Abstract
This article explores the mismatch that exists between what unmarried adolescents in Bangladesh experience, want and need in regard to their sexuality and what they receive from their society, which negatively impacts on their understanding of sexuality and their well-being. The findings provide a picture of Bangladeshi adolescents' (12–18 years) sexual feelings, experiences, behaviours, anxieties and concerns – in particular in relation to desire, pleasure, sexual power, masturbation, virginity, romantic love and dating, and arranged marriage – and how socio-sexual norms and taboos influence these. Curiosity of boys and girls about sex was driven by a need and desire to know and understand, but also because it was exciting to read about and talk about sex. Young people are not just passive recipients of adult norms and messages around sexuality, but agents who actively construe meanings and navigate between what is expected from them and what they want, need and feel themselves. Adolescents have a need for information and support – long before they ever have sex. We call for a positive, rights-based approach to sexuality education for adolescents and a focus beyond health outcomes alone to support adolescents and young people to make sense of the multiplicity of messages they encounter and reduce unnecessary feelings of guilt and anxiety.
Résumé
L'article analyse l'inadéquation entre les souhaits et les besoins des adolescents célibataires au Bangladesh pour leur sexualité et ce qu'ils reçoivent de leur société, qui influence négativement leur compréhension de la sexualité et leur bien-être. Les conclusions brossent un tableau des sentiments, des expériences, des comportements, des anxiétés et des préoccupations des adolescents bangladeshis (12–18 ans) en matière de sexualité, en particulier par rapport au désir, au plaisir, à la puissance sexuelle, à la masturbation, à la virginité, à l'amour romantique et aux rencontres, ainsi qu'au mariage arrangé, et décrivent l'influence des normes et des tabous socio-sexuels. La curiosité des garçons et des filles sur la sexualité était stimulée par un besoin et un désir de connaître et de comprendre, mais aussi parce que c'était excitant de lire et de parler de sexe. Les jeunes sont non pas des destinataires passifs des normes et messages des adultes sur la sexualité, mais des agents qui interprètent activement les significations et naviguent entre ce que l'on attend d'eux et ce qu'ils veulent, ce dont ils ont besoin et ressentent eux-mêmes. Les adolescents nécessitent des informations et un appui, bien avant d'avoir des rapports sexuels. Nous recommandons une approche positive, fondée sur les droits, de l'éducation à la sexualité pour les adolescents, la priorité allant au-delà de l'état de santé pour aider les adolescents et les jeunes à comprendre la multiplicité de messages qu'ils rencontrent et pour réduire les sentiments inutiles de culpabilité et d'anxiété.
Resumen
En este artículo se explora la incongruencia que existe entre lo que las adolescentes solteras en Bangladesh experimentan, desean y necesitan con relación a su sexualidad y lo que reciben de la sociedad, lo cual tiene un impacto negativo en su entendimiento de la sexualidad y en su bienestar. Los hallazgos ofrecen un panorama de los sentimientos, experiencias, comportamientos, ansiedades e inquietudes sexuales de las adolescentes (de 12 a 18 años de edad), en particular con relación al deseo, placer, poder sexual, masturbación, virginidad, amor romántico, citas románticas y matrimonio concertado y de cómo las normas sociosexuales y tabúes influyen en estos. La curiosidad de los niños y las niñas respecto a las relaciones sexuales fue impulsada por la necesidad y el deseo de conocer y entender, pero también porque era emocionante leer y hablar sobre sexo. Las personas jóvenes no son simplemente destinatarias pasivas de normas y mensajes de adultos respecto a la sexualidad, sino agentes que interpretan los significados y navegan entre lo que se espera de ellas y lo que desean, necesitan y sienten. La adolescencia necesita información y apoyo, mucho antes de empezar a tener sexo. Hacemos un llamado a formular y aplicar una estrategia positiva, basada en derechos, de educación sexual para adolescentes y a centrarse más allá de los resultados de salud para apoyar a la adolescencia y la juventud para que puedan entender la multiplicidad de mensajes que encuentran y disminuir sentimientos innecesarios de culpabilidad y ansiedad.
