What’s a “Hoo-Ha”? Puberty and the South Asian Child

There’s no right age to talk to about puberty because every child develops differently – surrounded by different people and raised in different homes. South Asians are notorious for withholding information. Let’s be real, we don’t like disclosing private information because we don’t want people to talk about us.

As parents, the first thing we have to do is give our kids an education. We shouldn’t be embarrassed if they say the word penis or vagina at a family party. “Pee-pee,” “shame-shame,” “private parts,” and “hoo-ha” are all slang terms used for genitals. Hiding these terms gives children a sense that there is something to hide. As a medical doctor who treats genitals all day, I can’t escape vulvas, vaginas, perineums, and rectums. Do you know how many of my patients point to their genitals and say the pain is here without knowing the name?! The average woman doesn’t know the difference between her vulva and vagina and it doesn’t even matter to them. So it does matter is that we destigmatize the proper use of vocabulary.

[Read Related: Is it Bollywood’s Job to Provide Sex Education?]

Parents who teach their kids these terms shouldn’t be looked down upon for being liberal, assuming that their kids will go out and be more sexually active in their teen years. Similarly, a lot of South Asian parents are scared to expose their kids to contraception because they fear this could encourage sexual activity. In reality, kids are learning about sex, drugs, and porn by the time they are in middle school. I remember learning about pornography on the school bus from some kids – I didn’t go out asking about it. It came to me on my way home from school!

I often get asked, how parents should approach genitalia and puberty. Here are some tips when breaching these topics.

Don’t Be Nervous; Puberty will Happen

If you are nervous your child will sense it and try to end the conversation before it has even started. Remain calm no matter what. It’s always a possibility that your child will open up and tell you things that he or she already knows or worse, something that may upset you. For instance, you may find out your daughter has already used a tampon. Yes, you wanted to be the one to teach her about them, but you might have been beaten to it by a girl in her class. The calmer you are, the more they inclined they are to share with you.

Get Your Facts Straight

Look up the anatomy and terms if you don’t know them. Kids are sponges and want to know everything so they will absorb every piece of information they receive. You would be surprised at how much detail they want. These are the things they will take with them to adulthood. Kids as young as two will begin to touch and explore their bodies. Your son might ask you why his penis looks different than his father’s or why his sisters don’t have a penis. Don’t be scared to use proper anatomical terms. Remember they will feed off of you.

[Read Related: What South Asian Parents Won’t Tell You About the “Birds and the Bees”… Vaginismus]

Show Your Daughters How to Use Menstrual Products

It may seem simple but most young girls cannot figure out how to insert a tampon on their first try. Remember if it’s painful, it’s not normal and could be a sign of vaginismus. Teach them about menstrual cups a relatively newer alternative to tampons and pads, and since they are reusable it’s cost-effective and eco-friendly.

Women struggle with leaks their entire life but as a young child or woman, the embarrassment that comes along with an accident can be devastating. Talk to your child about period proof panties like Thinx that can be used as back up to pads/tampons or used alone on light days.

Talk About Safe Sex

Most schools in the United States have a health class that will dive into puberty, sex education, and contraception, or so you would think. Just as you would ask about what they learned in social studies, ask about what they learned in their health class. If they are not learning about sexual health and their bodies’ transformation in school, teach them at home.

And Consent

And lastly, something that has resonated with me over the last few years with the #MeToo movement: Yes means yes and no means no. Consent is important. We should be teaching our daughters and sons that their bodies are sacred and should be respected and honored.

This is not about being a “cool parent,” as much as it is about having an open relationship with your child. As a mother of young girls, I want them to know the facts about their body, be aware of conditions that may affect them, and to know that I am there for them to discuss anything that they have questions about. I don’t want them to feel any shame when it comes to their genitals and have fears when they talk about anything that could be affecting them.

If you would like to try Thinx panties and want to a nudge, feel free to use the code TAYYABA for $10 off your first order and check out THINX (BTWN): the *new* line of super-absorbent underwear specially made for young people with periods.

