A Lament Over the Poor State of Sex Education in Egypt

The independent Egyptian news site in English Bikya Masr has a very interesting editorial by an unnamed Egyptian doctor called "The Struggle for Sex Education in Egypt."

The subject is not a new one; last year (I almost wrote "earlier this year," but it's a new year), I linked to and commented on a report by the Population Reference Bureau called "Facts of Life: Youth Sexuality and Reproductive Health in the Middle East and North Africa" which devotes a chapter to the problem of the lack of sex education in a society where for educational and financial reasons marriage is increasingly deferred and premarital sex is taboo, but basic knowledge is also unavailable. (Full report in PDF here.)

But that report is sociological and scientific; the Bikya Masr report is anecdotal. What is especially appalling is that the ignorance is not limited to elementary and secondary or even college education, but also affects the medical schools and thus practicing physicians. I recommend that you read it all, but a few quotes are in order:

It may sound striking that in the 21st century; there are highly educated people, even doctors, who have highly inaccurate information about reproductive health. But in Egypt, that is the reality.

Starting from school pupils and reaching all the way to medical faculties, there is an astonishing lack of basic information on sex and reproductive diseases. Misconceptions and old wives’ tales are reinforced in young peoples’ minds by the insistence of medical professors on ignoring such basic information.

Egyptian society is by nature a conservative one, making sex a taboo subject. Thus, it has become absolutely normal and expected that an entire body system be practically ignored in science curricula all over the country. Everyone in Egypt has memories of the bizarre class on the reproductive system. What usually happens is that the teacher maintains a stern face and monotonous voice to deter students from making lousy jokes. If it’s a co-ed school, there is no place for a constructive detailed discussion. Likewise, if a male teacher is standing before a girl only class or vice versa, the lesson is finished off at lightning speed. Girls would be unwilling and embarrassed to listen to a man explain the anatomy of the female genitalia, and boys will almost certainly make an inappropriate comment that will deter their teacher.

. . . Fast forward to high school, and the situation is not any different. The reproductive process is explained in terms of spermatogenesis and fertilization, leaving numerous girls wondering (and this is not an exaggeration) how the spermatozoa happened to reach the ovum. In addition, it prompts teenage boys, who will stop at nothing to find out about sex, to get their information from their friends, who are just as misinformed as them, or from pornographic movies.

The only time when sex is formally discussed in school is in a religious context, where the (inexperienced) religious studies teacher offers the students more misinformation as fact . . .

Khalid, a dentistry student at Alexandria University, recalls one of his experiences. He says “It was in our first year during a Zoology lecture. The professor (a woman) happened to mention the word ‘vagina’. A colleague of mine, who’s English was very poor, asked the professor after the lecture about the meaning of ‘vagina’. Suddenly the professor started stuttering and launched into a prolonged English-Arabic explanation interspersed with medical terminology. While he was looking at her with blank eyes, I whispered in his ear the Arabic slang (and offensive) word for ‘vagina’.”

Just a gloss here: the word he must have whispered will be immediately obvious to anyone with familiarity with Arabic (or modern Israeli Hebrew for that matter, which has adopted it enthusiastically), [كس] and it's not really "slang" since it occurs in classical Arabic texts (though not the ones taught in schools); but note the moral here: a scientific, medical explanation fails, while the use of arguably the single most taboo word in Arabic (though well known) conveys the meaning. I won't use the word here for fear of getting filtered by Arab world censors, but the tale makes the point that much of what people know is learned from peers, not from teachers.

It gets worse. In Medical School:

The country’s medical students, and future doctors, fare no better. Many still believe the common “masturbation ruins your eyesight” myth, while others believe it causes infertility. A medical student at Alexandria University laughs as he tells about one of his funnier experiences. “It was during our second year, and we were attending a psychology lecture where the topic of discussion was IQ. A student passed over a folded paper to the doctor with a question on it. (Note: this is how questions are commonly asked due to the massive number of students in the auditoriums) The question was ‘Excuse me doctor, but does masturbation affect your IQ?’ Many students burst out laughing but most of the girls seemed not to understand since they didn’t get the English term. The doctor was very professional, explaining that there was no harm at all in the act, unless it became an obsession or compulsive behavior. He also mentioned statistics that 99.9% of males and 70 percent of females masturbate.”

Naturally, the latter part of the statistic did not sit well with many. The student goes on to say “My male friends were astonished that he mentioned such a statistic so openly in front of girls, and most believed it to be a lie. Some went on to say that only a whore would do such a thing and one also wondered if by doing so, a girl could lose her virginity. A few were also astonished at the prospect that girls even thought about sex.”

These are medical students. The problem is not, or at least not solely, that a conservative society is reticent about sex: there are plenty of conservative Americans who object to sex education in the schools. But the problem here is that with an increasingly large population of young people who are mature and out of college but unable to marry, and frustrated by society's strictures, there isn't even necessarily decent medical advice because of deficiencies and reticence even in medical education.

The unnamed doctor's concerns and call for change are right on target. With the Muslim Brotherhood looking like the most "liberal" large force in Parliament compared to the Salafis of Al-Nour, however, I fear the realistic response to the doctor is "Good luck with that."

A Study That Goes Where Angels Fear to Tread

Most of us are aware of the sort of heavily funded study that comes out telling us something everyone already knew, and resent it if they had more funding than we do, but sometimes someone genuinely produces a study which, if fairly intuitive in its content, does say what most are reluctant to say, does go where angels fear to tread. The Population Reference Bureau has just come out with a study entitled, "Facts of Life: Youth Sexuality and Reproductive Health in the Middle East and North Africa," by Farzaneh Roudi-Fahimi and Shereen El Feki. The link goes to the press release/summary page; the whole report (PDF) is available here.

No one familiar with the region will fail to recognize the problem. A fifth of the Middle Eastern population is between 15 and 24; in many countries half the population is under 25; in most, it's at least under 30. The phenomenon of "Arab Spring" is in part the result of the frustrations of young people who do not remember their previous President or King; who are educated beyond any of their forebears but despite university degrees have few job prospects; who, in a society where youthful marriage was once universal, must defer marriage because they cannot afford an apartment or setting up on their own. Everyone knows this, and everyone also knows, but few talk openly about, the fact that deferred marriage in a society in which sex outside of marriage remains a major taboo adds an additional layer of frustration. An increasing religious conservatism in the past few decades has actually closed outlets that may have existed a generation or more ago.

I'm pleased to see that two female scholars of Middle Eastern background have been willing to go there.  They are not preaching promiscuity or advocating a Middle Eastern Woodstock; rather they are noting that there is a woeful lack of education among young people, especially young women, to the extent that even the onset of one's first period comes as a crisis. All this seems obvious enough, and given the constraints of a conservative society, it is probably better to advocate greater education rather than greater freedom, though the two may not be unrelated.

Unfortunately, the title itself may prove more polarizing than it should. Religious conservatives will oppose the very idea of the study, or portray it as an attempt to intrude Western mores into the Muslim world; many young women will shy away from the subject altogether, considering it taboo; and sadly, too many single young men will snigger and try to find "the good parts" of the report. (There aren't any.) Over this and the coming years, however, we are going to see a lot more discussion of the role of the youth in not only the Arab revolutions but the economic and social problems that confront the region. This study reminds us what we all once knew: that for the adolescent and young adult prior to marriage, social and economic issues are not the only, or even perhaps the central, issue on their minds.