SEXUAL HEALTH ISSUES
Sexual health is a broad area that encompasses many
inter-related challenges and problems. Key among the issues and
concerns are human rights related to sexual health, sexual
pleasure, eroticism, and sexual satisfaction, diseases (HIV/AIDS,
STIs, RTIs), violence, female genital mutilation, sexual
dysfunction, and mental health related to sexual health.
During a meeting held in Antigua, Guatemala in May 2000,
an expert group convened by the Pan American Health
Organization and WHO in collaboration with the World Association
for Sexology (WAS) compiled an overview of sexual concerns and
problems that should be addressed in order to advance sexual
health (PAHO/WHO 2000).
Sexual health concerns are life situations that can be
addressed through education about sexuality and society-wide
actions in order to promote the sexual health of individuals. The
health sector has a role to play in assessment, and in providing
counseling and care.
A. CHILD SEXUAL ABUSE
Sexual abuse - rape, incest and acts of
lasciviousness continue to plague our children.
The same goes true for children victims of
commercial sexual exploitation – child
trafficking, child prostitution and child
The Department of Social Welfare and Development
has served the following in 2010:
• 1,247 sexually abused children, 1,168 or 93 % of
which were female
• 127 sexually exploited, 120 or 94 % of which were
• 390 victims of child trafficking, 368 or 94% of
which were female
• Children victims of pornography are lumped within
those sexually exploited. In 2010, there were eight
8 victims, seven of which were female.
•The Department of Justice reports a total of 15,830
cases involving sex and commercial exploitation of
children as of December 2010 based on a nationwide
case inventory in 2006 to 2007.
•As of December 2009, a total of 20 establishments
were permanently closed by the Department of
Labor and Employment from 2005 – 2009 for
employing minors in prostitution or in obscene or
lewd shows pursuant to Republic Act 9231. A total of
58 victims of child labor have been reported.
• Majority of the offenders are family members or
someone close to the family.
• Both males and females sexually offend, however
males represent a higher percentage of known sex
• While media reports cases of abuse and
exploitation, many other cases remain unknown to
the general public either because information isn‘t
publicized or because the offenses have not been
• Child sexual abuse usually begins with a sex
offender gaining both the parent‘s and the child‘s
trust and friendship. Once a relationship has been
established, the offender will begin to test the
child‘s knowledge and ability to protect themselves
• Children who are well informed and empowered to
act, and who have someone who will listen to them
can, in many cases, prevent or stop sexual abuse.
Offenders do not usually choose victims who are
likely to resist or tell.
• Sexual exploitation and abuse can lead to
unwanted pregnancies among girls and put them at
risk to HIV/AIDS infection.
• Sexual abuse and exploitation can cause long-
lasting problems well into adulthood. It is
important to get your child into counseling after
abuse has been disclosed. It is necessary and
healthy for child victims to seek immediate
• Sexual exploitation of children may come in various
forms -child pornography, child trafficking or child
• Children and young people are primary users of
internet and mobile technology.
• Accessibility of children and young person to
technology makes them highly vulnerable to child
pornography and other forms of cyber-abuse.
• There is an Increasing incidence of child
pornography and cyber-related crimes.
• Cybersex is viewed as a source of income, it can
be operate even within the family.
• There are small-scale and large-scale international
organized networks operating inside through and
outside of the Philippines.
• There are already a number of laws pertinent to
the protection of children. Among them is Republic
Act 9775 or the Anti-Child Pornography Act was
enacted in 2009.
• Awareness on child pornography and child
protections laws is low.
• Efforts/initiatives of both government and non-
government are on-going, encourage/expand
partnerships to other sectors like ISP, civic,
business group, media others.
B. RAPE TRAUMA
• Rape is one of the most prevalent forms of
violence against women (VAW) in the Philippines.
• Reported rape cases ranked third (13.1%) of the
total reported VAW cases in the country from 1999
• The hard fact is that this is not yet the true
representation of the problem.
• Due to cultural and social stigmatization associated
with rape, many women victims prefer to maintain
their silence and not report their ordeal to the
• The government with the aid of NGOs have taken
initiatives to set up crisis centers for rape survivors
in collaboration with the different sectors of the
community to help victims deal with the trauma
and encourage them to report rape.
