Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 1 | 7 ORIGINAL RESEARCH Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregivers in Semarang city Eti Rimawati1,2, Tri Nur Kristina3, Sri Achadi Nugraheni2, Ani Margawati3 1 Faculty of Health, University of Dian Nuswantoro, Semarang, Indonesia; 2 Faculty of Public Health, University of Diponegoro, Semarang, Indonesia; 3 Faculty of Medicine, University of Diponegoro, Semarang, Indonesia. Corresponding author: Eti Rimawati; Address: Faculty of Public Health, University of Diponegoro, Semarang, Indonesia: E-mail: eti.rimawati@dsn.dinus.ac.id Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 2 | 7 Abstract Introduction: Taboos, filth, and shame are moral values resulting from cultural construction that limit names, leading to inappropriate sexuality. These values will impact the practice of caregivers in communicating reproductive health to their children. This study aims to describe the terms used for the names of reproductive organs and examine the connotations built in the marking of these names. Methods: The research design was a case report study. The sample comprised 224 caregivers to early childhood who were selected by stratified random sampling in the city of Semarang. Data analysis was carried out by description and basic quantification. Results: Researchers found 27 language terms for the names of male and female genital organs. The name's connotation was built because of inheritance, similarity to certain animals, and texture of the organs. Conclusion: The use of the connotation of reproductive organs in communicating to children will continue to reduce the culture of taboo and shame continuously. It is necessary to increase the ability of parents to say the correct name for the genital organs. Keywords: health literacy, reproductive health, sex education, term of sex organs. Conflicts of interest: None declared. Ethical approval: This research has received ethical approval from the Faculty of Public Health, the University of Diponegoro, number 223/EA/KEPK-FKM/2020. Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 3 | 7 Background In the last five years, the number of cases of children in conflict with the law (ABH) as victims of sexual violence has shown an increase in Indonesia. Currently, in the last year alone, the number has shown a sharp increase from 190 cases (2019) to 419 patients (2020) (1). Some of the causes of sexual violence against children are the attraction of adult sexual orientation to children (pedophilia), the influence of mass media porn, and children's lack of understanding of sexuality issues (2). Children's lack of understanding of sexual problems is due to communication between parents and their children. Communication between parents and their children is essential for children's development (3). Poor parenting practices can be one of the causes of reproductive health problems in adolescents (4). Parents' experiences in obtaining information about reproductive health (sex education) and sexual experiences experienced as adults influence them in teaching reproductive health (sex education) to their children. They consider it too medical, and there are difficulties delivering sex education to children (5). Health literacy is "the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions” (6). This study aimed to find the terms used for naming genital organs. It was known that mothers' knowledge of the names of genital organs would impact their practice in providing sex education (reproductive health) to their children. Methods The qualitative research design was conducted in the city of Semarang. The research sample was 224 early childhood caregivers selected by stratified random sampling. The data was collected by filling out the male and female genital names and discussing the argument. Data analysis was carried out descriptively to classify the terms of sex organs. Results From the survey results on questions about male and female genitalia names, the terms in Tables 1 and 2 appeared. Each caregiver wrote down a genital name that they usually use when communicating with their child. Most of them can explain the reasons for the term, but some cannot because they got it from generation to generation. Table 1. Terminology of the male genitalia Terms of male sex genital N % Penis 134 59.8 Titit (a local term for penis) 45 20.1 Burung (bird) 23 10.3 Sontong/sotong (cuttlefish) 4 1.8 Don't know 4 1.8 Gajah (elephant) 3 1.3 Alat kelaminlaki-laki (male sex genital) 2 0.9 Testis 2 0.9 Male 1 0.5 Nanuk/manuk (local term for bird) 1 0.5 Seli (N/A) 1 0.5 Sombosamalase (N/A) 1 0.5 Totot (a local term for penis, bigger than female’s) 1 0.5 Untuk pipis (for pee) 1 0.5 Vagina 1 0.5 Total 224 100 Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 4 | 7 Table 1 shows that the respondents expressed language by eleven terms of the male genitalia (others are marked italic). Most of them have correctly said that ‘Penis’ is the correct name of the male genitalia (59.8%). The research found the most widely used local language expressions are: "titit" (a local term for sex genital), "Burung" (bird), "Sotong or sontong" (cuttlefish), and “Gajah” (elephant). In Table 2 are listed sixteen linguistic expressions to describe the female genitalia as indicated in the survey, although most respondents said that ‘Vagina’ is the correct name (68.3%). Table 2. Terms of female genitalia Terms of Female Sex Genital N % Vagina 