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Sexual Health issues in Thailand and the UK

Pattaya - the Thai city of sin?
Both Thailand and Great Britain share a number of the same issues in Sexual Health but these issue express themselves in different ways. I want to learn from the situation in Thailand, especially how people are responding, to improve my work in the UK. I have just returned from a 12 week trip around South East Asia as part of this trip I visited a number of projects in Cambodia, see previous posts and I spent a month in Thailand. In Thailand I visited three projects all tackling different sexual health issues. "The House of Grace" A HIV orphanage, "The Tamar Centre" helping people who wish to leave the commercial sex trade and "ACET Singburi" a schools based prevention programme and HIV+ home visit team.

Traveling around South East Asia I became aware of a number of cultural differences that permeate society and impact sexual health in complex ways. I cannot claim to understand the social sexual health situation from such a short trip but I have taken note of a few things.

The commercialisation of sex
Sex sells, or so the advertising industry would have the world to believe and the full media force in Thailand acts just like the UK blasting women and sexual images across almost all adverts from phone networks to cars. Beyond advertising sex is boxed up, packaged and sold in various ways. From pornography, to live sex shows, i lost count of how many ping pong shows I was offered in Pattaya and Phuket, and prostitution the commercial sex industry turns over millions in Thailand. In Pattaya we visited the Tamar Centre a project helping people leave the commercial tourist sex trade. 

Now prostitution is illegal in Thailand but it still happens and prostitution is illegal in the UK but it still happens. Yet in parts of Thailand it is openly sold, in Britian it is more hidden but the negative side of this is it is easy to ignore the issue. Organizations like The A21 campaign are tackling the problem but they are need more support. 

The underlying issue is that sex has become a commodity that can be packaged and sold. The extension of this is that people, especially women, can be packaged and sold. Reinforcing sexism and gender inequality. How men treat women in the commercial sex trade can make inroads into general social issues. Of course this also links into the sexualisation of society debate.

Sex as a short cut to happiness
One of the saddest thing for me to hear in Pattaya was the number of girls and "lady boys" who go into the work out of a choice. A desperate choice because they may feel trapped in poverty. Not being trafficked into the work (which still goes on as well) but people looking at their life, and the life of their family, and thinking this is the best option. Money is the draw, money is what makes people go into this work. Like the american dream they go into the work to firstly financially support their family and with the dream of meeting a rich man who will transform their life. There our thousands upon thousands of prostitutes in Thailand and only a certain number of foreign men ready to buy a Thai bride and transform their life. Because of the difference in cost of living a man does not have to be very rich (UK standards) to make a big difference to a young Thai girl and her family. 

Singburi School team who taught us the term "Gik"
The idea of becoming rich through marrying someone is also a part of the UK culture with girls especially aspiring to get with a sports star or celebrity. I have worked with girls who's aim in life is to marry a footballer. In the UK many young people fell unsatisfied with their life. They feel sad and may be dealing with complex emotions. Sex can provide a temporary relief from this, it is a way to have a physical high that distracts from their concerns from life. Working with the SingBuri  school team we learnt about the Thai word "gik". Which could be closely related to the western term "fuck buddy". A sexual partner who is not an exclusive partner. Not a girlfriend or boyfriend but a "gik". This youth casual sexual attitude is in both cultures and is shaping the landscape of health for a generation.

It wont happen to me
Along with a more sexually promiscuous society this attitude could spell disaster in the continuing fight against HIV and other STIs. Talking in the schools in the UK the threat from possible sexual health concerns seems distant to most young people. Especially at the younger age groups they have rarely if ever meet anyone (who admits to) have caught an STI. Standard teenage mentality translates this as evidence that "proves" it wont happen to me. Visiting the HIV orphanage and the HIV+ home visits made me really contemplate how to get young people to face the reality of the risk. With advances in HIV care young people will not face the visual reminders of previous generations and the lie will be reinforced. School education is one way to help tackle this myth in both the UK and Thailand but it wont be easy. 
Me at the HIV orphanage 

Sexism, girls should say no but its ok for boys to ask.
It is harder to put my finger on where and when I concluded this was an attitude to some people both home and abroad. In fact now I have noticed it, I am spotting this attitude sneaking into my own work. A ton of SRE focuses on empowering women to be firm and make intelligent and informed choices. I can identify two good reasons for this; they may have to face directly the physical, social and emotional consequences of an unintended pregnancy and around the world the gender in-balance has meant that more women don't have a choice then men. Empowering women to say no is about tackling gender inequality. 

But is the result we slip into a different type of sexism where we don't spend as much time talking to males about why they shouldn't be asking or possibly forcing/coercing women. This attitude is sharply demonstrated in the related issue of domestic violence. Think of any case of domestic violence you have heard of by a man against a women. How many times have you heard "why doesn't she leave him?". What? not "why doesn't he stop hitting her?" Not "why doesn't he leave the relationship?" No we put the emphasise on her, she should do something, she should say no more and leave. As a male this attitude drives me nuts. Of course we should empower women to say no when they are facing pressure of any type but lets not forget to tackle the males. Men should be challenged. 

In Thailand as I went around the country I found this attitude impacting projects, people and policy. Same story in the UK. Women are often so dis empowered we identify the need to build them up and help them. We forget to challenge the men, or maybe it seems like an impossible task. Many projects are set up for women and lady boys wanting to leave the sex tourism industry in Thailand but I heard of only one project tackling men who come to Thailand for sex. Maybe we should be spending more time focusing on challenging and educating men in Bangkok on how to respect women and not giving them a free pass.  

(please let no one take this as a personal comment on their project or work, everyone I meet with for a short or long time was doing an amazing job meeting real needs. I am just exploring some wider issues and sharpening my own personal attitude to SRE in the UK. The first man standing project had a major influence on my thinking.) 

Travelling to Thailand/Cambodia was amazing and taught me so much much about how people around the world are tackling sexual health issues. I have barely scratched the surface of what I have been thinking about. I have not mentioned everything I learnt about practically working in these communities about the growing impact of technology in shaping sexual attitudes and specifically the role of Pornography. I am very grateful to both my employees giving me the time to go abroad and all the welcoming projects that shared their time with me. 

Please leave any comments about this below or email me at

I have hope for the future, working together things can be better


  1. It was lovely to read and identify with so much of your experience. Did you come across Siamcare while you were in Bangkok/Mukdahan or Khao Lak? Having been to Thailand 6 times now over the last 10 years to speak at Siamcare's international sexual health conference's and to visit our sponsor children in Mukdahan, I have this year become a trustee of Siamcare UK. It would be great to share if you have.

  2. I didn't come across Siamcare, I didn't visit Khao Lak and was only in Bangkok for a very short time. But If I go back I will defiantly see if I can visit the project. Looks like they are doing some really comprehensive work across a variety of groups. Sometimes it seems Thailand (and other countries) have more HIV awareness programmes then the UK.

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