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Posted in Uncategorized

About Me

Emma Chan works as a Facilitator for The School of Sexuality Education, delivering inclusive and sex-positive sex and relationship workshops, mostly to secondary aged children, across the UK.

They qualified as a doctor (BMBS) in 2015 from the University of Nottingham, going on to begin speciality training in Obstetrics and Gynaecology in 2017. They previously studied Psychology (BSc), also gained at The University of Nottingham. They are currently working towards an MSc in Reproductive and Sexual Health Research at the London School of Hygiene and Tropical Medicine.

Emma is a member of The Candid Collective, regularly helping to run ‘Genital Making Magnets’ workshops.  She has been interviewed about topics relating to sexual health by The Independent Online, Cosmopolitan Online, Ask Ella and even BBC Radio Devon! She has appeared as a guest speaker at UCL’s Institute of Education, on the ‘Gender, Sex and Education’ MSc module.

Emma’s pronouns are she/her or they/their. They are comfortable with the gender label ‘woman’. However, she is conscious of this having been strongly ‘externally’ imposed through a life-time of social conditioning. For example, Emma attended an all-girls secondary school in North London and still has the pink baby name band she was given at birth. If they had grown up in the fearless post-feminist, gender-stereotype-free utopia they would like to try to bring about, maybe this label would not be so appropriate…

Posted in reproductive rights

Bound and Gagged

As a new President has been elected in the US, you might hear campaigners in sexual health talk about ‘The Global Gag Rule’. But what is it and why does it matter to people working in sex and relationship education?

The Global Gag Rule is US policy which forbids NGOs (Non Governmental Organisations – for example, health charities) from taking part in certain activities if they receive US funding.

These activities include providing abortion care directly. But it also includes referring pregnant people to abortion services, simply providing them with information about abortion, or campaigning around legal reform in this area.

So NGOs (Non-Governmental Organisations) that want to receive US funding are effectively ‘gagged’ from working in abortion care – hence the name.

This policy was originally called The Mexico City Policy and was first introduced by the then President Reagan in 1984. Under the Mexico City Policy, the ‘gag’ applies to all of the work that an NGO does. For example, an organisation cannot use funds from another source to fund work in abortion care.

How big a deal is this? Well the US provides a huge amount funding to overseas NGOs. The US can be a major source of funding for NGOs. The Global Gag forces them to balance the importance of abortion care with the need for financial stability.

In addition to this, US culture and political ideology is hugely influential around the world. This is true, even if you are living in a high income country which doesn’t rely on overseas funding from foreign powers, like the UK.

The US position on abortion care is really important right now, at a time when some countries are rolling back on abortion laws – for example in Poland.

Remember, the WHO (World Health Organisation) recognises that abortions are both incredibly common and also continue to take place where they are not legally allowed – but in unsafe conditions.

So why are we talking about the Global Gag Rule at this particular time? Well, since it was first introduced this policy has been removed and reintroduced several times. There has been a pattern of Presidents from the Democratic Party to overturn the Global Gag Rule, and for it to be reinstated the next time a Republican President gets in to power.

The outgoing US (Republican) President – Donald Trump – is noted to have reinstated the Global Gag Rule. In fact, some people say that his version of the Mexico City Policy made it even more restrictive – for example by making it apply to all of the global health assistance funding, not just that set aside for family planning.

Many people hope that new US President will, as the pattern has been, remove the Global Gag Rule and allow NGOs to be supported in providing essential health care. At the time of writing this, there is an international petition to call on him to do just this.

Posted in puberty

The trouble with a textbook example…

A really common idea is that men and women are just fundamentally ‘biologically different’. Perhaps so common that it can lead us as a society to mentally overwrite objectively known facts.

The idea that gender itself is not necessarily related to biological traits is easy enough to recognise and call out. In most countries in the world, genital presentation at birth is how people are assigned a sex of either ‘male’ or ‘female’ – i.e. a penis for a boy, a vulva for a girl. But many of us seem comfortable enough with the idea that gender identity can be separate from the sex someone was assigned at birth. There even appears to be growing recognition that gender identities exist beyond the Western-centric binary standards of ‘man’ and ‘women’ only. In other words, that non-binary people exist.

Even where the above is generally accepted though, the idea persists that there are only two biological sexes and they are enduring different from each other. There is an assumption that everyone can be divided in to one of two groups: people with a penis and people with a vulva. Furthermore, we are taught that these two groups are mutual exclusive – someone can’t fit in to both categories.

Why is this a problem? Well, for a start it isn’t true.

There are a whole range of ways in which some people are born with physical, biological traits that don’t fit neatly in to a binary ‘male’ or ‘female’ presentation. This includes being born with genitals which are not typically or just either a vulva or a penis.

Sometimes when someone is born this way, the term intersex is used – although it might be considered problematic to define people in relation to what they are not. Other phrases like variations in sex characteristics might be more accurate and less emotionally loaded.

The existence of people whose natural biology defies the way in which we commonly define biological sex – as a society, but also in law. Very few countries in the world recognise any sex designation other than male or female in official spaces, like birth certificates or passports. This means that when someone is born with biology that doesn’t conform to our notion of the binary of male/female, we usually simply ignore it. This surely has huge implications for how valid or accepted people feel in bodies not conforming to this binary.

