Here’s a piece in the Independent online where me and some other excellent peeps in the field talk about some of the biggest taboos in Sexual Health – in other words, what we should be talking about more in sex ed!
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. Emma is a co-author of School of Sex Ed’s book, ‘Sex Ed: An Inclusive Teenage Guide to Sex and Relationships’.
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. Emma been interviewed about topics relating to sexual health by The Independent Online, Cosmopolitan Online, Ask Ella, BBC Sound’s Jacob Hawley: On Love and even BBC Radio Devon! They have appeared as a guest speaker at UCL’s Institute of Education, as part of 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, they are 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…
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:
- Stops the ovaries from releasing an egg.
- 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).
- 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:
Ever heard the term ‘designer vagina’? This generally refers to a certain type of cosmetic surgery, not to the vagina itself but to the ‘inner lips’ (or labia minora) of the vulva. Surgery here involves removing tissue from and reshaping the appearance of the labia minora- in other words to ‘trim’ it. Many people with vulvas have a labia minora that protrudes so that it appears visible – therefore however large this is it is likely to be ‘normal’. Additionally, in young people biological changes occur during puberty that can change the appearance of the inner labia. For this reason it is often recommended by the NHS that those under 18 do not get this type of surgery. However, there seem to cases of children having labiaplasties. According to one report over 200 people received labiaplasty procedures funded by the NHS in 2015-2016. We know that people with visible labia are more likely to think that their genitals look ‘abnormal’ than those without, even though both are equally common (Lykkebo et al, 2017). Some accounts have blamed this on the prevalence of seeing only vulva with neat and invisible labia minora. Whatever the cause, the desire to have this type of surgery seems increasingly common with a 45% rise seen in labiaplasty numbers worldwide between 2015 and 2016.
Womb carrying folks usually start menstruation (i.e. regular periods) before the age of 16 years*. I was much older than this when I began to accurately understand what my anatomy ‘down there’ was like. I think I had a conception of tampons being a cross between a plug and a sponge. I guess this isn’t completely wrong, but neither is it completely right as the bleeding’s coming from the cervix, with a vagina being a passage way.
I’ve come across a fair few people who have an aversion to using tampons, partly because they are not confident (or downright uncomfortable) with their anatomy and with the idea of placing something in to their vagina. Even amongst some of my liberated friends, I am considered a bit of a fringe eccentric for using a mooncup – something I’ve done of the last few years. About the size of an egg cup and made from soft silicone, it sits in the vagina, just below the cervix and catches blood. It can then be washed, without contributing plastic to the bin or cotton to sewage waste.
n.b. I’ve recently discovered that ‘mooncup’ is just one of many other brands. This has somewhat blown my mind.
*Lawrence and Impey (2012) Obstetrics and Gynaecology, 4th Ed.
Today is the 100th anniversary of the UK’s ‘Representation of the People Act’, which gave (some) women (over 30 and living in their own home) the right to vote. It also extended the franchise to a wider group of men.
Now in the UK, any woman over the age of 18 has the right to vote. We have a female head of state and Prime Minister. However, we also live in a country where women are under-represented in most other positions of power. This ranges from parliament to the boardroom. There is also growing recognition that gender equality is a wider issue and that the efforts of privileged white women is only part of the story, even if it is acknowledged as important. Let’s remember and celebrate that things got better 100 years ago, but not forget that we still have a way to go.
In just over a week, I’m sitting a professional exam. I’ve been spending most of my doodling time on that, so here’s a scribble from the margins:
Uterine fibroids are growths in the tissue of the uterus (womb). They can be quite common, particularly with increasing age, and can cause pain and per vagina bleeding. Fibroids: probably not your friend.
Condoms – simple barriers used as contraception. Originally made out of the insides of animals (mmmm, sexy). They’ve come a long way though, and a recent article in the Guardian describes some of the changes that are currently going on – from rebranding to innovations in the actual way that they are constructed. As a barrier form of contraception, they are also one of the few methods that protect against STIs.