In Conversation with Kizanne James

Let us introduce you to Kizanne James. Kizanne is a physician from Trinidad & Tobago working on reproductive health and rights.

In this conversation with Girls’ Globe, Kizanne speaks about the challenges she has faced as a woman – and especially as a black woman – working in the field of sexual and reproductive health and rights in the Caribbean.

“We were taught that if you had sex or you had a boy touch you, it’s like a tomato – the more that a boy touches you the less valuable you would be. And that’s not the same narrative for boys.”

Kizanne explains that it’s being grounded in her values that helps her to handle difficult circumstances. In the face of negativity or even hateful abuse from those who disagree with her, knowing her work and advocacy empowers women and girls to make decisions about their own lives keeps her motivated.

“Regardless of what I may be feeling, or the negative voices or concerns people may have…I feel like I’m on the right side.”

This video was made possible through a generous grant from SayItForward.org to support women’s advocacy messages.

If you liked this post, we think you’ll love our conversations with KingaWinfredScarlettNatasha & Tasneem, too!

The Women I am Not

After spending a weekend in bed with flu and catching up on TV, I have an aching sensation (which incidentally doesn’t come from my infected sinuses).

Sex on screen continues to be misogynistic, violent and completely unrealistic.

As young girls we are told to be good. While the definition of good varies from society to society, there seem to be some common traits: if you were born a girl, you should wait for the right man, dress appropriately, not be easy.

But when it comes to sex, mainstream TV teaches us the exact opposite: we should always be ready, willing and, of course, we should never say no. On TV, sex is both the preferred weapon and ultimate punishment, and there seems to be very little in between.

Mainstream TV-makers tend to portray women who have sex in three ways: (1) as manipulators, using sex to advance their agenda; (2) as props, used by the male characters to express their masculinity or to say an intense goodbye before taking off to war (or some other kind of heroic activity); and (3) as a victim of violence.

Needless to say, in all these scenarios, the women involved are beautiful, slim and perfectly groomed – including, to my horror, the penniless sex workers in 19th century Paris.

Women are not the only ones whose sexual lives are gravely oversimplified on screen.

The unfair representations of masculinity – including sexual performance, needs and emotions – are undoubtedly hurting those who do not see themselves as ever-eager, macho sex machines who fear even the idea of monogamy. Not to mention other groups, such as the trans* community or people with disabilities, whose sexual lives are often altogether omitted in popular culture.

It is well established that the representation of social relations is a powerful tool in media, which can have a strong impact on normalisation of behaviour and norms. For instance, it has been argued that the increased presence of LGBTQ+ characters on TV is positively influencing the coming-out and self-realisation in the community.

Other studies show less positively, that media portrayals of rom-com relationships can normalise stalking. So, in absence of other portrayals of sexual encounters, are we doomed to learn our sexuality from what we see on TV screens?

I know, in theory, that the characters and scenes we see in films, ads or TV series are there only for entertainment and not to be taken too seriously. But in practice, I often feel conflicted.

I am angry to see that unrealistic stereotypes about such an important part of human lives continue to be reproduced on TV, and I refuse to replicate them in my own relationships. But, years of media influence had an impact on my idea of what constitutes perfect sex, and I often find it difficult to completely reject the influence of over-sexualised images of women that we all know so well from pop-culture.

I am neither the good girl  society wanted me to grow into, nor the women I see on TV. And I’m trying to find my way to be okay with that.

There is little we can do about the decades of unrealistic and misogynistic sex on TV reels, which has undoubtedly influenced generations of viewers. But we can inspire the future. Let’s talk about sex. Let’s talk about it openly, without fear or shame. Let’s talk about our contradictions, misunderstandings and repressed needs. Let’s laugh together at the endless imagination of TV makers coming up with ever-new ideas on how to reproduce old stereotypes.

Sex is a spectrum, full shades, and we should all be encouraged to find our own way in navigating our own sexuality. After all, reality is much more colourful than TV.

Family Planning Realities for Young People in Nepal

In many developing regions, young people still lack access to safe and effective family planning methods, for reasons ranging from lack of information or services to lack of support from their partners or communities. Young people are still being prevented from making informed autonomous decisions about their lives and their bodies.

Speaking from my own experience in Nepal, values about sexuality vary and are defined by culture and religion. One common barrier is social stigma, which discourages young people from openly discussing their needs and seeking the necessary interventions.

Nepal is one of the countries with fairly high adolescent fertility rates. Age at marriage is an especially important variable shaping fertility levels in Nepal, since it is a society where premarital sexual involvement is strongly disapproved of. The high rate of adolescent childbearing is a result of early age at marriage among women.

Nepal Demographic and Health Survey data reports some encouraging trends, such as the progressively increasing age at marriage over the past 15 years. However, there has not been a similar increase in the age at which adolescent girls begin childbearing.

In Nepal, the level of unmet need for family planning remains high.

Some adolescents cannot afford to pay for services, and even if they can, many fear that they’ll be required to provide parental consent before they can actually receive those services.

Young people have the right to make informed decisions about their lives. Integrating their perspectives and helping them overcome the social, legal and practical barriers they face is critical to achieving the goals of Family Planning 2020 (FP2020).