• Several rape-related laws have also been passed to
address the concern.
• Through the provision of suitable legal support and
health services, it is hoped that women victims of
rape be encouraged to come forward for proper
intervention and justice to be served accordingly.
Rape is committed under the following
A man has sexual intercourse with a woman:
• Through force, threat or intimidation;
• When the victim is deprived of reason or is
• Through fraudulent machination or grave abuse of
• When the victim is under 12 years of age or is
demented, even if none of the above conditions
Any person who, under any of the above conditions,
commits an act of sexual assault through oral or anal
sex or by inserting an instrument or object into the
anal or genital orifice of another person.
In the Philippines, there are two laws enacted that
directly address rape namely:
• R.A. 8353: The Anti-Rape Law of 1997
• R.A. 8505: The Rape Victim Assistance and
Protection Act of 1998
Rape Crisis Center
The Department of Social Welfare and
Development (DSWD), the Department of Health
(DOH), the Department of the Interior and Local
Government (DILG), the Department of Justice
(DOJ), and a lead non-government organization
(NGO) with proven track record or experience in
handling sexual abuse cases, shall establish in every
province and city a rape crisis center located in a
government hospital or health clinic or in any other
suitable place for the purpose of:
• Providing rape victims with psychological
counseling, medical and health services, including
their medico-legal examination;
• Securing free legal assistance or service, when
necessary, for rape victims;
• Assisting rape victims in the investigation to hasten
the arrest of offenders and the filing of cases in
• Ensuring the privacy and safety of rape victims;
• Providing psychological counseling and medical
services whenever necessary for the family of rape
• Developing and undertaking a training program for
law enforcement officers, public prosecutors,
lawyers, medico-legal officers, social workers, and
barangay officials on human rights and
responsibilities; gender sensitivity and legal
management of rape cases; and
• Adopting and implementing programs for the
recovery of rape victims.
The DSWD shall be the lead agency in the
establishment and operation of the Rape Crisis
There are many influences on the manner in
which each individual survivor of sexual violence
copes and on the length of time the symptoms may
be present. These factors include:
• Support systems
• The relationship with the offender
• The degree of the violence used
• Social and cultural influences
• Previous experience with stress
• Ability to cope with stress
• Attitude of those immediately contacted after the
• The age and developmental stage of the survivor
(adolescent survivors are more vulnerable)
It is essential that all legal, medical and police
procedures must not cause further trauma to
survivors who must be given all possible support to
overcome and survive the ordeal.
C. DOMESTIC VIOLENCE
Domestic violence is threatening behavior,
violence or abuse inflicted upon a woman or her
child. It may be caused by the husband, ex-husband,
live-in partner, boyfriend, ex-boyfriend, the father
of her child or anyone with whom she has had an
intimate (sexual or dating) relationship with.
Acts of domestic violence are punishable by
law, specifically under The Violence Against Women
and their Children Act of 2004.
The law enumerates certain acts which can be a
ground for a criminal case. These include acts
• cause physical harm to the woman or her child
• compel a woman or her child to do something
which they can choose not to do
• restrict a woman or her child‘s freedom of
movement through force or intimidation. This may
be by depriving or threatening to deprive the
woman and/or her children of financial support
which they are legally entitled to
• inflict physical harm on one‘s self to control a woman‘s
actions or decisions
• force a woman or her child to engage in any sexual
activity (other than rape)
• cause emotional or psychological distress to the woman
or her child, such as stalking, harassing, destroying the
woman‘s personal belongings, infidelity
• cause mental or emotional anguish, public ridicule or
humiliation. This includes verbal abuse.
How widespread is domestic violence?
• In 2009, the Philippine National Police (PNP) has
recorded a 37.4 percent increase in reports on
violence against women (VAW) from the previous
• Physical injuries and/or wife battering account for
45.5 percent of all reported VAW cases in the last
• More than half of physical violence cases is
committed by a husband or domestic partner.
Sexual violence committed by the husband or
domestic partner of a woman represents 60.5
percent of the reported cases.
What can I do about domestic violence?
• Seek immediate protection from the proper
authorities. Every police station has a Women and
Children Protection Desk that you can go to for
• The DSWD can also offer you a safe place to stay if
you need to leave your home for protection. There
are a number of government-run shelters that can
provide you with the support you need.