It’s hard to say how common it is for people to naturally not fit in a binary sex category – precisely because most societies pretend that it doesn’t happen. The United Nations say that it may be as much as 1.7% of all people born – which they also note is a similar figure for the percentage of people around the world born with red hair. So while it may not be common, it certainly seems a significant amount!

Other challenges to the binary notion of sex characteristics are very common. Many of these relate specifically to something called secondary sexual characteristics. These are the changes that generally occur during puberty.

A biology textbook-type explanation of these would be something like:

  • Secondary sexual characteristics are some of the changes that occur during puberty because of hormones.
  • People with testicles produce the hormone testosterone, which causes changes in puberty like facial hair to grow, the voice getting suddenly much deeper (‘breaking’) and the body to get muscular.
  • People with ovaries produce the hormone oestrogen, which causes changes like breasts to develop and hips to get wider.

I said this was a ‘biology textbook-type’ explanation. In fact, this is identical in terms of factual content to the BBC Bitesize GCSE biology revision page. Except that I used the phrase ‘people with testicles’ instead of the word ‘boys’ and ‘people with ovaries’ instead of ‘girls’, because I understand the difference between anatomy and gender!

Like a lot of school science, this is a simplified version of what is actually known about biology. And in some ways, this makes sense in the context. However, I would argue that it’s an oversimplification… and a socially damaging one at that.

This explanation gives the impression of a firm dichotomy of biological sex. Biological males make testosterone, which is produced in the testicles and this produces masculine physical characteristics. On the other hand, biological females produce oestrogen because they have ovaries and this leads to well recognised feminine characteristics. This is a neat, comprehensible explanation of biological sexual characteristic traits.

It’s also wrong. For a start, it ignores the fact that oestrogen and androgen hormones (testosterone is a type of androgen) are both made by people with ovaries and by people with testicles – just usually in different amounts. It’s therefore possible for someone with one set of anatomy to show the physical traits that we overwhelmingly associate with the other.

A very common example of this is someone with testicles producing enough oestrogen to develop breast tissue. The medical word for this is gynaecomastia (pronounced guy-nah-coh-mast-ee-ah). It’s reported to be experienced by up to 70% of people with testicles undergoing puberty, exactly because this is a time of hormonal changes within the body.

Despite this meaning that gynaecomastia is very normal and frequently experienced by people with a penis in puberty, it is often described as a medical condition (for which, read: problem) or a hormonal imbalance (for which, read: your body isn’t working properly).

So fixed are our notions of binary sexual male and female characteristics, that it leads us to recognise a common bodily change as a medical condition – to label the majority of peoples’ experiences as abnormal.

Another reasonably common example of this phenomenon is hirsutism. This is when a person with a womb and ovaries has facial hair. The most common reason for this is for someone to have Polycystic ovary syndrome (PCOS). PCOS in itself is not at all rare, with one in ten people who has a womb and menstruates having it. But according to our oversimplified biology textbook definition, beards and moustaches are solidly masculine traits.

Can you imagine learning biology in a way that invalidates your physical experiences and makes your healthy, biologically non-binary body feel like it’s actually a freak of nature? Well, it turns out a lot of us don’t have to imagine, as this is what school curriculums are already teaching many of us!

Further Reading…

Cordelia Fine’s book Delusions of Gender: How Our Minds, Society and Neurosexism Create Difference (2010) is a hefty but excellent book on how science research is influenced by our social constructions of sex.

Posted in Political

“Just Stick a Rainbow on It”

The Outside Project, who work to support homeless people from the LGBTIQ+ community, have today reported on their instagram account that Attitude Magazine (‘The UK’s best selling Gay Magazine’) has used its platform at this time, to call on the government to financially support Virgin Atlantic as an ‘LGBTQ ally’.

Their publisher, Darren Styles, has written a letter to various members of the UK government, using the struggles of LGBTQ+ people and Virgin’s past financial support of LGBTQ campaigns to argue that the government should be especially bailing out this private company against coronavirus-related financial hardship. Virgin Airlines has in the past been complicit in the deportation of migrants – a practice that it stopped only after pressure from groups such as Lesbians and Gays Support the Migrants, who target airlines specifically for taking part in deportation flights as it often affects LGBT+ deportees especially, who struggle to have their status as vulnerable and persecuted people recognised by an immigration system with stereotypes and problematic notions of ‘queerness’.

Particularly pertinent, given the current national health emergency, is that Virgin’s founder, Richard Branson has a long and problematic relationship with the NHS surrounding private provision of public services via Virgin Care (as well as with paying his taxes).

On instagram, Attitude appear to have turned off comments to their post on this one, in the face of heavy criticism from the community.

It is still possible to report it as a ‘scam or fraud’ if you think rainbow washing a billionaire and his problematic private enterprises in a time of stress on national public services is damaging and disingenuous.

Also, follow, support and donate to @lgbtiqoutside to *actually* support homeless queers…

Posted in Genitals: A User's Guide

Self-Isolation and Masturbation…

In these uncertain times, one thing seems sure… we’ll all been getting a *lot* more time to ourselves and our bodies. Given this, a lot of us will be turning to masturbation.