Increasingly, young people are being involved more actively in sexual and reproductive health and rights (SRHR) programmes that target them. Young people themselves call for this involvement, and there is a growing realisation that their participation is not only their right, but also contributes to improving the effectiveness of interventions that target them. At the same time participatory processes help to build youth–adult partnerships and empower young people to be active citizens who contribute to social change.
Improving young people's access to sexual health information and services is critical. There is a real need to reach adolescents and young people with sexual and reproductive health information and services that respond to their realities and needs. This is necessary for public health reasons, like the prevention of unwanted pregnancies and sexually transmitted infections including HIV, as well as for supporting a healthy sexual development in children, adolescents and young people and counteracting misconceptions, fears and insecurities that arise through incomplete and incorrect information on sexuality.
Despite the importance of sexuality education and services for young people's healthy sexual development and well-being, health-related arguments for work on young people's sexual and reproductive health dominate and dictate that we evaluate the effectiveness of interventions in terms of specific health outcomes and safer sexual behaviour. Such discourses also problematize young people's sexual behaviour and leave little room for more positive and rights-based approaches which accept sexuality as a normal and positive aspect in all phases of a person's life, enabling (young) people to explore, experience and express their sexuality in healthy, positive, pleasurable and safe ways. This can only happen when the sexual rights of young people are respected.Citation1 A rights-based and sex-positive approach leads to inclusion of outcomes such as empowerment and reduction of gender inequality, sexual violence, shame, fear and insecurity, discrimination and stigma.
This article presents the findings from a participatory research project entitled “Do They Match?” in which a team of eight young people (17–23 years) in Bangladesh were trained and supported to conduct qualitative research about sexual culture among adolescents aged 12–18 and their access to information and services in Jessore, a city in the northwest of Bangladesh. The research aimed to gather insights into adolescents' realities, what they want and need and the barriers they experience in accessing information and services. The findings were used to formulate recommendations for strategies to increase the uptake of services by adolescents.Citation2
The research was carried out within the context of a comprehensive youth programme run by the Family Planning Association of Bangladesh (FPAB) in Jessore. The programme includes a youth-friendly sexual and reproductive health service centre called Tarar Mela, which provides information and services by youth counsellors under the age of 24 years; a peer education programme; community-based activities aiming to create an enabling environment and community support for the programme; awareness raising; and addresses issues such as early forced marriage.
Methodology
Four young women and four young men (aged 17–23 years) were selected from a group of peer educators active as volunteers for the youth programme of FPAB to become co-researchers in the research project. These eight young people came from four different districts where FPAB is working and were selected on the basis of their performance as peer educators and their letters of motivation. All were unmarried. They underwent an intensive two-week qualitative research skills training, and the research plan and interview questions were developed together with them. Data were collected among young, unmarried adolescents (aged 12–18 years) through focus group discussions (FGDs), in-depth interviews, observations, and content analysis of what adolescents indicated as sources of sexuality information (written and media). The research methodology is described in more detail in another paper from this study, which is about “eve teasing”, published in the same issue of Reproductive Health Matters as this one.Citation3
In this paper, we report on an analysis of questions raised by adolescents visiting the youth centre through the centre's questions box, and provide examples of those questions. We also describe what adolescent visitors to the youth centre had to say when we presented eight hypothetical cases (four for girls and four for boys) to them of experiences related to sexuality, based on data collected during earlier stages of the research and representing actual experiences of study participants.Citation4
During the research project, the youth research team presented their preliminary findings to panels of stakeholders, consisting of community leaders, parents, school teachers, health clinic personnel and staff members of the Family Planning Association of Bangladesh. Together they discussed the findings and developed recommendations for adolescent sexual and reproductive health interventions, which are presented in the discussion section of this paper. The stakeholders provided their views and opinions on the findings, enabling triangulation of the data. The workshop was facilitated by the research coordinators to encourage open and mutually respectful discussion and bring together the young people's insights and creative ideas and the stakeholders' and staff experience and realistic views.
