Advocacy on Bill seeks to let 12-yr-olds have non-penetrative sex is certainly not the right choice - Avnish Jolly

[Guest guest]

Advocacy on Bill seeks to let 12-yr-olds have non-penetrative sex is certainly

not the right choice - Avnish Jolly

 

Although there is increasing evidence of risky consensual sex among young people

in our society, non-consensual sexual experiences among them have rarely been

studied and few interventions have been designed to protect them from the risks

of such experiences.

Bill seeks to let 12-yr-olds have non-penetrative sex is certainly not the right

choice.

However, what is available suggests that coercion and unwantedness may play a

considerable role in the sexual relations of young people — girls and young

women but also boys and young men.

The implications of non-consensual sexual experiences for young people’s

rights, their health and development and the risks they pose in the transition

to adulthood are enormous. At the same time, anecdotal evidence, crime data and

my expearence while working with this group on this issue is disturbing picture

of coerced or unwanted sex and sexual touch among significant numbers of young

people, particularly girls but also boys and young men.

While rape is the most extreme form of non-consensual sex, diverse

socio-cultural settings have documented a broad range of experiences that can be

identified as sexual coercion, including unwanted touch, coerced sex through

threats, and sex in exchange for gifts and money.

 

Although young people who experience sexual coercion/violence should be able to

turn to health care providers, social service agencies and law enforcement

agencies for help that their friends and family cannot provide.

They need compassionate sources of counselling, emergency contraception, STI

treatment and care for other kinds of health problems. In cases of rape, victims

need the services of someone recognised by the courts as qualified to document

evidence with legal validity (in many countries a medical doctor is not

considered qualified to document legal evidence of rape by the law).

In cases where a young woman or man would like to bring charges against a

perpetrator, victims need a competent and sensitised police force and judicial

system. Above all, these services need to be delivered in compassionate and

non-judgmental ways. Unfortunately, throughout the developing world (and many

parts of the developed world), an appropriate institutional response is lacking

(if not non-existent).

In many cases, the experience of seeking help from health care providers, much

less the police, is traumatising and the same negative attitudes towards victims

of violence that permeate the larger society are rampant among the staff of

health care institutions, and even more so among the police and judicial

systems.

Young people themselves appear to be aware of the lack of institutional support.

The majority of rapes are not prosecuted and that more stringent punishment is

needed.

 

Indeed, the response of the health sector, judiciary and law enforcement

agencies can exacerbate rather than ameliorate the negative impact of a coercive

experience (for example, see Heise, Ellsberg and Gottemoeller 1999 and relevant

issues of Human Rights Watch reports such as Human Rights Watch 1999).

While few studies have explicitly explored this issue, studies from India and

Nigeria highlight the fact that the police and prosecutors often fail to address

victims in a sensitive and professional manner, and few reported rape cases

result in convictions (Gangrade, Sooryamoorthy and Renjini 1995; Omorodion and

Olusanya 1998).

 

While working with largely among the unmarried, there is evidence that it is

commonplace among married couples as well. It occurs largely among individuals

who are acquainted with each other.

It covers a continuum of behaviours ranging from unwanted verbal advances to

unwanted touch to assault and forced sex, as well as sex in exchange for money,

gifts, food or protection.

The consequences of sexual coercion are formidable: they are short and

long-term; and have physical, psychological and social effects.

Sexual health manifestations range from unintended pregnancy, abortion and

infection to risk-taking behaviours, including early onset of consensual sex,

multiple partner relations and non-use of condoms. Psychological outcomes range

from symptoms of anxiety and depression to suicide attempts. School performance

can also be affected.

While evidence suggests that sexual coercion may occur at any age, the

circumstances of young people’s lives and the resources at their disposal are

quite different from those of adults, requiring a specific focus on their

experiences and needs. Under certain circumstances, and particularly at the time

of first sexual experience, young people may be less equipped than adults to

avoid non-consensual sex and may have fewer choices available to them when they

do experience coercion.

A number of obstacles inhibit adolescents from protecting themselves from

non-consensual sexual relations and from taking action against a perpetrator or

to withdraw from a coercive relationship. Gender double standards and

expectations of women and men in the sexual arena dominate these obstacles.

