As teen pregnancies soar, Isaan youth calls for better sex-ed

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Guest contribution by Angela Yang and Joselle Escobar

Two years ago, after missing one day of her birth control pill, 20-year-old Fon realized she was pregnant.

“I was thinking of abortion because I was so stressed. It was unexpected. I didn’t plan to have a baby before,” remembers Fon, who studies at Rajamangala University of Technology in Khon Kaen. “But I didn’t know where to start; should I ask anyone? So I went to ask my friend. My friend said it’s normal to be pregnant at this age when you’re still a student.”

Her friend is right. A UNICEF study found that in 2013, 191.5 births out of every 1,000 births in Isaan were to adolescents aged 15-19, a rate that is steadily increasing every year. This is four times higher than the 2018 global average of 44 births per 1,000, according to the World Health Organization (WHO). In September, the Ministry of Social Development and Human Security set a target to reduce the number of unintended teenage pregnancies countrywide to 25 births per 1,000 by 2026.

Graphic from 2015 UNICEF report on adolescent pregnancies shows that from 2004-2013, the northeastern region of Thailand has grown to have the highest proportion of births from adolescents (aged 10-19).

Mod, a 24-year-old woman studying at the Faculty of Humanities and Social Sciences at Khon Kaen University (KKU), said in middle school many of her friends got pregnant and eventually dropped out of school.

“I knew about five to ten girls. It depends on family because in middle school I studied with many poor families and they were not focused on education,” Mod recalls. “So I wondered why Europeans or Americans can have sex when they’re in school but in Thailand we might get pregnant because we don’t have enough education about sex.”

While Fon had been using birth control before she got pregnant, she only learned about it from her friends and the internet.

“The school sucks at teaching about birth control. They tend to focus more on the men’s side,” says Fon. “For example, they didn’t really go into how birth control works but they go deeper into how to wear a condom properly. They should focus more on the women’s side.”

Birth control isn’t the only topic brushed over by Thai sex education. According to a 2016 UNICEF report on sex education in Thailand, many female respondents reported emergency contraceptive pills were their main way of avoiding pregnancy and were unaware of the negative health consequences. Many boys indicated an unwillingness to use condoms and only 54 percent of female students in secondary schools said they were confident they could insist their partner use a condom every time and have that request respected.

Students and teachers at KKU interviewed for this story say there is a distressing lack of knowledge and communication about sex not only among the youth, but also educators and parents.

It also brings to mind the question: What is wrong with the sex education the youth are receiving now?

A Khon Kaen University student searches online “What happens when the condom breaks?” Photo by Joselle Escobar

Is Thai sex education failing?

Thailand first introduced a sex-education curriculum four decades ago. Yet between 2000 and 2014, United Nations Population Fund (UNFPA) found that 1.5 million babies were born to teenage mothers. A 2014 report released by UNICEF found that 70 percent of all sexually transmitted HIV infections in Thailand happened in people aged 15 to 24. These statistics point to a growing trend of teens choosing not to use protection, likely caused by a lack of sexual or reproductive health education.

In response, the Teenage Pregnancy Prevention and Alleviation Act was passed in 2016, which mandated that all educational institutions to have Comprehensive Sexual Education (CSE) and train teachers to teach the content.

Valerie Taton, the UNICEF Thailand deputy representative, claimed in an article in the Bangkok Post that almost every school in Thailand has now implemented the CSE program, which is supposed to be a rights-based and gender-focused approach to sexuality education. But a report sponsored by UNICEF studying the CSE program from 2015-2016 found that important topics such as sexual rights, gender equality and diversity, and respect for the rights of others are often neglected due to a lack of time and poorly-trained teachers.

Kwang, a 24-year-old female student at the Faculty of Education recalls from her high school sex ed, “They taught me nothing. There was one textbook, a Thai physical education book, which taught that females should not express libido even if they are married. When you show this textbook to students, I think they don’t understand what sex is. When students don’t understand what sex is, they will do it in secret without any right recommendations.”

Young women often feel judged when buying and carrying condoms. Fon explains that she and her friends don’t carry condoms because others might think, “Why are you carrying condoms? Are you going to [have sex with] someone around you? Are you a whore?”