One of the major reasons for the decision to train and work with young people as co-researchers was Rutgers WPF's positive experience with involving young people in the collection of qualitative data for monitoring and evaluation purposes. Compared to adults, it is easier for young researchers to create a safe environment for open and honest discussions with other young people on sexuality issues and to collect data that give a more truthful representation of what is really happening in the lives of young people, from the perspectives of young people themselves. Young informants find it easier to relate to and identify with young researchers and feel less judged and restrained to talk about sexuality issues. Other reasons include the effects such participation in research has on individual and group empowerment and on the establishment of youth–adult partnerships within sexual and reproductive health and rights organisations, which can encourage meaningful youth participation in projects that affect them. In our experience, such youth participation is a means to improve programmatic learning, programme effectiveness and sustainability.Citation2 Footnote*
Findings
Feelings relating to sexuality among adolescents in Bangladesh
In the focus group discussions and interviews, the adolescents expressed a multitude of feelings they had experienced in relation to sexuality, most notably curiosity, desires and pleasure, and feelings of insecurity and concerns.
Girls expressed curiosity in relation to virginity, menstruation, sexual power, sexually transmitted diseases, and homosexuality. Many girls expressed worries and various misconceptions about the issue of virginity and were insecure about their ability to prove their own virginity. Some older girls wanted to know of ways a girl could increase her sexual power to please men. The words “sexual-power” were used to express concerns or ideas about the ability to perform sexually and give/get pleasure. The girls were curious about this because they felt insecure about their ability to please their future husbands sexually. They related this to the concern that if a wife cannot satisfy her husband, the husband will go to a sex worker or have extramarital sexual relationships.
“I have heard husbands go to other women if the wife cannot give him sexual satisfaction.”
Some girls expressed their desire to experience sexual excitement through talking about sex, through listening to stories about sex from married friends or relatives of the same age, and through watching erotic images or films. Although the girls looked for ways to experience excitement and arousal, they emphasised that they would wait to have sexual intercourse until they got married.
Boys on the other hand mentioned a strong curiosity about the female body and sexual intercourse. They were curious about masturbation and wet dreams and about the size and shape of the penis and duration of intercourse. Many of the boys mentioned their desire to have romantic relationships with girls, kiss them and get closer to their bodies. Boys expressed a desire to see women's breasts and genitals and to watch other people having sexual intercourse. The older boys said they felt an “overwhelming desire” to have sexual intercourse. Expression of this desire was found across the groups from slums to orphans, from rural illiterates to college-going boys. A few older boys said that they even wanted to get married early mainly to experience sex, because there were no obstacles to having sex for married couples. The research team found that the groups of boys from the slums admitted to sexual activities more than any other group. The boys who mentioned experience of sexual intercourse mostly had this experience with sex workers. One group of slum boys mentioned sexual experience through gang rape. Many boys mentioned finding sexual excitement and pleasure through sexually harassing and “eve teasing” girls in public places (described in the other article in this issue).Citation3
Sexual insecurity and concerns
Curiosity of boys and girls about sex was driven by a need and desire to know and understand, but also because it was exciting and physically arousing to read about, watch and talk about sex. Curiosity also seemed to be driven by the insecurities and concerns that young people have about their own bodies and (future) ability to perform sexually. Insecurities and concerns are fed through the taboo on sexuality and adolescents' lack of access to correct and complete information. There is no sexuality education in the government school curriculum in Bangladesh,Footnote* and in general sexuality is a taboo topic to discuss with unmarried young people. Their insecurities and concerns in turn encouraged the adolescents to look secretively for sources of information on sexuality, for which they relied mainly on peers, the media (erotic books, music, films) and (for boys) street canvassers. Some of the boys and girls said they watched pornography at internet cafes. All the boys said that watching pornographic clips on mobile phones was a common practice, bought at mobile phone shops for a few Taka. Street canvassers are quacks who sell medicines (biomedical to herbs to amulets) in the streets. They are known for their charismatic way of selling and are very popular, predominantly with men and boys, as it is culturally inappropriate for women and girls to stand among men while someone is talking about sexuality issues. The canvassers provide a range of unrealistic and false information regarding the size of the penis, duration of intercourse, masturbation, wet dreams, menstrual pain, signs and symbols of virginity, shapes of breasts, the hymen and so on. Street canvassers make use of misconceptions and exaggeration to sell their medicines, which they say will increase sexual power and penis size.