• If you feel that reporting the incident to the proper
authorities or staying in a shelter is not enough to
ensure your safety, you may apply for a protection
order at your barangay or in court.
• While you may apply for a protection order on your
own, it is best to consult with a lawyer. You may
also go to the DOJ Public Attorney‘s Women‘s Desk
at the Public Attorney‘s Office in your area for
• Anyone who has witnessed violence against a
woman and/or her child may also file a complaint.
This is because the law considers violence against
women and children as a public crime. This means
that the victim is not the only one who may file a
complaint against the abuser.
Where can I go for help?
• Crisis Intervention Unit
• Department of Social Welfare and Development
• Women and Children‘s Concern Division
• Philippine National Police (PNP)
• Violence Against Women and Children Protection
• National Bureau of Investigation (NBI)
• Public Attorney‘s Office Women‘s Desk
• Department of Justice (DOJ)
• Women‘s Desk
• Philippine General Hospital (PGH)
• Women and Children Crisis Care and Protection
• East Avenue Medical Center (EAMC)
There is also a Women and Children‘s Protection
Desk in the police station nearest you which can
provide immediate help when needed.
• In 1995, the DSWD defined incest as sexual
abuse committed against children and adults by
persons related to the victims by blood.
• The Bureau of Child and Youth Welfare (BCYW)
expanded its definition in 1996 by including
sexual abuse committed against a person by
any member of the household.
• The 1998 Family Code is so far the only existing
legislation that has no reference to incest. But
its pertinent provision (Article 37) pertains to
incestuous marriages, not to incest itself:
―Marriages between the following are
incestuous and void from the beginning, whether
the relationship between the parties be
legitimate or illegitimate: (1) Between
ascendants and descendants of any degree; and
(2) Between brothers and sisters, whether of full
or half blood.‖
• The only official document in the Philippines that
defines incest is the Philippine Plan for Gender
Development (PPGD). The PPGD defines incest as:
―the commission of sexually inappropriate acts or
acts with sexual overtones, with a child or
adolescent, by an older person or adult who wields
authority through emotional bonding with that
child or younger person.‖
There are three elements that recur in the
existing understanding of incest. These are:
• Sexual abuse
Despite the varying perspectives on the abuser-
victim/survivor relationship that qualifies an abuse as
incest, there is a common recognition that an essential
element of incest is betrayal of trust.
Compared with stranger abuse, incest has a different
psychological and emotional impact on the victim
because of the relationship of trust between the victim-
survivor and the abuser.
“A child molested by a stranger can run home for help
and comfort. A victim of incest cannot.”
• A recent joint study by the United Nations
Children's Fund (UNICEF) and the University of the
Philippines Center for Women's Studies Foundation
found that the culprits in a third of the reported
cases of child sex abuse were relatives — usually
the father or uncle.
• The research indicated that 70 percent of children
did not report the abuse; they suffered in silence.
• A DSWD study in 2000 showed that the majority of
the perpetrators of child abuse are acquaintances,
followed by neighbors, and one-third are fathers of
the victims. Uncles, brothers, employers, and
cousins follow in the ranking.
• In a report to the Philippine Congress, the DSWD
disclosed: 62.5 per cent of child-abuse cases
reported in the last years were not filed in court by
the children's families because of loss of interest in
• The main reason is that the victims are ashamed of
people knowing of their situation because it does
not only put them to shame but all of those in the
SBN-1500: Anti-Incest Act
An Act Criminalizing Incestuous Sexual Relations
Filed on July 15, 2010 by Defensor Santiago,
Legislative status: Pending in the Committee
E. SEXUALLY TRANSMITTED INFECTIONS
Sexually transmitted infections (STIs) are a public
• According to 2005 WHO estimates, 448 million new
cases of curable STIs (syphilis, gonorrhoea,
chlamydia and trichomoniasis) occur annually
throughout the world in adults aged 15-49 years.
• This does not include HIV and other STIs which
continue to adversely affect the lives of individuals
and communities worldwide.
• In developing countries, STIs and their
complications rank in the top five disease
categories for which adults seek health care.
Infections and transmission
• STIs are infections that are spread primarily
through person-to-person sexual contact.
