Terminology guide to discussing sexual and reproductive health and rights

Script

Abortion: A procedure that ends a pregnancy.

• Abortion is sometimes referred to as “getting rid of a pregnancy.” The circumstances surrounding an abortion are often complicated, emotional, and different for every individual, so using neutral phrases such as “deciding not to continue with a pregnancy” or “choosing not to move through a full pregnancy” may be a better choice.

Abstinence: Not engaging in sexual activity, regardless of relationship status or whether a person has previously engaged in sexual activity or not.

• When talking about people who have not been involved in sexual activity, use neutral, descriptive language rather than terms that suggest that avoiding sexual activity is morally superior. For example, avoid comments such as “Really? At your age you haven’t had sex? That can’t be true.” Similarly, use neutral, descriptive language to describe people who are actively involved in sexual activity rather than pejorative terms that discriminate against people based on their sexual activity. For example, avoid comments such as “You’ve had sex with a lot of people.”
• It is not possible to know whether somebody has been involved in sexual activities based on the condition of the hymen nor whether there is bleeding when something is inserted into the vagina. A hymen can be intact or not regardless of whether sexual activity has happened (e.g., some people are born without a hymen). Referring to people as “intact” is not accurate and implies that their value is connected to their sexual activities.

Birth / child spacing: The practice of leaving a period of time between pregnancies or births.

• Birth spacing is an important part of family planning. Benefits include that it allows the body to rest and recover from pregnancy and childbirth, and enables families to save money and other resources for the next child.
• The World Health Organization recommends waiting two to three years between pregnancies.

Bodily autonomy: The ability to decide what happens to your body. This includes being able to make decisions about your body without fear of discrimination, violence, or punishment.

• Bodily autonomy is a critical component of physical, reproductive, and mental health.

Body image: How a person sees their body, and the thoughts and emotions related to how they see it.

• A person’s body image can be associated with positive and negative experiences and emotions. Also, body image changes over time and varies in different situations.
• Often, people make assumptions about someone’s health based on how their body looks. But you can’t tell if someone is healthy just by looking at them. Healthy people come in a variety of shapes and sizes.

Breastfeeding: Feeding a baby with human milk directly from the body.

• It is important not to shame those who feed babies this way or those who cannot or chose not to do so. Everybody makes the choice that is best for them and their child based on their circumstances.
• Other less frequently used terms include “chestfeeding” and “bodyfeeding.”

Coercion: Forcing someone to do something, often by pressuring, manipulating, bullying, or threatening them.

• Coercion can happen regardless of the relationship between people (e.g., friends, co-workers, bosses, landlords, dates, spouses, family members, strangers). Common coercion tactics include:
  • making threats.
  • using drugs or alcohol to lower inhibitions.
  • cultural or economic pressure.

Consent: Actively agreeing to something. In the context of sexual and reproductive health and rights, “consent” refers to actively agreeing to participate in an intimate or sexual activity. Before engaging in sexual activity, those involved need to know very clearly whether the other person agrees to the activity. Without consent, sexual activity is sexual assault, or rape. You cannot assume that someone consents based on your perception of the situation.

• It’s important to note that power imbalances in relationships can affect someone’s ability to provide consent. A variety of factors can impact the power dynamic between people, including age, privilege, status in society, and level of ability.
• Consent needs to be free, informed, and ongoing. Free consent means that agreement is voluntary and free from coercion or threats. To give consent, a person must also be operating at full capacity, which excludes individuals who are underage/minors, intoxicated by drugs or alcohol, or who are asleep or unconscious. Informed consent can only occur when a person has all the necessary information to make a decision about sexual activity. Ongoing consent means having the ability to withdraw consent at any time during sexual activity.

Contraception: Various devices, sexual practices, medications, or surgical procedures to manage fertility and/or intentionally prevent pregnancy.

• Also known as “birth control,” contraception is commonly used as a method of family planning.
• Preventing unintended pregnancies helps to improve health, reduces pregnancy-related deaths, and helps ensure that families can support and provide for the children they have.

Family planning: Managing the number of children in a family and the spacing between their births, particularly by using contraception or undergoing sterilization.

• Family planning is an important tool for birth spacing.
• Generally, the optimal physiological age for childbearing is 20 to 35 years. This age range is associated with the lowest health risks, though there is no “right” age that works for everyone. Readiness for pregnancy and children also involves many factors related to both physiological and social development.