The most commonly mentioned concerns and insecurities that were mentioned by the adolescents, or raised through the questions box were the following:
Masturbation and wet dreams
Most of the boys, both older and younger, mentioned that they masturbated regularly. Most of them, however, worried that due to masturbation their penis might get deformed and their bodies would become weak. This fear came from the common belief that 40 drops of blood are needed to create one drop of semen. As such, boys believed that masturbation and wet dreams could negatively influence school performance, physical strength and sexual and reproductive power. In general, boys felt bad for having wet dreams and a number of them said they felt guilty after masturbating.
All the girls said that they had heard about girls masturbating but they themselves had not tried it. Almost all of them had heard that girls masturbate using eggplants, bananas, carrots, cucumbers, soda bottles, etc. Reasons for not masturbating related to their fear of damaging their hymen and losing their virginity before marriage. Some girls may also simply not have dared to admit they masturbated. A wide range of guilty feelings about masturbation were expressed by the youth of both sexes.
Many of the questions that were dropped into the youth centre's questions box were about masturbation and wet dreams. Some examples of questions were:
| • | Wet dreams result in scars on the penis, how can I prevent that? | ||||
| • | Does a wet dream take out all the energy of the body? | ||||
| • | How can I stop wet dreams and hold semen back in my body? | ||||
| • | Is masturbation bad for health? | ||||
| • | What are the consequences of masturbation? | ||||
Virginity
Girls mentioned that they had heard about the hymen being broken during first sexual intercourse and that blood was shed from the vagina as a result. According to them if a girl does not bleed on her nuptial night, it indicates that she has had sexual intercourse before marriage and is not a virgin. If she does not bleed and prove she is a virgin, this creates a substantial amount of problems ranging from abuse by the husband and community to family shame and stigmatization. It can even have financial consequences relating to dowry payments. Some girls also said that their bodies can be considered the property of their future husbands. Allowing others access to their bodies now was considered by these girls as cheating on their future husbands, giving something away to others that was not theirs to give away. Keeping their virginity was a serious matter and a preoccupation for all the girls.
A common misconception among both sexes was that breasts grow when touched by boys. So having relatively big breasts before marriage could indicate impurity and loss of virginity. This belief caused distress for a number of girls who were physically well-developed.
Sexual power
The boys had various concerns and ideas about “sexual power”, which included sexual stamina and libido. The boys thought that it was possible to increase sexual power by drinking hot milk and by taking a particular pill which the street canvassers sold (this quack pill is known locally as sreebori). They believed that if sexual power could be enhanced, a man could have sexual intercourse with a woman without ejaculating for an hour. The boys also believed that in order to have more sexual pleasure for themselves, they needed a bigger penis. Longevity of penetration and a big penis were seen as signs of masculinity which indicated the sexual power of a man.
