Gone are the days that your mom would color in your period days on a calendar with red marker. As a doctor, I can’t begin to tell you how important it is to keep track of the regularity of your cycle and flow. Many times, it can be the first indicator that something may not be completely right with your body health-wise.
Technology is a huge part of all of our lives. More specifically, our cell phones play such an integral role in our everyday. They keep track of our everyday conversations, plans for the day, important reminders; so, it naturally makes sense that our cell phones help keep track of our monthly cycles as well.
When I first set out to find the perfect app, I had to go through four or five before I finally settled on one. Below, I bring you a discussion that was struck up amongst the Brown Girl staff about our favorite apps that get the job done, or at least, helps count down the days till the internal torture can end.
Period Tracker Lite
[Screenshot of Period Tracker Lite main page | Photo Source: itunes.apple.com]
Period Tracker Lite is so accurate and efficient. I can always tell when my period is coming and I love that it has features where I can document my symptoms and moods. So the next time I go see a doctor, I can talk about any irregularities (if any) since everything is right there. It’s awesome! – Nidhi Singh
I use Period tracker Lite too. Like Nidhi said it’s fairly accurate, I also like that it tells you the number of days in your cycle, and also when you’re ovulating or most fertile because it helps me to know what days during the month I need to be extra careful with protection, sorry if TMI lol. – Sana H.
[Clue Period Tracker screenshot of main screen| Photo Source: itunes.apple.com]
Clue: simple, non-flowery design and easy interface. It includes ability to track mood, digestion, pain, etc, as well as “Cycle Science” if you’re curious about the biology behind it all. For someone who’s never had a regular cycle, it’s also been really helpful to print out a report directly from the app to discuss with my doctor. – Salwa Tareen
I was actually sent the Bellabeat Leaf by the company to try out over the past six months and it’s this beautiful piece of statement jewelry that you can wear as a bracelet, necklace or simply clip on to your clothing. The app that syncs with it keeps track of steps, your period, breathing exercises, and more. The developers are constantly updating the app and making changes. It’s definitely something that I’ve added to my everyday routine. – Atiya Hasan
Atiya Hasan is the COO and Co-founder of Brown Girl Magazine. She currently lives in Houston, TX and is a recently graduated MD. She strongly believes in empowerment through knowledge. She is also a contributor for the anthology “Faithfully Feminist: Jewish, Christian, and Muslim Feminists on Why We Stay.” In her free time, Atiya enjoys consuming large amounts of chocolate and TV shows. She also live-tweets a lot of Netflix shows @Atiyahasan05.
Traditionally, psychotherapy has let women down. This is not to say that women and other minority group members have never received help, but rather that the therapy they received made little attempt to address the root causes of their problems. In focusing narrowly on the personal and individual, which a lot of mainstream approaches focus on, they ignore the big picture and miss the point. An alternative approach — feminist therapy — can help challenge the norms and support South Asian women in a more comprehensive way.
A therapy which fails to address power issues in people’s lives automatically reinforces oppression. Feminist therapy is a way to look at people as part of society and not merely as individuals. As more people of marginalized identities realize that the cause of their mental and emotional difficulties are not individual factors but structural, they are seeking more thoughtful therapists and counselors. Feminist therapists are aware of the cultural dynamics that uniquely affect women and keep these at the center of their practice.
Feminist therapy has a lot to offer to women of color, particularly South Asian women. It is formed on the assumption that social forces impact, and these forces include the many identities that a South Asian woman holds — including race, ethnicity, caste, etc. Feminist therapy can help support our clients and us as therapists to conceptualize the client’s difficulties, as not just stemming from internal sources, but as an outcome of the deep-rooted patriarchal system.
Feminist therapy is the key to a progressive approach towards mental health care. There is a lot of awareness about feminism nowadays and women encourage feminist approaches to therapy. Feminist approaches look at how social and political forces interact with our own identities. Feminist therapy especially puts in a lot of emphasis on how our intersectional identities such as religion, family dynamics and social class plays a role in our own gender identity. Feminist therapy can help support our clients and ourselves as therapists to conceptualize the client’s difficulties as not just stemming from internal sources, but rather face the impact of the deep rooted patriarchal system.
Here are some important aspects of a feminist approach to therapy, whether you are a therapist or someone who wants to start therapy themselves:
Therapists’ own biases
Therapists, while working with South Asian women, as with any other client, need to put in their own personal work in understanding the assumptions and biases that they may hold towards these identities. If a counselor holds bias that a South Asian woman is timid, or doesn’t know what she wants, it may cause the counselor to take in a more direct approach rather than a collaborative one.
