Sexual Health: International Perspectives on FGC/FGM, HIV/AIDS, and Health Promotion

This essay discusses sexual health promotion, FGC/FGM, HIV/AIDS, and current issues in sexual health. It also covers ethical and legal frameworks and policies related to sexual health.

Sexual Health
International Perspectives

Contents
INTRODUCTION...........................................................................................................................1
BACKGROUND.............................................................................................................................1
MAIN BODY...................................................................................................................................3
CONCLUSION ...............................................................................................................................6
REFERENCES................................................................................................................................6

INTRODUCTION
According to the world health organisation, the sexual health is defined as not merely the
non existence of disease, infirmity or dysfunction, it is the state of mental,social emotional and
physical well-being in terms of sexuality. Sexual health needs a respectful and positive approach
to sexual relationship and sexuality as well as the chances of having safe and pleasurable sexual
experiences, free of discrimination,violence and coercion. Sexual health promotion is the method
through which an individuals can get the capability to improve and control their sexual health.
The promotion of sexual health can assist the people to decrease the risk of STDs (sexually
transmitted diseases) like, Gonorrhoea, HIV/ AIDS, Genital herpes, Chlamydia, unwanted
pregnancy and so on. It also help to increase emotional and sexual well being. There are more
than 20 health issue related to sexual health of male and female. In this essay, some of the sexual
health issue like FGC/FGM, HIV/AIDS, will be majorly discuss. This essay is going to discuss
about the FGC (female genital cutting)/ FGM (Female genital Mutilation). FGC/FGM term is
used by the activist and health advocates to represent the risk associated with the practice.
Awareness and Education related to the different health issue will also discuss in this essay.
Current issue in sexual health in terms of public health and health promotion will be discuss in
this essay. Ethical and legal framework and their impact on sexual health will be also included
in this essay. Finally in this essay, some of the policies and intervention related with sexual
health is going to discuss.
BACKGROUND
Sexual health promotion is defined as the process by which every individual know how to
control and develop their sexual health. The main goal of promoting sexual health is to enhance
emotional and sexual well being. It also help to decrease the risk of sexually transmitted disease.
It deceases the possibility of unwanted pregnancies. In UK, it is done for termination of
pregnancies and sexually transmitted disease. For being healthy by all the aspects such as
physical, mental, emotional and social it is very crucial to promote and talk about the sexual
health (Van Eekert, 2020). It also enables a person to enjoy himself sexually according to his
convenience. It is important to have good sexual health because poor sexual health may lead to
unwanted pregnancies and sexually transmitted diseases. WHO defined sexual health which
removed stigma by assisting clinicians, educators, policy makers and researchers. Sexual health
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is imperative to public health as a marker of health equity. Being sexually healthy not only talks
about terminating unwanted pregnancy or preventing sexually transmitted disease but it is a
umbrella term that covers a number of facts of a patient emotional and physical well being
surrounding sex and sexuality. Bringing awareness among public is really important because
most of the people hesitate to talk about their sexual health issues and do not consult to the health
care professional (Drew, 2021). World association of sexual health has launched world sexual
health day on 4th September, 2012 and the objective was to bring awareness of sexual health
among public and making understand the importance of sexual health. People need to understand
that sexuality is a natural part of individual's life and includes more than just sexual behaviour.
Sexual health may also defined as state of mental, physical, emotional and social well-being
associated to sexuality. Sexual health includes freedom, respect and safety from violence and
discrimination. There are four pillars of health and sexual health is one of them. Sexual health
refers as set of principles that includes personal values, cultural norms, religious beliefs, ethics
and unconventional sexual interests. This topic has selected just because increasing sexually
transmitted infections and only promoting sexual health can remove the stigma. Sexual health
can be promoted by interacting with others in appropriate and respectful ways (Sturgeon, and
Kraus, 2021). Boundaries should also be negotiated to promote the sexual life. Working together
to maintain the equality in relationship makes the partners belief and respect each other and thus
improve sexual health. Sexual health is public health problem with far reaching economics and
social impacts. Embarrassment, taboos, and stigma surround sexual problem creating a barrier to
women analysing the care they required and making it very difficult for women to talk about
them. Social stigma, discrimination and sexual violence, individual empowerment and choice,
clinical service and education are some barriers which can interfere with the promotion of sexual
health. FGC (female genital cutting) it is most painful sexual health issue. FGC can cause more
severe bleeding and issues in urination, and later cause infection, cyst as well as more
complication in childbirth also enhanced risk of newborn deaths. The prevalence of FGM?FGC
in all over the world but it is more associated with women of Western Africa. There are
94%,79%,74% and 72% FGC prevalence in Sierra, Gambia, Burkina and Mauritania
respectively (Granville, and Pregler, 2018). The women with FGC and FGM have to face several
issues such as pain during the intercourse, reduce sexual desire and reduce sexual satisfaction.
