As noted in the section on socialization of girls and boys, initiation and different life-cycle stages among the Tswana correspond strongly to ideologies of sexual reproduction. Having a child is often a means through which one can prove one's fertility and desirability as a sexual and marriage partner. The formation of a child is understood as a coalescing of male and female blood, where female blood has the potential to be considered hot, and potentially polluting and dangerous, and subsequently in need of cleansing and cooling through the passage of blood in menstruation, childbirth, and other ritual healing and cleansing practices (Comaroff, 1985; Klaits, 2001; Staugard, 1985; Upton, 2001).

While Schapera (1933) noted that if a girl engaged in premarital sex and became pregnant she was often described as o senyile, "spoiled," more recent research demonstrates how sexual experience is common among young people (Suggs, 1993) and carries less stigma than in previous eras, despite being of increasing concern to national and international healthcare policies. Sex outside marriage has been described as culturally appropriate if a partner, usually the wife, was considered to be unable to bear a child (Schapera, 1938, 1966/1971). In this case a seantlo, or substitute would be brought into the home. Given the large out-migration of men for extended periods of time, women have also often engaged in sexual relationships in order to have children, and such children are often explained in culturally appropriate terms such as "sleeping fetuses" (Upton, 2001).

Ideologies of modesty and culturally appropriate sexual behavior have changed in some ways over the last several decades. Largely a result of Christian influence, rules of modesty have become much more similar to Western ideas of covering the body and breasts, though this varies widely by class and, in general, breast-feeding children carries little of the controversy found in some Western societies. Cross-sex identification in the forms of cross-dressing and even homosexuality are not widely culturally accepted among the Tswana. In general, despite knowledge that homosexuality exists, there are some perspectives who treat homosexuality as aberrant and a type of illness. In the face of the current HIV/AIDS epidemic, homosexuality is often closely associated with Western attitudes and behaviors and the advent of the disease. However, it is difficult to discern with any accuracy the levels of homosexuality present in society, given that according to the Botswana Penal Code, homosexuality is punishable by up to 7 years in prison (Botswana Penal Code, CAP 08:01, pp. 164-167).

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