Dear Editor,
Gupta et al. analyse adolescent sexual bahaviours and its determinants by conducting a hospital-based study.[1] Because of higher exposure to modern day communication devices, adolescents have access to those contents which were inaccessible just a generation ago. The researchers state that they assess for the first-time the route of intercourse, frequency of sexual activity and place preferred by the adolescents to engage in the lustful exercise. They concluded that the prevalence of sexual activity is low among Indians as compared to the West.
However what we want to underscore is that in medical science we usually assess prevalence of a disease. But when a group analyses prevalence of something as natural as sex, we find something misplaced. While discussing about this, the private act is taboo in our society, many a time we witness that highly educated youngsters lack basic knowledge of essential facts. Unprotected sex, unplanned pregnancies, unsafe abortion, septic complications, perforations and premature mortality are eventual fallouts of the ignorance-muddled by social structure, patriarchy, women’s subjugation and caste hierarchy; compounded by lack of basic infrastructure in hinterlands. Here we would realize that only by naturalising the activity, we’ll be able to control the menace of STDs and other surgical complications.
In Table 2 of the study, adolescent girls are reported to have had intercourse with fellows and employers. There we need to differentiate between these two apparently similar entities. When someone, including a girl, has sex with a person of similar age, she is likely to have a consensual one.[2] And many a time when the boy belongs to a lower status in the social hierarchy, the family objects to the relationship. As our law has provision for criminalization of such acts, it’s widely misused in this circumstance.[3] There are cases in which an adolescent girl elopes with a boy and parents file a criminal-case of kidnapping. Later on, when the girl is recovered by the police, she is pressurized to give a statement to have undergone sex without her consent.[4] Then the boy is charged with stringent provisions of the POCSO Act.
Although these issues apparently lie outside the scope of medicine, many such cases result in misreading and misinterpretation of law. When the couple is scared due to such State-sponsored and other acts; result is handling of the pregnancy by untrained service-providers operating from dubious centres. We regularly observe cases in our maternity wards complicated by dais (untrained service providers) and many a time such patients face untimely death.[5]
Conversely, when the adolescent reports having sex with her employer, we’d look into the possibility of coercion, duress and usage of power: both economic and social. In this circumstance, the girl is a victim and the State with all its might and resources should come to her rescue. This is a classic example to illustrate that, when girls don’t get an opportunity to learn skills, lose on the education front, are forced to earn in an atmosphere of uncertainty and hopelessness; they surrender not only their agency but also freedom and choice.
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References
- 1.Gupta N, Anwar A, Varun N, Paneesar S, Nigam A. Adolescent sexual behaviour and its determinants: A hospital-based study. J Family Med Prim Care. 2020;9:5511–5. doi: 10.4103/jfmpc.jfmpc_1115_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Deswal V. Need to revisit the concept of age of consent. Times of India. 2019. Available from: https://timesofindia.indiatimes.com/blogs/legally-speaking/need-to-revisit-the-concept-of-age-of-consent/
- 3.Agnes F. Controversy over age of consent. Econ Polit Wkly. 2013;48 Available from: https://www.epw.in/journal/2013/29/commentary/controversy-over-age-consent.html . [Google Scholar]
- 4.Viz RK. India should consider lowering the age of consent. Hindustan Times. 2019. Available from: https://www.hindustantimes.com/analysis/india-should-consider-lowering-the-age-of-consent/story-BlWpuGuaQu93q4GdSsJ6KJ.html .
- 5.Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. Incidence of abortion and unintended pregnancy in India 2015. Lancet Glob Health. 2018;6:e 111–120. doi: 10.1016/S2214-109X(17)30453-9. [DOI] [PMC free article] [PubMed] [Google Scholar]