Adolescents’ sexual health in India – underlying gaps of female genital mutilation
By Laura Fellows
Content Warning: The following story contains mentions of violence against children and genital mutilation.
India utilises the Beveridge healthcare model, where care for all individuals is provided and financed by the government through tax payments. The quality of care is addressed by the government through legal measures, with many schemes in place to ensure that even those with low incomes are able to access care. Upholding sexual health in adolescents is a vital component in healthcare and should be a key concern for not only India, but all countries. Basic human rights are violated when gaps are present in a healthcare system, such as female genital mutilation (FGM). There are many ways in which we are able to assist countries in achieving eradication of these devastating health gaps.
India has made progress in the right direction to improve adolescents’ sexual health. The Adding It Up project estimates the cost of using contraceptives, maternal plus newborn healthcare and abortion related care. This gives adolescent females incentive to recognise and make smart decisions about their sexual health. India has also expanded the range of contraceptive methods available to adolescent females. Moreover, the Beveridge healthcare model provides the funding needed to deliver these programs to adolescents; however, there are gaps involved including difficulties accessing these services. Two million adolescent females in India have unmet needs for contraception and in hand, 78% of adolescent abortions are unsafe. When a procedure, such as abortions or FGM, is performed in an unsafe, unsterile environment then the adolescent female has a greater risk of infection and later complications. To provide adolescent females with the care stated above, direct and indirect expenses combined would annually cost about $0.23AUD per person. If India’s healthcare system was to utilise part of their budget to develop programs which would financially support adolescents with the sexual healthcare they need, then these statistics would decrease.
FGM is a non-consensual procedure involving partial or total removal of healthy external female genitalia for non-medical reasons, with four classifications depending on the severity. This occurs on girls during late childhood through adolescence; but unfortunately, effects of FGM last their whole life. The practice is illegal in most countries; however, it is still present in some due to being overlooked by local authorities. Indian officials have stated there is no data proving the existence of FGM within India. This is despite research showing that 75% of the Bohra Muslim community in India have undergone FGM, alongside countless personal experiences being frequently shared. Some religions practice FGM as they believe it is associated with reducing female sexual desire whilst purifying the body. It is believed FGM initiates girls into womanhood and increases their chance of marriage. However, there is no denying that FGM is a major human rights violation. It is typically performed in non-hygienic conditions by non-traditional practitioners. Despite religious beliefs, FGM poses no medical benefit. It does; however, increase the risk to health complications including infections and problems during childbirth. There is also a correlation between adolescent females who have undergone FGM experiencing dysmenorrhea. Research shows that FGM has long lasting effects on psychological wellbeing and is associated with increased levels of depression and somatisation.
As a whole, India’s proactive nature toward adolescent sexual health has a sound response with gaps present. An important key factor in minimising risks is to educate adolescents about sexual health. India’s Beveridge healthcare model achieves this through developing and funding programs which educate adolescents about sexual health and the costs involved with pregnancy and abortions. I believe this shows that India is on the right track when addressing adolescent sexual health. There may be; however, additional benefits through developing programs targeted to adolescents who require financial and emotional support due to implications of sexual health experiences, including pregnancy. A health gap that also needs profuse attention by the Indian government is FGM. Global education is vital. This means educating everyone, women and men, on FGM and the risks involved. Many people that live outside these specific countries do not recognise that FGM is happening. We can also help by signing petitions and supporting frontline activists in hopes that FGM can be banned by governments worldwide.
In closing, when looking at India’s approach to sexual health in adolescents, the Beveridge healthcare model has contributed by creating programs which aim to educate adolescents. However, there is still a huge gap for female adolescents. Not only is this group not financially supported which increases the rate of unsafe pregnancies and abortions, but there is also evidence of FGM occurring within India, which can lead to further complications. If the government will not protect adolescent girls from this major human rights violation, then who will? Globally, everyone should be educated on the gaps present in India’s healthcare as this will promote awareness and hopefully, in turn, generate change.