Female genital mutilation (FGM): The practice of removing part or all of the external female genital organs or any other lesion of the female genital organs for non-medical reasons. This is the term agreed on by most national and international organizations.

• UNICEF considers FGM to be a harmful cultural or religious practice. It may come with criminal sanctions, e.g., fines or prison.
• In many communities, people have been socialized to participate in FGM and may fear they will be ostracized if they do not participate.
• When talking to those who have experienced FGM, ask them what term they want you to use and use their preferred term. There are many terms used for FGM worldwide and respecting the person who has experienced it should be your priority. For example, other terms for FGM in Mali include selidjili (ritual purity or ablution), bolokoli (circumcision and cleanliness) and “excision” (which can refer to a particular type of FGM or FGM in general). It is also sometimes referred to as “cutting.”
• Some terms for FGM may be demeaning or insulting to women and create further harm. It’s important to remember that women typically undergo FGM as a child, usually sometime between infancy and the age of 15, meaning that they cannot consent and do not choose what is being done to them.

Fertility: Ability of an individual or couple to reproduce.

• It’s important to remember that fertility is not an indicator of strength, well-being, masculinity, or femininity. Terms like “sexual strength” or “virility” might suggest this. Use terms that describe the situation in a neutral fashion rather than making value judgements.

Forced marriage: A marriage in which one or both of the partners is married without their consent or against their will.

• Forced marriages include formal marriages or informal unions between a child under the “age of majority” and an adult or another child. It’s important to note that the age of majority (also called the “age of consent”) can be different for women and men and varies somewhat by country. While forced marriage is still common in many countries, many other countries have established a legal minimum age for marriage in order to protect the child’s welfare.
• As children cannot legally marry, it is not technically correct to use terms like “child marriage,” “early marriage,” “married young,” or “child bride,” though some of these terms are still commonly used in some places in Africa.
• A forced marriage is different from an arranged marriage in which both people consent to others choosing their spouse.
• Even if both parties enter a marriage with full consent, the marriage can become a forced marriage if one or both partners are later forced to stay in the marriage against their will.
• Forced marriage has been designated by UNICEF as a harmful cultural or religious practice.

Gender: Refers to the socially-constructed roles and responsibilities of people in a given culture based on their sex. It includes expectations and assumptions about the characteristics, aptitudes, and likely behaviours of people based on their sex.

• The terms “gender” and “sex” are often used interchangeably, but they do not mean the same thing. See the definition of “sex” (a biological rather than social term) below.
• Terms describing gender include “women” and “men,” but not “male” and “female” (which refer to sex), although these terms may be the same in some languages. Some cultures around the world, including in Africa, recognize more than two genders, while others recognize only two genders, both culturally and legally.
• Gender includes both gender expression and gender identity.
• Gender expression refers to how a person publicly expresses or presents their gender. Gender expression is also socially constructed and includes aspects of behaviour and outward appearance such as dress, hair, make-up, body language, and voice. For example, in some cultures, women have longer hair and more often wear make-up.
• A person’s name and pronouns (see definition of “pronouns” below) are also common ways of expressing gender.
• Gender identity refers to an individual’s internal sense of their gender.

Gender-based violence (GBV): Harmful acts directed at an individual based on their gender. This includes physical, mental, emotional, sexual, or economic harm inflicted in public or in private and includes threats of violence, coercion, and manipulation.

• GBV includes, for example, intimate partner violence, sexual violence, rape, forced marriage, female genital mutilation, sexual harassment, human trafficking, online / cyber violence, forced pregnancy / abortion, honour-based violence, and denying opportunities and resources.
• Take care that the terms you use to describe people who have experienced gender-based violence do not suggest that they are powerless or weak, or that they bear responsibility for the violence. Many organizations favour using the term “survivor” to emphasize strength and resilience in the face of adversity rather than “victim.”

Incest: Sexual activity between people who are closely related.

• Laws vary around the world regarding what constitutes incest. Regardless of national laws, unwanted sexual contact from a family member can have a lasting negative effect on the survivor both psychologically and physically.
• For many reasons, it can be difficult for individuals to disclose incest or seek support, especially if the perpetrator is a family member. Reasons include fear of consequences for the perpetrator or themselves, fear of not being believed, and fear of being accused of doing something wrong.
• Survivors of incest may not realize that they have experienced abuse because they have been told by the perpetrator that what is happening is normal.
• Incest can happen in any family, no matter their income, ethnic group, religion, or where they live.

