Croakey is closed for summer holidays and will resume publishing in the week of 9 January 2023. In the meantime, we are re-publishing some of our top articles from 2022.
This article was first published on Wednesday, September 28, 2022.
Sex educator Brenna Bernadino recently took the reins of Croakey’s rotated Twitter account @WePublicHealth for a wide-ranging and timely discussion given that September hosts World Sexual Health Day, World Contraception Day and BiVisibilityDay while today is International Safe Abortion Day.
A summary follows below, including details of how communities around the world are fighting back against restrictions on sexual and reproductive health, and links to a wealth of reading and related resources.
Brenna Bernadino tweets:
This week for Sexual Health September, I plan to cover pleasure, access to sexual and reproductive healthcare (SRH) in Australia, racism and eugenics in SRH, sex-positivity, global threats to SRH and then will finish by covering World Contraception Day and International Safe Abortion Day.
The World Association for Sexual Health – @WAS_org – Sexual Pleasure Declaration states: “Sexual pleasure is the physical and/or psychological satisfaction and enjoyment derived from shared or solitary erotic experiences, including thoughts, fantasies, dreams, emotions, and feelings.”
The first @WAS_org goal for World Sexual Health Day WSHD 2022: “Promote sexual pleasure in law & policy as a fundamental part of SH and well-being, grounded in the principles of sexual rights as human rights, including self-determination, non-discrimination, privacy, bodily integrity & equality.”
The 2nd @WAS_org goal for WSHD 2022: “Recognise that significant barriers to sexual expression and the experience of pleasure are rooted in diverse systems encompassing policy and legal frameworks; cultural mores, and economic injustice.”
@WAS_org believes that “leadership from institutions is ESSENTIAL” to address barriers to pleasure in our society.
Read the SMH article on getting ‘cliterate’ here.
There’s even some research to suggest that animals may experience pleasure too!
Have you heard of the orgasm gap? It’s “the disparity between men and women’s frequency of orgasm while having sex”.
How do we understand what gives us pleasure (in the bedroom)? Well, they say practice makes perfect…
Pleasure can look different to everyone. Asexual activist Yasmine Benoit notes that “Masturbation has no bearing on my sexual orientation and it doesn’t make me more or less asexual.”
Pleasure x disability: We need to shift the focus on pleasure rather than penetration and make it accessible. Some disabled people may have injury/sensory issues, and instead may get pleasure from earlobes, knees or any touch that isn’t medicalised!
Pleasure may also be important for kinks, such as with BDSM. Some people experience pleasure from painful sensations like impact play which can increase endorphins and also just sound good!
Pleasure also happens across the lifespan. As we get older, we can still experience pleasure but just in different ways. Things to be mindful of include physical changes due to age, but also the added health issues that arise when getting older.
When most people think of pleasure, they might associate it with an orgasm. But some people have anorgasmia, or a lack of orgasms. That’s why it’s important not to focus on “achieving” an orgasm as the end goal, and to centre overall pleasure instead!
Pleasure sounds nice and all, but does it reaally add anything in sexual health interventions? One massive study says YES! Pleasure x condom use can HIV and STIs, and improve sexual health knowledge, attitudes and safer sex practices.
The conversation around access to SRH care such as abortion has been in the media a lot recently in Australia since Roe v. Wade was overturned in the US in June this year
And did you know it was only in July when South Australia finally decriminalised abortion, extended their gestation limits and permitted teleabortions??
There are many other barriers to abortion access besides the law. There are more challenges for “rural women, young women, disadvantaged women, and women from culturally and linguistically-diverse backgrounds” says @Danielle_Mazza.
Abortion laws don’t mean access in Australia. A recent @smh article found three women who shared their own challenges: docs who said it was against their religion to provide an abortion, long travel to access care and family stigma.
A recent study also found that family or intimate partner violence also are a critical barrier to abortion care: “Cost, stigma, and intimate partner violence continue to impede access”.
How can we reduce abortion costs to ensure healthcare equity? One way would be to ensure medical abortions have their own Medicare Benefits Schedule #. This would help reduce out-of-pocket costs!
Since there are low numbers of abortion providers, it would make sense to train up others like nurses to support abortion care. That’s why the legislation and policies would need to change.
What about access to #SRH in the workplace? It’s where most spend the majority of our time right? One employer decided recently to provide support for menstruation, menopause, miscarriage, abortion & fertility! See this article @WomensAgenda.
Access to SRH care has also been identified as an “area of urgent need” for women on temporary visas in Australia.
It’s critical to remember that access to SRH care in Aus is always ongoing. As we have seen from the US, access can change dramatically. It’s unlikely that Australia will severely roll back SRH access, but it doesn’t mean we should stop fighting for it.
Threats to access
Now I will extend on the previous discussion about local laws and access to abortion by looking at global threats to sexual and reproductive healthcare access.
When Roe v. Wade was overturned, I was actually in a nightclub celebrating a cousins’ birthday. I didn’t feel mad or sad. I knew that I just had work to do.
Threats to contraception access are also an issue in the US. Although Grisworld v. Connecticut protects the right to birth control, access is a problem due to funding, location and conflicts with religious beliefs.
