Young unmarried women in India are subject to cultural barriers associated with being sexually active - such as social conservatism and gender-based discrimination.1 India has a growing population essentially consisting of adolescents and young adults: 10-24 years, who make up 33% (253 million: as per 2011 census) of our population; a figure much higher than Western countries.2 While there is an increase in sexual promiscuity in the Indian adolescent population, it is not supplemented by an appropriate increase in awareness regarding sexual health information - leading to a rise in sexually transmitted diseases and higher abortion rates.3 These abortions are complicated with serious adverse events as women undergo untimely procedures with 75% of individuals falling between 18-19 years of age.4, 5 Our piece focuses on unmarried, sexually active women residing in urban India.
The purpose of this correspondence is to highlight the obstacles associated with contraceptive seeking behaviour, especially stigma - perceived, anticipated and experienced, and we’d like to explore the reasons for the same.
Inherent societal taboo: The stigma primarily arises from the poor confrontational skills of their respective legal guardians and the archaic societal taboo. While India is vastly influenced by western culture and we are a more receptive society at present, talking about sexual activity is still considered to be a taboo in most households.
Lack of sexual education: There is a deep-rooted reluctance among parents and teachers who are bestowed with a responsibility to impart relevant information about sexual and reproductive behaviour. The evident lack of sexual education in schools and colleges cumulatively potentiates adolescent ignorance.
Being presumptuous while enquiring about sexual history:
The use of substitute phrases by healthcare workers while asking about sexual history embarrasses patients and increases the chances of hesitation for future contraceptive seeking consultations. Phrases like, “Are you married?” instead of “Are you sexually active?” indirectly hint at marriage being a pre-requisite for sexual activity, further intensifying the existing stigma.
India is on the brink of constant population explosion and yet there is no clear evidence of successful contraceptive knowledge and awareness in the adolescent population, despite a desperate need for decades. Understanding this existing inconsistency, it is imperative to provide sufficient response to their sexual and reproductive health requirements which remains unmet to this day.6 Potential prospective observation-based studies and public surveys would be the first step in order to quantify this problem followed by curating measures to abolish this stigma tagged along with contraceptives and safe sexual practices for once.
