Which assumptions and stereotypes around religion and migration influence sexual health care for African migrants in the Netherlands? In this blogpost Brenda Bartelink and Kim Knibbe investigate health disparities in the Netherlands against the background of approaches to religious and cultural diversity.

A girl comes home and asks her mother: “What is sex?” Startled, her mother responds: “We don’t talk about that.” “Okay,” the girl responds, “I will ask the guy who told me about sex.”

Rachel Theodore Smith, a pastor, church founder, and health scientist of Nigerian descent, told this story during a presentation for religious leaders, mostly representatives of African dominated churches in The Hague. The goal of her presentation: to urge religious leaders to undertake sexuality education themselves, to understand what young people experience with regard to sexuality, how they respond and what they need in terms of information and guidance. Churches and the parents have an important role in this, according to Theodore Smith.

The mother's horror at her daughter's question confirms a common stereotype about religious migrant communities in the Netherlands. Yet Theodore Smith’s approach is the complete opposite. Rather than shrinking away and avoiding the at times tricky topic of religion and sexuality, she openly and directly addresses it. She is not the only religious leader who considers sexuality an important matter for conversation with (young) people. In the research project Sexuality, religion and secularism. Cultural Encounters around Sexual wellbeing in the African Diaspora in the Netherlands we gathered many examples of religious leaders giving education, counselling and other forms of religious and secular support on sexual wellbeing to their communities. The project also investigated the Dutch public health approaches to sexual wellbeing. This comparative perspective allowed our research team based at the University of Groningen and the University of Amsterdam to reflect on common assumptions and stereotypes between religious and secular approaches of sexual wellbeing, while offering insight into overlaps and the potential for common ground.

Are taboos really religious?

A stereotype that is challenged by the research is that in religious contexts, sexuality is surrounded by taboos. This stereotype has a particular resonance in the Netherlands. Iconic images of the 1960s and 1970s when the Netherlands became ‘sexually liberated’ and secularized rapidly have contributed to the idea that religion is conservative with regard to sexuality. Clashes with conservative Christians around nudity, free love, abortion and homosexuality were widely mediatized (e.g. Bos 2010). These clashes have led to the generalized assumption that the contemporary secular majority in the Netherlands is liberal and tolerant when it comes to sexuality and sexual diversity. This image of a liberal nation is exemplified by approaches of sexual health and wellbeing that value 'open speech’ about sexuality, naming everything without being restrained by prudishness, taboos and moral squeamishness (Roodsaz 2018). Speaking about sexuality should be neutral and focused on biomedical facts. Ethical and moral aspects of sexuality are often not discussed to avoid ‘moralizing’ of sexuality, an attitude associated with religious approaches to sexuality.

This stereotypical representation assumes a much stronger conflict between secular and religious approaches than the empirical research of religious and secular approaches to sexual well-being suggests.  The following three findings speak to this:

1. Addressing sexuality is complex and sensitive in religious and secular contexts.
We observed many instances in which teachers, parents or young people themselves had a ‘we don’t talk about that’- attitude. The example from a training on the acceptance of homosexuality is a case-in-point:

“Do you explain how homosexuals have sex?" The peer educator of COC Netherlands, an LGBTI advocacy organization shakes his head: “No, I have done that a couple of times, but speaking about sex invites such strong responses from students, it is not yet possible to discuss this”

In these and other cases the option of not-speaking about certain aspects of sexuality was even preferred, not only because the issues are controversial in certain contexts, but also because sexuality is a private matter that needs a sensitive approach.

By contrast, even though religious leaders sometimes struggled with how to give information on sexuality to young people, among adult populations and women in particular, sexual wellbeing was regularly a subject of conversation in private conversations as well as in religious gatherings and trainings.

2. Religious and secular approaches to sex are heteronormative
Part of the secular liberal approach to sexuality is the assumption that religions are violent and oppressive towards women and people with diverse sexual orientations (Bracke 2011). As the first nation allowing people of the same sex to get married, the acceptance of homosexual orientations in the Netherlands is often seen as a sign of cultural progress. The previous example demonstrates, however, that while homosexuality is discussed in terms of identity and tolerance in schools, the primary focus in sexuality education is based on heterosexual sex because of the strong reactions it invokes among younger populations. In religious contexts the focus was on heterosexual relationships within marriage. Thus, conversations about sexual wellbeing would exclusively take place in a heteronormative frame.

3. Religious and secular approaches are gender normative
At an annual women's conference organized by a Nigerian-initiated church in Amsterdam, a female religious leader gives 250 women instructions on sexual positions that increase sexual pleasure. She stresses that it is important to have pleasure in marriage, emphasizing women’s responsibility to please their husbands and realize a stable marriage.

During a secular sex education lesson in a high school, the teacher explains: "Guys always want sex, if you as a girl do not want to have sex, you just tell them that you have your period."

In both religious and secular health approaches we found the assumption that the sexual desire of men and boys is strong, overwhelming and that they have difficulty managing these urges themselves. Girls and women are made responsible for responding to male sexual desire, either by offering strategies to sexually satisfy their spouses or by offering strategies to avoid engaging in sex that rely on skilled communication or even, as in the example above, subterfuge.  

Who made (the) difference?  
These three findings suggest that the approach of sexual wellbeing in religious and secular contexts have more in common than the strong contrasts presented in public discourse suggest. Approaches to sexual wellbeing always include normative aspects, and as such are never entirely neutral or based on scientific evidence. The gender normativity in sexuality education in schools in the Netherlands, referred to above, is a case-in-point. However, when it is assumed that secular approaches to sexual wellbeing are morally neutral, this makes it difficult to discuss the normative frameworks underlying sexual health programming and perhaps find common ground. At the same time, religious migrant actors in the Netherlands frequently experience being called to account  by journalists, policymakers and NGOs (Knibbe 2018) for their approaches to sexuality and gender. There is little space for them to share their views and approaches as equal and respected partners in the conversations or for them to correct negative stereotypes. In addition, they are sometimes critical of the real and assumed moralities underlying secular approaches to sexual well-being in The Netherlands. However, as a minority, they do not have the power to address these moral issues in a setting where the moral subjectivity of secular approaches are routinely denied. When minorities do attempt to question secular moral frameworks around sexuality, secular actors and commentators see this as confirming the stereotypes of religion as backward, conservative and patriarchal.

While the research questions the assumed conflict between religious and secular approaches, it does confirm that a gap exists between health service providers and people with (African) migrant backgrounds, with regard to their sexual health needs. We have observed suspicion and critique of service providers, often rooted in negative experiences. Coming from different health and medical contexts, migrants may struggle with understanding the Dutch health system and do not feel that they are heard and respected. In addition, our interlocutors also shared their experiences of ‘feeling different’ or ‘standing out’ because of their bodies and/ or language proficiency, while also sharing examples of experiences with racism and discrimination.

These findings invite critical and ethical questions, such as how do we distribute responsibilities in bridging this gap? This is an important question, as it comes down to people’s right to access (sexual) health care. In the Knowledge Agenda for the future, experts from academic and professional institutions have argued that the Dutch government should improve preventive health care by focusing on reducing health disparities in the population in the Netherlands. Based on our research we ask for caution in terms of how differences are understood and addressed. Our research and that of others suggest that focusing on religious, cultural or ethnic differences is counterproductive. However, health professionals in the Netherlands should consider the very real experiences of religious and cultural minorities with exclusion and ignorance and develop approaches to connect, build relationships and meet people where they are. 

This blogpost builds on a Policy Brief and Report that was presented on September 19 at the NIDI in The Hague. They are now accessible on www.culturalencounters.nl.