How To Teach Sex Ed When Even The Word Is Taboo

Mariya Karimjee is a writer based in Karachi, Pakistan. The views expressed here are her own.

When Munira (not her real name) asked me how I peed with a tampon inside me, I was certain her question was a joke. Then my eyes met hers and I realised that she was entirely serious. “They’re separate holes,” I said, confused that she didn’t already know where her urethra was. “Yes,” she said. “There’s one where you shit from, and another that’s your vagina.” She didn’t say anything else. That’s when I added, “And then there’s the hole where you pee.” At first, Munira didn’t believe me. So I pulled out my cell phone to find an image — but it made no sense to her. “What is that?” she asked. I have known Munira my entire life. Though we didn’t attend the same private school in Karachi, both Munira and I were taught in some of the best educational institutions in Pakistan’s financial capital. I moved to the United States when I was 11, but Munira stayed in Karachi for high school, and then attended a private university in the Midwest.

Munira’s lack of knowledge hit me hard. I knew too well the result of ignorance about female anatomy. When I was 7, my mother took me to a neighbour’s house in Karachi for a ritual practiced in the Dawoodi Bohra community, the sect of Shiite Islam to which I belong. Under pressure from her in-laws, my paternal grandmother and grandfather, my mother watched while a woman removed a part of my clitoris on a tarp on the living room floor. It was only when I was in my mid-20s, after a tense conversation with my grandmother about my memories of the incident that I realised she didn’t seem to know what the clitoris was. That difficult conversation with my grandmother — about how women can and should experience pleasure during sex — showed me the importance of knowing our bodies. Perhaps because many women in my sect lack this basic information, generations of women who have had their clitorises cut perpetuate this ritual on their daughters. Female genital mutilation, or FGM, is still not illegal in Pakistan, and many members of my sect who live abroad have returned to Karachi to have their daughters cut. While I don't know of any Bohra women in my mother’s generation who were not cut, I do know some my own age. They, in turn, are choosing not to cut their own daughters because they’re better informed about the physical and psychological effects of FGM. A study in Egypt also found that education reduces the likelihood of FGM being passed down from one generation to the next. Now, here we are, 50-something years after my grandmother got married and first had sex, and we still don’t have all of the facts. Highly educated, cosmopolitan Munira still didn’t know the first thing about her sexual organs.

Women in Pakistan — a deeply patriarchal country — face high rates of gender-based violence. Estimates from the World Population Foundation, a nonprofit that educates women on their sexual and reproductive rights, show that at least 70% of them have experienced some form of domestic violence. Premarital sex is illegal here, punishable by up to five years in prison. Talking about sex is culturally taboo; medical school students are taught to assume that an unmarried woman has never had sex, unless symptoms clearly dispute this. This cultural norm of secrecy and shame permeates every level of society. None of the seven women I spoke with for this story wanted me to use their real name. As a result, I’ve changed all the names used in this essay.

I received my sexual education in a public middle school outside of Houston. While I learned that it was bad to have sex outside of marriage, I also learned that condoms prevented STDs and that I could take oral contraceptives to prevent pregnancy. Though discussing sex was never really comfortable for me, I knew where I could find more information: teachers, family members, doctors, and, of course, the internet. In Karachi, however, the situation could not have been more different. My family belongs to a privileged sliver of Pakistani society — the urban elite. Unlike approximately 90% of the country’s population, I have had access to good, internationally recognised English-language schools, higher education outside of Pakistan, and the financial and social capital to have traveled widely. When I moved back to my hometown four years ago, I realised, clearly, that I was an outlier. I asked a former principal at a private school conglomerate in Karachi how she handled sex ed for her students. In her classes, she said, most conversations about reproduction were held using plant biology. “Many of the younger teachers would plead with me that they not have to teach reproduction,” she said, explaining that the teachers feared retribution from parents, judgment from their colleagues, and sometimes just didn’t know the answers. Parents were often no help, either. “I don’t think that girls are actually learning what’s happening in their bodies,” the ex-principal continued. “I had to have countless one-on-one meetings with students and parents when my eighth-grade girls were coming to school on their periods and had no understanding of what to do.” A former biology teacher who was hired by some of Karachi’s most expensive private schools to give lectures about changing bodies, agreed. “We can’t even refer to it as sexual education,” she said. School administrators titled the lecture “Health and Hygiene,” and split up the kids by gender. The educator was quick to explain that, though parents and schools called her a sex educator, “I never get to talk about sex. I don’t even get to tell young boys that it’s okay to have wet dreams.” Instead, she said, she often felt as though she was competing with the resources that teenagers were able to find themselves. “Even the Pakistani serialised dramas on television are alluding to extramarital affairs,” she added. “These kids already know way too much, but none of them have been given the tools to understand it.”

Had I stayed in Pakistan, I wouldn’t have received any formalised sexual education either. According to a friend who attended the same school as I did in Karachi, her classmates were separated by gender in the sixth grade to listen to a very basic lecture about puberty. They didn’t learn about sex, contraceptives, or sexually transmitted diseases. Instead, they patched together an understanding of sex through friends and the internet. While boys discussed sex in middle school and watched porn on DVDs, for girls it was a more taboo subject. “I think that many times, we’re taught from such a young age that sex is something that we should be afraid of,” said another friend of mine who also learned about sex through friends. “And this is particular to girls in Pakistan. Boys are still able to know that they can have sex, and sometimes live under the impression that they are entitled to it, and to enjoying it when women are not.” Many of the women I know in Pakistan have premarital sex with multiple partners — they just aren’t copping to it. And because they’re not able to talk about it openly, or haven’t had any sex ed, they often don’t have enough information about sex despite being sexually active. Munira was only one example. Another friend who had studied in Canada didn’t know that Plan B and the birth control pill were different — back in Pakistan, she routinely had unprotected sex with her boyfriend, popping a Plan B afterwards to prevent pregnancy. A third friend insisted that the withdrawal method worked, according to her mother, who swore it was more effective than condoms and birth control pills. Many of these women say that no one taught them that sex should be fun for them; some admit that they don’t enjoy penetration. Though they talk frequently about relationships and will tell close friends that they’ve “hooked up,” they don’t discuss the actual act of sex. If I could go back in time, and visit my grandmother when she was 13, I’d take a copy of Our Bodies, Ourselves with me. That 1973 classic was instrumental to my own understanding of the female body, as well as my sexuality. I’d show dadi (grandma) the illustrations of female genitalia, let her read the explanation about how natural and healthy it is for a woman to masturbate. I’d tell her a clitoris can bring joy, not shame, and beg her not to deprive me of it.