraid of where to go, how to get services, whether there will be confidentiality, and whether their families will find out,’ he says.

Many health institutions do not have family planning materials, pregnancy test kits, counseling services, and an adolescent-friendly environment. Access is even weaker for adolescents in rural areas and out of school.

Concerns from the international community

In Nepal’s fourth Universal Periodic Review (UPR) under the United Nations Human Rights Council, various member states have recommended that Nepal further strengthen the rights of adolescents.

They have urged Nepal to ensure access to comprehensive sexuality education for all adolescents, expand sexual and reproductive health services, and review legal barriers.

Iceland said that all adolescents, both in and out of school, should have access to comprehensive sexuality education. Norway emphasized access to age-appropriate, equitable health services, information, and safe abortion for all, including adolescents and sexual and gender minorities. Uruguay recommended expanding sexual and reproductive health services with multisectoral coordination to prevent adolescent pregnancy and child marriage.

Mexico has recommended reconsidering a law that automatically criminalizes consensual relationships between teenagers of the same age. Human rights activists say criminalizing non-exploitative and consensual relationships between teenagers of similar ages does not prevent such relationships, but rather makes them afraid to seek health care, counseling, and legal help.