You might be wondering: why is there a day dedicated to contraception? Why is that necessary, or even useful? You might think contraception is just a useful tool that people know about and can take advantage of when there’s a need. Actually, in many countries and for many groups that’s not the whole story. As is so often the case, youth are a vulnerable group when it comes to contraception. Not only do we have fewer financial resources, our sexuality is also more controlled and stigmatized. That’s why world contraception day is a great opportunity to explore what youths’ access to contraception looks like – and where the obstacles are rooted. This article is exploring problems surrounding access to contraception in Malaysia and Germany, though there are so many more issues in a range of other countries.
What are some issues that surround contraception in your country? Is it access? Costs? Sex-education? Safe access for women to choices with regards for unwanted pregnancy? Stigma?
Malaysia; where lack of sex education is the problem
Surprisingly, in a country where religious authorities have strong influence and power, every drugstore or pharmacy has birth control pills and condoms for purchase. Though, certain products may require a prescription, for the most part contraceptives are easily attainable.
The reality of things don’t seem to fit the painted picture. According to police statistics, over 100 babies are being dumped each year – with more than half of them found dead. Flung out the window, flushed down the toilet, chucked in garbage cans, left at playgrounds – often, by young unwed mothers.
With contraception being so readily available, why are there so many unwanted children?
In a survey conducted by Durex, it was found that 42% of Malaysian youth believed that withdrawal is an effective method of preventing pregnancy. Another 36% were unsure whether standing up during sex will prevent pregnancy.
If those figures don’t say enough, it’s painfully evident that most Malaysian youth simply just do not know how to prevent unplanned pregnancies. Google may be just one click away, but when you don’t even know what exactly to look for, what is the use of access? Sex in this country is a subject so taboo that it’s a conversation that most don’t engage in. In fact, for most young people, there’s no one they could to talk to about it.
How can we expect our youths to know better when we’ve never taught them about just what exactly, better means?
The problem lies in the makeup of the mentality of the society. Holding on to faith, culture, and not very much else, the decision to have sex education be a part of the national school curriculum has never gone beyond parliamentary debate due to the protests of parents and religious agencies, who continue to believe the myth that equipping teens with knowledge of sexual reproductive health would encourage them to have sex. Teenagers are only taught school reproductive systems of men and women, with only a brief mention of contraceptive methods. If you paid attention in class – great, you know it exists! However, you’d still have no idea as to how to use them. Many also endure hour long sessions on the merits of abstinence and why you shouldn’t have sex. Abstinence is the way to go – and not only that! Yes, there’s more. You’d be asked to sign a card where you pledge to abstain from sex until you’re married. 
30 years ago, preaching abstinence may have worked. But today? Absolutely not.
Our youth deserve better than to be forced to rely on themselves or their peers for knowledge. When we don’t equip them with a comprehensive sexual education curriculum, we have become the reason behind why young girls believe that abandoning their babies is the answer, that there was no other solution to what they’ve been made to believe is the end of their lives. Why? Because we don’t realize that the root of ‘all evil’ stems from the lack of sex education. It’s beyond due time that we say yes to empowering our youth with their sexual and reproductive rights.
Germany; where the cost of contraception is the problem
Unsurprisingly, contraception in Germany is very accessible, and people generally take advantage of it: 80% of women between the ages of 15 and 45 use contraception (and most of the rest want to become pregnant or do not have sex). Difficulties in accessing contraception is considered a “developing country problem”, but really Germany has its own challenges to face.
Before we dive into the issues with accessibility, let’s take a deeper look at the pill and condoms, the two preferred methods of youths and adults. This will help us understand who tries to access what and where the system has its gaps.
Condoms can be purchased basically everywhere, in every colour, size, and flavour. As a method it’s much cheaper than the pill and it is easily accessible. However, especially for less experienced youth, the use of condoms involves risks and takes some practice.