Many of the questions that were dropped in the questions box related to sexual power and size and shape of genitals. Some examples of questions were:
| • | How can a boy enlarge his penis? | ||||
| • | What is the reason for having a distorted shape of penis? | ||||
| • | What is the treatment for penis distortion? | ||||
| • | How can I make my penis healthier? | ||||
| • | What is the normal size of a penis? | ||||
| • | What is the level of girl's sexual power? | ||||
Menstruation
Girls said there were some taboos in relation to food and mobility during menstruation. They believed that they should not eat fish, meat or eggs during menstruation. They should also not eat sour fruits or turmeric spice during menstruation, as these would cause excessive, odorous bleeding. The girls also believed that during menstruation girls should not touch anyone, and should not go outside at certain times in order to avoid being affected by a “bad wind” (evil spirit), which could also cause excessive bleeding. Many Bangladeshis, both in rural and urban areas, consider menstrual blood to be impure, and that bad spirits are attracted to dirty things.
Romance and dating
Boys and girls mentioned that they were afraid of getting involved in romantic or sexual relationships. The boys said society had a negative attitude towards premarital romance. According to the boys, adults think that romantic love may lead to sexual relations, which are prohibited before marriage. As a result families have no tolerance for romantic relationships between young people. The girls mentioned that if they were found to have love affairs, the reputation of their families would be damaged. They thought this might hamper their future marriage prospects, as girls who had a history of love relationships found it difficult to get a bridegroom and also needed to pay more dowry than others. For the orphaned boys and girls, it was not only the family or society that worried them, but that they might be expelled from the orphanage if the authorities found out that they were involved in romantic relationships.
“If someone falls in love and people get to know about it, she will be punished, as if it is a crime.”
The boys said that they mainly chatted, hugged, and held hands with their girlfriends when they dated. Some of them mentioned kissing, or caressing the girl's breasts too. The girls similarly mentioned kissing, chatting and hugging as the main dating activities, and they said some boys even touched their genitals. Girls also mentioned that boys caressed girls' breasts during dating. Both boys and girls said sexual intercourse during dating was rare but not unheard of. Some girls used the burkha (veil) to hide themselves while dating. Even if they did not have their own burkha, they would borrow one from a friend who had one.
Boys and girls who were involved in romantic relationships were afraid to get caught and were also afraid to lose the person they loved when forced to marry someone else through an arranged marriage.
Responses to hypothetical cases
We presented 12 boys and 12 girls who visited Tarar Mela with hypothetical cases (separate ones for boys and for girls) related to the issues raised by adolescents during our research. For the girls, the four cases were: (i) a girl who has experienced sexual harassment that is followed by threats after she refuses a love proposal, with the girl fearing for her reputation, (ii) a girl being made to stay at home for fear of bad spirits during her menstrual period, (iii) a girl who is feeling guilty and afraid of unintended pregnancy and sexually transmitted infection after unprotected pre-marital sex, and (iv) a girl who is afraid of masturbation and losing her virginity. For the boys the cases were: (i) a boy who is feeling guilty and afraid of unintended pregnancy and sexually transmitted infection after unprotected pre-marital sex, (ii) a boy who is caught dating and is afraid his loved one will have a forced marriage, (iii) a boy with insecurities about masturbation and its effects on sexual power, and (iv) a boy with insecurities about the size and shape of his penis and the length of sexual intercourse.
With each case we asked them whether the youth centre could help the young people involved with their worries and if so, how.Citation4 In their responses, many of the boys and girls thought that the Tarar Mela counsellors had an important role to play in many ways. They could provide clinical services as required; demonstrate condom use for safer sex; provide counselling and support in cases of sexual harassment or threat of forced marriage (many also advised that counsellors should involve the parents in such cases); provide correct information for both boys and girls to correct misconceptions about menstruation and menstrual taboos, about virginity, about sexual power and the fact that masturbation is normal and has no ill effects. In the case of superstitions around menstruation, the girls advised that parents should also receive counselling as they were the ones keeping girls inside to avoid bad spirits. All boys and girls saw a role for Tarar Mela staff in relation to all the cases presented and suggested to include taking up these issues in the services provided by FPAB.