Infertility: A failure to achieve a pregnancy after 12 months or more of regular, unprotected sexual intercourse. Men and women are affected equally by infertility, with 30% due to male factors and 30% to female factors; 40% of infertility is caused by both male and female or unexplained factors.

• People have different emotional responses when experiencing infertility. Using neutral language avoids assuming how they are feeling or treating them as having lesser worth because of their infertility. It may be preferable to say someone is “experiencing infertility” rather than “suffering from infertility.” Additionally, terms like “barren” and “impotent” can imply weakness or worthlessness, and may cause distress to the individuals you are describing. Thus it’s preferable to simply say “experiencing infertility.”
• In many cultures, women face more stigma for a couple’s failure to have a child. When discussing infertility, avoid statements that place blame for infertility on women.

Intersex: Describes a person who is born with, or who develops naturally during puberty, physiological characteristics that do not conform to the medical definitions of “female” and “male.”

• The word “hermaphrodite” is considered offensive and outdated in some countries.

Intimate partner violence (IPV): Actions committed by a current or former partner, such as a husband, wife, boyfriend, or girlfriend, with the intention to harm.

• IPV can involve physical, mental, emotional, sexual, and financial abuse. It can involve stalking, reproductive coercion (see below for a definition), and harassment over the phone or online.
• Violence can happen in any type of intimate relationship, not just marriage, and is not only physical, so use terms that reflect that fact.

Labour: The process of childbirth, from the contractions of the uterus and dilation of the cervix to delivery of the infant and finally the placenta.

Menstruation: The flow of blood, fluid, and tissue out of the uterus and through the vagina that usually lasts from three to seven days. It typically occurs every month until menopause, though for some, it might be irregular.

• It is also referred to as “a period” and many other terms.
• Consider using terms that consider menstruation as what it is—a natural process, not a health problem, and not harmful to others. For example, in many Ugandan dialects, references to menstruation or periods have a negative connotation translating to “sickness” (okulwara) or “problem” (ensonga).
• Menstruation begins with puberty, and is not caused by interacting with men or being involved in sexual activities.
• Stigma around menstruation has many negative impacts on women and girls, such as social exclusion during periods.
• All persons who menstruate have a right to manage menstruation in a hygienic way, in privacy, and with dignity. When these rights are not protected, it may mean missing work or school.

Menopause: The life stage of a woman when menstruation permanently stops and childbearing is no longer possible because of hormonal changes.

• Menopause usually happens between the ages of 45 and 55, but sometimes earlier. Menopause is often accompanied by symptoms such as hot flashes, difficulty sleeping, mood swings, and vaginal dryness. Irregular post-menopausal vaginal bleeding can also happen because of reproductive cancers or physiological changes related to menopause.
• Menopause is not a sign of witchcraft.
• Individual women have different experiences of menopause, and some women’s experience is more difficult than others. Using neutral, descriptive language like “experiencing menopause” avoids assuming what an individual woman’s experience is like.
• Language used to describe menopausal or post-menopausal women can often imply that fertile women are superior. This includes terms like “dried up” and “past their prime.” Use respectful terms when referring to anyone of any age.

Obstetric fistula: A hole between the birth canal and bladder and/or rectum caused by prolonged, obstructed labour. It often results in chronic leakage of urine and/or faeces, which can lead to other health problems.

• Women with untreated obstetric fistulas often experience social exclusion, isolation, and stigma. They are often described in unflattering and even insulting terms, which can both cause and worsen stigma. Women with obstetric fistula are not less hygienic and it does not indicate a failure of any kind.
• Obstetric fistulas are not caused by witchcraft or unfaithfulness.
• Obstetric fistulas can often be repaired or improved with surgery.

Personal pronouns: A set of words used to refer to an individual in place of their name.

• Pronouns can be used to indicate an individual’s gender identity or expression. Common pronouns used in different countries include “he/him,” she/her,” and “they/them.”
• Whenever possible, ask someone how they would like to be referred to on air, including how to pronounce their name. Using the pronouns that individuals themselves use is an important aspect of respecting their gender identity and can play a crucial role in creating a safe and inclusive environment.

Pregnancy: Carrying a developing fetus in the uterus. Pregnancy begins with implantation of the fertilized egg and progresses through the embryonic and fetal stages until birth. It usually lasts approximately 40 weeks from implantation to birth.

Pregnancy loss: When an embryo or fetus dies.