South Asian women are often being told what to do. Hence, therapists who may choose to be more directive rather than collaborative, may often reinforce the position of power and authority onto a South Asian woman reflecting what she faces in the world. South Asian women, especially who may have not been exposed to therapy, may look at counselors from a view of receiving advice or guidance. It is through our own ability to explore and process our biases that we can help challenge this narrative for the client, and help take a more collaborative approach.
Exploring identity work
It is important for a therapist to be aware about gender, sexuality and the intersectional aspects of feminism; about how sexual minorities, caste, religion impact gender in influencing the kind of experiences that women face. The counseling relationship is a space for clients to process the identities that are the most salient to them. We can start off with providing some context and psycho-education around the purpose of understanding these identities. Helping the client process different identities that are important to her can help take a more holistic approach to understand her difficulties. We can help provide information around how every identity that we hold impacts us in some way or the other, because of its interaction within the social context. This can also be a time when a client may self-disclose about their own identities, if comfortable and appropriate, to model this understanding.
Ask instead of assume
It is considered best practice with every client to ask their preferred pronouns; as well as identities they would like to highlight at the beginning of the counseling relationship.
Asking, instead of presuming, can help clients hold their voice from the beginning of the counseling relationship and create a safe environment. Processing identities that are salient to them and opening up space to share other identities can help clients share openly about how they choose to identify with their gender/sexual identity. It creates space for clients in the process of exploring their identities, to get curious about their identified gender/sexual identities for the first time.
One of the initial and ongoing processes of feminist therapy is educating women from a collaborative aspect. Providing psycho-education about their rights, consent, impact of patriarchy and other systemic factors promotes empowerment. While providing psycho-education, it is important to process the power dynamics in the relationship and model consent within the relationship by exploring the question: “What is it like for you to hear this information from me?”
We as therapists can be considered as guiding forces, but we should also be mindful that we are providing this guidance and information from a collaborative aspect rather than enforcing authority or being direct. South Asian women are often asked to respect people in authority and not defy them. We, too, as therapists may end up reinforcing these patterns, and instead need to do our own exploration by engaging in psycho-education with collaboration and continuing to check in with the client’s internal process.
Hold context around starting therapy
A South Asian woman puts a lot of thought into seeking therapy. The cultural stigma towards mental health can have an imperative impact on her recognising that therapy could be a potential need to take care of herself. Along with the courage that it takes to reach out to a therapist, either openly or whilst keeping it hidden from her family, there may also be a potential element of what kind of therapist do I want to see. Especially for South Asian women living in the US/UK or other Western countries, there may be a significant deliberation that goes into seeing a white therapist v/s a person of color therapist v/s a south asian therapist.
Can we think of potential factors that may prevent a South Asian woman from reaching out to a therapist who may hold similar cultural identities ?
Can we think of potential factors why a client may want to work with a South Asian therapist?
Explore reasons that led them to choose you
When a client comes in for therapy, she has probably considered the therapist’s background. She may choose to see a non-South Asian woman because of past and internalized fear of being judged by other South Asian women in her life. Or a client may deliberately choose to work with a South Asian woman therapist for perceived similarities in identity. For therapists, it’s important to create space at the beginning of the relationship to ask the client what led them to choose you as their therapist. For clients, it’s important to ask questions about your therapist that are important to you.
Fostering environment for all their identities
Clients are fully seen and valued for all aspects of their identity, background and experiences. It also means that we ground our interventions from a systemic and anti-oppressive approach.
We constantly learn and evolve to provide responsiveness, humility and respect to our clients and really redefine the standard of care based on the identities and background of South Asian women.
Background of the client
Particularly while working with South Asian immigrants, it is important to know the background of the client we work with in order to design culturally-appropriate interventions. As a lot of research has asserted, not all Asians are alike and group differences within Asian groups is often overlooked.
There’s a lot of information and knowledge around Indian groups that tend to be generalized across other communities from South Asia such as those from Pakistan, Sri Lanka, Bangladesh, etc. It is important for counselors to be aware about similarities and differences across these cultures, and create interventions that are more specific to the client’s cultural background.
It is important to check in about how the interventions land with the client. We may use certain strategies from a Western perspective that go into exploring a client’s relationship with her parents or caregivers. This can particularly bring guilt or shame for the client as it may be in conflict with her cultural value of holding respect for her parents.
A lot of the deep respect and regard towards family comes in the form of loyalty and not speaking “ill” about the family with strangers. Reflecting on family, based on Western interventions, can sometimes make it challenging for clients based on their values. Checking in with clients on how these interventions feel, and making space for the guilt and shame to surface can once again help clients to hold value in her own voice.