Nevertheless, while most of the boys and girls said that counsellors should provide this advice and information, e.g. that masturbation is normal, many of these same boys and girls also said that the counsellors should advise the boys and the girls in the hypothetical cases to control their sexual desires and refrain from watching pornography. A few of them even said that the counsellors should say that masturbation is a bad thing. Nine of the 12 boys and three of the 12 girls said that the counsellors should tell young people that pre-marital sex is wrong and prohibited by Islam. And five of the 12 boys thought counsellors should advise the boy who got caught dating and feared to lose his girlfriend to stay away from her and not to fall in love again. Only one girl mentioned that Tarar Mela counsellors should console the girl who had premarital sex by saying that “making mistakes is natural for people” so that she would feel better.
So despite having been given correct knowledge on, for instance, masturbation, and having romantic and sexual feelings themselves (and acting on them), deeply rooted norms that sexual desire and activity are taboo before marriage prevailed and resulted in conflicting messages and recommendations even when they contradicted the actual behaviour of the boys and girls concerned.
Discussion
What do these findings mean for adolescent sexual and reproductive health and rights promotion in Bangladesh? The findings illustrate the immense gap between the experiences, feelings and needs of Bangladeshi adolescents regarding sexuality on the one hand, and what they are actually receiving in terms of information, services and guidance on the other. The findings show young people do not just accept and follow adult norms and messages around sexuality, but actively construe meanings and navigate between what is being expected from them and what they want, need and feel themselves. Even though many adolescents actively repeat adult normative discourse, most of the unmarried adolescents in our study created ways to actively express their curiosity about sexuality and looked for ways to experience romance, eroticism and pleasure despite religious prohibition and fear of social stigma and punishment. To manage these conflicting norms, messages and expectations, adolescents kept their activities secret and outside the control of adults, and girls especially created constructions of “bad love” versus “good love”, whereby bad love involved sexual intercourse whereas good love involved romance resulting in marriage. However, these contradictory norms, messages, feelings and activities resulted in feelings of guilt and anxiety.
The questions asked and responses to the hypothetical cases by both the boys and girls show how important it is to recognise and accept their curiosity, desires and feelings as a normal part of healthy sexual development during adolescence. While social taboo and stigma serve to control young people's sexual activities and prevent pre-marital sex, the research shows that this has negative consequences for adolescents' sexual well-being. Because access to correct information and services is limited, boys and girls suffer from insecurities and often unwarranted concerns about their own bodies and sexual functioning. They feel afraid and guilty when having sexual and romantic feelings and desires, and they suffer from not being able to be with a romantic partner. Boys turn to expressing their feelings through the few, sometimes harmful channels that are open to them – going to sex workers, eve-teasing and sexual harassment.Citation3 The question is whether and how far their lack of information, understanding, anxieties, guilt feelings and lack of confidence stay with boys and girls into adulthood and influence their ability to enjoy sex in positive, pleasurable, mutually respectful and safe ways.
We therefore argue that a sex-positive, rights-based approach towards young people's sexuality will help to bridge this gap, and will do so better than a health-focused approach alone. Currently many governmental and non-governmental organisations and institutions that promote sexual and reproductive health, in Bangladesh and elsewhere, do so on the basis of public health arguments and focus on improving health outcomes such as reduction of STIs, unwanted pregnancy, unsafe delivery and maternal mortality. Sexuality education within this framework is often understood as a way to increase knowledge and risk perceptions relating to health dangers. And services focus primarily on sexually active people with a need for contraception or medical care. While this too is necessary, as other research has shown a lack of knowledge among adolescent girls on reproductive and sexual health matters,Citation7 it is not sufficient alone.
But the adolescents in this study, like many other adolescents in the world, have a need for information and support – before they ever have sex – to make sense of the multiplicity of messages they encounter and to reduce unnecessary feelings of guilt and anxiety. Those in need of clinical or counselling services should also be able to access these without fear of being stigmatised by those they turn to for help.