By Tayyaba Ahmed

Dr. Tayyaba Ahmed is a Board Certified Doctor of Physical Medicine and Rehabilitation. She is a native of New York … Read more ›

Shedding Light on South Asians and Intimate Partner Violence

@golibtolibov

In July 2022, Sania Khan’s life was ruthlessly taken from her by her ex-husband. Sania was a young, vibrant South Asian woman – a creator and photographer who had the courage to step out of an abusive marriage, even in the face of community norms that discourage women from speaking out. While this tragedy seemed to stir a consciousness in the South Asian diaspora that we can no longer justify the status quo, it is far from the only such incident. Just months later in December of 2022, Harpreet Kaur Gill was stabbed to death by her husband in Vancouver. While the most extreme cases like those of Sania Khan and Harpreet Kaur Gill are highlighted by mainstream media, a small body of research provides evidence that intimate partner violence experiences are equally, if not more, prevalent in South Asian communities than the general population in the US or Canada. That’s why we need to do more as a community and throw light South Asians and intimate partner violence.

[Read Related: A South Asian Daughter of Divorced Parents Speaks up After the Tragic Death of Pakistani-American Photographer Sania Khan]

Violence prevention researchers have long used traditional gender roles to explain intimate partner violence in South Asian countries. These norms are deeply entrenched beliefs in society about appropriate roles for people based on their gender. In South Asian communities, these norms typically privilege men in intimate relationships. These beliefs are further perpetuated by mainstream media. For example, despite historic criticism for its depiction of harassment as “romance” or abuse as “lovers’ quarrels,” Indian cinema has only normalized toxic masculinity and violence as a form of conflict resolution with its hundreds of millions of viewers.

Despite the identification and investigation of these norms in South Asia, there’s so much we still don’t know about diaspora communities, especially in relation to South Asians and intimate partner violence. In the US, South Asians have become one of the fastest-growing populations, but we remain unaware of how the stresses of raising a family in a different culture, and the weight of growing up between two worlds, affect these norms, expectations, and experiences among South Asian immigrants, the second generation and beyond. 

In this article, we’ll take a deeper look at how these norms are enacted to influence intimate relationship dynamics, discuss the recent rise in intimate partner violence, and explore the work that researchers, policymakers, and program implementers can do to address violence in South Asian diaspora communities.

[Read Related: On Domestic Violence: Model Minority, Private Pain]

Social Norms and Violence in South Asian Diaspora Communities

Why does it take catastrophic events to serve as a call to action? For one, the “model minority myth” continues to portray South Asians in America (who originate from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) as a healthy and wealthy group. As a child of Indian immigrants, I always thought this was just a frustrating trope that lived rent-free in my head next to the eternal question, “Log kya kahenge?(What will people say?) However, I have realized that this constant worry is not just an innocent preoccupation. It’s the result of a dangerous spiral beginning with the portrayal of South Asians as a model minority and the need to maintain that well-to-do image. This only reinforces the traditional gender norms that overlook men’s perpetration of violence and encourage women’s silence, crippling any efforts to understand the scope of the problem and draw attention and resources to address it. 

The Impacts of COVID-19 on Intimate Partner Violence

Prior to the start of the COVID-19 pandemic, the frequently-uttered phrase among researchers, practitioners, and advocates alike was “one in three” — one in three women ages 15-49 experiences physical and/or sexual violence inflicted by an intimate partner in their lifetime. Under the cover of the COVID-19 pandemic however, rates of violence against women rose dramatically, prompting UN Women to call for recognition of this “Shadow Pandemic.” During the height of the pandemic, the social isolation that came with lockdowns and quarantine procedures to curb the spread of disease made home a more dangerous place for an increasing number of women. As communities seek to rebuild, the inequities in access to and use of potentially lifesaving services have deepened. Now more than ever, it is critical that we shine a light on the many intersections of our society to prevent South Asian women’s experiences of intimate partner violence from being pushed even further into the shadows. 

