Shame and Sexual Knowledge

It’s not like mom and dad are conservative, I thought. After spending our entire lives abroad, a solo academic career in the US and all this liberation, why the heck hasn’t Amma ever talked about this? Why did I have to learn this from Joyeta rather than mom? What if it’s not licoria and I really have cervical cancer? Frantic questions chased each other, before the inevitable conclusion. The best way – the only way – is to ask Mom about it.

“Mom….umm… Do you know… did you know that every girl above 18 years of age is supposed to have a regular cervical cancer test?”

And I saw my mother’s face bleach out.


Aahung’s life skills education manager, Sheena Hadi, says it’s a very common scenario – most girls discover facts related to sexual health through friends.

“Puberty is an introductory point, the prime time for information regarding basic hygiene, physical changes, our bodies, etc. But because parents are so uncomfortable discussing the subject of our bodies, I’ve noticed that less than 30% girls know what menstruation is – although it’s a biological phenomenon, not sexual.”

Talking to Hadi made me realize that I, too, had grown up with myths. Myths like showers during the menstruation cycle “swell up the lower tummy”. Elder women, aunts, and cousins, share minimal sexual information, guarding them like Pentagon secrets. Friends are the best, non-judgmental relations where shame is covered by giggles and questions are answered. Hadi says a lot of myths are born right here. “As parents and adults, we define who are the right and wrong friends to hang out with. It’s really a matter of what our expectations are and what steps we are taking to help our children live up to them.”


In an era driven by unlimited mediums of disseminating information, a vast majority of young Pakistani women resort to gossip to answer their queries about their own sexual health. Commonly, mothers squeeze the “women’s problem” between deciding what to cook for lunch and the hit soap opera. Fathers, as Hadi says, never have a chat about the “birds and bees” with their sons.

“Girls will resort to cousins for information but in this particular instance, boys are at a greater risk. Boys are less likely to question these things because they are “wrong.” “Dirty” is a frequent term they use to describe their thoughts and even visit quacks to control normal bodily functions.”

At a recent conference regarding sexual rights, Pramada Menon, director of a sexuality institute CREA , demanded a second look at how we define our bodies. “I don’t understand… why do we use the words ‘chi chi’ and ‘shame shame’ for our private parts? Since childhood, because they are shameful and oh-so-taboo, our children never discuss them.”

Hadi reaffirms that this “shame” is internalized and associated with our private parts. She says when cases of sexual abuse come to her, most children suffer with guilt because someone touched their “shameful” parts and so they don’t want to talk about the experience, as an extension of that guilt.

But the problem doesn’t stop at guilt only. Neha Sood, training coordinator of IRAD (Institute of Research, Activism & Development, CREA) says denying this basic information might mean the difference between acquittal or prosecution in sexual abuse. “In a famous child abuse case in Delhi, the offender was almost declared ‘not guilty’ because the child could not define the body part that was used to sodomize him. Eventually he likened it to an ‘oozing glue stick’. A phrase that saved the lives of a potential score of children that the pedophile might have abused.”

Yesterday, riding high on my “right to information” as a journalist, I visited a very prestigious hospital in Islamabad to interview a “top-notch” gynecologist. Minutes later I was blushing furiously and squirming in my seat because the gynecologist reprovingly enquired, “You are not married… but you need to know about the symptoms of pregnancy?”

Hadi comforted me that I’m one of many victims of the “information provider/moral judge” syndrome. “More often than not doctors frame their questions to make a patient rethink their moral values. Aahung trains information providers to address the problem because a marital status, for example, does not validate sexual activity or lack of it. Similarly, issues of confidentiality are important because a girl cannot discuss her sexual history before her mother-in-law.”


The problem, of course, is multifold. It’s not only a lack of information – basic information that pertains to survival, but a stark denial as well. Take the time to get close to any teenager above 15 (or even younger – 15 is not necessarily the starting age) and you can discern symptoms of sexual activity in the conversation and behaviour. Researchers in Rozan, an Islamabad-based NGO working on child sexual abuse, say that no concrete data is available but young people in the higher economic classes have a greater rate of engaging in sexual activity.

As Sheena Hadi returns to designing school curriculum, I slip out of the room, thinking my mother has spent an entire lifetime believing that showers during menses cause a bloated stomach. I hope finding out that it’s not true will bring some color back to her face.

Marginalized Voices

Who can legitimately have a say on the topics of sex and sexuality? This is determined by one’s relationship to privilege. We know that whereas one voice may be heard, many are marginalized and never heard. Therefore, before we speak about sex and sexuality, I wish to consider those voices that are often not heard within such discussions. The challenge thus is to include these Other voices within this very important discussion.

