Not surprisingly, young men are much more likely than young women to report having multiple sex partners, of those acknowledging that they were sexually active. Of those males who report being sexually active before marriage, more than 50 percent report having multiple sex partners. Of adolescents reporting to be virgins, more than a third say they engage in some kind of non-intercourse behavior, such as mutual masturbation or oral sex. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Sherpas — the Tibetan-Himalayan people of mountaineering fame — call having sex "making sauce." Sherpa men often make vows of chastity, which are often broken. In the trekking business, extramarital affairs are not uncommon for Sherpa men; if a Sherpa woman strays, her man would leave her and she would be labeled a prostitute.Few Sherpas become monks these days. Of those that try two thirds eventually quit. "Some fall in love with girls," one trainee said, "Others can't take the responsibility." If old timers can change their ways. One man was a monk for 16 years before he left for "chang and a good woman." [Source: Jim Carrier, National Geographic, December 1992]

Finding the language for talking about sexuality and reproductive health in Nepal remains an enormous challenge for Nepalese professionals, as well as professionals from other countries working on programs in-country. One U.S.-based professional working in Nepal reflected on the language of sexuality. She found: Nepalis discuss sexuality in terms of kinds of relationships and ways of being sexual. Terms for specific sexual acts and body parts are a subset of this vocabulary, but not its core. Instead, the Nepali vocabulary for sex includes terms for sanctioned and unsanctioned relationships (marriage, elopement, lovers) and roles (husband/wife; patron/mistress; boyriend/girlfriend; seducer; virgin; “loose” woman, etc.) It also consists of terms for feelings of love, sexual desire, arousal and attraction and an array of verbs for seducing, wooing, flirting, and the like. All these words are powerful, value-laden terms that immediately bring to mind elements of the social context, such as power relations between men and women, that are relevant to AIDS prevention efforts. These words, in and of themselves also draw attention to the fact that to be involved in a socially sanctioned sexual relationship has very different implications from being involved in a hidden or illicit relationship. Words relating to love, flirtation, seduction, and sexual coercion make evident the various ways people might come to be drawn into sexual relationships. (Pigg, n.d.) Other professionals have found that talking about sexuality in Nepali to be impolite, and substitute English words as necessary.

Premarital Sex in Nepal

According to research by Sweden’s Dalarna University in the mid 2010s, Premarital sex is largely unacceptable in the Nepalese society, but studies show that young people have started to engage in premarital sexover the past decade or so. In a study conducted with male college students in Kathmandu, 39 percent saw no problem with premarital sex. This included sex with sex workers and unsafe sex. In another study with college students, 47 percent of the males and 28 percent of the females indicated that they had had premarital sexual intercourse. According to a study on barriers to sexual health services for youths in Nepal, the number of Human Immunodeficiency Virus (HIV) cases and unwanted pregnancies are steadily increasing. [Source: “Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal,” Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson, Dalarna University, Sweden, Journal of Asian Midwives, February 2015;2(2): 21–35]

According to one study, 40 percent of unmarried men who are 19 or older are sexually active. Most of these men report having their first sexual relationship during adolescence. A study in Kathmandu found the average age of first intercourse for males to be 21 and for females to be 20. (UNICEF Nepal & UNAIDS 2001). Adolescents and teens with less education and from more-marginalized ethnic groups are more likely to engage in early and premarital sex than those who are educated and have a high potential for achieving their life goals.

According to the 1996 Nepal Health Survey, approximately half of all girls begin having babies by the time they are 19. While most teenage boys and girls report that they know what condoms are and where to get them, only about two thirds of teenage boys in one survey reported using condoms during premarital sexual relationships (UNICEF Nepal & UNAIDS 2001). When a pregnancy does occur out of wedlock, the father of the child is not usually seen as partially responsible, although this varies depending on where the couple lives. In some areas, the male is forced to marry his female sex partner, or, if he refuses, must either pay a fine or spend time in jail. As with the likelihood of sexual initiation, the likelihood of condom use was higher with boys living in Kathmandu and who were educated. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Birth Control in Nepal

Contraceptive use increased from 24.6 in 1994 to 52.2 percent in 2015. Contraceptive use (any method, women ages 15-49): 53 percent (compared to 12 percent in Sudan and 84 percent in the United Kingdom) [Source: World Bank ]

Contraception is widely available in Nepal and access to has increased dramatically since the 1970s, when approximately 3 percent of couples were estimated to use contraception. In 2002 the figures was approximately 33 percent. At the same, the country’s family planning policies tend to favor the use of the IUD and injectible hormonal methods ccording to the Center for Reproductive Law and Policy. Access to contraception depends greatly on where a woman or couple lives. Any reproductive health service that can be accessed in Nepal is most likely to happen in the urban areas, and the rural areas closest to the cities. As one moves farther and farther away, up through the hills and into the mountains, the quality and access to healthcare diminishes dramatically. Problems exist with staffing reproductive or any other health facility in remote areas, as well as with non-appearances of the staff who have been hired. As a result, inhabitants of the more-remote areas receive even less care than those in the urban areas. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Top method of contraception: female sterilization. pill [Source: Birth Control Around the World ]