Examining values and beliefs
Therapy can support South Asian women in differentiating between their own values and society’s expectations. Even though collectivism is a value within South Asian culture, it may not necessarily be an individual value to our clients.
South Asian women very often bear the burden of the value of collectivism where they have to meet family’s expectations, be in touch with other family members and engage in other collective activities. It is an expectation that has been imposed upon them. A therapy space can be a space for clients to explore what their own individual values look like. It can be a space for counselors to collaboratively work with clients in choosing what matters to them, even if what matters to them is to take care of the family.
In this essence, she now has had a voice in choosing how she wants to move forward as v/s feeling stuck in expectations set by others. When the client recognizes that she has a choice in exploring her own values and beliefs, there can be support around how to engage in behaviors that are based in these values. Sue and Sue (2008) has recommended discussion about values, beliefs and behaviors of their family and culture, so that clients can discover those that are for them, those with which they identify and those with which they are ambivalent.
The reason why a South Asian woman may choose to work with a South Asian therapist is to feel understood and not hold the burden of having to explain different cultural norms and expectations. When working with a therapist from a different racial background, clients may feel the need to explain and defend their own culture. It may feel difficult to hear about certain norms being toxic or problematic from someone who doesn’t share the same background as you.
When we as South Asian therapists work with South Asian women clients, we have the unique opportunity to validate the importance/meaning of these cultural norms, as well as challenge its problematic impact on our mental health. We have the context and ability to hold the community and cultural system accountable. It is important to hold the value of one’s desire to have a community and fellowship, as well as hold the impact of this collectivism on the mental health of South Asian women.
It is important to pause and explore: What about the culture feels impactful? How does this impact self-esteem and the way they view the world?
South Asian women are bound by the cultural value of adjustment and acceptance. Accepting our culture the way it is and moving on is what they have been taught to do across generations. The therapy room can be a good space for us to pause and help them choose what aspects of the community are helpful and what feels unacceptable.
This, in turn, can help with increasing their voice and control on their own value system. When they come to you looking for that cultural connection, you can hold space to both empathize with their cultural upbringing and to be able to challenge it. There’s more likelihood that they need it to be challenged and from someone who understands what they are going through.
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.
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.
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.
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.
The Covid-19 pandemic and feelings of uncertainty, which have been prevalent across the globe, had lasting effects on all of us. One of the more positive impacts has been on the mental health industry, particularly the normalization of mental health challenges and a more open dialogue about mental health. There have been discussions in the workplace, in schools, and even on Hinge profiles, but what about in South Asian communities? Though some progress has been made, mental health stigma is still widely prevalent among South Asians, impacting individuals’ desire and comfort in seeking help. As a result, the South Asian community reports lower rates of seeking mental health services. And of the individuals who do seek out mental health services, many face challenges in finding therapists who are equipped with a multiculturally competent skill set to understand the South Asian client’s concerns. This is why it’s important to recognize and become aware of the intersections of mental health and South Asian communities.
Although there is an overlap between the mental health concerns of South Asians and other communities of color, there are also unique intersections between culture and mental healththat I want to bring to the forefront of this conversation. As a South Asian psychologist, who is both a researcher and clinician, I have firsthand experience examining how our individual cultural context impacts our emotional experience. If we can understand, or at least consider, how the cultural context impacts us, we can better understand ourselves and feel seen by others too. We, South Asians, are a diverse group in terms of ethnicity, language, food, religion, traditions, and so much more. So, while learning about the “state of mental health in South Asian communities” is much more complex and nuanced than what I can cover in just one editorial, I believe starting the conversation about issues that don’t get talked about nearly enough is an important first step towards destigmatization.
What is the state of mental health in the South Asian community?
Here are some numbers to set the stage, based on research done on South Asian communities. One in 5 South Asians currently reports experiencing mood or anxiety disorders. South Asian youth and young women, in particular, are at greater risk of having suicidal thoughts and behaviors compared to other groups. Only 24 percent of South Asians diagnosed with a substance abuse problem sought treatment. And South Asian Americans express greater stigma toward mental illness than other ethnic groups. How often are facts like these discussed? Not often. Since South Asians are often mixed in with the larger Asian American population, these issues and their nuances are rarely discussed within mental health communities. This underrepresentation can make the reality of our emotional experiences easily misunderstood and make our needs feel invisible. Relatedly, concepts like “model minority” lead outsiders to often assume that South Asians are well-adjusted. And even within the South Asian community, stigma and beliefs about the causes of mental health issues (e.g., mental illness indicates problems within the family, a sign of weakness, etc.) lead all these facts to continue being ignored.
How do mental health concerns intersect with South Asian culture?
While mental health concerns are prevalent among my clients from all backgrounds, these common concerns intersect with culture to create an individualized version of the issue that requires specialized attention and care.