[Read Related: How to Talk to Your Child About Domestic Violence: 5 Tips for Parents]

Addressing the “Shadow Pandemic”

First and foremost, to better understand South Asians and intimate partner violence, we need better data disaggregated by racial/ethnic group. Since the 1980 Census, only those of Indian origin have had a fill-in bubble. All other South Asian groups have to write something in, decreasing their participation. South Asian communities in the US are not a monolith and they are certainly not all of Indian origin. This perception, fed by our lack of data, likely privileges the Indian community in America and limits the visibility of other South Asian communities. 

More accurate information will help us better understand where the need is greatest. We can make a stronger case for more equitable resource allocation, improve South Asian language materials for survivors, and enhance provider training programs, accounting for the specific cultural implications of disclosing and seeking treatment for violence in South Asian communities. Public health researchers should increase efforts to understand the prevalence of experiences of violence, the environmental factors that make South Asian women in America vulnerable to experiences of intimate partner violence, and how it impacts their health.

While outstanding organizations such as Narika in California and Sakhi in New York are leading the charge in raising awareness, running active helplines, and providing support, they cannot be the sole safe space for survivors. While the system’s failure to protect Sania is not an isolated incident, it has served as a wake-up call.

All South Asian women in America should be able to be healthy and safe and lead lives free from violence, coercion, or abandonment. To achieve this, we need better data, more research, culturally-tailored resources, and appropriate legislative action that will allow for prevention, screening, and treatment efforts to finally take root.

 Intimate Partner Violence Resources:

  1.     National Domestic Violence Hotline Call: 1-800-799-SAFE (7233) or 1-800-787-3224; Text: “START” to 8878
  1.     National Dating Abuse Helpline Call: 1-866-331-9474
  1.     National Sexual Assault Hotline Call: 1-800-656-HOPE (4673)
By Sneha Challa

Sneha holds a PhD in Global Health and is currently a researcher at the University of California San Francisco working … Read more ›

Painful Sex is More Common Than you Think

Close up on couple having intimacy moments

Ten to 28% of the world’s population of women experience painful sex. Keep in mind, that this is just what is reported. As embarrassing and as vulnerable as you may feel, you are absolutely not alone. The good news is that in addition to your traditional medical care to treat painful sex (also known as dyspareunia) such as medication, injections and surgery — a conservative approach is effective and long-lasting. Conservative care ranges from pelvic floor physical therapy, chiropractic care and acupuncture which are beneficial in treating the root cause of painful sex, as well as symptoms, for long-term healing. 

Some of the signs to look out for if you experience pain are:

  1. Deep pain/burning during or after sex
    • Pain descriptors: sharp, stabbing, deep, dull, burning
  2. Vaginal Dryness
  3. Low Libido
  4. Tightening at the vaginal opening

[Read Related: 12 Beliefs About Sex That South Asians Need to Throw Out the Window]

Treatment Options 

Treatment options for painful sex such as pelvic floor physical therapy, chiropractic care and acupuncture provide a long-lasting and profound effect on the pelvic floor and address your entire physical well-being.

The pelvic floor is a layer of muscles that range from the pubic bone to the tailbone. The purpose of these muscles is to assist in bowel and bladder control, support a baby during pregnancy and contribute to sexual sensations. Just like any other muscle in your body, these pelvic floor muscles can become tight or weak which can be a contributing factor to pain.

Pelvic Floor Physical Therapy

Pelvic floor therapy can assist by strengthening and relaxing the muscles which is necessary to relieve pain during sex. 

[Read Related: My Awkward First Time at the Gyno]

Chiropractic Physician

Chiropractors can be extremely beneficial with assisting in helping relieve pain. Associated pain and discomfort can originate from the lower back and buttock muscles. Chiropractors are trained in taking a history and performing a neurological, orthopedic and soft tissue examination to identify treatment options. Deep tissue massage, skin rolling, Active Release Technique, muscle energy technique, ice, heat and electrical stimulation are just to name a few.