Types of birth control used (2015); female sterilization: 18.3 percent; male sterilization: 4.8 percent; pill: 4.8 percent; injectible: 13.2 percent; Implant: 1.3 percent; IUD: 1.7 percent; male condom: 3.8 percent; early withdrawal: 3.9 percent; rhythm method: 0.4 percent; traditional: 0.2 percent total: 52.2 percent [Source: Trends in Contraceptive Use Worldwide 2015 — the United Nations ]

Types of birth control used (1994): female sterilization: 11.5 percent; male sterilization: 7.2 percent; pill: 1.0 percent; injectible: 2.2 percent; implant: 0.3 percent IUD: 0.2 percent; male condom: 0.6 percent; total: 24.6 percent. [Source: Trends in Contraceptive Use Worldwide 2015 — the United Nations ]

Injection or injectible contraceptives such as Depo-Provera, Sayana Press or Noristerat release the hormone progestogen into the bloodstream to prevent pregnancy. Depo-Provera lasts for 13 weeks. [Source: Birth Control Around the World ]

Ideas About Love and Sexuality in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: Virtually all sexuality in Nepal is seen within a heterosexual context; therefore, all examples in this chapter will be about heterosexual relationships unless otherwise indicated. The concept of love and sexuality are quite romanticized, fed in part by the images presented in the Indian media that is prominent in Nepal. Young people tend to meet at social functions, become interested in each other, and decide to meet in secret. Part of the appeal is the secretiveness, and their behaviors might involve kissing, intimate touching, or sometimes, sexual intercourse and other sexual behaviors. Clearly, this behavior is normalized for boys much more than for girls; while many boys in a focus group said they had or knew someone who had had sex with a girl already, none of the girls would acknowledge that they had. If they knew of a girl who had engaged in premarital sex, it was through gossip. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Girls are more likely to romanticize love and marriage than boys. It is expected that young people will not have sexual intercourse outside of marriage, resulting in one of three outcomes: either young people will sneak off and get married at young ages, they will get married with their parents’ support or intervention at a young age, or they will go ahead and have sexual relationships outside of marriage. While incidences of boys and girls running off together is more common in the rural areas of the country, it also does occur in the city. Often, the discovery that a boy and girl are having a romantic relationship will cause the parents of both young people to arrange for the adolescents’ marriage. In fact, among the reasons for early arranged marriage is to protect a girl’s reputation, which can become tarnished by public association with a boy.

In sexual and romantic relationships, men are expected to be the initiators. Women are expected to remain faithful to their husbands. Husbands, however, may have extramarital sexual relationships. In particular, men who travel for their work may seek out sex workers during their travels. Infrequently using condoms, these men often contract sexually transmitted infections, return home, and continue to have unprotected intercourse with their wives. A wife usually does not have the social power, clout, or right to insist that her husband use condoms — particularly if they have never used them before in their relationship. To do so could raise questions about her own fidelity, rather than reflect the reality of her husband’s sexual activity.

Childbearing is also valued highly in Nepal, although strains on natural resources, threats to women’s health, and a desire for a higher quality of life have caused individuals, the government, and NGO professionals to focus on family planning methods. In one study, the vast majority of adults believed that a couple should wait at least two years before trying to conceive a child, with others favoring a wait of at least three or even four years. The reason behind this is to enable the couple to raise enough money to ensure that they can provide for the infant. At the same time, however, they do not believe that a married couple should use contraception immediately after marriage. The reason for this is a mistrust in family planning methods, and a concern that using, in particular, hormonal methods, will affect a woman’s fertility once she is ready to have children. Therefore, pregnancies do occur shortly after marriage. Adults who push for pregnancy as soon after marriage as possible do so because having a child creates a family. Adults living in the urban setting tend to support fewer children, one or two per couple. Rural parents tend to favor larger families of at least four or five children.

There are different views from adolescents on friendships between the genders. Girls are not to do things alone, nor is it a good idea for a girl to have male friends. Once a girl is noticed or seen with a boy, questions are raised immediately about the nature of their relationship. Some report having friends of different genders outside of the context of romantic connections, while others do not believe that boys and girls can be friends.

Religious Views on Sex in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: Religion is important in Nepal. Hinduism’s role in the social status of women in Nepal depends on how liberally or conservatively one observes Hindu tradition. Women’s sexual roles, as being either “maiden, married woman, or widow” are defined within the context of their relationship to men. Some sects do not consider women to be human, responding to the birth of a female child by stating, “nothing was born.” Others vehemently assert equality between men and women, and support the role of women in maintaining Hindu tradition. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Hinduism’s greatest social effect on Nepal is that it is the source of the caste system. The caste system continues to have a strong influence in society, even though it is prohibited by the Constitution. At Hindu temples, for example, members of the lowest castes have not historically been permitted to enter. There has been a growing desire, however, to change this. In 2001, the Prime Minister spoke out emphatically against caste-based discrimination, including barring access to temples. Since then, members of the lower castes have successfully entered many temples, including Pashupatinath, the most sacred national site to Hindus.

Buddhism has a fundamentally egalitarian view of men and women. As a result, Buddhism has offered social liberation to some women, if they have felt free to adopt the religion. As mentioned earlier, the beliefs and celebrations of Buddhism and Hinduism are equally celebrated and respected in Nepal.

