Let's talk about sex: Mabel van Oranje, Board chair

BRUSSELS – Last week, at the “She Decides” conference in Brussels, government ministers met with representatives from NGOs, United Nations agencies, and foundations from around the world to talk about an issue that is rarely discussed in such dignified settings: sex.

Too many young people – especially girls – lack access to quality sex education. They do not know what sex is, much less that unprotected sex can lead to pregnancy or put them at risk of sexually transmitted infections, like HIV. Even girls who know about sex often lack the information they need to avoid pregnancy, or don’t have access to contraceptives. As a result, millions of girls around the world are disempowered.

Gender inequality exacerbates the situation. In most societies, girls are valued less than boys. Often, they are viewed as the property of men. Decisions related to sex, marriage, and reproduction are out of their control.

The practice of child marriage is closely linked to sexual autonomy and health. As it stands, 15 million girls per year – an average of 28 per minute – are married before they reach the age of 18. Girls may be forced to marry because they become pregnant, because of concerns about their security or their family’s honour, or because there is a financial transaction involved, such as a dowry or bride price. These child brides are forced into sexual activity when their bodies are still developing, and most lack the knowledge, confidence, and power to negotiate safe sex.

These child brides are forced into sexual activity when their bodies are still developing, and most lack the knowledge, confidence, and power to negotiate safe sex.

I have met many girls and women around the world who have suffered for this lack of education and decision-making power. In Zambia, I met Cynthia, a 12-year-old girl who was shocked when she found out that she was pregnant. Growing up in a community that considers talk about sex taboo, she hadn’t known what sex was, let alone that it could lead to pregnancy. When she found out she was going to have a child, while still a child herself, she was devastated. Marriage was now her only option. Unable to continue her education, she had lost any chance of escaping poverty.

In India, I met Meera who, in keeping with her village’s tradition, had been forced to leave school and marry an older man by the time she was 15. Never having learned about contraception, she had already had multiple pregnancies. Then there was Amal, a Syrian refugee girl whose parents had married her off, in order to protect her (and her family’s honour) from becoming a victim of the sexual desires of unknown men.

Child brides have an enormous unmet need for contraception.

They are vulnerable to the complications of early pregnancies, sexually transmitted infections, fistulas, and death in childbirth. Globally, complications related to pregnancy and childbirth are the second leading cause of death among those aged 15 to 19, after suicide.

The She Decides conference – hosted by the Belgian, Danish, Dutch, and Swedish governments – focused on securing financial and political commitments to support the sexual and reproductive health and rights of girls and women. There was universal recognition that girls and women should have the right to decide whether, when, and with whom to have children. Participants pledged more than €181 million ($192 million) of new funding to support the provision of contraceptives, sex education, maternal health programmes, and other initiatives. With the funding gap growing wider, fulfilling these pledges is crucial.

We must change the attitudes that make talking about sex taboo. We need to address the power dynamics that limit access to reproductive health services, even when they are available.

But more than money is needed. We must change the attitudes that make talking about sex taboo. We need to address the power dynamics that limit access to reproductive health services, even when they are available. And we must recognise the damage caused by child marriage, including to girls’ sexual and reproductive health.

Many of the organizations engaged in the Girls Not Brides global partnership to end child marriage are focused on tackling these issues. We know that progress is possible only with the engagement of civil society, which has a huge role to play in changing norms, driving policy reform, and providing services. Small local organizations are often in the best position to understand and respond to the needs of girls and families.

To live happier and healthier lives, girls everywhere need to be able to make informed decisions about their bodies, their sexual and reproductive choices, and their future. So let’s talk about sex.