Published in Kosovo 2.0’s fourth magazine issue, Sex, December 2012.
Schools and medical institutions have long let young people down by diluting or obscuring sexual education. Youths turn to rumor, conventional wisdom and each other to learn about sex, with sometimes disastrous results. New thinking and program efforts are pushing for change.
I have only a vague memory of my first — and only — sex ed class in Kosovo. I was in eighth grade in the year 2000. That day, biology teacher Ms. Lirie Hana talked about reproductive organs and how a baby was made. We could feel the tension in the room, and we could sense the only thing that prevented us from commenting and laughing was Lirie’s tight classroom control. Everybody in my elementary school had a healthy respect for and fear of Lirie. She soldiered through the lesson, and an hour later, it was done. The moment she left the room, the class exploded in laughter. This is my one and only memory of sex ed in Kosovo’s public school system.
In October, I met up with Gersi, Hana, Vesa and Vigan for drinks in an unused corner of Prishtina’s Mexican restaurant. I gathered them together to talk about sexual education; I’ve been out of school for a while, and I thought maybe things had changed. They haven’t.
According to the group, apart from visits by workers from NGOs like the Red Cross, sexual education now consists of an hour of barely contained discomfort (the teacher’s) and a technical “where babies come from” approach.
“I remember once in biology, the teacher started explaining how a child is made, and everybody started laughing,” panelist Hana said. “She felt really bad. We were stupid, and we didn’t give her space to teach.”
The content of the lesson was lost, a typical story from these glimpses into modern Kosovo sex ed classes. All of the panelists’ stories involved classes laughing at the words “penis” and “sex.” It’s apparently hard even to start the conversation.
“It isn’t talked about. The minute you start talking about sex, the conversation ends,” explained Gersi, 19.
In Kosovo’s public education system, sexual education is not a single course, but an intercurricular topic that’s supposed to be included in classes like biology, life skills and health education. Biology is the only core course, and the other two are electives.
Sexual education gets the most attention in ninth-grade biology, in a single lesson called “The Life Cycle.” In 60 minutes, the reproductive system, puberty, contraceptive methods and STDs are explained to a roomful of hormonal teenagers. According to elementary school teacher Nerxhivane Halili, the information covered in the lesson is too narrow and too general. Halili explains that conservative parents believe spending more time on sexual education will encourage young people to become sexually active. The Ministry of Education-approved textbook addresses a small number of sexually transmitted diseases. And while it extensively covers the risks and danger of HIV/AIDS, it doesn’t explain how young people can get protection.
Since the immediate post-war period, the curriculum of the public education system has undergone a series of transformations. Sexual education was addressed in this long reconfiguration, and UNICEF Kosovo was a player, spearheading the program “Healthy Lifestyles.” The initiative lobbied for inclusion of healthful lifestyle choices in Kosovo’s education system. But the program ended in 2009 with unclear results. A joint evaluation by UNICEF Kosovo and the United Nations Population Fund Kosovo (UNFPA) noted that despite progress, some teachers were still uncomfortable talking about sexual health in front of their students. It was not uncommon for teachers to skip sexual education, even though it was part of the curriculum.
A 2009 UNFPA survey on reproductive health found that a majority of women received information on contraceptive methods from relatives and friends. Withdrawal was the most widely used form of contraception. According to Visare Mujko-Nimani of UNFPA, this is worrisome for several reasons.
“Unfortunately, there is still a perception that contraceptive methods are harmful. This perception dominates even the medical community,” Mujko-Nimani said.
Too few medical professionals in Kosovo place importance on consultation when it comes to sexual health, Mujko-Nimani added. In the absence of professional consultations, most women discuss their sexual health problems with other women.
“They say, ‘Take this because it helped me,’ but it doesn’t mean that it’s good for you. The information they get is only partial or inaccurate information, which means that ‘accidents’ happen again, whether it’s an unwanted pregnancy or a sexually transmitted infection,” Mujko-Nimani said.