Both Hinduism and Buddhism have teachings on sexuality, and there is extensive writing on both — including Tantric sex, practiced by some Buddhist and Hindu individuals. However, there is not as much literature specific to the effects of these teachings on the sexuality values in Nepal. It seems clear that some Nepalese individuals will base their values around sexuality on Hindu and Buddhist teachings, and others will not. Resources for further reading on Hindu and Buddhist teachings on sexuality are included at the end of this chapter.

Cultural Values and Sexuality in Nepal

In Nepal, parents are seen as a vital source of cultural values, including those around reproductive health and sexual behavior. As in other countries, research in Nepal has shown that parents who are actively involved in their children’s upbringing, and communicate their values clearly and openly, end up with children whose values are congruent with theirs. When it comes to sexuality, this translates into young people who postpone sexual involvement until they are older or married, and who are able to avoid pregnancy and sexually transmitted infections if they do not remain abstinent.

Modern Nepal is a society, like others, that is faced with conflicting messages and values around sexuality. There is a generation gap in comfort and knowledge levels around sexuality, with adolescents speaking more openly about sexuality issues if not often knowing more themselves. There is also an increase of sexual images in the media, because in great part of television programming from India, which includes Western programming and MTV India. As cable television grows, individuals in Nepal who can afford television will be “treated” to such “American” television shows as Baywatch and Beverly Hills 90210. The irony is palpable in Nepal as it is in other cultures: As a society, individuals can barely discuss sexuality issues, yet the culture ends up bombarded by explicitly sexual media images and messages that can throw a culture into social chaos around sexual values. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Another example of the cultural values relating to discussing sexuality came when I was conducting a meeting with adult women living in Kathmandu. My plan was to conduct a brief activity about the menstrual cycle. The professionals with whom I worked recommended that when I was done, I was to apologize to the group for discussing such a personal subject with them. When I apologized after my talk, the group of women forgave me, and then apologized themselves for not knowing some of the details I had discussed.

The terms “ethnicity” and “caste” are often used interchangeably. There may be larger populations of members of certain castes in particular parts of the country, and the available sexuality research data have revealed differences in sexuality values based on geographic location. Therefore, it is a reasonable assumption to make that different castes and ethnic groups will often have different values and beliefs around sexuality. At the same time, it is difficult to gather accurate information about people of different castes and ethnic groups for a number of reasons. First, geographic location often makes it challenging to obtain data from certain groups of people. Second, it is often challenging to obtain data from members of the highest caste, because they do not feel they need to participate in community-based programs. These programs are, they believe, for people of lower castes.

Sexual Activity in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: Masturbation is, like many other sexuality topics, generally not discussed. This is changing among younger people. In one focus group of teenagers throughout the country, professionals found that masturbation was discussed, but only by boys. These young men saw masturbation as a sign of a boy’s maturity and approaching adulthood. If masturbation is discussed among girls or between girls and their mothers or older sisters, they do not share this publicly. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Having the word “heterosexual” before the word “behaviors” when discussing sexuality and Nepal is assumed. Homosexuality is rarely discussed, and the assumption is that people are or should be heterosexual. Not surprisingly, young men are much more likely than young women to report having multiple sex partners, of those acknowledging that they were sexually active. Of those males who report being sexually active before marriage, more than 50 percent report having multiple sex partners. Of adolescents reporting to be virgins, more than a third say they engage in some kind of non-intercourse behavior, such as mutual masturbation or oral sex. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Sexual exploration by children is not discussed, if it exists. Conversations and concerns tend to arise when a young person reaches puberty. This is because of perceptible physical changes, and the understanding that pregnancy can happen. Most teenagers say they know that parents frown upon premarital sexual relationships. However, nearly 20 percent of teens in a survey conducted by UNICEF Nepal and UNAIDS (2001) believed there to be nothing wrong with a premarital sexual relationship. There is a significantly higher acceptance of premarital sex among teen boys than among teen girls, and a higher rate of sexual behaviors among boys than among girls. This suggests any of three things: that teen boys are being sexual with older women, that teen boys are being sexual with commercial sex workers, and/or that teen girls are not truthful in reporting their sexual experiences because of social mores that frown much more upon girls’ sexual activity than boys’ engaging in sexual activities.

It is virtually impossible to document this aspect of Nepali society beyond the presence of commercial sex work. Discussions of non-coercive fetishes or sexual behaviors are infrequent, so that admitting to, let alone discussing, any type of unconventional behavior would be virtually unheard of. Perhaps the most unconventional behavior would be a man who avails himself of a commercial sex worker — and even if the sex worker fulfills a non-traditional sexual fantasy, this type of work has not been reported on in the literature about Nepal.

The scope of sexual dysfunctions is widely unknown, because of, in great part, the lack of information and education, and taboos about discussing sexuality, especially for women. If girls do not know what to expect when going into their marriage or sexual relationships, it is unlikely that they will know that something painful or pleasureless is not simply part of their duties as wives. And it is even less likely that a woman would request information about sexual behaviors or pleasure. Male sexual dysfunction is not discussed either, although men are less likely to be seen as “responsible” for their dysfunction or stigmatized for it.

