Informed choice is best

  • Letters
  • Tuesday, 09 Jul 2019

THIS is in response to the letter by Dr Rafidah Hanim Mokhtar that was published yesterday in The Star, “Sex education must be guided by our values” (July 8; online at

Various arguments on the approach to empowering young people about their sexual and reproductive health inevitably include a personal and moral compass. There is no doubt that the notion of abstinence would serve as one of the solutions to the social issues young people are facing – but when it comes to interventions, they must be evidence-based rather than based on moral judgements, which are often subject to personal bias.

The Comprehensive Sexuality Education (CSE) introduced by Unesco, International Technical Guideline of Sexuality Education: An Evidence Based Approach (Women, UN and Unicef, 2018) and IPPF Framework for Compre-hensive Sexuality Education (International Planned Parenthood Federation, IPPF, 2013) are two of the most credible and widely used guidelines in helping educators around the world to provide non- judgemental and youth-friendly sexuality education.

They are based on scientific evidence and on consultations with many stakeholders and they incorporate lessons learnt from the ground for practicality.

Both modules have similar definitions of CSE, incorporating the concept of gender, sexual and reproductive health and HIV, citizenship, sexual behaviour, violence, diversity, relationships, and skills for health and well-being; all these can be delivered in formal and non-formal settings and are scientifically accurate, incremental, human-rights based, and gender- transformative based.

The perception that these guidelines are amoral and culturally insensitive, that they would undermine young people’s ability to understand the conundrum of sexual behaviour is hardly justified by any scientific evidence. Both of the guidelines are culturally-relevant and context-appropriate. This is because CSE fosters respect and responsibility within relationships, and supports learners as they examine, understand, and challenge the ways in which cultural structures, norms, and behaviours affect people’s choices and relationships within a specific setting.

This is where CSE plays a vital role, in creating conversations and interactions among young people that reflect on social norms, cultural roles and values, and traditional beliefs. Such conversations can help them to understand and better manage their relationships with friends, parents, teachers, and other members of society. They help them develop life skills that are needed to support healthy choices that include the ability to make informed decisions, communicate and negotiate effectively, and demonstrate assertiveness.

The framework of both manuals underpins that CSE should be an informed, choice-based approach, as it believes in the ability of young people to make decisions about their bodies armed with adequate education and information about their sexual and reproductive health.

CSE provides children with the opportunity to develop confidence by learning about their emotions, self-management (hygiene, emotions, behaviour), social awareness (empathy), relationship skills (positive relationships, dealing with conflicts) and responsible decision- making (constructive and ethical choices). These topics are introduced gradually, in line with the child’s age and evolving capacities.

Apart from that, the guidelines lay the foundation for a healthy childhood by providing children with a safe environment in which they can learn the correct names for parts of the body; understand principles and facts of human reproduction; explore family and interpersonal relationships; learn about safety, prevention and reporting of sexual abuse, etc.

We applaud the efforts made by the Women, Family and Com-munity Development Ministry in educating children about safe and unsafe touch. However, the social issues children face now cannot be solved by the abstinence approach. Our national curriculum is an abstinence-based, restricted and rigid framework that does not take into consideration the fact that we are all from a variety of backgrounds, living a diverse set of circumstances.

How do we explain the rising numbers in Malaysia of cases of sexual violence, sexual exploitation, teenage pregnancies and child marriage? When the education framework employs an abstinence-only focus, it clearly disregards the interlinkage of informed choice (inclusive of abstinence) with that of protection and promotion of young people’s health and well-being.

The recently launched Country Monitoring Report by the Federation of Reproductive Health Associations, Malaysia, presented at a National Policy Dialogue with the Women, Family, and Com-munity Development and Edu-cation Ministries showed the

ineffectiveness of the abstinence approach in the school curriculum with testimonies from respondents – including young people, teachers, parents, and other stakeholders – agreeing that an abstinence-based approach is not enough to empower young people about their safety, security, boundaries, and consent.

The report also found that despite the milestones achieved by Malaysia in the area of sexual and reproductive health, adolescents and CSE, there are still a multitude of issues surrounding adolescents today, like teenage pregnancies, sexual violence and child sexual grooming, that need to be better addressed.

A curriculum that is based on abstinence instead of informed choice, the lack of parental and family support, compounded by the lack of a robust monitoring and evaluation mechanism, untrained teachers and the lack of political willpower have also decelerated the progress of CSE. This has been hugely supported by research (Haberland & Rogow, 2015).

Besides, the regional study done by the Asia Pacific Research and Resource Centre for Women in 2018 illustrates that CSE is not a “Western value” but widely accepted by Asian countries due to its relevance to Asian cultures and values.

CSE is a guideline that is based on extensive empirical evidence collected across the globe. The evidence reaffirms that curriculum- based sexuality education programmes contribute to delaying the initiation of sexual intercourse, decreases the frequency of sexual intercourse, decreases the number of sexual partners, reduces risk-taking (Unesco, 2009; Fonner et al, 2014; Shepherd et al, 2010), increases the use of condoms (Lopez et al, 2016), and increases the use of contraception (Unesco, 2016c).

In conclusion, the guidelines of both the IPPF and Unesco on CSE are voluntary and nonmandatory, based on universal evidence and practice, and recognise the diversity of different national contexts in which sexuality education is taking place.

As to where Malaysia is right now, young people need sexual education that is effective in empowering them based on informed choice so they can make better choices for themselves now and in the future when they become adults.


Executive Director

Federation of Reproductive Health Associations, Malaysia

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