• According to the WHO, if the death is before the 28th week of pregnancy, it’s called a “miscarriage.” After the 28th week, it’s called a “stillbirth.”
• Pregnancy loss is common. It is often caused by spontaneous problems in fetal development that could not be prevented.
• It’s important to note that pregnancy loss through a miscarriage or a stillbirth rarely occurs because the pregnant person did something wrong. Instead, it most often occurs because the fetus didn’t develop as expected.
• Pregnancy loss is a very emotional and sensitive issue for women who lose the fetus or embryo. It’s important to use sensitivity and sensitive language when talking about the issue.

Primary sex characteristics: These include external genitalia such as the penis, scrotum, labia, and vulva; internal genitalia such as the vagina, uterus, fallopian tubes, clitoris, and cervix; and androgen (including testosterone) or estrogen hormones.

• It is recommended when speaking about sexual and reproductive health and rights to use accurate, but well-understood terms. Your radio station or national laws may have rules around what terms are allowed on air, which may mean that certain “slang” or “street” terms should be avoided. However, some medical terms might not be well understood by the audience or might be considered offensive. Use your judgment of the local context and discuss with subject-matter specialists if you are unsure of the right terms to use.

Puberty: A natural period of physiological and psycho-social development, often including developing the ability to reproduce.

• Puberty is marked by physiological development of secondary sex characteristics such as breast development and menstruation, hair growth, and first ejaculation. Puberty is natural and usually happens around 10 to 13 years of age but may occur anytime between 8 to 14 years of age.
• The onset of puberty does not indicate that a child is ready to be involved in sexual activities or get married.

Reproductive coercion: Any acts that interfere with a person’s freedom of choice with regards to reproductive health. This is a type of gender-based violence.

Reproductive coercion can involve:

• Refusing to use contraception.
• Falsely claiming that one used a method of birth control.
• Hiding, tampering with, or destroying contraceptives.
• Deliberately trying to give a partner a sexually transmitted infection (STI).
• Pressuring or shaming a partner about their decision to have or not to have children.
• Forcing somebody to get an abortion or preventing them from getting one.

Reproductive health: A state of complete physical, mental, and social well-being related to the reproductive system and its functions and processes.

Reproductive rights: All people are entitled to reproductive rights, regardless of gender, sex, or any other characteristics. The extent to which these rights are protected and respected varies around the world. Reproductive rights include:

• The right to make decisions about reproduction free from discrimination, coercion, and violence.
• The right to receive accurate information about the reproductive system and the services needed to maintain reproductive health, such as services that ensure healthy pregnancy and childbirth and safe abortion services. What are considered safe abortion services varies from country to country based on national laws.
• The right to access the safe, effective, and affordable methods of contraception of one’s choice.
• The right to freely decide the number, spacing, and timing of children; to access the information and means to do so; and the right to attain the highest standard of reproductive health.
• The right to manage menstruation in a hygienic way, in privacy, and with dignity.
• The right to access services to prevent and respond to gender-based violence.
• The right to privacy.

Reproductive system: The system of organs and body parts that functions in reproduction, including the testes, penis, seminal vesicles, prostate, urethra, ovaries, fallopian tubes, uterus, vagina, and vulva.

Safer sex: Ways to reduce the risk of unwanted outcomes of sexual activity, such as unintended pregnancies or sexually transmitted infections (STIs).

• In the past, healthcare professionals used the term “safe sex” instead of “safer sex.” It is more accurate to say “safer sex” because, while these techniques are effective at preventing STIs and unwanted pregnancies, there is still a possibility that people can contract an STI or have an unintended pregnancy.
• People sometimes refer to sexual activity without contraception or having many sexual partners as “risky sexual practices.” This can stigmatize certain kinds of sexual behaviour, which can marginalize people and reduce the likelihood that they will access the information and services necessary to maintain their sexual and reproductive health, and that of their partners.

Secondary sex characteristics: Physical characteristics that develop naturally during puberty, for example, fat distribution, developing breasts and facial hair, changes in the pitch of the voice, and pubic hair. It is important to note that there is a great deal of individual variation in the degree to which these characteristics are expressed.

Sex: The medical classification of physiological traits that make up a person’s primary and secondary sex characteristics (see definitions of these terms above).

• Medical professionals usually assign a sex to someone at birth. However, secondary sex characteristics only develop in puberty, meaning that sex assignment at birth is not always accurate.
• “Sex” and “gender” are often used interchangeably, though they have different meanings. (See the definition of gender above.) However, in some languages, the words for “men” and “women” are the same as the words for “male” and “female.”
• The word “sex” is often also used to refer to “sexual activity,” for which see the definition below.

