When Young Girls are at Risk

In her final undergraduate year, 19-year-old-Janki* took up a job at a call centre, where her classmate also worked. Janki was able to balance studies with afternoon job-training sessions, but once she was given the night shift, it became a problem. Her New Delhi college hostel did not allow late nights, so she moved to the classmate's paying-guest place.The call centre was a new world for Janki, who'd come to the city from provincial Uttarakhand. "Neat money, sexy girls, cool dudes, slick office and great cafeteria," she told me. "For the first time I saw girls drinking or kissing guys publicly although no one ever forced me into all that." The freewheeling spirit was infectious but Janki maintained her distance, priding herself on her strength of character. Little did she know how vulnerable she was-until she met Jinesh*, a young colleague, also from Uttarakhand. Talking to him in her native Garhwali was a delight. They struck an instant friendship. The office crowd soon began to see them as a couple-a situation where a young girl's status grows among her peers. Janki had her first drink at a friend's engagement party, followed by a few more. That night she went with Jinesh to his flat and had unprotected sex. As their intimacy grew, it became addictive, with the young man becoming increasingly insistent. Janki felt helpless. Protection was irregular. She knew this wasn't right, but she gave in for fear of losing her boyfriend-a classic situation. When Janki skipped a period, Jinesh reassured her saying it must just be erratic. When the next one was missed, they got worried. Jinesh got her what he was told were abortion-inducing pills. When they didn't work, she went to a busy abortion clinic in the city's Lajpat Nagar area.That's where I met Janki a few years ago, while working for my PhD at the University of Delhi. My given subject: Sexual Risk-Taking Behaviour Among Adolescent Girls. Few studies of the sort, my research guide told me, had been done in India. I was to meet and survey 200 pregnant girls, aged 12 to 19, who came to the clinic for abortions. Half of them-Janki included-would be unmarried. Although the clinic's staff were cooperative, it wasn't always easy to get the unmarried pregnant girls I approached to talk to me or fill my extensive survey form. The 100 unmarried ones I managed to survey were students or working girls and many of them lived alone. They came from different social strata, but had much in common in their ignorance of sexual matters.  An adolescent's burgeoning sexuality is more confusing to deal with today because of changes sweeping through modern Indian society. Children mature physically earlier these days, which brings with it the problem of dealing with a mature body before they are often psychologically able to cope with and understand these changes. Although my study was conducted in Delhi, the experiences of these teenagers will, I believe, generally reflect patterns of behaviour almost anywhere in urban India. My five key findings:

1. Parents are neither communicative nor updated enough Romantic relationships and sexual activity among adolescents are much more common today, and attitudes are very different from the time their middle-aged parents were teenagers. Yet, if parents stay closely in touch with their children's activities and are openly communicative, adolescents are less likely to be sexually active too young. And teens who have clear educational goals strongly supported by parents, tend to be more focused on studies rather than love affairs while in school.  Very rarely are adolescent girls taught about sexual matters by their parents. They usually learn by overhearing conversations, observing adult behaviour, from peers and older siblings and, increasingly, from the media.Learning this way can be risky. Such information is typically limited, false and unduly glamorized. Adolescents tend to allow media messages to colour their goals. Girls in a relationship are likely to interpret sexual relations as a way to be intimate with their future husband. To many of them, a sexual and romantic relationship is seen as eventually ending up in marriage. Yet these girls know surprisingly little about safe sex.Of the 100 unmarried girls, their families were unaware of the pregnancy in as many as 80 cases. And of the few who were aware, the parents were angry or disgusted. Just one girl got any sympathy. Most of these girls, parents should realize, had grown up learning not to talk about their bodies. And negativity surrounding menstruation was reinforced by restrictions on outdoor activities, meeting friends or talking to boys, further clouding matters.

2. Girls with low self-esteem are most vulnerable "Sexual resilience" describes a dating partner's ability to avoid starting intercourse. I could see that it had a lot to do with an adolescent girl's attitude towards premarital sex and her self-esteem. Girls with high self-esteem are better able to cope with partner pressure. Earlier studies, too, have come to similar conclusions. Even among the single pregnant girls, those who scored high on self-esteem had been more resilient than others. Why, a positive self-image helps prevent male partners from intimidating or exploiting them. Early, less-resilient sex puts girls at risk of sexually transmitted diseases (STDs). Another disadvantage of early sex is that the relationship seldom progresses to marriage and so any premarital pregnancy is hidden. Even those girls who are confident of marrying their partners are forced to opt for abortions because pregnancy interferes with their life plans. Twelve percent of the unmarried girls studied had been abandoned by their partners. Males leave their "in trouble" girlfriend, shirking responsibility or to preserve "family honour."