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FGC/ FGM is lead to cause an extra one to two newborn deaths per 100 deliveries. There are
four types of FGC like:-
type1: in this, clitoris is fully or partially removed.
type II: in this labia minora with clitoris are fully or partially removed.
type III: clitoris, labia majora, labia minora and clitoris are cut away.
type IV: in this includes piercing, pricking and so on (Florquin, and Richard, 2020).
Women with FGC had issues with lubrication during the sex, which may cause that they have
lower sex desire and no orgasm. Tat women have lack of sexual enjoyment because of other
elements like pain experiences during intercourse (Johnson‐Agbakwu, and Abdulcadir, 2020).
MAIN BODY
Sexual health is not merely the non existence of diseases or dysfunction but also the well
being of individuals, couples and famille's social, mental, physical and emotional state in terms
of sexuality. However, to get sexual health and well being depends upon the ability of
individuals having : knowledge about the risks they face, approach to appropriate information
about sexuality, knowledge about the vulnerability of risk factors of sexual issue, approach to
more advanced sexual health care and the culture that promotes and affirms sexual health. Sexual
health when seen positively, then it needs a respectful and positive attitude to sexual relationship
and sexuality (Jones, and et. al., 2019). There are also the possibility of having safe and
pleasurable sexual experiences, free of violence discrimination and coercion. The capability of
women and men to get sexual health and well-being hangs on their: (1) Approach to good quality
information to sexuality and sex. (2) Ability to retrieve sexual health care. (3) Knowledge about
the risks and its vulnerability, (4) Living in such environment which promotes good sexual
health. Issues related to sexual health are very wide ranging. They also have negative conditions
and consequences like: HIV/AIDS and their adverse results, sexual violence, harmful practices
like FGM/FGC (Schmidt, Brown, and Darragh, 2020). Who,2008 describe fours type of female
genital mutilation/cutting, which are excision, clitoridectomy, infibulation and other. It is widely
identified that it violates a number of human rights like the universal declaration of human rights,
elimination of discrimination against women and so on. It causes permanent and some time
detrimental changes in the external genital organ of female like as infections, difficulty in
passing faeces and urine and chronic pain. FGC/M was generally practice among different
ethnic women in more then twenty eight country in Africa. The reason for regular practice of
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FGC/M involve preservative chastity, rite of passage, hygiene, enhancing sexual pleasure for
men, religion, improving fertility and ensuring marriageability (Lane, and et. al., 2019). FGM/C
is a subject of legal, ethical and cultural debate in African and north American countries if there
are the participation of well qualified and trained health care providers in this. Where as
according to many Country's principles the health care providers and the doctors who involve in
this practices violate all the principle of ethics because of cutting of female genital at any degree
is an unethical process (Roden, Schmidt, and Holland-Hall, 2020). According to the some
reports, it is demonstrated that the females with FGC/M are more likely experiences to
psychological disturbances like psychiatric diagnosis, phobia, low self estimation, suffer from
anxiety and somatisation. There are several challenges which intervene in the promotion of
sexual health like conservative religious hierarchies, fear of stigma and discrimination in
society, lack of knowledge about healthy sexuality and so on. In the developing countries, people
feel hesitation to talk about sexual health therefore they never share their problems with doctors
and colleagues (Mitchell, and Rogers, 2021). But in developed countries it becomes easy to
promote a good sexual health because people of developed countries are open minded and they
freely talk about their sexual health. There are several cultural, traditional, religious and social
aspects to scrutinize the practice of FGM/C. A number of social and religious reasons which
create challenges in the promotion of sexual health in those country who is in favour of FGC/M.