153 68.3 Gembus (one of the typical dishes in Java) 16 7.1 Memek (whining) 12 5.4 Nunuk (javanese term for vagina) 11 4.9 Sempuk (javanese term for vagina) 11 4.9 Don't know 6 2.7 Pepek/pipik/pipit (Sumatra term for pee) 2 0.9 Untuk pipis (for pee) 2 0.9 Bebek (duck) 1 0.5 Female 1 0.5 Kupu-kupu (butterfly) 1 0.5 Mentul (soft and supple) 1 0.5 Pipis (pee) 1 0.5 saru (taboo) 1 0.5 Senuk (female sex worker) 1 0.5 Sombolase (N/A) 1 0.5 Tempe (one of the typical dishes in Java) 1 0.5 Titit (local term for vagina, smaller than male’s 1 0.5 Zeweh (N/A) 1 0.5 Total 224 100 Based on the respondents’ arguments, the team of researchers classified the terms in Table 3 by paying attention to the reasons for mentioning the specific names . Table 3. Classification and connotation of language expressions Classification (based on the argument) Connotation Language Expression Scientific context  Penis terms for sex genital  “Titit” (a local term for penis)  Alat kelaminlaki-laki (male sex genital)  Testis (testicle)  Male  Vagina Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 5 | 7  “Nunuk” (javanese term for vagina)  “Sempuk” (javanese term for vagina)  Female The resemblance to animal shape  Burung (bird) terms for genitals that are similar to specific shapes and characteristics of animals  Sontong/sotong (cuttlefish)  Gajah (elephant)  Nanuk/manuk (local term for bird)  Bebek (duck)  Kupu-kupu (butterfly) Referring to the function  Pepek/pipik/pipit (Sumatra term for pee) terms of the genitals according to their function  Untuk pipis (for pee)  Pipis (pee) Refer to size  Totot (a local term for penis, bigger than female’s) terms of genitals based on size  Titit (local term for vagina, smaller than male’s The resemblance to the shape of the food  Gembus (one of the typical dishes in Java) The term for female genitalia is similar to the shape and texture of local food  Tempe (one of the typical dishes in Java) Referring to the character memek (whining) The term genitals according to character in women Referring to texture Mentul (soft and supple) Nunuk (stand out) The term genitalia according to its soft shape and texture Refers to the type of work Senuk (female sex worker) A term that refers to a particular profession Blur interpretation saru (taboo) A term that indirectly refers to the genitals Discussion The respondents named language terms for the genital organs due to consideration of animal- like shape/function/size, resemblance to the shape of food, character, texture, type of work, and blur interpretation. Respondents remembered that when they were taught the correct names of the genitals, they were ashamed and considered it taboo to mention penis and vagina to their children. They argued that the teacher at the school should convey the information. A taboo is still the opinion of most people and parents regarding sex. They think that sex will always be associated with pornographic, dirty, perverted, and the like. In contrast, sex education is an effort to raise awareness and explain sex, instinct, and marriage (7). Meilani et al (8) describes that most mothers have not been able to provide sexual education properly, where 66.3% have not communicated openly about sexuality, 52.2% use other terms in mentioning reproductive organs, and 83.3% have a perception of feeling inadequate to provide sexual education. They think that saying the correct name of the genitals is taboo, dirty, has Rimawati E, Kristina TN, Nugraheni SA, Margawati A. Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregiver in Semarang city (Original research). SEEJPH 2022, posted: 20 March 2022. DOI: 10.11576/seejph-5328 P a g e 6 | 7 no morals, and is uneducated. This may be why things that refer to sexuality are inappropriate (9-11). Parental fears and cultural taboos will hinder effective parent-child communication regarding sexual health (12). They forbid children to ask questions, consider sexual education unnecessary, and feel uncomfortable (taboo) when mentioning penis and vagina (13) and assume children will know by themselves (13) - thus making it difficult for them to communicate with their children, the next generation (14). Appropriate sex education involves getting informationand forming positive beliefs, values, and attitudes (15). Conclusions Our results show that reproductive health literacy in early childhood is still hindered by shame and cultural taboos in mentioning the name of the genitals. This will affect decision- making in providing reproductive health education to children who are repeating themselves like their parents. The use of the connotation of reproductive organs in communicating to children will continue to reduce the culture of taboo and shame continuously. It is necessary to increase the ability of parents to say the correct name for the genital organs. The readiness of parents to provide open-minded reproductive health education for their children will help protect children from becoming victims of sexual violence. The lack of accurate knowledge about the risks and indicators of child sexual abuse will negatively influence prevention and detection (16). References 1. Indonesian Child Protection Commission (KPAI). Data Kasus Pengaduan Anak (Case Data on Child Complaints) 2016 – 2020 [Internet]. Available from: https://bankdata.kpai.go.id/tabulasi- data/data-kasus-pengaduan-anak- 2016-2020 (accessed: October 9, 2021). 2. Fauzi’ah S. 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