Acupuncture

Acupuncture can activate the human dopamine system which helps regulate hormone levels and can assist in psychological factors. Acupuncture can improve mood, decrease pain and can be vastly beneficial in managing pain and mental health symptoms. 

Ask for help

“Everyone is having pelvic pain and no one is talking about it”

  1. Start with seeing your gynecologist who you trust for a history and examination of current symptoms to rule out any other medical conditions that could be a contributing factor to symptoms. 
  2. Locate a pelvic floor physical therapist through Apta Pelvic Health or Pelvic Rehab.  
  3. Locate proper chiropractic care that is trained as a licensed acupuncturist; look for credentials such as DC, LAc. 

[Read Related: Not Your Auntie’s Tips: 5 Sex Myths Busted]

How to talk to your partner about this in a safe/healthy way

Being open with your partner about your symptoms and painful sex may seem like a difficult conversation. Intercourse should never be painful and learning when to stay ‘stop’ is important in communication. Talking about pain before, during and after sex is important also in your own health diagnosis to see if pain symptoms are improving or becoming worse. Having open communication does not only benefit your relationship but most importantly, your own health.

To experience these symptoms may seem taboo or unheard of but quite frankly, they are common in many women. Women deserve to be directed to proper healthcare. 

Disclaimer: These are based on recommendations from a board-certified chiropractic physician and licensed acupuncturist. If symptoms become new or worse, consult with a primary care physician and or OBGYN to co-manage symptoms.

 

Reference: Tayyeb M, Gupta V. Dyspareunia. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/

 

Photo by anushkaniroshan stock photo ID: 2071991336

jasmine bhoola
By Jasmine Bhoola

Jasmine Bhoola DC, LAC - A chiropractic physician and licensed acupuncturist in Midtown East Manhattan. A graduate from the University … Read more ›

Dr. Samosa on Sex, Love and Coming out — the Ultimate Taboos in South Asian Households

Dr. Samosa
Photo Courtesy of Dr. Samosa | Photographed by Farzana Chowdhury

I’m going to be a sex therapist. 

I was taken aback when my late cousin shared this with me on the cusp of our twenties. 

As a fairly modest Indo Guyanese girl raised in the Connecticut suburbs, the thought of discussing a stranger’s love life seemed not only foreign but shocking to me. Nevertheless, my cousin was always bold in this way. She took pride in the more daring aspects of our Caribbean culture with natural confidence. It was one of the things I loved and now miss most about her. 

Admittedly however, it was over a decade before I started to understand some of her deeper curiosity in love, sexuality and mental health. This awakening was thanks greatly to Dr. Samosa. 

[Read Related: 3 Indo-Caribbean Mental Health Counselors Talk About Community’s Stigma]

In early 2020, Dr. Sarika Persaud, a New-York based, Indo Guyanese psychologist specializing in relationships, sexuality and complex trauma, took to Instagram as “Dr. Samosa,” an alias inspired by her favorite South Asian snack — and one she feels is a common thread for brown girls. 

 

View this post on Instagram

 

A post shared by Dr. Samosa (@doctor.samosa)

The platform became a safe space for brown girls to connect on topics like mental health, psychoanalysis, sexuality and relationships. From discussing sexual empowerment to building a strong sense of self, Dr. Persaud quietly became a confidant for those craving practical and candid insights the community shied away from. 

Dr. Persaud and I sat down to talk about her journey and breaking these taboos in the South Asian society.

Her interest in psychology started as a journey of self-discovery as a pre-teen.

“I think I experienced myself as different from my peers,” she explained during our interview.

She didn’t get caught up in teenage drama and avoided certain types of relationships and people. Meanwhile, the friends she did make saw her in “this sort of teacher role.”

“I became curious about that about myself — how, in some ways, I found it beneficial to feel my feelings and have a depth people were drawn to, but also use it in ways to isolate myself,” Dr. Persaud said.

She was also beginning to identify as bisexual.

She shared, “I think I was avoiding my sexuality in some ways and psychology became a way for me to understand myself more. It’s always been this confluence of philosophy and science and even art for me.”