3. Guys offer love for sex, while girls offer sex for love In 1999, two Indian researchers, Nirmala Murthy and Akhila Vasan of the Foundation of Research in Health Systems, Ahmedabad, reported that while girls used the words love, prem or pyaar as an abstract noun for the emotion, boys often used them for both the emotion and as a verb, for the sexual act. Love for boys also meant sexual conquest. Another Indian study reported boys admitting they used the pretext of friendship to trap girls into sex.My Delhi study also revealed that partners of the unmarried pregnant girls were significantly more likely (than those of the married ones) to have had multiple sexual partners. "I once agreed to his demand for sex as his birthday present," one girl disclosed. "It was just the beginning of violent and tortured sex. I cried with pain, but there was no respite. He often boasted about his sexual adventures with various women, including a call girl. I was alarmed and scared and felt all the more abused." What attracts adolescent girls? They do not necessarily have sexual motivations for liking their partner. Even physical considerations are biased towards his looks rather than his sexual prowess. "Affectionate nature" was the single biggest reason given for liking a male by 68 percent of the girls, followed by appearance (57) and intelligence (47). Another important trait is common cultural roots or native place (29), more so in girls like Janki who live away from home. In fact being rich (18 percent) and sexy (9) figured lowest in the girls' priority list.A classic, oft quoted research study in this area is the 1977 Boston Dating Couple Study of abstaining couples, where as many as 64 percent of participants admitted to the female partner resisting sex. Only 11 percent of males did so. Women, the study said, are the "more adamant virgins and men the more potential non-virgins."

4. Male dominance is a major risk factor I found significantly unequal power dynamics favouring the male partner. For instance, women find it difficult to refuse sex even when unwell. Condoms were generally disliked by the men, who demand unprotected sex with wives, girlfriends or extramarital partners. Indeed, as many as 75 percent of the partners of unmarried girls' in my study had never used condoms. (Unprotected sex also exposes girls to genital ulcers, herpes and warts, sexually transmitted diseases including HIV/AIDS, and cervical cancer.) I also found that girls often do not negotiate protection because of their extreme inhibitions in discussing sex, especially at the beginning of a relationship, when it is vital. A girl is often afraid that, by asking her boyfriend to use a condom, she would be perceived as being of loose character and experienced in such matters. Although it is a girl's future that is affected most by an untimely pregnancy-be it her health, social status, education or career-it's a difficult situation for her. Yet it's her responsibility to avoid pregnancy without avoiding or losing her partner. Such domineering continues and takes unexpected turns even into marriage. A young married abortion seeker told me: "Not wanting another baby while my daughter was still a toddler, I requested my husband to consider abortion but he consulted his mother, who said, 'Let her wait three months and we'll do an ultrasound. If it's a girl she can abort.' My mother-in-law is probably right…" Notice how her family's desire for a male child is routed through her as if it were her own decision. This young woman's case also offered an insight into the psyche behind rampant illegal female feticide. Female subordination is perceived as "adjustment" and is a desirable trait among in-laws. Such culturally conditioned, deep-rooted male authority is a major cause of unwanted pregnancies and recurrent abortions.

5. Counsellors, sex-education teachers and parents need to change focus Studies, mine included, show that surprising numbers of unmarried Indian girls were ignorant about the link between sex and pregnancy. And, irrespective of how many contraceptives were known to my study group, 99 percent had had unprotected sex at some time. Condoms and pills were known to 96 and 79 percent of the girls, respectively. Even so, adolescents who use condoms are often unaware of correct procedure. Emergency contraceptive pills were known to just four percent of the unmarried girls I surveyed. Although it was at an abortion clinic that I conducted much of my study, ignorance about abortion, too, was widespread. "I tried my best to abort," one girl said. "I drank a hot decoction of jaggery and grams [chick peas]." It did not work. Indeed, as many as 43 percent of adolescents had unsuccessfully tried alternative methods-even risky ones to puncture the amniotic sac. And basic measures, like scheduling an early abortion or following safety instructions, are skipped. Such ignorance is mixed with a false belief that abortions are safe. Thus abortions had become a substitute for contraception in some repeat cases. In fact teenaged girls are more susceptible to risks from unsafe abortions. And adolescent abortions, even when handled by specialists, are more prone to complications and risks: a wounded uterus, cervical injury, tube pregnancy in later life, inflammation and septicemia. Such ignorance and risk-taking may result from the fact that sex-education programs and the media have become overly preoccupied with HIV/AIDS education, although the incidence of unwanted pregnancy is much higher than the incidence of AIDS among adolescent girls. Now is the time for counsellors, sex-educators and parents-who live in ignorance or denial of their children's experiences-to change tack, talk more with teenagers and address these issues. Once parents see their teens in serious relationships, they need to inform them about safe sex and strong resilience-a new duty for Indian mums and dads. By doing so, their girls would have more self-esteem and remain safe in unexpected situations. And boys will likely be more understanding and considerate.The prevailing notion that the typical unmarried adolescent abortion-seekers are social deviants who ought to be punished often leads them to suffer widespread stigma, even from counsellors and the medical fraternity. The truth is that adults often fail to see see their vulnerability to men's culturally conditioned behaviours, roles and biases. Such girls need as much compassionate treatment, counselling and understanding as does any other adolescent.