Sexual activity: Stimulation or contact of a sexual nature, intended for enjoyment and/or reproduction.

• There are many kinds of sexual activities, including those that do not involve another person.
• Any contact or stimulation of a sexual nature that does not include consent from those involved is sexual violence.

Sexual harassment: All forms of repeated and unwanted sexual attention or advances that cause discomfort, fear, and threaten a person’s well-being or employment.

Sexual health: A state of physical, emotional, mental, and social well-being related to sexuality. Sexual health requires a respectful approach to sexuality and sexual relationships, and full sexual health requires access to the services described below in the section on sexual rights and information (see also the definition of reproductive health.)

Sexual orientation: Which gender(s) a person is romantically and/or sexually attracted to. The terms used to refer to the variety of sexual orientations vary by culture and geography, and change frequently. For example, in Uganda, the term “same-sex attracted” is used. In other places, commonly used terms include “gay,” “lesbian,” “straight,” “bisexual,” and “asexual.”

• Using the term “sexual orientation” rather than “sexual preference” or “sexual identity” underlines that people choose their partners, but sexual orientation itself is not a choice.
• If you plan to address issues related to sexual orientation on air, it’s always best to speak to local organizations who work on these issues to understand the best terms to use, as well as the issues they are facing. However, in some countries it is illegal to discuss sexual orientation and so you should review local laws and your station’s editorial policy before deciding to discuss this issue.
• The terms “straight” and “heterosexual” are both acceptable and can be used interchangeably.
• The word “homosexual” is often used as a blanket term to refer to people who are not straight/heterosexual, though those individuals may identify differently and prefer other terms.

Sexual rights: This gives everyone the right to, for example, freely choose if, when, and with whom they want to have sex. Under these rights, women and girls, men and boys must be able to make decisions about their health, their bodies, and their sex lives. These fundamental rights are already recognized in numerous laws and international treaties. This includes the right of an individual to:

• achieve the highest attainable standard of sexual health;
• access sexual and reproductive health services, including family planning services, testing and treatment for STIs, support for survivors of various types of sexual violence, antenatal birth visits, and other services;
• seek, receive, and provide comprehensive, evidence-based information and education related to sexuality;
• choose their sexual partner and decide whether and when to be sexually active;
• pursue a satisfying, safe, and pleasurable sexual life, free from stigma and discrimination;
• access services for preventing and managing sexually transmitted infections and sexual dysfunction;
• seek counselling and treatment for sexual dysfunction and disorders.

Sexual violence: Acts of a sexual nature against one or more persons or that cause such person(s) to engage in an act of a sexual nature by force, or by threat of force or coercion. Forms of sexual violence include rape, attempted rape, forced prostitution, sexual exploitation and abuse, trafficking for the purpose of sexual exploitation, child pornography, child prostitution, sexual slavery, forced marriage, forced pregnancy, forced public nudity, and forced virginity testing.

• Sexual violence can happen to anyone, no matter their gender, age, appearance, or what they are wearing.
• No one deserves to experience sexual violence. There is no excuse for committing sexual violence.
• Sexual violence can manifest in physical force, psychological pressure, or emotional manipulation.

Sexually transmitted infections (STIs): Infections that are passed from one person to another during vaginal, anal, or oral sex, sexual skin-to-skin contact, or exchange of bodily fluids.

• The terms “sexually transmitted diseases (STDs)” or “venereal diseases” may create the impression that STIs are permanent and always produce severe symptoms, which is not the case. Many STIs can be treated and resolved with proper medication.
• Some STIs cannot be cured and can have serious, lasting impacts on health, such as HIV and hepatitis B.
• STIs are often non-symptomatic. Since it is not always possible to tell when somebody has an STI, it is important to get tested regularly.

Survivor: In the context of sexual and reproductive health and rights and gender-based violence, a survivor is a person who has experienced sexual or gender-based violence, and is still living.

• Using the term “survivor” rather than “victim” emphasizes that people with these experiences have agency and power over their own lives.
• The term “victim” can be perceived as disempowering and imply that the person is helpless and/or weak. However, some survivors feel it’s important to use the term “victim” to indicate the gravity of the harm they experienced and, in legal cases, to emphasize the fact that there was a perpetrator.
• Be flexible enough to use the term that persons themselves prefer.