In Pakistan, “poor women’s higher unaccompanied mobility was associated with a loss of prestige and susceptibility to sexual violence. Among richer women, such movement did not constitute a legitimate target for male exploitation, nor did it lead to a loss of status on the part of their families.”1 So we know that Pakistani women face issues of access and mobility within public space specially women belonging to the disadvantaged classes. Being seen or heard in public space can lead to violence for women who cross the threshold that delineates the home as the “private” sphere and the supposedly “safe” space for women. Public space is for men, and to cross that threshold is to break the rules that govern female bodies and for this, they are punished. Rules that create the public/private dichotomy are certainly not specific to Pakistan.

However, do the same socially-constructed rules of the public/private boundaries apply to cyberspace?. It seems, women with better educations, better access to knowledge, and access to technology and the internet have a better chance of taking part in conversations on cyber-space. Therefore, in some ways, the same rules do apply.

Another barrier to speaking openly and honestly about sex and sexuality in the Pakistani context is religion or the degree of religiosity of your family. You cannot speak about sex and sexuality if you believe that doing so is a sin or can lead to sin. Such beliefs are fed to women at an early age in order to keep them from having agency over their own bodies. “Your body does not belong to you; it belongs to your father, brother, and husband”. Therefore, you need not think of your own needs, desires, health, or anything else that makes you a whole person. In fact, women are taught to deny themselves pleasures in order to achieve piety which we are told comes with rewards in the afterlife. However, there will not be 40 virgins waiting for you women next to streams flowing with milk and honey. The Muslim male subject, however, is conceived as a whole person, with an active sexuality, and deserving of more sex and sexuality in the afterlife.

The politics of self-expression is premised on a notion of a subject who is capable of being self-reflexive, inward-looking, self-contained2, and whole subject who belongs to himself, and not to his mother, sister, or wife. Supposedly, the right to legitimately express opinions and ideas belong to only those who have agency, who own themselves and therefore can look within themselves and speak from their whole selves. Alternatively, Muslim women are taught that they do not have “right” to express themselves the same way as men. We are told that we must let our (mostly male) ‘guardians’ to decide on our behalf. For those women who believe that their sense of piety and honour is in jeopardy if they speak out about sex and sexuality, these women will not be part of the discussions here.

I do not assume that women lack agency; I believe they do have the option to believe that a sense of piety and honour is not at stake if they make claims over their own bodies and choose to speak from their bodies; I believe that honour and piety should depend on the strength of your faith in humanity and social justice; and I believe that they themselves choose to stay silent in spaces where I believe their opinions are much needed and their insights much valued. Is it not said, “speak up or be spoken for”? At the same time, I also know that patriarchy has made it so that speaking up comes with a price, one which many women are unwilling to pay; so they do not speak up in fear of punishment or loss of social capital.

The point is, when “we” as Muslim women come to the table to speak about issues of sex an sexuality, “we” are not on an equal playing field, therefore, some voices have more weight than others, and still others are silent all-together. We also have different, and at times, conflicting concerns. Once we recognize these differences between women, only then can we start to think of ways to alleviate the inequalities, if we believe that we all have the right to express and be heard.

1 Mumtaz Z, and Salway S. “I never go anywhere’: extricating the links between women’s mobility and uptake of reproductive health services in Pakistan”. SOCIAL SCIENCE & MEDICINE 60(8) (April 2005: 1751-1765.

2 Majeed, Javed. “Being Middle-Class in South Asia”. History Workshop Journal. Issue 65, Spring 2008: 247-252.

Last Night

I thought of you as an incomparable portrait; all framed in gold.
You were Dorian Gray last night.

My dream of paradise left incomplete, I suddenly woke up.
I ate an apple last night.

Everyone knew the truth about you and me.
I spread a rumour last night.
I remembered our ink-stained hands; the prose we used to write.
I typed a sonnet last night.

You instructed me about the rules of languages – yours and mine.
I read Shahid Ali last night.

Your love had something in it unbearable – a mother.
It was the night of the scorpion last night.

You had made my mind your house; my body your room.
I tripled the rent last night.

You were the muse of my story; of my first novel.
I wrote the epilogue last night.

And I, Akhil, knew well that God died yesterday; his was the other pyre.
The ashes ceased to smoulder last night.

