Reimagining sex from performance to pleasure as a pathway for family planning: evidence from India

Summary:

The Sustainable Development Goals (SDGs) and Family Planning 2020 commitments make specific references to health and gender equality, drawing pertinent linkages to family planning (FP). SDGs emphasize on access to acceptable and good quality modern contraceptives as an essential element of reproductive health. Our research defines pathways for achieving better reproductive health outcomes for men and women. It suggests that it is critical to focus on perceptions and sexual behaviour of couples, especially men, to understand their FP choices. This paper examines how notions of masculinity influence sexual behaviour of men and in-turn their engagement in FP, defining couple-making and overall dynamics between two partners. Findings inform that the sexual socialization of men leads them to perceive sex as a physical need, and a performance as they consider that their sexual prowess lies in deciding when and how to have sex. Controlling their sexual urges is also a manifestation of mens need to perform a certain role in the intimate space where they are in control of the process and the outcome. These perceptions along with lop-sided communication and limited information about fertility, reproduction and contraception create an illusion of control among men, often resulting in rejection of modern methods and unplanned pregnancies. This research highlights the need to reimagine sex using pleasure as a guiding principle; with communication and consent built into it. The Couple Engage project uses a multidisciplinary approach which sits at a cross-section of Human Centered Design, ethnography and synthesis of global evidence.

Background/Objectives:

The National Family Planning Program has burdened women, mostly using instrumentalist approaches, to use contraceptives without considering the skewed gender power relations between men and women. Negligible attempts have been made to engage men in FP. Further, these programs have failed to acknowledge the role of other influencing factors that precede the conversation on FP and inform the contraceptive choices within the couple space. This paper examines and draws linkages between mens sexual perceptions and behaviour and their FP decision-making. Behavioural hooks and pathways may be used effectively to address and bring in FP in an equitable manner.

Description of Intervention and/or Methods/Design:

Couple Engage is a multi-disciplinary project which uses HCD approach, to build evidence and prototypes to engage men and couples in FP. The evidence reviews focused on behavioural, programmatic and HCD studies, to understand the influence and interplay of masculinities, aspirations, couple communication, decision making, on FP. This was followed by an immersion to deep dive into specific areas of enquiry, including constructs of couple making, spousal communication and decision making, through qualitative fieldwork. The immersion uses participatory and design research tools to gather insights. The respondents were young married men and women from 18-29 years and three rounds of in-depth engagements were conducted with 35 couples. In the first two engagements, interactions were held with husband and wife separately and in the third, a joint interaction was held. Further, discussions with 11 groups of unmarried and married men, and interviews with 28 key informants were conducted.

Results/Lessons Learned:

Notions of being a man weigh heavy on men. In our study, we found that mens sentiments on sex were around physical need and performance with a conspicuous absence of pleasure in their experience of sex. This was further extrapolated to inform that sexual pleasure narrative of men is largely determined by how they evaluated themselves as a performer in a sexual act. This finding can be extended to mens expression of rule and self-control for sex. They mentioned that there are rules to have sex; and men should exercise self-control, for instance, to hold ejaculation and withdraw on time. These processes enable men to be in-charge of preventing pregnancies, while protecting health interests of their partners and their active dismissal of modern methods. This, coupled with exposure to pornography and sexual messaging reinforce that mens performance of sex is heavily linked to satisfying a physical need.

Discussion/Implications for the Field:

This research calls for a reimagination of sex for men without a hyper masculine messaging attached to it; needs to be based on mutual pleasure and consent. Such articulation can enable couples to negotiate better within the couple space, take away the burden of performance of sex from men and the burden of family planning from women alone. We find that this is vital in establishing clear and open communication channels with focus on safe sexual experiences. In upcoming phases of the project, we will develop intervention prototypes to translate this learning into actionable ideas and test in program sites.

Abstract submitted by:

Kuhika Seth - International Center for Research on Women (ICRW)
Aishwarya Sahay - ICRW
Divya Datta - Vihara Innovation Network
Ravi  Verma - ICRW