Cultural identity, protection of virginity, better marriage prospect, greater pleasure for the
improvement of fertility, prevention of immortality and female cleanliness are some important
element which promote FGM OR FGC and creates a barrier in promotion of Sexual health.
Family pressure to continue the traditional practice is other strong inspiration to continue these
tradition. To overcome or promotion of sexual health related to FGC, meet some older women
and know about their complication. After knowing the complication, educate those women and
try to inspire them to assist in sexual health promotion (Nam, 2021). Several effort by which
incidence of FGM can be reduced such as: tradition change with the assist of older generation,
educate younger girls to their right, tell about realities and risk of FGM and so on. Ethical
considerations are undertaken to end the harmful cultural practice of Female Genital Cutting
(FGC). Some ethical principles that highlights the objections for FGC practice are: Autonomy,
non-maleficence, and beneficence. Ethical considerations covers the discussion regarding the
codes of conduct or standards set by people related to the specific practice or profession. FGC is
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a unethical cultural practice as it is painful, harmful, useless, stressful and clearly represents the
violation of human rights. People involved in such practices are used to believe that these are the
cultures and traditions of their tribes that cannot be discontinues at any cost (ten Have, 2021). So
even professionals involved in such activities were not able to raise their voice against the
harmful traditions because it may results in loss of their reputation among the community and
even get discarded from the community. Putting an end on harmful cultural practices needs
discussion at the community, national and international level. After coordination and discussion
regrading the issues the parliamentarians engage in discussion and make laws in order to ban the
practices. International laws ordered the regional government not only to implement laws but
also take some actions to change people's beliefs and views about the wrong practices (Essén and
Mosselmans, 2021). Some of the legal frameworks that put an end to harmful traditions are:
Universal declaration of human rights, the convention on the rights of the child, UNICEF, the
convention on the elimination of all forms of discrimination against women, etc. FGC is widely
recognised as violation of human rights principles by the perception of international law. The
debate about the FGC traditional practice has promptly took place even in western interventions.
A women's health activist named Nahid Toubia stood against the FGC and portrayed the practice
as evidence of the barbaric, evil, and inherent patriarchal culture negatively effects the third
world women. The practice of female circumcision has no health benefit rather it may result in
causing number of problems. The FGC is usually carried on girls between the age of infancy and
15 years, that is, the age before the beginning of the puberty (MacNamara, 2020). It is a painful
process that can seriously harm the health of the girls and women. The cruel traditional practice
can leads to cause long-term problems with childbirth, sex, and even mental health may get
affected. Effects of FGC are: constant pain, genital area become prone to repeated infections,
problems during peeing or while holding pee, intense pain and difficulty in having sex,
infertility, formation of cyst, continuos bleeding, depression, anxiety, self-harm, and problems
during labour and child birth. Some girls even died during the procedure due to heavy blood loss
or infection at the genital part. Despite from sexual problems, FGC can cause trauma and
depressive experience that may impact the mental health of the girls and women badly
(Johnsdotter, 2018). Some of the mental health issues are: Depression, Anxiety, Flashbacks from
the traumatic experience of cutting, nightmares, and other problems related to sleep. Working to
finish or eradicate FGM and FGC is a complex process because it is not only practice rather, it is
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a tradition which holds different meanings for various communities, often there are more than
one meanings within single community. By ensuring that girls are empowered, educated, free
from discrimination and violence and healthy, UNICEF supports ending of FGM. In addition to
putting up to meeting SDG aim 5.3, finishing FGM advances the UNICEF plan, 2018 to 2021,
identified AIM area 3 are “ Every child is protected from the exploitation and violence. A 2019
evaluation of the UNICEF-UNFPA joint programme on FGC and FGM phase 1 & phase 2 (2008
to 2017) got that the program has participated to great achievements at the international level. It
had vital success around the world like: (1) enhanced coordination between subnational and
national actors. (2) reinforce national legal framework. (3) support changes in discourse
associated with FGC AND FGM, outcomes in breaking of significant of FGC AND FGM related
stigma, discrimination and Taboos.(4) enhanced awareness around FGC and FGM related sexual
health problems. (5) Ban of the practice with meaningful proportions of communities in
intervention space (Perron, and et. al., 2020).