To purchase the pill, you need to visit a doctor to get a prescription and then purchase it in a pharmacy. The pill is only fully covered until the age of 18. After the age of 20, the pill is not covered by health insurance or social services. Like other methods of contraception, it is considered a private expense and this is where it starts to get tricky. Statistically, the use of the pill increases with higher incomes, which shows that more women would take the pill if they could afford it. The pill costs 4.50 to 22 €/month – an obstacle that hinders low-income women’s ability in family planning. Sexual health centres have established pilot projects to provide the pill for free.
Youth aren’t equal, and neither is their access to contraception
We see that financial obstacles exist, but these are not the only ones. Beyond financial costs, young people can feel ashamed, embarrassed, or simply find it difficult to organize a doctor visit or walk into a sexual health centre. Youth in precarious circumstances not only have less money for purchasing condoms, chaotic living conditions can also make it harder to take the pill regularly, even if it is provided for free. And if you don’t have papers, or are insured through your parents and don’t want them to know, you can’t easily get a prescription. That means even though services are out there, they are necessarily easy to use.
Surprisingly, not all youth are equal in Germany, and neither is their access to contraceptives. Instead, it’s shaped by family situation, status, and education.
What can we do to close the gap? The answer is both simple and complex: sexual education
Sexual education is crucial! It decreases barriers based on shame and misinformation and helps break through the barriers of inequality. When youth know their options and are empowered to talk about what’s important, they are better able to get the information and contraception needed. Sex ed comes in a variety of ways: as part of the curriculum or outside of school.
The reality of sex education in schools basically depends on the teacher. Some teachers invite external experts and give time and attention to the subject, others just show a brief video. However, 80% of youth mention sex education in schools as their main source of knowledge on the subject. One positive sign is that use of contraception increases with increased levels of education on the subject.
Sexual health centres have introduced special youth office hours to provide information specifically catered to young people’s needs. The office hours have been well received and have increased youth visits. Still, it’s not always easy to just walk in, ask for advice and get free condoms (if you like those). The government also offers multiple websites with different focus areas (sexual education, contraception, sexual abuse, healthy relationships, mental health, websites for parents and much more). The websites provide anonymous and easily accessible information in the language of their target audiences. The best thing: they can pick up on new questions and be always up-to-date on the changing needs of their clients.
The examples from Germany and Malaysia show that accessibility and its obstacles are complex and deeply rooted in cultural values and social inequality. We need to stop making sex and contraception taboo. We need to stop leaving our youth alone in this struggle. Sex education can do all of this. No matter if brought to youth by schools, sexual health or youth centres: Youth can only make self-determined decisions when they have the information and services needed. Let’s prioritize youth empowerment! Our youth deserve to have choices. That’s how we can exercise our sexual and reproductive rights – and that’s why there’s a day dedicated to contraception worldwide.
Mindthis Magazine is partnering with International Youth Alliance for Family Planning to bring sexual health content from experts on the front lines. Their mission is to enable youth from around the world to contribute a significant voice and lead interventions and decisions on family planning and sexual and reproductive health (SRH) and rights. They are looking to empower young people to become global advocates with the skills, knowledge and resources needed to scale up youth-friendly sexual and reproductive health initiatives and services.
Fila Magnus and Marietta Wildt are the Directors of Communications and Public Relations of the International Youth Alliance for Family Planning.
Fila is from Malaysia and is a photographer and activist passionate in the field of human rights, with a special interest in children, youth, and women.
Marietta is based in Germany and uses her background is academia, grassroot activism and NGOs to improve the lives of youth and women.
 https://www.forschung.sexualaufklaerung.de/fileadmin/fileadminforschung/pdf/Jugendendbericht% 2001022016%20.pdf (p.3)
 https://www.forschung.sexualaufklaerung.de/fileadmin/fileadminforschung/pdf/Jugendendbericht% 2001022016%20.pdf
 https://www.forschung.sexualaufklaerung.de/fileadmin/fileadminforschung/pdf/Jugendendbericht% 2001022016%20.pdf (p. 151)
 Federal Centre for Health Education http://publikationen.sexualaufklaerung.de/cgi-sub/fetch.php?id=181