“Factors that have negative effects on sexual behaviour are identified as: lack of youth-friendly services, feeling of embarrassment, influence of alcohol and peers, and poor sexual and reproductive health knowledge. [Source: “Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal,” Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson, Dalarna University, Sweden, Journal of Asian Midwives, February 2015;2(2): 21–35]

Sex Education in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: Sex education in the early 2000s consisted of “a curriculum titled, Health, Population and Environmental Education, that is used in the 9th and 10th grades. This curriculum includes reproductive health, family life education, and “safe motherhood.” Teachers are widely undertrained in sexuality issues, and often extremely uncomfortable about discussing the topic with young people in class. While some schools require teaching about reproductive health, teachers have been known to assign the chapters without allowing time for in-class discussion or questions. Teachers who do address the topic tend to stick to easier topics, including biology, without discussing emotions or more challenging topics. They are also more likely to lecture on this topic rather than taking a more interactive, participatory approach. Some teachers believe that sexuality information should only be accessible by adults — and still others believe it should only be available to married adults. Local and international NGOs have been increasing efforts to provide teacher training on sexuality and reproductive health topics. Most parents say they support some kind of sexuality education for their children, although some opposition remains. Supporters believe that this kind of education will keep young people pregnancy- and disease-free; opponents believe that providing information about sexuality will encourage young people to have sexual relationships. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

According to research by Sweden’s Dalarna University in the mid 2010s, Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth. The Government in Nepal developed policy initiatives and criteria for examining sexual health education, in 2006. There are several important policy documents guiding the officialschool system in Nepal with regard to sex education. However, in reality, there are wide variations in the extent to which teachers follow the government’s guidelines in the classroom. Hence, sexual and reproductive health education in Nepal is inadequate due to teachers’ feeling of embarrassment and lack of knowledge on the part of the teacher.” [Source: “Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal,” Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson,Dalarna University, Sweden, Journal of Asian Midwives, February 2015;2(2): 21–35]

School-based sex education programmes are significant tools for disseminating information on good sexual health and the prevention of pregnancies in youths. However, there are several reasons why these programmes are not always implemented.In Nepal, some castes and areas still follow traditions which promote early marriages, even though the rate of delayed marriage is increasing nation-wide. Additionally, health personnel and teachers appear to think that providing information and education encourages young people to engage in unsafe sexual activity instead of helping to prevent unsafe sexual behaviour. STI/HIV education programmes have, so far, been considered favourably in an effort to reduce risky adolescent sexual behaviours among Nepalese young people.

Informal Sources of Sexual Knowledge

According to research by Sweden’s Dalarna University in the mid 2010s, “Due to a lack of sexual education, both in schools and at home, young people acquire their sexual and reproductive knowledge from friends and the mass media, such as television, newspapers, radio, and pornography. When asked where young people currently learnt about sexual issues and from whom theparticipants would like to receive information, friends and the Internet were the most common answers among both males and females. A higher proportion of female participants, compared to the male participants, chose their mother as the easiest person to talk about sexual issues. Other sources were: parents, sisters, cousins, siblings, teachers, fathers, books, mobile phones, the Internet, Facebook, a girlfriend, a boyfriend, healthcare personnel, doctors, midwives, nurses, older people, and sexual partners (data not shown). [Source: “Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal,” Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson,Dalarna University, Sweden, Journal of Asian Midwives, February 2015;2(2): 21–35]

“When asked from whom a teenage girl would like to receive information regarding sexual issues, friends and the Internet were the most common answers among both genders. Approximately, one fourth of the participants responded that the easiest person with whom a teenage girl could discuss sexual issues was her mother. There is difference between who the young females and males would prefer to discuss sexual and reproductive health issues with. While young females are far more likely, than males, to discuss their sexual and reproductive health issues with their parents, usually mothers, males find it easier to discuss sexual issues with outsiders, such as medical practitioners.

Elizabeth wrote in the Encyclopedia of Sexuality: As mentioned earlier, Nepali parents support information for their children about sexuality issues. However, one survey found that only one in ten parents had actually discussed these issues with their children themselves. Discussions that did take place differed, based on the gender of the child. In the urban areas, parents were more likely to talk with both their sons and daughters. In the rural areas, parents were more likely to talk with their daughters than sons. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Many parents, particularly those living in the rural areas, are unaware of where they can access this information. According to one group of parents living in the urban areas, sources of sexuality and reproductive health information are government hospital (85 percent), private doctor/clinic (49 percent), and pharmacies (28 percent). Parents in the rural areas named health post (76 percent), health workers (17.9 percent), and pharmacies (13 percent) as sources for this type of information and support.

Local organizations, like the BP Memorial Health Foundation, have been working to establish language that can be used with individuals in the community that are both medically accurate and culturally respectful. In addition, international organizations, such as Family Health International and EngenderHealth, have been working in collaboration with local organizations to provide accurate, respectful sexuality information. Research conducted by EngenderHealth and the International Center for Research on Women revealed that young people want to receive information about sexuality and reproductive health, particularly from their mothers, older sisters and brothers, and sisters-in-law. However, they say they do not feel comfortable approaching these individuals with their questions, nor do they feel confident that these identified family members would be comfortable or well equipped to answer. Young people, in particular, have questions and concerns about the menstrual cycle, nocturnal emissions, and dealing with feelings of sexual arousal that are heightened during puberty. As a result, young people and adults alike are likely to ask questions of the local pharmacist — although concerns about confidentiality remain high.

