By: Anannya Chatterjee
Right to health is deeply connected to a positive approach to sexuality.
By: Anannya Chatterjee
Handwashing before eating is a common act of hygiene. We are reminded of the importance of washing hands through advertisements for soaps, which proclaim they wipe out 99.9% of germs, as well as leave behind delicate scents of roses, jasmines and whatever might be your pick. The latest addition to our handbags is hand sanitiser. Hand hygiene, therefore, is not alien to us. It has had a tedious journey in developing nations, and there are large-spread programmes dedicated to it.
Hand hygiene is a part of public health intervention, whose knowledge is disseminated widely, and has mobilised communities. Yet, it is one that deliberately shies away from speaking about sex and sexual health. Further, the use of hand hygiene, even in WASH, is careful to leave out the arena of sexual activity, and what role might hand hygiene play in ensuring sexual health.
This is not to say that it has not found its way into the public dialogue on reproductive health, menstrual health and hygiene. Yet the ‘sanctum’ of sexual health is far removed from WASH. I say sanctum since it is fiercely guarded against any ‘outer touch’, as well as carefully shunned within the public sphere. Sexual activities are deemed to be appropriate behind closed doors and, therefore, spoken about in hushed whispers. This can be blamed on patriarchal underpinnings of how sex is imagined, understood and lived in societies.
To understand how the two areas of public health are not given equal weightage despite their medical interconnections, it is important to understand what sexual health stands for, and how it differs from reproductive health. The WHO in 2002 defined sexual health as “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.”
We must notice how in this definition, sexual health and sexual rights like the right to sexuality, and safe and pleasurable sexual experiences are bound together. The Pan American Health Organization (PAHO) report states that “since protection of health is a basic human right, it follows that sexual health involves sexual rights”. Sexual well-being encompasses a wider domain, which is not limited to diseases and prevention but extends to pleasure and autonomy in people’s sexualities. Hence, it must be part of public health discourse, one that may be able to equip individuals with knowledge and resources to access safe sexual spaces.
Where does hand hygiene feature in sexual health? For starters, it must be understood that the realm of sexual activity is far more complex and wider than simply peno-vaginal penetration. Sexual activities lead to contact, and exchange, of bodily fluids other than semen, and an essential organ that facilitates pleasure is the hand. This stands true for sexual activities done solo or with external objects such as sex toys. It is a no-brainer that the hand comes in contact with an array of intimate parts of the body of oneself or one’s partner, making them precariously susceptible to infections.
People with vaginas, for example, may suffer from bacterial and yeast infections due to dirty hands. This might sound intimidating, but the solution is quite simple; wash your hands before, during and after engaging in any form of sexual activity. More importantly, it features prominently in rights-based discourse, where the right to health and safe sexual activities is your and your partner’s inherent right, and washing hands might be a step towards realising them.
But the simple solution is not practised due to a variety of factors, like shame and stigma associated with sex. Within Indian societies, the discussions around the subject are invisibilised effectively and relegated to the private sphere. Even within private spaces, sex is delegated to the conjugal bedroom of heterosexual married couples. Sexual activities outside of wedlock are met with resistance, little is done to ensure the sexual well-being of young people. The stigma is so internalised that married couples do not feel comfortable speaking about sexual needs; one can only imagine how closeted sexual narratives are and what kind of a humungous challenge it poses.
Secondly, the dominant script of sex is that of heterosexual arrangement. What gets excluded, and marginalised, are LGBTQ+ couples. Narratives around their sexual health are muzzled, keeping the couples in dark about the dos and don’ts of sexual well-being. This leads to hesitation in seeking healthcare services due to the fear of being outed and stigmatised. The more sexual activities and their associated narratives are pushed into the private sphere, the more it gives way to myths, superstitions, misconceptions about sexual health, and an overarching shame to reach out to healthcare providers.
Thirdly, and more importantly, is access to clean water. Many communities, especially women from marginalised communities, bear the brunt. The same is true for adolescents, people with disabilities and people in conflict areas. Even among healthcare service providers, problems related to sexuality are not legitimately critical as they are brushed under the rug, to be spoken about and taken care of in private. This brings with it the baggage of associated stigma, shame and judgement.
However, young people have actively taken up such discussions and engaged in subversive conversations. Hand hygiene finds its way through such attempts. If you must wash your hands before eating, you must wash hands to get and give sexual pleasure.
(Anannya Chatterjee is a trained sexuality and menstrual educator.)
Disclaimer: Views expressed in this article are personal