Communication and negotiation on sexual matters, moreover, tend to be difficult

and are often replaced by actions that include force and violence to resolve

differences. The lack of a supportive environment and trusted adults and peers

to consult on sexual health matters may also enhance young people’s (and

particularly young women’s) vulnerability to coercive sexual relations. And

finally, perceptions of institutional indifference — at the community, school,

crime and health sector levels — can inhibit help-seeking both among victims

as well as others who may wish to seek counselling on how to confront a

potentially threatening situation.

Moreover, the implications of non-consensual sexual experiences for young

people’s rights, their health and development, and the risks they pose in the

transition to adulthood are enormous.

The World Report on Violence and Health cautions that sexual violence is

complicated by the multiple forms it takes and the contexts in which it occurs,

and by the fact that risk factors may vary in importance according to the life

stage of the victim (WHO 2002).

The report cites a number of factors that may increase the vulnerability of

women in particular to sexual violence, namely young age, alcohol and drug

consumption, previous experiences of abuse, multiple partner relations and

poverty.

Some research has explored the types of structural and environmental factors

that put young people at greater risk of sexual coercion, including poverty,

patriarchy, societal norms that support sexual violence and gender inequity,

early marriage, inadequate educational and health systems, and ineffective laws

and policies.

Most available studies have focused on young women’s — rather than young

men’s — experiences and suggest that young people who

experience non-consensual sexual experiences are more likely than others to

report poor educational attainment, migrant status, residence away from parents,

and alcohol and drug use (see for example, Bohmer and Kirumira 1997; Cheng Yimin

et al. 2001; WHO 2002), although, in some cases these may be consequences of

rather than risk factors for abuse.

Anecdotal evidence points, moreover, to such factors as crowded housing

conditions and the lack of adequate or safe housing as additional, yet

unexplored, factors. While few studies have directly explored beyond these

factors, the context of non-consensual relations described in these largely

qualitative studies offers an insight on the kind of risk factors that make for

a dangerous environment for young people.

Aside from the structural factors noted earlier, these factors work at the

individual, family, community and systemic levels. Prominent among these are

gender double standards, power imbalances and

inadequate negotiation skills, lack of awareness of rights and opportunities for

recourse, lack of supportive environments and trusted adults on sexual health

matters, unfriendly institutional responses (health, crime, legal), and perhaps

most important, a failure on the part of social and legal institutions in the

community to recognise the problem and punish the perpetrators rather than the

victims.

We highlight below what is known in each of these areas.

 

Recommendations

 

The objective is to review what is known about non-consensual sexual relations

and sexual coercion among young people in developing countries.

What is clear is that studies of non-consensual sexual relations and sexual

initiation among young people are sparse. The profile depicted here has relied

on a small, pioneering case studies in selected settings drawn from selected

sub-populations of youth; consequently, findings may not be representative.

Also clear is that existing studies adopt varying and somewhat ambiguous

definitions of non-consensual sexual experiences; and that, as this is one of

the most methodologically difficult and sensitive areas of sexual health to

research, responses to questions in standard survey instruments may not be

entirely reliable.

 

Notwithstanding these very real limitations, the few available studies provide

many common insights and have suggested that although definitions, study

populations and study designs may differ, making comparison difficult,

non-consensual sex is indeed experienced by disturbing proportions of young

people in all settings from which data were drawn. Coercive sex is experienced

largely by girls and women, but also by boys and men, as well as those in same

sex relationships (although the literature on this is sparse).

While sexual coercion has been studied largely among the unmarried, there is

evidence that it is common among married couples as well.

Such incidents occur largely among individuals who are acquainted with each

other. Sexual coercion covers a continuum of behaviours ranging from unwanted

verbal advances to unwanted touch to assault and forced sex, as well as sex in

exchange for money, gifts, food or protection.

The consequences of sexual coercion are formidable: they are short- and

long-term, and physical, psychological and social. Sexual health manifestations

range from unintended pregnancy, abortion and infection to risk-taking

behaviours, including early onset of consensual sex, multiple partner relations

and non-use of condoms.

Psychological outcomes range from symptoms of anxiety and depression to suicide

attempts. School performance can also be affected.

 

A number of obstacles inhibit adolescents from protecting themselves from

non-consensual sexual relations and from taking action against a perpetrator or

to withdraw from a coercive relationship. Gender double standards and

expectations of women and men in the sexual arena dominate these obstacles.