HIV, Women and Sex Work

The prevalence of HIV/AIDS in Pakistan is still low compared to rates in Sub-Saharan Africa and other countries throughout the world.  But there is also a great deal of denial from government officials and the public about this disease so the numbers may be higher than we think.  For example, in 2002 the official estimate of HIV/AIDS in Pakistan was about 2000 whereas World Health Organization rates were between 80,000 and 100,000 across the country.  The key to preventing Pakistan from becoming like South Africa is to put in the effort and resources at this critical juncture to educate and therefore prevent the further spread of infection.  Pakistan must utilize proven prevention and education methods in order to save lives even if these make us culturally uncomfortable.

Underlying causes

HIV/AIDS is a complicated issue with many underlying causes.  It’s not as simple as being promiscuous, being a drug user, or being gay.  In the majority of the world poverty is directly correlated with your chances of contracting and dying from the disease. Poverty here refers to two things: insufficient income to satisfy basic food and essential non-food needs; and human poverty, fundamental stumbling blocks such as illiteracy, malnutrition, poor maternal health and illness from preventable diseases. Both of the above contribute to a context that makes one more susceptible to transmitting HIV.  Living in extreme poverty can lead people to engage in risky behaviour such as joining the sex industry, undertaking long distance labour migration and entering into substance use.  While in some contexts, high risk behaviours and poverty are not so clearly correlated, research suggests that countries with the highest income inequalities are the hardest hit.

Disempowerment: feminization of HIV/AIDS

Unfortunately HIV/AIDS disproportionately affects women.  In most societies women are given less importance in regards to receiving healthcare and education. They are also more likely to be victims of sexual violence. Regrettably also women are also more likely to contract HIV based on their biological makeup: the female genital tract has a greater exposed surface area than the male genital tract; therefore, women are biologically at greater risk of infection.  The male-to-female transmission rate is about twice that of the female-to-male rate. Currently more women are becoming infected than men. Globally, nearly 50% of people living with HIV are female.  In 1992, 42% of those infected were female.

The main method of prevention that is being used and encouraged by those with money is the ABC method.  Abstinence, Be faithful, and use Condoms.  However, the ABC method is not relevant for females. Abstinence is moot in the face of coercion and rape, etc., faithfulness will not prevent transmission if the woman’s partner is not faithful, and condoms require the consent of the man.

High-risk group

There are many high-risk groups that are more susceptible to HIV.  Migrant workers that travel away from there families for work, injecting drug users, men that have sex with men, and sex workers.  Sex workers are adult women and men, children, young people, and transgendered people that exchange money or goods for sexual services, including intercourse, either regularly or occasionally.  In several regions, significantly higher rates of sexually transmitted infections and HIV infection are found among sex workers and their clients than in other groups.  It generally spreads among sex workers and their clients before it spreads to the general population to their spouses, families, extended sexual networks and then the population at large.  Sex work can be either voluntary or involuntary.  While some people work in the industry out of choice, it is more typically the only means to escape poverty, or is forced upon individuals as part of human trafficking.  Sex workers frequently have little control over their working conditions and their capacity to negotiate condom use.

It is estimated that there are tens of millions of sex workers worldwide.  Their clients number in the hundreds of millions.  However, little is known about sex work in pre-dominantly Muslim countries.  The few statistics we have are worrying.  In Tamanrasset, Algeria, sex workers have an HIV prevalence rate of 10%.  In Karachi, Pakistan, more than one quarter of sex workers had never heard of AIDS.  Three quarters do not know that condoms prevent HIV, and only 2% use condoms with all their clients.  In Jakarta, Indonesia, one in five drug injectors buys sex, which doubles the chances of contracting HIV.  In the Eastern Mediterranean, only 0.5% of sex workers are protected by any sort of HIV protection program.

In November 2007, Islamic Relief Worldwide held a unique international consortium in Johannesburg, South Africa.  We invited scholars, practitioners, and people living with HIV/AIDS with the purpose of informing scholars of what HIV really is, the practicalities of how it is transmitted, how poverty plays a role, how women’s rights play a role, and the difficulties in living with it.  The consultations were a success, with representatives from over 50 countries participating in ground-breaking initiatives and steps decided on to help the Muslim world face this problem. Consultation discussions included talks on the stigma and discrimination; rights and obligations; gender dimensions; awareness and prevention; protection, treatment, care and support; and particularly vulnerable groups.

Although Islamic and cultural guidelines do not allow for the behaviours that can lead to contracting the disease, we do not live in a world that is that simple.  There are many factors such as poverty that we need to realize do affect situations and contexts.  And as you can see women bear the brunt of many of life’s disproportionate challenges and therefore are more likely to contract and suffer from HIV and other diseases.  We as a community need to acknowledge these facts and do our part to bring awareness, education, and much-needed funds to face this challenge head-on before Pakistan becomes another South Africa.