Another effort came from the Family Planning Association of Nepal, when they introduced a confidential telephone hotline in Kathmandu to answer questions about sexuality and reproductive health. In the first two months, they received over 200 phone calls on this line, which was staffed by a trained counselor. FPAN has also published materials, including Your Queries: Our Answers.

Sexual Knowledge in Nepal

In the mid 2010s, researchers from Sweden’s Dalarna University gave out a written questionnaire to 160 students age 15 to 23 in four relatively elite schools in Kathmandu and found that males demonstrated less knowledge than the females regarding every aspect of sex and reproduction, with the exception of pregnancy prevention. [Source: “Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal,” Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson,Dalarna University, Sweden, Journal of Asian Midwives, February 2015;2(2): 21–35]

More than two thirds of the participants responded that it is possible for a teenager to become pregnant after the first intercourse, with no differences between the males and females’. When asked about contraceptive methods to prevent pregnancy, condoms and contraceptive pills were the most common answers. Moreover, a higher proportion of female participants answered in favour of abstinence from sexual activity. When asked about methods to use to prevent STIs, condom use was the most common answer.

“The results revealed that one third of the participants were not aware that it is possible to become pregnant after having intercourse once. About two thirds of the girls knew that they could get an STI after having intercourse once. More than half of the students knew that one was most likely to conceive between days 12-18 in the menstrual cycle. The proportions are consistently lower for males. The males have less awareness regarding sexual and reproductive health knowledge, except for methods to prevent pregnancy. Both females and males wanted to receive their sexual health knowledge primarily from friends and secondarily from the Internet.

“The findings in this study show that both the males and females had some knowledge of contraceptives. Condoms were the most mentioned method of birth control. This supports the findings from earlier studies in low income countries. Other methods mentioned were Copper T IUD, contraceptive injections, the day-after pill, abortion, vasectomy, and minilaparotomy. The suggested suitability of these methods to prevent pregnancies among teenagers revealed a need for further information and discussion. It is a problem if youth believe that abortion, vasectomy, or mini-laparotomy are suitable contraceptives methods for teenagers. It also leads to speculate whether these answers are a sign of the low level of awareness that youth have regarding suitable contraceptive methods.

“One interesting finding though, is that more students mentioned condoms as a method to prevent pregnancies than as a method to prevent STIs. Hence, although young people are aware of the existence of STIs and that people in their age group can become infected, few seem to perceive that they are personally vulnerable. They are more concerned with preventing unwanted pregnancies than preventing STIs. This is in line with the conclusions of prior studies.21 Within Nepalese culture and traditions it is more devastating to become pregnant while single than it is to become infected with an STI.Almost one third of participants in this study did not know they could contract an STI after having sexual intercourse once. This is a common misconception among people in the participants’ age group. Other misconceptions include: a condom can be used multiple times; one can tell by looking at someone if that person is infected with an STI 22 and that using modern contraceptives might lead to infertility if the woman has never been pregnant.

“The main reason why youth fail to utilize contraceptives may be because they do not anticipate intercourse; they describe it as “just happening”. It is argued that perceived, rather than actual risk, of intercourse leading to unwanted pregnancy or STIs that determines the use of contraceptives among young people.

Sexually Transmitted Diseases in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: A major challenge in tracking STD incidence is obtaining local data. The World Health Organization estimated that in 1999, there were 340 million new cases of curable STDs throughout the world — specifically syphilis, gonorrhea, chlamydia, and trichomoniasis. Of these, nearly half, or 151 million, were said to have happened in South and Southeast Asia alone. Specifically, this breaks down to 43 million new cases of chlamydia in this region, 27 million with gonorrhea, 4 million with syphilis, and 76.5 million with trichomoniasis. Statistics specific to Nepal about STDs other than HIV are difficult to come by accurately. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

There is much stigma surrounding STDs. People who think they might have an infection are unlikely to seek out medical treatment, often exacerbating an easily treatable or curable infection. In one survey, adolescent and teen boys who ended up with an STD say that they are more likely to go to a pharmacy and purchase medicine in an effort to treat themselves, than they are to go to a family planning clinic to be diagnosed and treated appropriately by a health professional.

The majority of information and data available around infections relates to HIV and AIDS, described in the next section. Of the limited information about infections, there is information about syphilis within one population. In 1997, 1,800 women who went in for prenatal screening tested positive for this infection.

Culturally, myths and misinformation about STDs abound. One is the concept that a man who urinates on the grounds of or against a temple will be stricken with an STD as punishment. There is also a strong sense of invulnerability among males if they do not engage in sexual behaviors with a commercial sex worker. Unprotected sexual behaviors with a girl or woman who is not a commercial sex worker is, therefore, not seen by men and boys as risky. Unprotected sexual behaviors may be seen by young girls and women to be risky; however, they usually do not have the option of insisting that their partners wear condoms.