“If we carry condoms and our friends know then they would think of us in a bad way,” says Film, a 21-year-old student from the Faculty of Public Health. “I’m afraid that my friends would think that I sleep around and then would stop being friends with me.”

A male worker at a local 7-Eleven store near Khon Kaen University estimates that out of all the people who come in to buy condoms, seven out of ten people are men.

The fear of judgement may originate from the conservative attitudes towards sexual norms embedded in Thai culture and society. Toey, a 19-year-old male student from the Faculty of Music, argues, “For people in Thai society, it’s not normal if women buy condoms because Thai society looks at women like they should be proper and should have good behavior.”

The double standard might harm young women the most as the ones expected to comply with Thai societal norms. By suppressing conversations about sex, the problem worsens.

“In Thailand, there’s still a lot of culture that presses down, and it’s a concern because we don’t talk a lot about sex in the family either” says Keng, a 21-year-old male student from the Faculty of Humanities and Social Sciences. “I think the more they try not to talk about it the more people are willing to do that–it’s like a taboo.”

Women are often the ones who suffer the consequences of a poor sex education but many say it is men’s attitudes that are the biggest obstacle. Piyapa Muangman, manager of the Women’s Health Advocacy Foundation based in Bangkok, argues that “Thai patriarchy is the reason for sex without male responsibility. We often see families teaching girls to feel embarrassed about sex.”

“But with boys,” she says, “things are not so strict, and they end up learning more about sex. This often results in teenage girls having unprotected sex. Sex education should therefore begin with families teaching boys to be more responsible”

What needs to change and how?

Dream, a 22-year-old woman from the Faculty of Business, believes that a way forward begins with educating boys on gender equity. “Boys always think that they have more power than girls so they can do what they want,” she says. “They need to learn that we all have equal power when we have sex. If your girlfriend says she doesn’t want to have sex today, you have to respect her desire. Don’t force her to.”

Girls certainly need more education in using contraceptives, Dream says. But men also need more knowledge in gender equitable attitudes and practices to combat double standards in Thai society.

In addition, many believe sex education needs to begin earlier.

“Education needs to start from when students are young,” says Joy Belardo, a lecturer at the Language Institute of Khon Kaen University. “We cannot force parents to talk about this, but if we include this topic in class then it will be normal for students to learn.”

Many of those interviewed are calling for improved sex education that teaches students information that can be applied in real life, like the nature of sex and emergency contraception.

Kwang, a 24-year-old woman studying in the Faculty of Education, is more upfront. “Just give them a choice. Don’t prohibit them from having sex because we cannot force someone to stop having sex.” Instead, she says, “Provide them with choices. If you want to have sex you do masturbate or if you have a boyfriend you do blowjob, handjob something like that. And birth control. Teach them! And often, so that students will be open minded. At least they know how to protect themselves.”

However, Kwang, who is studying to become a teacher, also believes that change is difficult within the education system.

“You have to understand that Thai social context in schools are different. The generation of old teachers don’t accept what the new generation says today,” Kwang argues. “Many of my senior friends say that I cannot change the system because most teachers are old and traditional. I am just a little spot to make a change.”

Despite difficulties in changing the system, there is evidence that better sex education can reduce rates of teen pregnancy and HIV/STIs. A 2015 review of sex education programs in various countries found that 80 percent of programs that incorporated teaching about gender and power were effective in reducing unwanted pregnancies and STI transmission, while only 17 percent of programs that did not include them were effective in producing the same outcomes.

What is next?

So how can Thailand not only prevent teenage pregnancy but also move towards a more gender equitable society? For Keng, the answer is simple: talk about it.

“I want to break the barrier of the culture because sometimes we hold onto things from the past. We never used to talk about politics before but we talk about it more nowadays. I think it should be the same with sex,” Keng says.

“Teachers and students, parents and children should really talk about it because if you can get them to talk about sex, then those children can learn that sexuality and gender differences are very fundamental things that everyone needs to understand and be respectful of.”

Angela Yang is a student of International Relations at the University of Pennsylvania. Joselle Escobar studies Political Science and Government at the University of Illinois. Both studied about development and human rights issues in the Northeast in fall 2019.