Posted in Genitals: A User's Guide, Uncategorized

Seeing Red…

I’d like to take a look at periods!

Even though it’s an *extremely* common experience – there are estimates that 800 million people in the world are having a period every single day – this is one of the topics that often gets the most ‘yucks’ and discomfort in schools.

In my experience, people often have misconceptions about periods in the UK. Despite this, I find that there’s a tendency to talk about period stigma as a purely foreign problem – often only acknowledging problems in low income countries. Unicef recognises that period stigma is a global issue.

As someone who regularly talks to young people about menstruation, it seems sadly alive and well in the UK. Often, just bringing out (completely new and unopened) tampons and other period products is enough to evoke palpable – and audible – signs of discomfort in the classroom. I firmly believe that the way to tackle this is to talk to all people about periods – whether they have them or not themselves…

Firstly, let’s start with the basics – what is a period?

It’s bleeding through the vagina from the uterus, usually for a few days, most often once a menstrual cycle (more on variations and problem periods later). The bleeding is the lining of the uterus being shed. It’s made up of clots, tissue and blood – so is very different to the ‘fresh’, bright red blood you might get from veins or arteries from a cut.

Usually (but not always) people use something to manage this bleeding. Different types of period products include:

Pads: Either disposable or reusable material that is attached to underwear and soaks up blood. Disposable pads are widely available. They usually contain some sort of plastic to make them waterproof and are single use – i.e. they are thrown away after being used. Reusable pads are made from fabric and can be washed and reused. At least in the UK, they can be a bit harder to get hold of. Some brands sell them online, or independent makers sell them through websites life Etsy.com. If you are craft savvy, you might like to make them yourself.

Tampons: These are cylinders of cotton wool-like material. They are inserted into the vagina. The walls of the vagina keep them in place, where they can absorb blood. They are removed by pulling on a little ‘string’ attached to them. Concerns about tampons getting stuck, lost or causing harm seem quite common. Although people do sometimes find they can’t remove a tampon, this doesn’t seem to happen very often. Even if it does, the vagina is a closed ‘space’ and a healthcare professional should be able to remove it using special tools (I have had this job at one point). Like anything that is inserted in to the body from outside (including food) there is always going to be some risk of infection with inserting a tampon. Again, this isn’t very common, especially if tampons are removed and changed regularly and you make sure to wash your hands before removing or inserting one.

Period Cups: Shaped a bit like an egg-cup without a stand and made from a squishy but solid material. They are inserted in to the vagina, where they sit underneath the cervix (entrance to the uterus) and collect blood. They can then be emptied and washed – rinsed out in between uses and sterilised (e.g. in boiling water) in between cycles. They usually have a little ‘pull’ on the end that can be used to remove them – a bit like the string on a tampon. Along with fabric pads, they are another type of reusable period product.

Period Disks: They work in a similar way to period cups – but are shaped differently. They are a flattish ‘disk’ shape, rather than a ‘cup’ shape, but are still inserted in to the vagina, where they sit and collect blood. They don’t have the little ‘pull’ piece, and sit a bit higher up in the vagina.

Pants: These are shaped and worn like regular underwear. But the ‘gusset’ (the bit that sits underneath the vagina in people with vulvas) is made from absorbable material, to soak up period blood. As with reusable pads, these are washed and then reused.

Freebleeding: Some people don’t use any particular product when they are menstruating – bleeding ‘freely’ on to their clothes. This can be by accident, or it has been used as a political statement.

Busking it: Sometimes people use anything to hand, such as tissues or cloth, to soak up period blood. One reason for this might be period poverty – the inability to afford period products. It is thought that millions are affected by this, even if high income countries like the UK.

How do people choose which period product to use? People are different – and what is good for some, isn’t for others. Also, your needs and your cycle might change over time or in different circumstances. For example, personally I like to use a period cup during the day because it can be reused and is fine to take swimming. But at night I prefer period pants, as they feel more ‘secure’ which I’m moving about in my sleep.

Another thing that doesn’t get talked about very much is problem periods. There’s sometimes a feeling that periods are meant to be unpleasant – for example, painful. Whilst some discomfort is common, there is such a thing as as a problem period. A period might be a problem might be one that:

  • Is too painful (e.g. effects your ability to do the things you would usually do), including pain just before your period.
  • Is very heavy (e.g. you have to change pads or tampons very frequently or no period products seem to deal with period blood at all), including last for a very long time (i.e. longer than 8 days).
  • Causes you lots of emotional distress, including just before your period.
  • Is very irregular (e.g. your cycle varies by more than several days between each period).

If this or something else is bothering you about your period, it’s probably worth talking to a healthcare professional – like your GP – about it!

Resources:

I cannot recommend the book Red Moon Gang by Tara Costello enough, for anyone who has periods (or who doesn’t, and wants to know more). Informed by Costello’s extensive research, as well as interviews with what seems to be a huge range of people who have periods (including people of different genders). There is also a blog and information site of the same name, which includes a really nice and short article on what a period is!