Sexual Abuse and Rape in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: According to the United States State Department, Nepali laws against rape carry prison sentences of 6 to 10 years for the rape of a woman under 14 years of age and 3 to 5 years for the rape of a woman over 14. The law prescribes imprisonment for one year or a fine for the rape of a prostitute. The law does not forbid spousal rape. A 2001 survey found that 39 percent of rape victims who reported the crime to police were under the age of 19. Of the reported rapes, 25 percent resulted in convictions and jail sentences. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

Sexual abuse and incest are not discussed as much. In fact, before September 2002, there were no laws against sexual abuse of a child. The new law carries penalties of up to 16 years in prison for pedophilic acts. Teenagers surveyed in Kathmandu overwhelmingly expressed disagreement with domestic violence. Some, however, both male and female, did say that they thought that a man had the right to beat his wife under certain circumstances. These include a woman who does not look after her children well, or who is disrespectful to her in-laws.

When working with teenagers in Kathmandu, there was much discussion of “teasing,” which translates in Western terms to “sexual harassment.” The term “sexual harassment” was not used, because it does not translate, both in terms of language and in terms of its significance. It is used in Western cultures as a legal concept — a term that describes behaviors and situations that can result in legal actions and remedies. Nepal, as other cultures, may use the phrase “sexual intimidation” or “teasing.” According to Nepali professionals, this is not to minimize the experience — it is culturally more accurate. Discussions have begun, however, in the media about sexual harassment of women in the workplace. These discussions, as the discussions of teen-to-teen harassment, tend to focus more on what the people being harassed should do to avoid giving mixed signals, and less on teaching men more appropriate, respectful behaviors.

LGBTQ People and Homosexuality in Nepal

Elizabeth wrote in the Encyclopedia of Sexuality: Homosexuality is rarely discussed, and the assumption is that people are or should be heterosexual. When referring to relationships and/or sexual behaviors, heterosexuality is implied by default. Information about same-sex behaviors and relationships is rare. According to both professionals and other individuals living in Kathmandu, homosexuality “does not exist” in Nepal. I was, therefore, not to include discussions on sexual orientation in any of my meetings or training manuals. To have done so would have been culturally irrelevant. The International Lesbian and Gay Association states that same-sex sexual behavior between two men is against the law in Nepal. As in many other countries, sexual activity between two women is not mentioned. People visiting the country who are caught engaging in same-sex behaviors can face expulsion. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

“The true prevalence, real or perceived, of same-sex relationships and sexual behaviors in Nepal depends on the person with whom you speak. Some will acknowledge that “these types of relationships exist,” but that there is no community for it. Others will say that there is an underground community in Kathmandu. Still others will insist that there are no lesbian, gay, or bisexual people in Nepal. Health professionals, however, are beginning to acknowledge same-sex behaviors, at least between men. This is happening primarily within the context of screening for HIV. Physical intimacy, however, appears to be common between people of the same sex. Adult men and women may walk arm-in-arm or hand-in-hand. A teen girl might sit with her head on a female friend’s shoulder; two male adolescents might sit with fingers interlaced, lovingly stroking one another’s fingers. However, there was no perceptible identity attached to these behaviors as being homoerotic or implying anything about a person’s sexual orientation. The extent to which intimacy translates into same-sex sexual behavior is unknown.

“In my fieldwork in Nepal, I had no conversations with Nepali professionals about transgender individuals, and there is very little written information specifically for transgender people in Nepal. There are, however, a growing number of transgender websites and organizations covering South and Southeast Asia, which may serve as sources of support for transgender individuals throughout the region, including Nepal.”

Laws, Abuse and Violence Against LGBTQ People in Nepal

In the mid 2000s, there were reports of police beating gays and transsexuals in the streets. Reporting from Kathmandu, Ravi Nessman of Associated Press wrote: Nepal's journey into gay acceptance has been a near-revolution, born out of chaos and conflict that decimated the nation's traditional political and social systems.” During civil war in the 1990s and early 2000s “between the government and Maoist insurgents, and fighters on both sides preyed on marginalized communities and outcasts. Transgender men, known as metis or eunuchs, were often robbed, beaten and sometimes raped at Maoist checkpoints, and again at government checkpoints, said Sunil Pant, a gay rights activist and founder of the Blue Diamond Society. Other than the metis, homosexuality was almost never discussed in the rural areas, where tradition pushed people into arranged marriages at a young age, he said. [Source: Ravi Nessman, Associated Press, March 19, 2010]

Henry Chu wrote in the Los Angeles Times: “A law forbidding "unnatural sex" was rarely, if ever, used to prosecute sexual minorities. Nonetheless, many people said they were harassed by police, who would beat them or extort money. They were sometimes fired or denied housing. Pant launched a drive to document and publicize such cases. Even Maoist rebel leaders described gays and lesbians as social "pollutants," wrote support for gay rights into their platforms. [Source: Henry Chu, Los Angeles Times, May, 2, 2008]

“For years, they were mute. And even now, Nepalese society remains extremely traditional, bound by deeply inscribed values and rigid hierarchies. Conservative mores reign in this majority Hindu country, where millions of uneducated villagers eke out meager livings in near-feudal conditions. An extraordinary week in 2004 catapulted his cause to the center of public attention. Even conservative Nepalese who don't approve of homosexuality were horrified by the actions of a policeman who slit the throat of a transgendered person after forcing her to perform oral sex. When 39 members of the Blue Diamond Society were arrested at a protest a few days later, sympathetic media coverage and international outrage stung the government. That "was a turning point," Pant recalled. "We became much stronger in responding to violence against us."