The Government of Nepal is committed to improving health outcomes in the country, and several policies and strategies have been put into place. The recent initiatives by government to provide family planning services through satellites and mobile clinics as well as community health volunteers is commendable to expand the reach of services in area of low accessibility.

Despite significant efforts, the idea of offering family planning services to young people is still not well accepted and easy to advocate for in Nepal. 

In advocating for young people’s rights to access family planning, factors such as age, religion, livelihood and education need to be taken into account. It is also true that young people are often more likely to seek information about reproductive health from informal sources.

Accordingly, to advance progress, information should be provided through media, peers and informal sectors. Peer education can be an effective in facilitating young people’s access to sexual and reproductive health (SRH) services and influencing social norms. Providing adolescents with Comprehensive Sexuality Education (CSE) has been shown to improve adolescent sexual reproductive health knowledge, attitudes, and behaviors when implemented well.

Adolescents and youth constitute a large section of the population in Nepal. Given its size and likely trajectory of growth in the future, this population warrants a focused policy attention, especially when it comes to education, health and population. Adolescents make up a high percentage of Nepal’s total population, and so policies and programs in family planning and reproductive health will have to be expanded to meet the needs of these groups.

For adolescent SRH programs to be effective, we need substantial efforts from the government along with the non-governmental organizations and the private sector. Unproductive approaches should be abandoned, proven approaches should be implemented. New approaches should be explored that better respond to adolescents’ needs.

We must commit to providing young people with the tools to take action in their communities and identifying funding opportunities for youth-led efforts.

As we continue to build the framework for Universal Health Coverage, we must ensure meaningful and sustainable youth engagement on family planning at all levels.

Breaking the Silence on Vulval Pain

“Well, you need to have sex, if you don’t it will only make things worse,” the gynaecologist told me.

At the time, I was a single woman at the age of 24. For lots of people, being told to have sex wouldn’t be much of an issue, but when you experience pain during sex like I do, those are hardly the words of comfort you want to hear.

Since the age of 18, sex has been a problem for me.

As a young girl, sex education didn’t teach me which feelings are normal and which aren’t, and I never learnt anything about issues or difficulties I might face in the future.

As a result, for years I thought painful was how sex was supposed to feel.

Other women must experience this pain and just get on with it, right?

But from the way everyone else spoke about sex, I felt confused. It didn’t match up with my own experience. I felt lonely, isolated and upset, so I turned to a doctor for help.

I visited my university doctor 12 times over the 4 years I was studying.

“Maybe it’s this…”
“Maybe it’s that…” 
“Can you test me for this..?”
“Can you do a swab for that..?”

I went back time and time again with my own internet-researched-suggestions of what might be causing the pain I was experiencing and what the solution could be. During each appointment I was examined, assured that physically I was fine, and told it’s all in your head”.

Being told a problem is ‘in your head’ is never easy to hear. At the time, I understood it to mean that there was no solution available to me and I would need to work this one out on my own. Did I need to be more relaxed? Was I too tense?

I was young and clueless and I had no guidance whatsoever.

It wasn’t until I eventually opened up to my mum that I realised I wasn’t being proactive enough. Yes, I was doing all of the research I could do on my own but I didn’t really know what I was looking for. I didn’t even know at this point that I could request a referral to a gynaecologist myself.

Years passed by, and I visited the hospital every 4 months in the hopes my next NHS appointment would shed some light on what was happening to me, but the process moved slowly. Each scan ruled out another potential cause of my symptoms, which I knew was a positive thing – but with each month that passed, the experience began to take its toll on my mental wellbeing.

I started to fill the gaps between these appointments any alternative method I could think of – Acupuncture, Hypnotherapy, Psychosexual Counselling… Each new option gave me a glimmer of hope, but time and time again I had no luck.

I felt let down by my doctors. I felt as though no one was taking me seriously.

I’ve cried in medical appointments more times than I’d care to admit and each referral to a different department left me feeling abandoned – as though no one was willing to take the time to learn about the pain I’d been experiencing for years.

I was the one coming up with potential solutions and offering ideas to my doctors, but every suggestion I made was cast aside. I even had one Gynaecologist laugh and shrug while casually asking me, oh, what are we going to do with you?!, trivialising what I was going through even further.

According to the NHS, vulval pain affects women of all ages, although symptoms often begin before the age of 25. A study on almost 5000 women in America showed 1 in 6 women experienced the symptoms of vulval pain for 3 months or longer, with 60% of women visiting more than 3 doctors, many of whom provided no diagnosis.

How is it that so many women are experiencing the same problem, yet so much of the medical world is completely oblivious to our pain?

Instead of being supported, we’re being made to feel like we’re ‘crazy’. I believed something was really wrong with me until one day, I found an online forum that changed everything.

All of a sudden, I found a group of women from all around the world providing support and advice for each other. It was unlike anything I’d experienced anywhere else. It was the conversations I had in the forum that led me to find a doctor in the UK who sounded as though she had not only heard of, but actually treated, many people in my position.

After all that time, all it took was a 15 minute appointment to lead to the diagnosis I’d been searching for. It may have taken me 8 years to get here, but I can finally say it;

I have Vestibulodynia.