I wrote ‘The Body’ chapter in Sex Ed: An Inclusive Teenage Guide to Sex and Relationships, which is available from Walker Books now! This chapter includes loads of information about periods, and the rest of the book is full of other RSE info for young people!

This video from Amaze.org is a nice summary of the basic of a period (although briefly gets a bit reproductive focused).

Episode 23 of the Guilty Feminist is all about Periods! Nice, normalising discussion of periods. The guest on this episode is Evelyn Mok, who talks about being diagnosed with PCOS (i.e. problem periods).

This short film about getting a period for the first time might be a nice conversation starter!

Follow the Bloody Good Period campaign on social media for period education.

I am the Co-Founder of PeriodPal – an online app for tracking periods that aims to be inclusive and ethical. This is funded by donations, with no subscription fees. To sign-up for a free account to track periods and your health, go to periodpal.eu.

Posted in sex ed

Lessons learned…

****Content Warning: In the audio you’ll find general discussions of sexual assault and false rape allegations, and misogyny*****

Where, exactly, do we get our sex education from?

Most people would say that they learnt something at school. But when we think about formal sex ed lessons, we are often talking about the biological aspects of reproductive sex – e.g. how people get pregnant, or how to avoid pregnancy.

The messages about sex that we pay attention to – what it is, what makes ‘good’ sex and what a sexual relationship is meant to look like – come from all sorts of places other than the classroom. From rumours and ‘dirty’ jokes that circulate on the playground, to the bizarrely genital-less sex scenes from PG rated films.

In this week’s Conversation Starters, I think about where our sex ed can and does come from, looking at things like:

  • How do we learn what sex actually is?
  • What are these messages – what does ‘good’ sex look like?
  • Are some types of sex or relationships seen as more valid than others?
  • Where can we look to for reliable information if we have questions about sexual health?

Listen to this episode of Conversation Starters to find out more…

Conversation Starters: Episode 1

Glossary

Phallocentric: focusing on a phallus (i.e. penis), especially as a symbol of importance and dominance.

Heteronormative: a view or assumption that heterosexuality is the ‘normal’ or only important sexual orientation.

PIV sex: a specific type of sex act, (penetrative) penis-in-vagina sex!

Further resources:

This episode of Jacob Hawley On Love from BBC Sounds is all about sex education, featuring me, as well as the fantastic Poppy and Rubina from Brown Girls Do It Too.

Sexwise from the FPA contains loads of resources (generally aimed at young people) on topics like contraception, STIs and unplanned pregnancy.

The School of Sexuality Education has a website, which features blogs, information and also links to the Teachable Moments project, where you can find worksheets to accompany programmes such as Netflix’s Sex Education, the BBC’s Noughts and Crosses, and Disney’s Hercules.

The Amaze.org website has a whole host of videos, each one about a different sex ed topic. Examples include ‘Porn: Fact or Fiction’ and ‘HIV and health disparities’. These are aimed mostly at pre-teens. They are English language and made in the US, so some of the references (e.g. to the healthcare system) might need a bit of contextualising and explanation.

Everyone’s Invited is a web-based project that encourages young people to talk about their own experiences of sexual harassment and violence in schools and universities.

The 2016 NSPCC report on children and their experiences of and attitudes towards pornography, ‘I wasn’t sure it was normal to watch it’.

Lisa Lazard, a Psychologist with the Open Unversity, writes an article on false rape allegations – ‘Here’s the truth about false accusations of sexual violence.’

The Relationships and Sex Education (RSE) curriculum came in to effect in September 2020 and the DfE’s guidance on implementing it can be found here.

If you have any questions or suggestions about this episode, please email at squishsquashsquelch@gmail.com with ‘Conversation Starters’ in the subject line.

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 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 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.  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…

Posted in Anatomy, SRE

Lark in A Park

As well as facilitating Sex Ed workshops in schools for the last month, I’ve been involved in a few events aimed exclusively at adults.  Although the style of presentation has been different, these have all involved using an arts & crafts or D.I.Y approach.  These events reaffirmed my belief in this as a particularly good medium for exploring personal issues in a fun, engaging and accessible way.

The first was a ‘genital making’ workshop, hosted by the Candid Collective.  Adapted from an activity used to teach children about anatomy, puberty and health, this saw us showing adults how to make vulvas and penises with air drying clay to then be turned in to fridge magnets!  Held in a cosy upstairs room of a pub in South London, it had a very different feel to the classroom and was lots of fun.

The second was a talk for the antiuniversity lecture series – in which a group of us took to a local park to talk about arts and craft as a medium for discussing bodies and our own experiences of sex ed.  This culminated in making a ‘zine page about some of the issues that had been brought up.

There are a couple of future crafting themed sex and relationship events (in London) for adults that you may be interested in:

Thanks to Lisa, Leah, Adam and Bel for the images!