CONCLUSION
In the above essay, definition of sexual health has been discussed which is related to
physical, mental, social and emotional well being sexuality of human. In this essay outline of
several sexual disease like AIDS, HIV, Genital herpes, Chlamydia, gonorrhoea and unwanted
pregnancy has been mentioned. whereas FGC and FGM has been discussed in detain in this
discussion. Problem associated with FGC and FGM has been discussed. Types of FGC has also
been mentioned in this discussion. A case study of activist Nahid Toubia has also been outlined
in this discussion. Finally, Also discussed some policy and intervention To FGC and FGM.
REFERENCES
Books and Journals:
Drew, l.b., 2021. female genital cutting in nigeria: an exploration of national-level trends and its
associations with sexual and reproductive health (doctoral dissertation).
Essén, B. and Mosselmans, L., 2021. How to ensure policies and interventions rely on strong
supporting facts to improve women’s health: The case of female genital cutting, using
Rosling’s Factfulness approach. Acta Obstetricia et Gynecologica Scandinavica, 100(4),
pp.579-586.
Florquin, S. and Richard, F., 2020. Critical Discussion on Female Genital Cutting/Mutilation and
Other Genital Alterations. Current Sexual Health Reports, 12(4), pp.292-301.
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Granville, L. and Pregler, J., 2018. Women's sexual health and aging. Journal of the American
Geriatrics Society, 66(3), pp.595-601.
Johnsdotter, S., 2018. The impact of migration on attitudes to female genital cutting and
experiences of sexual dysfunction among migrant women with FGC. Current sexual health
reports, 10(1), pp.18-24.
Johnson‐Agbakwu, C.E. and Abdulcadir, J., 2020. Female Genital Cutting. Female Sexual Pain
Disorders: Evaluation and Management, pp.261-271.
Jones, K., and et. al., 2019. Adolescent and emerging adults’ evaluation of a Facebook site
providing sexual health education. Public Health Nursing, 36(1), pp.11-17.
Lane, J.L., and et. al., 2019. Female genital cutting: Clinical knowledge, attitudes, and practices
from a provider survey in the US. Journal of Immigrant and Minority Health, 21(5),
pp.954-964.
MacNamara, N., Mackle, D., Pierson, C. and Bloomer, F., 2020, September. Interrogating the
politicization of female genital cutting (FGC) within conditions of asymmetrical cultural
convergence. A case study of Northern Ireland. In Women's Studies International
Forum (Vol. 82, p. 102391). Pergamon.
Mitchell, M. and Rogers, J., 2021. Prohibiting the queer body: gender affirmation, female genital
cutting, and the promise of gender intelligibility. Critical criminology, 29(4), pp.707-721.
Nam, Y., 2021. Learning through social interaction: Kenyan women against female genital
cutting in Kenya. Culture, Health & Sexuality, 23(6), pp.840-853.
Perron, L., and et. al., 2020. Guideline no. 395-female genital cutting. Journal of Obstetrics and
Gynaecology Canada, 42(2), pp.204-217.
Roden, R.C., Schmidt, E.K. and Holland-Hall, C., 2020. Sexual health education for adolescents
and young adults with intellectual and developmental disabilities: recommendations for
accessible sexual and reproductive health information. The Lancet Child & Adolescent
Health, 4(9), pp.699-708.
Schmidt, E.K., Brown, C. and Darragh, A., 2020. Scoping review of sexual health education
interventions for adolescents and young adults with intellectual or developmental
disabilities. Sexuality and Disability, 38(3), pp.439-453.
Sturgeon, J.A. and Kraus, S.W., 2021. Resilience in Women’s Sexual Pain After Female Genital
Cutting: Adaptation Across Time and Personal and Cultural Context. Archives of Sexual
Behavior, 50(5), pp.1891-1895.
ten Have, H., 2021. FGC (Female Genital Cutting). In Dictionary of Global Bioethics (pp. 513-
514). Springer, Cham.
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Van Eekert, N., 2020. 1. The association between women's status and the medicalization of
female genital cutting in Egypt. Journal of Obstetrics and Gynaecology Canada, 42(2),
p.e25.
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