Within the South Asian community, there are cultural differences in alcohol and drug use and the discussion of these topics. Alcohol is prohibited in Muslim and Jain faiths which makes open dialogue about substance abuse and its prevalence even more of a challenge within these communities. Admitting you have a problem can be hard and adding the cultural taboo can make it more difficult.
There is a tendency in the South Asian community to highlight that only linear careers in financially stable or ‘reputable’ fields — such as medicine, engineering or finance — will lead to success. This expectation not only impacts career decisions but also mental health, self-esteem, and self-confidence. Even if we think we are not influenced by outside factors in our career choices, how do we know that subconscious messaging is not impacting our decisions? I personally was pre-med for as long as I can remember and was apprehensive if my parents were going to accept my desire to go into psychology and mental health instead of medicine.
Caring for loved ones, who are aging or ill, is emotionally challenging for most people. What makes this stress unique for the South Asian community? South Asian communities are collectivistic and therefore rely strongly on interdependence well into adulthood. Therefore, caretaking and providing for elders is an integrated part of our lifestyles. Pursuing personal goals can sometimes be seen as selfish and therefore South Asians feel the need to sacrifice personal desires. This can make setting boundaries in relationships or making decisions focused on one’s own needs especially difficult and not as straightforward as may be suggested by Western psychotherapy interventions.
Romantic relationships can be especially stressful for South Asians because of the need to navigate between one’s own desires and family expectations. Older generations pass down messages that people should focus on their careers instead of dating, which can lead to not dating or secret dating and youth navigating romantic relationships on their own. Then, suddenly, the conversation shifts to the need to get married by a certain age, which seems especially difficult when you have not been allowed to date or when it is not something you want in your 20s. South Asians may also experience family expectations about their partner being from the same ethnic/religious background, working in a specific industry, or having a specific family background. These family or cultural expectations and issues also impact the LGBTQI+ South Asian community and South Asians often feel the need to sacrifice personal desires for the expectations that their families or deep-rooted social norms have set for them.
Being able to communicate the complexity of our emotional experience is especially challenging when being emotional is considered a weakness. This cultural sentiment further perpetuates emotional suppression and increases the barrier to seeking support. Also, South Asian languages have limited vocabulary to describe mental health and the emotions involved. It is not only challenging to identify our emotions, but it is difficult to communicate the complexity due to the lack of words in South Asian languages to describe those emotions. Let’s take the word, “gussa,” which means “angry” in Hindi. The only way to explain the level of anger you are feeling is to describe the full situation. While in English, you can use variations of the word “anger,” such as “annoyed” or “furious” to describe the emotions with more nuance.
Culture is integrated in small and big ways into how South Asians experience their body. It can be common for family members, especially older women or “aunties,” to comment on one’s body weight in direct ways like telling someone they have gotten fat or thin. There are also unspoken rules about food that impact one’s relationship with food and potentially overeating, including “it is rude to not finish all the food on your plate,” or if you don’t go up for seconds that means you didn’t like the food. Research has also found South Asian women in particular often struggle with the pressure to conform to Western beauty norms (e.g. removing dark hair, and lightening skin color).
We all are constantly evolving and understanding who we are and what we value. What makes this unique for South Asians? Culture intersects with other parts of our identity, including generational status (1st, 2nd, or 3+ generation), religious beliefs, gender identity, and age which impact the way we make sense of who we are. Being born in the US makes one American, but are you still American if you primarily connect with your South Asian ethnic identity or maybe your religious identity? Or what messages does culture pass down about what it means to be female? Are you supposed to do all the cooking and cleaning? Do you have to have children? Culture intersects with identity development in complex ways.
How can you get support with what you may be feeling and experiencing?
I believe the first step in breaking the barriers, is shifting your mindset about seeking mental health support from something that means you have a “character flaw” to something that you do for your overall well-being. Taking care of your emotions and processing your emotional experiences is as important as your weekly workouts, annual physicals, or that apple a day. One way to start this process on your own is to spend 10 minutes a day engaging in mental hygiene practices (meditation, gratitude journal, positive experience journaling, writing a thought log, prayer, or deliberate time in nature).
If any of the concerns I discussed earlier resonated with you, consider signing up for Anise Health by filling out this short intake form; you’ll get matched to a culturally-responsive clinician within two business days. I’ve also listed a few additional resources below that aim to address mental health needs in South Asian communities.
I hope we can continue to bring the ways our South Asian culture impacts our well-being into the forefront of the conversation around mental health. By highlighting the South Asian community’s experiences,we can feel more seen and create a more accepting environment that allows us to get the help that we all deserve.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.