Dr. Samosa
Dr. Samosa photographed by Nushie Choudhury

Growing up in Queens, New York, Dr. Persaud saw fellow Indo Caribbean women at a “very specific intersection of religion and culture.” It was the nexus of Caribbean values which welcomed sexuality and more modest Indian traditions. Caribbean influence seemed to “remove a boundary” on how Indo Caribbean women felt permitted to present themselves sexually, she explained. On one hand, after her Bharatanatyam dance classes, she saw her didis (the older girls) leave their classical moves behind for sexy Bollywood choreography and dancehall songs. 

“It was exciting, like they were just beginning to find ways to express their sexuality,” she reflected. Then, around the same time, Dr. Persaud discovered a copy of the “Kama Sutra” at home and her mother was appalled. “What’s wrong with your daughter?” aunties asked.

Confused, Dr. Persaud thought “You own this. This is from our culture and it’s a Sanskrit text. It’s literally a religious text. It all seemed so powerful — and yet so many people were afraid of it.”

Something didn’t add up.

In 2013, she started a blog to bring a voice to topics like these. As word of her content spread, Dr. Persaud was met with backlash from her temple. Leaders said her blog was inappropriate and dishonorable to her community, but she stuck with it and her family stuck by her.  

A few years later, when she launched Dr. Samosa to share her research and insights with a wider audience, sexuality came front and center.

“Sexuality — how you understand and honor what you want and like, and the ways you let yourself experience that pleasure — is intrinsically connected to how deserving you feel in the world,” she explained.  

 

View this post on Instagram

 

A post shared by Dr. Samosa (@doctor.samosa)

For example, if you think you’re worthy of a raise at work, a partner who desires you, or a family that listens to you — all can be linked back to a block in your relationship with yourself as a sexual being. 

However, if you can feel confident in something as “primal, instinctual, and personal” as your sexuality, Dr. Persaud argues you lay the foundation for confidence in these other areas of your life.

Dr. Persaud says the fear of sexuality comes into play for South Asians.

“Being comfortable with your sexuality means being comfortable with your power,” she explained. “If everyone felt empowered and had a healthy relationship with themselves sexually, a lot of our relationships and hierarchies in society would change. And there are just so many people who benefit from women and marginalized communities (like LGBTQ+ and those with chronic illnesses) being disempowered,” Dr. Persaud said.

Throughout her work, Dr. Persaud has found it’s especially difficult for South Asian women to feel pride in themselves as sexual beings.

“There’s so much shame about the self and the body. Women especially are held to a double standard and it’s so confusing. If you look one way, you won’t get a husband. If you look sexual, no one will want to hire you for a job. Regardless of the South Asian ethnic group, there’s the same shame and belief that your body has to look a certain way, and if it doesn’t, you’re not desirable. Everything gets tied up in sexual shame.”

It’s undeniable that Bollywood movies have also heavily impacted many of our views on love and sex, but Dr. Persaud didn’t condemn this.

She says, “People need to realize Bollywood started from a tradition of classical drama and dance from ancient India. Those dances were meant to be explorations of dreams and mythical and philosophical ideas. Bollywood is just a continuation of that. It’s meant to be a break from reality.” 

Real relationships are much more fraught and complicated than in films, but that doesn’t mean you should be ashamed of looking to Bollywood as a way to be in touch with romance and love in your life.

“They’re a fantasy,” Dr. Persaud added.  

She also argued Bollywood isn’t necessarily as “censored” as many claim.

“People don’t have to watch others physically have sex or kiss to be in touch with their sensuality,” she noted. “It can be much more nuanced to see two people just embracing in a way that stirs up feelings. Like, how does it feel to have your lover’s head against your chest? Culturally, we just explore and express sexuality differently than the West.”

When it comes to becoming more comfortable with our bodies and sexual health, Dr. Persaud says it starts with self-reflection.

“Ask yourself why you’re afraid of being sexy or seen as sexual. Are you afraid your family will reject you? That you’ll be thrown out of your home? We all have different triggers, and once you identify yours, you can get to the issue underneath it all.” 

