Healthy Sexuality and the Elimination of Harmful Practices Print E-mail
Sexuality is a central aspect of people's lives and encompasses gender identities and roles, sexual orientation, eroticism, pleasure, and intimacy as well as reproduction. WHO's work on sexuality, which is a new thematic area of work for the Department of Reproductive Health and Research, emphasizes the positive aspects of healthy sexual development as well as the need for protection from physical and emotional harm. Initial work has focused on the development of working definitions of sex, sexuality, sexual health, and sexual rights and on the context in which they are to be studied and understood (see www.who.int/reproductive-health/gender/sexual-health.html):

Healthy Sexuality and the Elimination of Harmful Practices

Sexual health is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. 

Research and data

The area of sexuality clearly overlaps with other areas of sexual and reproductive health such as the prevention of RTIs/STIs and HIV/AIDS; the dynamics of contraceptive use and prevention of unwanted pregnancies; gender relations (including men's roles in sexual and reproductive health and violence against women); and adolescent risk taking. Research on sexual behavior among adolescents is summarized in the publication Sexual Relations Among Young People in Developing Countries: Evidence from WHO Case Studies (2001) described in Adolescent Sexual and Reproductive Health (p. 18 below). Approaches to investigating sexual violence are described in Gender, Health and Reproductive Rights (p. 22 below).

WHO has not yet engaged in research or in the development of tools or guidelines addressed to issues such as gender inequality and power in promoting healthy sexuality at the individual, family, community and health system levels.  Rather, it has drawn attention to harmful sexual practices with significant health complications such as the practice of female genital cutting (female genital mutilation or FGM). Research on this topic is summarized in A Systematic Review of Research on Health Complications following Female Genital Mutilation, including Sequelae in Childbirth (1998).

Guidelines for providers

Health care practitioners can learn about caring for women with FGM in the manual, Female Genital Mutilation: Policy Guidelines for Nurses and Midwives (2001); see also Management of Pregnancy, Childbirth and the Postpartum Period in the Presence of Female Genital Mutilation: Report of a WHO Technical Consultation (2001). For a useful review of programs that attempt to eliminate or modify the practice or to mitigate its health consequences, consult Female Genital Mutilation Programmes to Date: What Works and What Doesn't. A Review (1999). 

WHO's training program for nurses and midwives includes practical guidelines for managing various aspects of FGM, including physical complications, counseling, psychosocial and sexual complications, family planning, and pregnancy, delivery, and postpartum care. An introductory training module discusses traditional practices, types of FGM, and their professional, legal, ethical and human rights implications.  Community involvement in prevention is treated in a separate module that examines traditional beliefs, values and attitudes and discusses strategies for involving individuals, families, and community, political and government leaders in prevention campaigns.  See Female Genital Mutilation: A Teacher's Guide (2001) and Female Genital Mutilation: A Student's Manual (2001) for a comprehensive treatment of these issues.

Policies and strategic plans

The theme of healthy sexuality and the elimination of harmful practices encompasses fundamental concepts of human rights, including the right to make free, informed and responsible decisions and the right to bodily integrity. Sexual rights embrace human rights that are already recognized in national laws and international agreements. An analysis of the human rights basis of sexual and reproductive health and rights can be found in WHO's Considerations for Formulating Reproductive Health Laws (2000) and Summary of International and Regional Human Rights Texts Relevant to the Prevention and Redress of Violence Against Women (1999). 

 
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