Efforts to spread information and supplies are frustrated by refusals and misuse. Many medical professionals do not teach or promote sexual health — even in cases of unwanted pregnancies or abortions. And in one documented incident, contraceptives that were donated by UNFPA for free distribution were later spotted for sale in privately owned pharmacies.
The consequences of “accidents” are much rougher on young women than on young men. “For women, honor and shame are the basis of morality,” writes sociology professor Nita Luci in her paper “Endangering Masculinity in Kosova.”
It’s a widely accepted truism in Kosovo that sex is something that occurs in the context of marriage. Another is that the result of sex should be children. A young woman who has sex outside marriage is treated like she has done something shameful, and shame is a particularly potent punishment in a society preoccupied with honor. And it extends to the public realm. The “shaming” of sexually active young women is widespread and occurs even within the public health system, as Hana related to me:
“I had a problem with my ovaries, and the doctors that treated me thought I was pregnant. They treated me really badly, like I was a cow. They didn’t ask me if I was a virgin; they asked me if I was a ‘girl’ or a ‘bride.’ I didn’t understand, and when I said I was a girl, they thought I meant that I was a virgin. When they figured out that I wasn’t, they said angrily ‘Why didn’t you say so!’ And when it comes to abortions, patients are referred to as ‘cases.’”
Conversely, the sexual expectations placed on men celebrate virility as an indicator of manhood. I asked Vigan what kind of reactions a man could expect for getting a girl pregnant.
“You might get asked by your friends why you didn’t use a condom, but men don’t get the same shame put on them.”
So men are allowed sex without shame and women are not, and this seems to affect how young men in Kosovo think about romantic relationships. These young men want to have sex with their pre-marital partners, but they believe that marrying a virgin is important, according to focus groups conducted by the Kosovo-based Peer Education Network.
It’s not unusual to hear stories of young women taking the morning-after pill as a regular form of contraception, or to hear of men “forgetting” or outright refusing to put on a condom. In fact, 42 percent of women interviewed in UNFPA’s 2009 survey said that they do not use any form of contraception. Those who do use contraception heavily rely on the withdrawal method, which does not entirely guard against pregnancy. And, of course, it does not protect either partner from sexually transmitted diseases.
Withdrawal is the contraceptive method of choice for several reasons: There is a perception that it is effective and protects against pregnancy, and people say that other forms of contraception interfere with pleasure. Even if young women prefer to use a condom, they are reluctant to interfere with their partner’s pleasure.
“I think most women have sex to satisfy their partner. They sacrifice more than they experience pleasure,” Hana said.
Fundamentally, sexual education should be about safe sex. It should lead to sex that is protected from STDs and sex that two people have consensually, without fear or shame. Yet what is acceptable in Kosovo is murky. It’s unclear how sexual education can achieve its goals when women are expected to be both virginal and sexually available, while men are expected to embody stereotypes of hypermasculinity.
Bujar Fejzullahu of the Peer Educators Network (PEN) says that having conversations is the first step. PEN is a network of 1,500 volunteers — mostly teenagers — who are trained to hold discussions and workshops on safe sex in schools across Kosovo. Students do laugh, but underneath the giggles is real curiosity, Fejzullahu says. Peer groups are a good conduit for teaching life skills and for passing on information, he explains.
“Young people talk about their problems with their friends, and when a young person is well informed they can give their friends good advice,” he said.
“We offer a lot that the school system doesn’t offer. Even though teachers and professors are obligated to teach sexual education or sexuality, students say they skip those topics. Teachers aren’t ready to talk freely with young people about problems that preoccupy them. We train young people, and they give information to their peers.”
Kosovo’s older generations may not be ready to talk about sex, but my conversation with Hana, Vesa, Vigan and Gersi indicates that younger people definitely are — whether the discussion happens in a class, in a peer group, or over margaritas.
Fejzullahu, an advocate of meaningful discussion, concurs, saying, “They are more ready than we think.”