• Several, in particular HIV and syphilis, can also be
transmitted from mother to child during pregnancy
and childbirth, and through blood products and
• STIs are caused by bacteria, viruses and parasites.
Some of the most common infections are below.
Common bacterial infections:
• Neisseria gonorrhea (causes gonorrhea or
• Chlamydia trachomatis (causes chlamydial
• Treponema pallidum (causes syphilis)
• Haemophilus ducreyi (causes chancroid)
• Klebsiella granulomatis (previously known as
Calymmatobacterium granulomatis causes
granuloma inguinale or donovanosis).
Common viral infections:
• Human immunodeficiency virus (causes AIDS)
• Herpes simplex virus type 2 (causes genital herpes)
• Human papillomavirus (causes genital warts and certain
subtypes lead to cervical cancer in women)
• Hepatitis B virus (causes hepatitis and chronic cases
may lead to cancer of the liver)
• Cytomegalovirus (causes inflammation in a number of
organs including the brain, the eye, and the bowel).
• Trichomonas vaginalis (causes vaginal
• Candida albicans (causes vulvovaginitis in women;
inflammation of the glans penis and foreskin
[balano-posthitis] in men).
The main syndromes of common STIs are:
• urethral discharge
• genital ulcers
• inguinal swellings (bubo, which is a swelling in the
• scrotal swelling
• vaginal discharge
• lower abdominal pain
• neonatal eye infections (conjunctivitis of the
STI syndromic approach to patient management:
• The traditional method of diagnosing STIs is by
laboratory tests. However, these are often
unavailable or too expensive.
• Since 1990 WHO has recommended a syndromic
approach to diagnosis and management of STIs in
patients presenting with consistently recognized
signs and symptoms of particular STIs.
• The syndromic approach uses flowcharts to guide
diagnosis and treatment is more accurate than
diagnosis based on clinical tests alone, even in
• The syndromic approach is a scientific
approach and offers accessible and immediate
treatment that is effective. It is also more cost-
effective for some syndromes than use of
• The pathogens causing any particular syndrome
need to be determined locally and flow charts
adapted accordingly. Furthermore, regular
monitoring of the organisms causing each
syndrome should be conducted on a regular
basis to validate the treatment
• The most effective means to avoid becoming
infected with or transmitting a sexually
transmitted infection is to abstain from sexual
intercourse or to have sexual intercourse only
within a long-term, mutually monogamous
relationship with an uninfected partner.
• Male latex condoms, when used consistently and
correctly, are highly effective in reducing the
transmission of HIV and other sexually transmitted
infections, including gonorrhea, chlamydial
infection and trichomoniasis.
• The control of STIs is a priority for WHO. The World
Health Assembly endorsed the global strategy for
the prevention and control of STIs in May 2006.
• More recently, the United Nations Secretary-
General Global Strategy for Women's and Children's
Health highlighted the need for a comprehensive,
integrated package of essential interventions and
• The Strategy urges partners to ensure that women
and children have access to a universal package of
guaranteed benefits, including family-planning
information and services, antenatal, newborn and
postnatal care, emergency obstetric and newborn
care and the prevention of HIV and other sexually
• Such a package could accelerate the response
towards meeting the lagging health-related
Millennium Development Goals.
F. ILLEGAL SEX
• Prostitution in the Philippines is illegal. It is a
serious crime with penalties ranging up to life
imprisonment for those involved in trafficking.
• It is covered by the Anti-Trafficking in Persons Act.
• Prostitution is sometimes illegally available through
brothels (also known as casa), bars, karaoke bars
(also known as KTVs), massage parlors, street
walkers and escort services.
• As of 2009, one source estimated that there were
800,000 women working as prostitutes in the
Philippines, with some of them believed to be
Violence and coercion against prostitutes
• Women and children involved in prostitution
are vulnerable to rape, murder, AIDS and other
sexually transmitted diseases.
• Surveys of women working as masseuses
indicated that 34 percent of them explained
their choice of work as necessary to support
poor parents, 8 percent to support siblings and
28 percent to support husbands or boyfriends.
• More than 20 percent said the job was well
paid, but only 2 percent said it was easy work
and only 2 percent claimed to enjoy the work.
• Over a third reported that they had been
subject to violence or harassment, most
commonly from the police, but also from city
officials and gangsters.