Communication and negotiation on sexual matters, moreover, tend to be difficult

and are often replaced by actions that include force and violence to resolve

differences.

The lack of a supportive environment and trusted adults and peers to consult on

sexual health matters may also enhance young people’s (and particularly young

women’s) vulnerability to coercive sexual relations. Perceptions of

institutional indifference — at the community, school, legal and health sector

levels — can inhibit help-seeking both among victims as well as others who may

wish to seek counselling on how to confront a potentially threatening situation.

 

Programme recommendations

 

Sexual and reproductive health programmes for young people are largely premised

on consensual sex: they often aim to increase young people’s knowledge of safe

sex, advocate abstinence or condom use, and provide sexual health services in

youth-friendly ways. They are not necessarily equipped to deal with the needs of

young people who experience non-consensual sex, whose needs go far beyond

receiving more information on safe sex. At the same time, programmes that deal

explicitly with non-consensual sex are often narrowly defined.

Their focus has tended towards improving the management of the few rape cases

that are actually reported to the police, on the assumption that increasing the

chances of apprehending and sentencing perpetrators will act as a deterrent.

While this is a necessary step, it is not sufficient.

There is a paucity of published literature on programmes that address

non-consensual sex among young people, and the absence of a discussion of these

in this review is a reflection of this sparse information. We acknowledge that

this limitation makes it difficult to draw programme recommendations from this

review. However, the evidence presented in this review underscores a number of

factors that appear to compound young people’s vulnerability to sexual

coercion, and a perusal of these suggest a number of programmatic actions:

• Education, counselling and service activities that address non-consensual

sex among young people must be integrated into existing programmes and extended

to reach places where young people congregate

Non-consensual sexual experiences have major implications for STIs and HIV, for

young people’s health and development, and for their rights. Yet, neither

school activities, nor STI/AIDS prevention programmes nor reproductive health

and family planning services typically address these concerns. Steps must be

taken to fold appropriate prevention and care activities into existing

programmes and facilities, and to reach young people outside of schools and

health facilities — at youth centres, in programmes for the out-of-school and

wherever else they may gather.

• Sexuality education activities must counter traditional gender stereotypes

and equip young people with the awareness and skills necessary to protect

themselves from coercive encounters and to seek appropriate care in case of such

incidents

Evidence suggests that young people may accept sexual coercion as inevitable in

their lives and may not perceive options in practice that enable them to prevent

or seek help for such incidents. Sexuality education must dispel these

misperceptions, reverse ingrained norms of gender double standards, power

imbalances and male entitlement to sex, and reinforce life and negotiation

skills activities that strengthen young people’s ability to protect themselves

from unwanted sexual advances and to take appropriate action should such

incidents occur.

• Sensitise parents, teachers and other trusted adults with whom young people

interact to the importance of communicating about sexual matters with youth and

of providing a supportive and non-judgemental environment more generally

The importance of a supportive environment — and in particular a close

relationship with parents — has been stressed in available studies as a

protective influence. Findings have also suggested that known adult males are

frequently perpetrators of sexual coercion among young people and that fears of

censure from trusted adults inhibit young victims from disclosing a coercive

experience.

Programmes are needed therefore that apprise adults, particularly parents, of

the reality of sexual coercion and the need to communicate with their children

on sexual matters, and to provide their children a supportive environment where

they can raise sexual health concerns.

Train providers to identify adolescent victims, to understand the links between

sexual violence and health and rights, and to provide them sensitive

counselling, appropriate services and safe options

Case studies suggest that many health providers have negative attitudes towards

those who experience sexual coercion/violence (for example, see Guedes et al.

2002).

These findings suggest the need to train health providers to recognise and

enquire sensitively about sexual abuse. Ideally, health providers should be able

to Non-consensual sexual experiences of young people:

A review of the evidence from developing countries provide appropriate

counselling and services that enable young victims to deal with the incident,

and assist others who may not have experienced the “tip of the iceberg†in

protecting themselves from further and even more severe forms of coercion.

They also need to know how to provide emergency contraception and basic

referrals to available competent and compassionate community services (including

the police) to help young people who have experienced sexual violence.

Avnish Jolly,

#3008,Sector-20D,

Chandigarh 160020, India.

Cell: +91-9814213809