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Taboo and misinformation surrounds masturbation – genital stimulation for sexual pleasure. However, it is a very natural and health thing to do… So  much so that it is rife in the animal kingdom!

Furthermore, we often assume that it’s not something people with vulvas do. This is simply not true.

People with vulvas do masturbate – for example the vagina, clitoris or anus can be stimulated with fingers or a sex toy.

A pdf with lyrics and (ukulele) chords to this video are available to all subscribers on my Patreon!

Posted in contraception, Genitals: A User's Guide, Uncategorized

Put a Ring On (?/In) It!

Last week I was interviewed for Cosmopolitan about ‘femidoms’ or internal condoms. These are one of a handful of contraceptives that often get talked about in sex ed classes, but appear to be less commonly in use.

Another type of contraception that this can be said about is the vaginal ring.

It gets its name from it’s shape – it’s a ‘ring’ made from a soft rubber like materials, about 5 cm across. It is inserted in to the vagina by the user and once inserted sits just below the cervix.

It’s another type of hormonal contraceptive – which means it protects against pregnancy by affecting the womb, ovaries and the fertility cycle.

It contains the same hormones as the combined pill – oestrogen and progesterone. Because of this, it works in a very similar way:

  1. Stops the ovaries from releasing an egg.
  2. Helps make the lining of the womb stay thin, rather than building up (a thick womb lining is needed for a fertilised egg to implant in and grow).
  3. Helps create a thick ‘plug’ of mucus in the cervix – the entrance to the womb. This helps stop sperm from entering the womb from the vagina in the first place and coming in to contact with an egg.

Also like the combined pill, the vaginal ring is used for three weeks and then not for one week – usually with a ‘withdrawal bleed’ in this week off. The main difference is that whilst the pill is delivered to your system by swallowing a pill, the vagina ring releases these hormones in to your system slowly over time.

After the week off, a new one is inserted. This is done by the user – so no need to attend a clinic or other appointment to get it fitted by a health professional, like with other contraceptive methods such as the coil.

From speaking to friends about their personal and professional experiences it seems like the vaginal ring isn’t something that is as easy to get hold of as other forms of contraception, at least in the UK!

Pros and cons

Because it doesn’t form a barrier between the vagina and the penis, it doesn’t protect against STIs. The vaginal ring is a form of contraception (helps reduce the risk of pregnancy) but not protection (doesn’t help reduce the likelihood of passing on infections through sex).

Some people may find it difficult to use – it involves being quite comfortable with your anatomy, slightly more so than a tampon.

On the other hand – it works very well. If used correctly, the vaginal ring is more than 99% effective. For comparison, this is more effective than condoms (98% effective). It only needs removing and replacing every four weeks – unlike the pill, which you need to think about every day.

For further details see:

NHS Contraception advice 

 

Posted in Genitals: A User's Guide

Reduce and reuse…

Just a quick reminder that not all period products are disposable. We already looked at period products in some detail here.

When we talk about periods in schools, most people seem to know about tampons and sanitary pads. Menstral or ‘moon’ cups however, seem to be a little less well know about and to cause alarm. Made from a soft rubber-like material, they can be squigged a little to fit in to the vagina, where they they retain their shape and stay in place in the vagina. There it collects blood. It can be emptied, washed and reused. They can also be sterilised in between uses – the one I use recommends either boiling it or using baby bottle steriliser in between cycles.

Several companies have started making moon cups. Most are a basic ‘cup’ design but come in different sizes. oftentimes the little ‘pull’ at the bottom of the cup to help remove them is a slightly different shape too.

IMG_0747.jpeg

Washable pads are a bit more conceptually easier to get your head around! Just like disposable sanitary pads, they can be washed after each use.

Or of course, there’s… IMG_0746.jpeg

‘Freebleeding’ means not trying to stop the blood flowing in any way. For now, accounts of free bleeding seem largely restricted to those making a political statement or investigative journalists… but maybe that’s something that will change in the future!

 

 

Posted in Anatomy, Genitals: A User's Guide

Rubber Band Theory…

In schools at least, some variation of this question is reasonably common – people worry either that a vagina isn’t big enough to accommodate a penis/sex toy/ tampon, or that it will become stretched out of shape by any of those things.

The vagina is a tube, about 8cm long. It isn’t quite hollow – but it can stretch a lot. To make space for a baby’s head, for example – which is much  bigger than pretty much any penis.

The vagina might change shape after childbirth (after any number of children). But the idea of it becoming ‘baggy’ is probably more of an exaggeration.

 

 

Posted in SRE

My Clear Vision for 2020!

Here are my (blogging) new year’s resolutions…

(also fine if you want to shave it off – it’s yours!)

I look forward to spending lots of 2020 with menstral cups and 3D printed clitorises (as I did for much of 2019).

Sex is literally what you make of it. Also, for those of you living in London, UK – why not check out Sexual Health London’s online and home testing kits?!

Happy New Year and let’s go for a patriarchy smashing 2020

XOXOXOX