[Read Related: What South Asian Parents Won’t Tell You About the “Birds and the Bees” and… Vaginismus]?

Dr. Persaud encourages women to ask themselves important questions.

“If you’re afraid that if you assert your sexuality, your family will reject or not support you, how can you be more financially independent? How can you find pride in being able to take care of yourself?” She urges women to take inventory of what they like. “Look at books and movies and what you see in the world and consciously take note of what you react to. This puts you more in touch with yourself.”

When it comes to fostering open conversations with others, Dr. Persaud says to lead with vulnerability and clarity.

“If you wonder whether your friends have had sex yet and are embarrassed to ask, voice that concern. Share how you’re feeling or ask yourself why. Leading conversations with vulnerability allows people to connect a little bit more; to feel safer to share.” 

 

View this post on Instagram

 

A post shared by Dr. Samosa (@doctor.samosa)

“If you’re uncomfortable with something your partner does or want more of something else, talk about what you want to change and why it’s important to you. It’s not a shortcoming on their part, but rather you saying ‘this is what I need for myself. Is this something we can talk about and work on together?’” 

With South Asian families, especially older relatives, things can get a bit more complex. Boundary setting is important as the family can bring out your biggest triggers. 

“You need to be at a point where you own yourself,” Dr. Persaud explained. For example, if your mom finds out you were out with someone and questions you about it — “A bai? A boy?!” — you should be able to say confidently, ‘Yeah I was on a date,’ and also not feel obligated to give more details. Of course, that may not always be safe for someone younger, but at a certain age, it is OK to be private, to have that shield to protect and develop yourself and your confidence,” Dr. Persaud says. 

Dr. Persaud also reinforces the importance of knowing your boundaries when reflecting on “coming out” to parents. She wanted to be open about her bi-sexuality with her parents; that she was dating — but not just men. She stresses however, one does not need to be excessively open.

“Not everyone has to come out and not everyone has to come out to everyone. You’re likely not facing anything new from your parents when coming out. If they are critical and judgmental generally in life, they’re probably going to be like that again. South Asian dads can really just be like, ‘Okay, don’t tell me you’re a sexual being,’” she laughed. 

While Dr. Persaud is thankful for her parents’ acceptance, there are members of her family who’ve been less than supportive. She credits her confidence and sense of self for drowning them out. 

“I’ve found the more I become comfortable with myself, the more I have this sexual energy that I can use creatively and in other good ways. If my dad rejects me, it doesn’t change that I am bisexual. Or if my mom rejects me, it’s not going to change this thing I know so deeply about myself. I’m just sharing something true. I can’t change it.”

Toward the end of our conversation, I shared with Dr. Persaud that I wondered how my own family would react to this article. I felt a bit of shame.

But she reminded me, “You can also find pride in it — ‘Yeah, I’m really proud of the fact that I’m one of the people breaking the stigma. I’m talking about something important to people’s health.’” 

And she’s right, as was my dear cousin in her early ambitions. These conversations are never easy, but walking in curiosity, confidence and pride can help us find our power as South Asian women. It can help break the stigma surrounding love, sexuality and relationships in our community and their roles in our greater health. 

In so many ways, sexual health and mental health are not only connected but interdependent. In fact, Dr. Persaud believes the more confident people are in their bodies and identities, the more confident they are as a whole — and the more attractive they are.

“Sexual attraction and energy comes from people being competent and peaceful and calm with themselves; knowing who they are,” she said, and the more we learn to embrace this and speak about it openly, the more we can not only grow but thrive.

For more on Dr. Sarika Persaud’s (aka Dr. Samosa) doctoral work and writing, visit her website or Instagram @doctor.samosa. For more on how to talk to your family or children about sexual health, visit sexpositivefamilies.com.

Avatar photo
By Ramona Sukhraj

With a B.S. in Marketing from the UCONN School of Business, Ramona has made a name for herself publishing over … Read more ›