• A survey conducted by the International Labor
Organization revealed that in the experience of
most of the women surveyed, prostitution is
one of the most alienating forms of labor.
• Over 50 percent of the women surveyed in
Philippine massage parlors said they carried out
their work ―with a heavy heart,‖ and 20
percent said they were ―conscience-stricken
because they still considered sex with
customers a sin.‖
• Interviews with Philippine bar girls revealed
that more than half of them felt ―nothing‖
when they had sex with a client, the remainder
said the transactions saddened them.
G. SEXUAL HARASSMENT
As defined by the Philippine Anti-Sexual Harassment
Act of 1995, sexual harassment is ―a request for a
sexual favor, accepted or not, from an employer,
employee, manager, teacher, instructor, professor,
coach, trainer or other persons who have authority,
influence or moral ascendancy over another.‖ It is
committed by anyone who demands a sexual favor in
exchange for work, promotion or other privileges.
The Sexual Harassment Act not only covers those
who are directly involved but also those who
cooperate ―in the commission of‖ the violation.
In a work-related environment, sexual harassment
is committed when:
• The sexual favor is made as a condition in the
hiring or in the employment, re-employment or
continued employment of an individual;
• Granting an individual favorable compensation,
terms, conditions, promotions or privileges, or
• The refusal to grant sexual favor results in the
limiting, segregating or classifying the employee
which in any way would discriminate, deprive or
diminish employment opportunities or otherwise
adversely affect said employee.
What to do in case of sexual harassment?
1. Say ‗No‘ or ‗Stop it‘ firmly and loud enough for
someone to hear.
2. Document the event/s.
3. Inform someone about what happened.
4. File a complaint.
***If your case is ignored and you wish to pursue it,
then you might want to go to the police and file a
report. Be prepared for a more taxing process,
though. If you want justice, you‘ll need a lawyer
and the judicial procedures can take a while.
ANNULMENT, DIVORCE AND LEGAL SEPARATION
IN THE PHILIPPINES
Is divorce allowed under Philippine laws?
No, divorce is not allowed in the Philippines.
However, there are certain instances wherein the
divorce secured abroad by the foreigner-spouse,
and even by former Filipinos, are recognized
under Philippine laws.
Is “annulment” different from a “declaration
of nullity” of marriage?
Yes. In essence, ―annulment‖ applies to a
marriage that is considered valid, but there are
grounds to nullify it. A ―declaration of nullity‖ of
marriage, on the other hand, applies to
marriages that are void or invalid from the very
beginning. In other words, it was never valid in
the first place.
So, if a marriage is void from the very
beginning (void ab initio), there’s no need to
file anything in court?
For purposes of remarriage, there must be a
court order declaring the marriage as null and
void. Entering into a subsequent marriage
without such court declaration means that: (a)
the subsequent marriage is void; and (b) the
parties open themselves to a possible charge of
What are the grounds for annulment?
• Lack of parental consent in certain cases.
What if a spouse discovers that his/her spouse is a
homosexual or is violent, can he/she ask for
Homosexuality or physical violence, by themselves,
are not sufficient to nullify a marriage. At the very
least, however, these grounds may be used as basis
for legal separation.
How is “legal separation” different from
The basic difference is this – in legal separation, the
spouses are still considered married to each other,
and, thus, may not remarry
What are the grounds for legal separation?
• Repeated physical violence or grossly abusive
conduct directed against the petitioner, a common
child, or a child of the petitioner.
• Physical violence or moral pressure to compel the
petitioner to change religious or political
• Attempt of respondent to corrupt or induce the
petitioner, a common child, or a child of the
petitioner, to engage in prostitution, or connivance
in such corruption or inducement.
• Final judgment sentencing the respondent to
imprisonment of more than six years, even if
• Drug addiction or habitual alcoholism of the
• Lesbianism or homosexuality of the respondent.
• Contracting by the respondent of a subsequent
bigamous marriage, whether in the Philippines or
• Sexual infidelity or perversion.
• Attempt by the respondent against the life of the
• Abandonment of petitioner by respondent without
justifiable cause for more than one year.
