7.1. SEXUAL HEALTH RIGHTS

7.1.1. INTRODUCTION

According to the WHO (n.d.), sexual health requires a positive approach on sexuality and sexual relationships, and the possibility of having sexually safe and pleasurable experiences, free of any type of discrimination, violence, or coercion. The ability of achieving sexual health depends on access to comprehensive, good-quality sex education (about sex and sexuality), access to information on safe sex, types of protection and possible consequences of unprotected sex, access to health care specialists and living in an environment that supports and protects sexual health. The same organization mentions possible sex related issues that result as a lack of application of sexual health rights. Among those possible issues are unwanted pregnancies and abortions, sexual violence, sexual disfunction, harmful practices (such as female genital mutilation), infections with the HIV, STD, STI, and problems with the reproductive tract.

7.1.2. DEVELOPMENT OF THE TOPIC

7.1.2.1. Laws and policies on sexual health

Laws and policies of sexual health can include:

• Policies related to STD and STI prevention and treatment.
• Policies ensuring access to information and sexual health care services for everyone.
• Reproductive Health and Planned Parenthood laws.
• Policies related to prevention, destigmatising, and treatment for HIV patients.
• Policies related to health care (not necessarily sexual health care).

When it comes to sexual health rights, sexual orientation is a big factor that can affect the accessibility of these rights. Social, cultural, and legal background can all be elements that offer or have your access denied to sexual health care, prevention and contraceptives, access to information, marriage, etc. There are currently 69 countries in the world that criminalise homosexuality, some of them punishing it with the death penalty. In addition to this, six of these countries are part of the United Nations (UN) (Byrnes, 2019). This criminalisation is denying people’s rights to be themselves, to have access to health care and can often come with other forms of discrimination, such as the interdiction to donate blood/to work in a specific place, etc.

Gay people (and people of the LGBTQ+ community) are being silenced in these countries by being forced to choose between expressing their identity, and their safety. Being pushed to hide their identity, more often than not, these communities do not have access to sexual health care, sexual health prevention instruments or information out of the fear of being discovered and sent to prison or to the death penalty depending on the country. This isolation is possibly pushing them towards unsafe practices and exposing them in vulnerable situations. Even though this might seem extreme and isolated cases, it is the daily life of the LGBTQ+ community in 69 countries, showing how basic human rights (such as access to health care) are being violated on a daily basis.

Even if in most countries non-normative sexual orientations and sexual expressions are not technically illegal, they are being stigmatised and seen as a reason for discrimination.

During the 1980s and 1990s when the HIV/AIDS epidemic spread through products used from donating blood, the health authorities created special policies that required “high risk behaviour” patients to not donate blood. Those patients that were perceived as being high risk were gay and bisexual men. Although it has been over 40 years since that happened, there are countries nowadays where donating blood as a gay or bisexual men is forbidden/illegal.

This stigmatization came from associating the gay community with the HIV virus out of lack of information and fear, and it also showed the whole world the level of isolation fear can take us. According to the Thomas Reuters Foundation Research (2020), Croatia, Ukraine and Iceland were among the countries banning blood donation for gay and bisexual men (Ohlen, 2020).

This stigma and its perpetuation contribute to the increased violence against the LGBTQ+ community around the world. The circle of misinformation (consisting of spreading the information without verifying, discriminating/isolating LGBTQ+ community members and violence) is denying access to basic human rights and sexual health care.

You can read more about sexual health on the topic 3.

7.1.2.2. Mental health

This stigmatization and isolation of certain groups is creating more distance between majority and minority groups, because often non-normative practices and people are being isolated (for example gay men from donating blood) and denied access to comprehensive sexual health care. This is enforcing cisheteronormativity and having an impact on the mental health of people who are stigmatized or reduced to a stereotype. Seeing this societal disapproval and that sexuality, sexual orientation or gender can change someone’s behaviour towards a person or can deny that person’s access to sexual health clinics, or sexual health care services can negatively impact someone’s mental health. Anxiety, isolation, and depression can be a few of the possible consequences of these practices.

When teaching children/teens about sexual health rights it is important to clarify that everyone should have access to these rights regardless of their sex, sexual orientation, gender, or any other form of discrimination that people can experience due to their traits, social status, etc. You could spend some time to deconstruct stereotypes, sexual stigma and offer sources of information. Try explaining how spreading rumours or not checking information can contribute to the stigmatization and isolation of certain groups and how this could be avoided with a bit of research from their side.

7.1.2.3. Deconstructing sexuality and sexual health stigmatization

Myth: HIV is the same thing as AIDS

As it is noticed right from the name, the Human Immunodeficiency Virus (HIV) is the virus while the Acquired Immunodeficiency Syndrome (AIDS) is the disease (WHO, 2020). Being diagnosed with HIV does not automatically mean that you have AIDS. While this virus was heavily attributed to the gay and bisexual community during the 80s-90s epidemic, studies have shown that it anyone engaging in oral, vaginal, or anal sex can be exposed to it. After being diagnosed, people can live their life as they used to with the help of medication and regular check-ups. Moreover, when taking the medication regularly, the virus load decreases significantly up to the point where it cannot be transmitted anymore. Meaning that even though one might be diagnosed with HIV, when engaging in protected sex, the virus cannot be transmitted. Thus, even the name “acquired autoimmune deficiency syndrome” hints to the fact that AIDS can be the result of not getting tested or not taking the medicine and it is something that can be avoided.