A recent example of religious objections that prevent contraceptive access: A US college outsourced its health services to a Catholic health agency who prohibited contraception to prevent pregnancy, yet it was ok for health reasons.
In promising news, the US FDA will discuss in November whether to make birth control pills available over the counter!
External factors impede SRH access too. One key issue is the effects of climate channge, which disproportionately impacts minorities and can negatively impact maternal mortality in the US.
Since Roe was overturned, the US is now “one of only four countries that has rolled back abortion rights since 1994”: ‘With its Regression on Abortion Rights, the U.S. is a Global Outlier’.
In China, sex-selective abortions are illegal to counter the preference for boys over girls. Unfortunately these sorts of bans can be problematic in Australia. NYT article: ‘Abortion laws around the world’.
Have you heard of the “green wave”? It’s the efforts to expand reproductive rights in Latin America. “In the last two years, Mexico, Argentina and Colombia have decriminalised or fully legalized abortion.” Via @NPR: ‘What the U.S. can learn from abortion rights wins in Latin America’.
Chile was next in the “green wave” to expand reproductive rights in Latin America but recently voters blocked a move to legalise abortion.
One Mexican clinic in Tijuana has become a destination clinic for Americans who are struggling to access sexual and reproductive healthcare. Via @NPR: ‘This Mexican clinic is offering discreet abortions to Americans just over the border’.
Although Latin American feminists are not immediately concerned about a ripple effect of SRH restrictions in their countries, they are remaining vigilant because “rights are fragile”.
Did you know that France recently announced that emergency contraception will be free for women and access to STI screening will improve?
Despite total abortion bans in San Marino, Andorra, Malta and an almost near-total ban in Poland, women are fighting back.
Roughly one in four Pacific women does not want to become pregnant but is not using modern contraception.
One midwife in Nepal treks across Nepal with hand sanitiser, medical tools and pills. Ensuring SRH access means that people will literally move mountains to deliver essential care!
Read the article about Kenya services here.
The group “Back Off Scotland” is fighting back against abortion protestors outside clinics. Friendly reminder that NO ONE should have to deal with this kind of abuse.
On sex positivity
Read more here.
What’s wrong with mainstream sex positivity? Rather than embracing your sexual side, it take away the “humanity of it” and become more about expectations and transactional experiences.
@askGOODY defines sex-positivity as, “the idea that people should have space to embody, explore, and learn about their sexuality and gender without judgment or shame”.
Sex positivity is not always bout shouting that “sex is great!”.
What are some of the origins of sex-positivity? Ballroom culture in NY was embracing it in the 20’s, psychoanalysis and sexology used the term way back and it also resurged during the 60s & 70s sexual revolution.
On the other side of sex-positivity, what is sex-negativity? It can be about thinking that sex is bad, wrong or sinful.
Can we raise sex positive kids? Of course! One blog suggests that it’s key to start sex education early, practice body positivity, and encourage kids to have agency over their bodies.
How can YOU be sex-positive? 1. Educate yourself 2. Take time to reflect 3. Communicate…a lot! 4. Be more accepting of different ideas!
What if you’re trying to be sex-positive when others around you aren’t? Find allies, go online for more resources, and find common ground where you can.
Did you know that sex-positivity could enhance your mental well-being too? Feeling less isolated and anxious can build resilience and confidence against stigma which improves health outcomes!
Some Gen Z women just aren’t feeling the sex-positivity vibe. They thought it was corny, somewhat passé or even shallow. What do you think?
What is the future of sex-positivity? Five trailblazers said it is sustainable, virtual, educational and more than about sex. I believe it’s equitable and cross-generational.
World Contraception Day
Now I’ll dive into World Contraception Day (which was on Monday, 26 September).
Sharing my personal experience here: I’m on my 3rd implant in the arm which has allowed me to plan on having children after I received 2 degrees, got married, travelled and worked on building a career. Next year might be the year I have it removed!
I’ve also been fortunate to have a supportive partner who allows me to decide what to do with my own body – key to a respectful relationship.
At the ICPD in Cairo in 1994, the late Dr. Nafis Sadik, said: “Healthy families are created by choice, not by chance.”
@UNFPA SDG Indicator 3.7.1 on Contraceptive Use informs the global review of SDG target 3.7. “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning…”
Ahead of World Contraception Day and International Safe Abortion Day, UN experts say that States must ensure the highest attainable standard of physical and mental health for all, including the right to sexual and reproductive health.
“We commend the positive steps taken in some countries relating to the constitutional recognition of sexual and reproductive rights and encourage States to follow such promising practices” _ @UNHumanRights
In honour of World Contraception Day, @ibp_network & @WHO are hosting a webinar on Male Contraception – Research, contraceptive options, and policy implications.
As we celebrate World Contraception Day we need to recognise that adolescents are too frequently overlooked. They too need to have choices, access, confidential care, resources and support.
There are so many kinds of contraception. Do you know the difference between the pill, the implant and the hormonal IUD? Find out more here.
Also FYI, contraception is not abortion…pass it on.
Using contraception should always be your choice, it should never be coerced.
See previous articles by @WePublicHealth guest tweeters