The term ―child‖ shall include a child by nature or
If you’re separated from your spouse for 4
years, is that a sufficient ground for
No. De facto separation is not a ground for
annulment. However, the absence of 2 or 4
years, depending on the circumstances, may be
enough to ask the court for a declaration of
presumptive death of the ―absent spouse‖, in
which case the petitioner may again re-marry.
What are the grounds for declaration of nullity of
• Lack of authority of solemnizing officer
• Absence of marriage license (except in certain
• Bigamous or polygamous marriages (except in cases
where the other spouse is declared as
• Mistake in identity (those contracted through
mistake of one contracting party as to the identity
of the other).
• After securing a judgement of annulment or of
asolute nullity of mariage, the parties, before
entering into the subsequent marriage, failed to
record with the appropriate registry the: (i)
partition and distribute the properties of the first
marriage; and (ii) delivery of the children‘s
• Void by reason of public policy
• Psychological Incapacity.
Abortions in the world
• An abortion is the termination of a pregnancy by
the removal or expulsion of an embryo or fetus
from the uterus, resulting in or caused by its
death. An abortion can occur spontaneously due to
complications during pregnancy or can be induced.
• Abortion as a term most commonly - and in the
statistics presented here - refers to the induced
abortion of a human pregnancy, while spontaneous
abortions are usually termed miscarriages.
• The data on abortions displayed on the Worldometers'
counter is based on the latest statistics on worldwide
abortions published by the World Health Organization
• According to WHO, every year in the world an
estimated 40-50 million women faced with an
unplanned pregnancy decide to have an abortion.
This corresponds to approximately 125,000 abortions
• In the USA, where nearly half of pregnancies are
unintended, and four in 10 of these are terminated
by abortion there are over 3,000 abortions per day.
Twenty-two percent of all pregnancies in the USA
(excluding miscarriages) end in abortion.
Abortion in the Philippines
• The basic status of Abortion in the Philippines is
that it is illegal, or banned by rule of law.
• Article II of the 1987 Philippine Constitution says,
in part, "Section 12. The State recognizes the
sanctity of family life and shall protect and
strengthen the family as a basic autonomous social
institution. It shall equally protect the life of the
mother and the life of the unborn from conception.
• The act is criminalized by the Revised Penal Code
of the Philippines, which was enacted in 1930 and
remains in effect today. Articles 256, 258 and 259
of the Code mandate imprisonment for the woman
who undergoes the abortion, as well as for any
person who assists in the procedure, even if they
be the woman's parents, a physician or midwife.
Article 258 further imposes a higher prison term on
the woman or her parents if the abortion is
undertaken "in order to conceal [the woman's]
• There is no law in the Philippines that expressly
authorizes abortions in order to save the woman's
life; and the general provisions which do penalize
abortion make no qualifications if the woman's life
• Proposals to liberalize Philippine abortion laws
have been opposed by the Catholic Church, and its
opposition has considerable influence in the
predominantly Catholic country.
• One study estimated that, despite legal restrictions, in
1994 there were 400,000 abortions performed illegally
in the Philippines and 80,000 hospitalizations of women
for abortion-related complications.
• It was reported in 2005 that official estimates then
ranged from 400,000 to 500,000 and rising, and that
the World Health Organization estimate was 800,000.
Seventy percent of unwanted pregnancies in the
Philippines end in abortion, according to the WHO.
• Approximately 4 in 5 abortions in the Philippines are
for economic reasons, often where a woman already
has several children and cannot care for another.
• While some doctors secretly perform abortions in
clinics, the 2,000 to 5,000 peso (USD $37 to $93) fee is
too high for many Filipinos, so they instead buy
abortifacients on the black market, e.g. from vendors
• Two-thirds of Filipino women who have abortions
attempt to self-induce or seek solutions from those
who practice folk medicine.100,000 people end up in
the hospital every year due to unsafe abortions,
according to the Department of Health , and 12% of all
maternal deaths in 1994 were due to unsafe abortion.
• Some hospitals refuse to treat complications of unsafe
abortion, or operate without anesthesia, as punishment
for the patients.
• The Department of Health has created a program to
address the complications of unsafe abortion,
Prevention and Management of Abortion and its
• Women‘s sexuality has been used to remove
women‘s power for decades. Desexualization of
women take away a woman‘s power by only
focusing on her sexuality instead of her whole
• A very severe, yet common case of the
desexualization of women is female genital
• About 140 million girls and women worldwide are
currently living with the consequences of FGM.