Nepal: a Leader in Gay Rights in South Asia

Ravi Nessman of Associated Press wrote: In 2006, the government signed a peace accord with the Maoists. Street protests forced the king to end his brief grab for absolute power and the centuries old monarchy was abolished. In 2007, the Supreme Court ordered the government to draw up new laws to protect gay rights. [Source: Ravi Nessman, Associated Press, March 19, 2010 ^*^]

A new constitution put into effect 2015 banned discrimination based on sexual preferences. It says the rights of gender and sexual minorities are protected by the new constitution with provisions of special laws to protect, empower and develop minority groups as well as allowing them to get citizenship in their chosen gender. [Source: Wikipedia]

“Now, the issue of gay rights is almost passe here. Nepal has an openly gay parliamentarian, it is issuing "third gender" identity cards and it appears set to enshrine gay rights — and possibly even same-sex marriage — in a new constitution. “(It) is not an issue anymore, for anybody," said Vishnu Adhikari, a 21-year-old lesbian. "Society has basically accepted us." ^*^

“The government has issued a handful of third gender identity cards. The next census is expected to allow respondents to choose between male, female or third gender. Parliament is working on a same-sex marriage law even as the constitution drafters are incorporating gay rights into the document expected to be ratified later this year, said Pant. “It's a land of minorities and we support each other," Pant said. "We all have been marginalized so long and it makes sense that we extend solidarity to each other's rights and issues." ^*^

“In a sign of how much the nation of 30 million has changed, the gay community faces no real opposition in its fight for expanded rights, said Ameet Dhakal, editor in chief of the Republica daily. The major parties, battling for votes, see no benefit to alienating a community that Pant says numbers at least 200,000, and religious leaders here generally stay out of politics. Dev Gurung, a senior Maoist party leader who was once viewed as a strong opponent of gay rights, now publicly supports legal protections for the community. “People, including lawmakers and government officials, were not aware that people like them even existed in the past," he said. ^*^

“Homosexuality has now entered the cultural lexicon. There is a weekly TV show called "Third Gender" and writers and filmmakers have begun exploring society's treatment of homosexuals. Poet Usha Sherchan published a short story last year in a literary magazine about a closeted gay man struggling with the pressure to get married. She thought broaching the subject was a risky move. Instead, she was inundated with praise. “I was shocked," she said. ^*^

Gay Rights Groups in Nepal

The first Nepalese gay rights group, the Nepal Queer Society, was created in 1993. However, as of 2002 there was available information on whether the group was still in existence, or what their activities are or have been. In the early 2000s, the Internet began to provide information and support for lesbian, gay, and bisexual Nepalese individuals. Gay Cyber Nepal and Queer Nepal were two sites created for gay or bisexual men. Other websites have been created by South and Southeast Asian individuals not living in Nepal or India, which seem to provide more of a community for people living abroad than there would be in that region. [Source: Elizabeth Schroeder, M.S.W, Encyclopedia of Sexuality, 2002]

The Blue Diamond Society was the most influential gay righst group in the 2000s. Henry Chu wrote in the Los Angeles Times: In 2000, “Sunil Pant wondered whether there was anyone else in this Himalayan land like him. To his engineer's mind, it was a riddle to be solved, and he methodically set about doing so. Pant planted himself in Kathmandu's biggest park and handed out free condoms, seeking to help curb the rising incidence of sexually transmitted diseases. At the same time, through subtle conversations, he teased out an answer to his ulterior question: Were there other gays and lesbians out there? [Source: Henry Chu, Los Angeles Times, May, 2, 2008]

“Not only was the answer an emphatic yes, but from the ad hoc beginnings sprang what is the most successful gay rights movement in South Asia. In less than a decade, Pant's Blue Diamond Society has scaled massive heights in a nation known mostly as the home of Mt. Everest. At the beginning, the Blue Diamond Society focused solely on health issues. When an official saw the word "homosexuality" in the group's application, he told Pant he couldn't register unless his goal was to turn gay people straight. Pant removed the reference. But within a few years, Pant concluded that it was impossible to wage an effective battle against HIV/AIDS without also addressing official attitudes toward gays.

“Political recognition was slower in coming. Gay activists joined other nonprofit groups and political parties in agitating against the 15-month absolute rule imposed by King Gyanendra. Yet after popular government was restored in 2006, they found few friends willing to take up their cause in the corridors of power. “They continually ignored us," said Pant, who then set his sights on another vehicle for securing gay rights: the judicial system.

In 2008, Pant overseed “an operation with more than 50 full-time staff members, funded entirely by donations and grants. Nepal has 10 registered groups catering to the gay community. “But there's a lot of work [still] to be done," said Long of Human Rights Watch. With so many groups clamoring to be represented in the new constitution, he said, "it's going to be an enormous challenge to meet all those demands with a constitutional solution that actually provides for remedies against discrimination." Pant has other headaches as well. A hospice his organization runs for AIDS patients in Kathmandu has been evicted four times in 2 1/2 years and is seeking a new home. "We still face problems," Pant said. "But on the other hand, compared to other countries, it's quite remarkable that we've achieved so much in such a short time."