Instead of letting fear or misinformation guide children/teens, try to explain how and why HIV was associated with so much stigma and that being informed and going to regular check-ups is a thing anyone can (and should) do for their sexual health.

Myth: STD tests are only for those who have multiple sexual partners

STD tests and STI tests are for everyone who is sexually active. The number of sexual partners does not indicate the chances of catching an STD/STI but engaging in unsafe or unprotected sex can do it. When starting your sexual activity, getting tested regularly for STDs can benefit both you and your partner(s).

Getting tested for STDs can be seen as a form of self-care and awareness towards your body and your mental health. Stigmatizing STDs because sex is considered taboo (in most societies) is contributing to the belief that if you do not see/feel anything wrong, you do not have any STDs or STIs. This is completely untrue as you can be a carrier of an STD without it being activated in your body. This means that it can stay in your body up to a certain amount of time and it can be given to other sexual partners, where it might activate, making them develop symptoms or it might be inactive. Depending on the STD the incubation period differs. The main idea is that having an STD is not necessarily visible and the absence of physical symptoms does not mean you do not have any. This is why STDs and STIs tests are an important part of sex education and sexual health care.

Getting tested for STDs and STIs can be done in sexual health clinics, in hospitals, at your doctor or even at home through self-testing kits that are sent to be analysed in a laboratory after.

Myth: Having and STD makes you “dirty”

Studies have shown that more than half of the people in the world had or will have an STD at some point (STD Statistics, 2022), making STDs part of our life. Often, these people might not even know it because of the absence of physical symptoms. By staying informed, getting tested and practicing safe sex the chances to catch an STD and to spread it are significantly lower. However, there are still some STDs that can be spread even through protected sex (e.g., human papilloma virus).

Teaching children/teens about safe practices involves teaching them about STDs and STIs and how they can protect themselves. Stigmatizing these diseases or infections only because they are related to sex can contribute to an unsafe environment and the spreading of misinformation.

Myth: Bisexual and gay people have more chances of getting and STD

Sexual orientation does not define the likeliness of catching an STD. However, as it was mentioned before, unprotected, and unsafe sex practice can do that. Regardless of the gender and the sexual partners, prevention and protection can be your best friends when it comes to STDs and STIs.

Knowing what sexual health means is the first step for children/teens to acknowledge and advocate for their sexual health rights. Making sure that they are informed, contributes to the way they perceive sex, sexual health and the stigma attached to certain non-normative practices. This can later contribute to their advocacy for better sexual health care and respect for the sexual health rights of all.

– 7.1.3. SITUATIONS OF DISCRIMINATION RELATED TO THE TOPIC –

A teenager that identifies as bisexual and queer does not access to information related to sexual health and protection when it comes to being sexually active with more than one gender. In school, they do not receive a sex education class and all of the material they tried to read that was available where they had access without exposing their sexual identity, was written from a heteronormative point of view. They did not know any other queer/bisexual people in person because they are not out when it comes to that aspect of their life, so they keep postponing having talks with possible partners because they are embarrassed for not knowing how they can protect themselves.

As an educator, making sure resources are available to everyone is a starting point or encouraging sexual health and acknowledging one’s own sexual health rights. If there are no printed material available, online sources can be suggested (books, blogs, groups, social media accounts, etc.).

7.1.4. BEST PRACTICES

7.1.4.1. Discuss and advocate for sexual health rights

Options for talking about sexual health rights and diversity in sexuality and gender could be:

• Talking to experts

Learning from experts in the field, activists, people working with gender equality and sexual health rights on a daily basis can increase student’s interest in knowing and defending their rights, by also increasing their motivation to advocate for the accessibility of these rights for everyone.

• Sex education workshops/games

Teaching about sexual health rights can be also done through workshops or games. By using age-appropriate language, you could start teaching about sexual consent, laws and policies related to sex and sexuality, checking on one’s sexual health, etc.

• Anonymous questions

Allow students to write down anonymous questions related to sexual health rights and answer them in front of the class. You could even organise a debate or ask if anyone knows the answers.

Offering access to resources, trying to discuss the topic of sex, sexual health and sexual health rights can be some of the measures that can help guiding children/teens towards answers. It can be a space specifically created for this talk, or it can be integrated in daily life conversation.

7.1.5. REFERENCES

Byrnes, H. (2019). 13 countries where being gay is legally punishable by death. USA TODAY. Retrieved from https://eu.usatoday.com/story/money/2019/06/14/countries-where-being-gay-is-legally-punishable-by-death/39574685/.

‌Ohlen, R. S. (2020). What are the blood donation rules globally for gay and bisexual men? Reuters. Retrieved from https://www.reuters.com/article/us-global-lgbt-health-factbox-trfn-idUSKBN22N2GS.

STD Statistics (2022). Retrieved from https://www.stdwatch.com/learn/std-statistics#what-are-the-most-common-stds-by-percentage.

WHO (2020). HIV/AIDS. Retrieved from https://www.who.int/news-room/questions-and-answers/item/hiv-aids.

WHO (n.d.). Sexual health. Retrieved from https://www.who.int/health-topics/sexual-health#tab=tab_3.