• FGM is mostly carried out on young girls sometime
between infancy and age 15.
• In Africa an estimated 101 million girls 10 years old
and above have undergone FGM.
• FGM is a violation of the human rights of girls and
• Female genital mutilation (FGM) comprises all
procedures that involve partial or total removal of
the external female genitalia, or other injury to
the female genital organs for non-medical reasons.
Female genital mutilation
• Female genital mutilation (FGM) includes
procedures that intentionally alter or cause injury
to the female genital organs for non-medical
• The procedure has no health benefits for girls and
• Procedures can cause severe bleeding and
problems urinating, and later cysts, infections,
infertility as well as complications in childbirth
increased risk of newborn deaths.
• The practice is mostly carried out by traditional
circumcisers, who often play other central roles in
communities, such as attending childbirths. However,
more than 18% of all FGM is performed by health care
providers, and this trend is increasing.
• In 2008, the World Health Assembly passed a resolution
(WHA61.16) on the elimination of FGM, emphasizing
the need for concerted action in all sectors - health,
education, finance, justice and women's affairs.
WHO efforts to eliminate female genital mutilation
• strengthening the health sector response: guidelines,
training and policy to ensure that health professionals
can provide medical care and counseling to girls and
women living with FGM;
• building evidence: generating knowledge about the
causes and consequences of the practice, how to
eliminate it, and how to care for those who have
• increasing advocacy: developing publications and
advocacy tools for international, regional and local
efforts to end FGM within a generation.
WHO is particularly concerned about the
increasing trend for medically trained personnel
to perform FGM. WHO strongly urges health
professionals not to perform such procedures.
J. AGING PROCESS (Sexuality and Aging)
Sexual health is important at any age. And the desire
for intimacy is timeless. While sex may not be the
same as it was in your 20s, it can still be as fulfilling
Communication is key
To maintain a satisfying sex life, talk with your
partner. Set aside time to be sensual and sexual
together. When you're spending intimate time with
your partner, share your thoughts about lovemaking.
Help your partner understand what you want from
him or her. Be honest about what you're experiencing
physically and emotionally.
Aging and men's sexual health
• Testosterone plays a critical role in a man's
• Testosterone levels peak in the late teens and
then gradually decline.
• Most men notice a difference in their sexual
response by age 60 to 65.
• The penis may take longer to become erect,
and erections may not be as firm.
• It may take longer to achieve full arousal and
to have orgasmic and ejaculatory experiences.
• Erectile dysfunction also becomes more
common. Several medications are available to
help men achieve or sustain an adequate
erection for sexual activity.
Aging and women's sexual health
• As women approach menopause, their estrogen
levels decrease, which may lead to vaginal
dryness and slower sexual arousal.
• Women may experience emotional changes as
• While some women may enjoy sex more
without worrying about pregnancy, naturally
occurring changes in body shape and size may
cause others to feel less sexually desirable.
Medical conditions and sexual health
• Any condition that affects your general health
and well-being may also affect your sexual
• Illnesses that involve the cardiovascular
system, high blood pressure, diabetes,
hormonal problems, depression or anxiety —
and the medications used to treat these
conditions — can pose challenges to being
• High blood pressure, for instance, can affect
your ability to become aroused, as can certain
medications used to treat high blood pressure.
• In addition, any surgical procedure that affects
your pelvis and your central nervous system will
have a temporary — but often significant —
impact on your sexual response.
• The body, however, is resilient. Given time to
heal and some loving attention, you can
become sexually responsive again
Looking forward not back
Many couples want to know how to get back to the
sexual arousal and activity levels they experienced in
their 20s, 30s and early 40s. Instead, find ways to
optimize your body's response for sexual experiences
now. Ask yourselves what's satisfying and mutually
Many books are available about how to maintain a
healthy sex life as you get older. In addition, many
couples find consulting with an expert helpful. Your
doctor may be able to provide useful suggestions or
refer you to a specialist.
BARROGA, Marilyn Richelle
DIGUEL, Brenda Lee
GRAGERA, Jennifer C.
LA MADRID, Cyprene Grail
MASIGMAN, Mary Ann
VALENTON, Kathleen Anne Marie