Developing recommendations through participatory meetings
During the research project, the youth research team presented their preliminary findings to panels of stakeholders, consisting of community leaders, parents, school teachers, health clinic personnel and staff members of the Family Planning Association of Bangladesh (FPAB). Together they discussed the findings and thought of recommendations for adolescent sexual and reproductive health interventions. Holding those discussions was not easy. For many of the participants this was the first time they had talked about sexuality in a formal setting, let alone with young people. As one of the community stakeholders said: “Today, after 30 long years, this is only the second time I'm hearing a discussion on sexuality issues or speaking about it myself.” Some stakeholders raised concerns about the age of the informants, as they thought the adolescents were too young to discuss sexuality. Yet their concerns created discussion that opened up a dialogue and in this process the stakeholders accepted the research findings as the reality on which they had a responsibility to act.
One important outcome of these stakeholder meetings was consensus on the need for sexuality education. Community members mentioned they were willing to support FPAB's project activities, and teachers invited FPAB to come into their schools to provide education. Nevertheless, they pointed out the importance of having sessions with parents too, and the importance of involving religious and opinion leaders as well, to address misconceptions about and objections to sexuality education for adolescents. A study in 2006 found positive attitudes among parents towards introducing reproductive and sexual health education in schools. Nevertheless, it also found a serious lack of knowledge among parents on reproductive and sexual health matters, and some parents had reservations about their children receiving this education. We support that earlier study's conclusions that making parents more aware of these matters and developing their communication skills, so they can talk to their children, along with in-school education, should be given high priority.Citation8
The Tarar Mela youth centre and its youth counsellors have been very successful in addressing adolescents' real needs and lowering the barrier for them to access information, counselling and sexual and reproductive health services. However, Tarar Mela is at a fixed location and for many adolescents it is difficult to reach. Recommendations were made for ways to mobilise youth counsellors and bring services to young people through outreach. However, conducting field activities on sexuality issues in the community is challenging for FPAB staff, as they face a lot of resistance from the adult population, which may be damaging for their reputation, thereby making it even harder for young people to access the youth centre and FPAB services. Considering the extent of the barriers to providing youth-friendly services, it is quite an achievement that young people are now coming to FPAB and Tarar Mela, while before they were not.
FPAB are increasing their adolescent sexual and reproductive health programmes with more sexuality education and community activities, and training more staff, youth volunteers and youth counsellors, following a sex-positive approach. But these processes are intensive and cannot easily be scaled up by them alone.
The stakeholders, young people and sexual and reproductive health and rights specialists also formulated recommendations for developing interventions making use of modern media, as this is already a popular way for Bangladeshi adolescents to access sources of information on sexuality. Peer educators could use mobile phone clips with correct and relevant information to blue-tooth to their peers. The youth counsellors are already experimenting with telephone hotlines to provide advice to callers – though they are experiencing a lot of abusive calls as well, especially the female youth counsellor at Tarar Mela.
Following this sex-positive and rights-based approach FPAB and 50 other organisations in four Asian and five African countries, united in the Dutch Sexual and Reproductive Health and Rights Alliance, have developed programme and monitoring frameworks that include measuring results on sexual well-being outcomes like empowerment and reduction of gender inequality, sexual violence, fear and insecurity, discrimination and stigma.Footnote* We feel that effects on these outcomes carry equal weight to public health outcomes (that are also measured) and have an impact on those health outcomes in time.
Youth participation is an integral part of a rights-based approach towards young people's sexuality and contributes to bridging the gap between realities, needs and interventions. We hope we showed through this research project how involving young people to conduct qualitative research has contributed valuable insights into adolescents' sexual culture. Youth participation in research can increase our understanding of youth culture, adolescent sexual behaviour and needs. This understanding is relevant to youth programming, as it can help to adapt methodologies and strategies to benefit young people and help to formulate messages and programmes that better address adolescent realities. And as the stakeholder meetings showed, it can help to open up a dialogue on youth sexuality issues between NGO staff, parents, community leaders and members and young people, working towards more acceptance of young people's sexual rights and towards social change.