Laws Improving Gay Rights in Nepal

In 2007, Nepal’s Supreme Court ordered the government to draw up new laws to protect gay rights. Henry Chu wrote in the Los Angeles Times: Despite deep-seated social conservatism, the Supreme Court’s landmark anti-discrimination ruling for gay rights was supported by two of Nepal’s biggest political parties and garnered international accolades. “It's absolutely astonishing," said Scott Long, who works on issues of sexuality for Human Rights Watch. "Considering how few resources they have and the depth of prejudice they have to fight against, what they've achieved is extraordinary." [Source: Henry Chu, Los Angeles Times, May, 2, 2008]

“The advances are part of a larger social and political ferment brewing in Nepal, one of the world's poorest countries. After 10 years of a Maoist insurgency, a peace process and democratic transition are underway. It will be based on a constitution to be written by a special assembly elected for the task last month. There is a clear sense that everything is up for grabs as Nepal reinvents itself, a rare moment when groups of whatever stripe — women, ethnic minorities, members of lower Hindu castes — have a shot at leaving their imprint on the fabric of the state. “We have a golden opportunity to raise our voice and contribute to this country," Pant, 35, said of gay, lesbian, bisexual and transgendered Nepalese. "This is a struggle I think this generation has to do, about being brave and honest."

“With three other civil groups, the Blue Diamond Society filed a petition with the Supreme Court appealing for equal rights and an end to discrimination. "It's the court's responsibility to be the eye-opener of society a lot of the time and to lead the government and country," Pant said. A favorable outcome was never a sure bet. After one or two hearings, Pant was still trying to explain the difference between gay men, lesbians and transgendered people.

“The historic decision came down in December: Members of sexual minorities were "natural persons" deserving of protection from discrimination. The court ordered the government to come up with legislation guaranteeing civil rights for homosexuals and to establish a committee to study legalizing same-sex marriages. Official documents such as national identification cards and passports are to offer a third option for a person's gender.

“Even gay activists were floored by the scope of their victory. "If we ask for 1000 percent, maybe we'll get 10 percent" was the feeling when they filed their petition, Pant said. The ruling put Nepal way ahead of other South Asian nations in terms of official attitudes toward gays and lesbians. In neighboring India, for example, efforts to overturn a Victorian-era law penalizing homosexuality have been unsuccessful.

“The court decision here paved the way for further successes. The Nepali Congress Party and also the party of the former Maoist rebels, whose leaders had in the past described gays and lesbians as social "pollutants," wrote support for gay rights into their platforms. Violence by the security forces against sexual minorities has dropped, Pant said.

Nepal Seeks a Slice of the Gay Tourism Market

Reporting from Kathmandu, Ravi Nessman of Associated Press wrote: Nepal wants to paint Mt. Everest pink. It wants gay honeymooners trekking through the Himalayas. It wants to host the world's highest same-sex wedding at Everest base camp. But mainly, the conservative Hindu nation wants a chunk of the multibillion dollar gay tourist market to help pull it out of poverty. That quest — brushing aside historical biases in pursuit of economic opportunity — is symbolic of one of the gay rights movement's most stunning successes. [Source: Ravi Nessman, Associated Press, March 19, 2010]

“That acceptance has become a major marketing opportunity for a country cursed by desperate poverty, but blessed with majestic beauty. Tourism is one of the main drivers of Nepal's economy, worth about $350 million last year, and government officials are determined to double tourism to 1 million visitors next year. They hope gay tourists will be far more lucrative than the backpackers who stay in cheap hotels here and travel on shoestring budgets. “They do have a lot of income ... they are high-spending consumers," said Aditya Baral, spokesman for the Nepal Tourism Board. "If they behave well, if they have money, we don't discriminate."

“The driving force is Sunil Pant, a member of parliament, the nation's most prominent gay activist and founder of the new Pink Mountain tour company. The nation's mountains, food and culture are a natural tourist magnet, he said. Additionally, gay tourists could get married at Everest base camp and honeymoon on an elephant safari — though since Nepal doesn't marry foreigners, such weddings would have no legal status, he said. “With that, money will come here and jobs will be created," he said.

“A growing segment of the gay tourism market — worth $63 billion in the U.S. alone — craves adventure travel and exotic locations, especially if they are seen as hospitable to gay travelers, said John Tanzella, president of the International Gay and Lesbian Travel Association. As for an Everest wedding, "I think there would certainly be a niche within our community that would be very excited for this type of memorable experience," he said. Pant says Nepal also has a huge advantage in appealing to this niche because its neighbors in South Asia — some of them with laws outlawing homosexual sex — are not seen as gay-friendly destinations. “There is virtually no competition," he said.

“Despite the rapid gains, Pant recognizes the nation's sensitivities, and wants to ensure that an influx of gay tourists doesn't turn Nepal into a sex tourism destination. “They should come for the trekking, mountaineering, the culture, food ... and for weddings, of course," he said.

Image Sources: Wikimedia Commons

Text Sources: New York Times, Washington Post, Los Angeles Times, Lonely Planet Guides, Library of Congress, Nepal Tourism Board (, Nepal Government National Portal (, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Reuters, Associated Press, AFP, Wikipedia and various books, websites and other publications.

Last updated February 2022

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