Acknowledgements
The research project was commissioned by the International Planned Parenthood Federation (IPPF) with financial support from the Netherlands Ministry of Foreign Affairs; coordinated by Rutgers WPF and an independent professional Bangladeshi researcher, in close cooperation with the Family Planning Association of Bangladesh, their staff and volunteers. Special thanks go out to the youth research team in Bangladesh: Akhter Moshammat Sabina, Islam Mainul Hasan, Islam Mohammad Jahidul, Khatun Parijat, Pervas Kamal, Rahman Mahfuza, Ray Mithon Kumar, Sume Afroza Khanam, Tanzir Azmarina. The youth research team was supported by Dr Papreen Nahar and trained by Dr Miranda van Reeuwijk. We are very grateful to the adolescents for sharing their views and experiences. Special thanks go to Doortje Braeken and Kat Watson from the IPPF London office.
Notes
* Rutgers WPF and IPPF have published a Toolkit entitled Explore for involving young people as researchers in SRHR programmes on the basis of their experiences with this research project. The toolkit includes guidelines on how to create conditions for successful youth participation in research and enhance the effectiveness of youth sexual and reproductive health and rights programmes, as well as three manuals to train and support young people to conduct qualitative data collection for research, monitoring and evaluation. www.rutgerswpf.org/article/explore-toolkit-involving-young-people-researchers-sexual-and-reproductive-health-programmes.
* There are some non-governmental initiatives, e.g. (i) an intervention to present a session on reproductive health in eight secondary schools for grades 9 and 10, and distribute an educational booklet that covered, among other topics, physiological changes of adolescence, duration of menstrual cycle, fertile period, leucorrhoea, masturbation, and night emissions, in a peri-urban school of Dhaka in 2004–05;Citation5 and (ii) the Adolescent Reproductive Health Education project that was introduced by BRAC through local schools and community libraries in areas with poor socio-economic conditions throughout Bangladesh in 1995, taught by women teachers from the community, which covered physiological and emotional changes during adolescence, the process of reproduction and pregnancy, family planning, early marriage, disease prevention, substance abuse, smoking, equality between the sexes, and gender-based violence.Citation6
* For more information, see: www.rutgerswpf.org/content/srhr-alliance-unite-body-rights or contact [email protected]
References
- D Braeken, I Rondinelli. Sexual and reproductive health needs of young people: matching needs with systems. International Journal of Gynecology and Obstetrics. 1(19): 2012; S60–S63.
- Rutgers WPF. “Do They Match?” Research Project. Reports and training manuals. www.rutgerswpf.org/content/downloads
- P Nahar, M van Reeuwijk, R Reis. Contextualising sexual harassment of adolescent girls in Bangladesh. Reproductive Health Matters. 21(41): 2013; 78–86.
- P Nahar. Do They Match? Young people's realities and needs relating to sexuality and youth-friendly service provision in Bangladesh. Research project report. 2010. www.rutgerswpf.org/content/downloads
- S Tasnim, A Rahman, I Ara. Talking about sexuality at secondary schools of periurban area of Dhaka city. International Journal of Adolescent Medicine and Health. 21(4): 2009; 601–608.
- SF Rashid. Providing sex education in rural Bangladesh: experiences from BRAC. Gender and Lifecycles. 2000; Oxfam: Oxford.
- U Rob, T Ghafur, I Bhuiya. Reproductive and sexual health education for adolescents in Bangladesh: parents' view and opinion. International Quarterly of Community Health Education. 25(4): 2006; 351–365.
- J Uddin, AM Choudhury. Reproductive health awareness among adolescent girls in rural Bangladesh. Asia-Pacific Journal of Public Health. 20(2): 2008; 117–128.