39. Sex Ed 101: The Talk You Wish You Got From Your Parents (with Kelly Davis, Dr. Fatu Forna, Mary Emily O’Hara and Jennifer Weiss-Wolf)

With Guests:

  • Kelly Davis, a maternal health policy expert and vice president for global birth equity and innovation at the National Birth Equity Collaborative, an organization devoted to Black maternal and infant health. She is a public health professional and has worked in the past with the New York City Department of Health and Mental Hygiene to launch programs for maternal health, HIV prevention, food access and more.
  • Dr. Fatu Forna, a maternal health consultant, obstetrician-gynecologist and epidemiologist. She has worked with the World Health Organization as their lead for reproductive and maternal health in Sierra Leone, and with the CDC as a medical epidemiologist. She is also the founder of the Mama-Pikin Foundation, which works to fight Sierra Leone’s high maternal mortality rates.
  • Mary Emily O’Hara, an LGBTQ media and policy expert and rapid response manager at GLAAD. They are also an award-winning journalist specializing in LGBTQ+ issues, and have written for Teen Vogue, Vice, Rolling Stone, The Advocate, Al Jazeera and more.
  • Jennifer Weiss-Wolf, an advocate for menstrual equity and the founder of Period Equity, a legal organization devoted to achieving menstrual equity through advocacy and policy change. She is also a lawyer with expertise in nonprofit leadership and development, and is currently a fellow at the Brennan Center for Justice at NYU Law. In addition to being a regular contributor to Ms., her writing has been published in the New York Times, the Los Angeles Times, Time magazine, Harper’s Bazaar and more. She is also the author of the book Periods Gone Public: Taking a Stand for Menstrual Equity.

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In this Episode:

In this exciting episode, we’re having the sex talk you wish you got from your parents.
Do you remember Judy Blume’s Are You There God? It’s Me, Margaret? Well, today it’s me, host Michele Goodwin, asking the questions and inviting you to join us as we talk about sex, periods, non-binary health care, maternal health—and what don’t we know or ignore about our own bodies.
Today we ask: What do you wish you learned from your parents, in school, or even now?  And when it comes to reproductive and sexual health as policy issues, what’s on the docket and on the ballot in 2021? Whose rights are at stake?

Have a guest suggestion, topic suggestion or just want to say hi? Email us at ontheissues@msmagazine.com!

Background Reading:

Transcript:

00:00:04 Michele Goodwin: 

Welcome to “On the Issues with Michele Goodwin” at Ms. magazine, a show where we report, rebel and tell it like it is. On this show, we center your concerns about rebuilding our nation and advancing the promise of equality. Join me as we tackle the most compelling issues of our times. On our show, history matters. We examine the past as we think about the future. 

On today’s show, it’s pretty exciting, we are having the sex talk you wish you’d got from your parents: Sex Ed 101, birth control, periods and more. Do you remember Judy Blume’s Are You There, God? It’s Me, Margaret? Well, today, I’m asking the questions and inviting you to join us as we talk about sex, periods, nonbinary healthcare, maternal health, what we don’t know even about our own bodies. 

So, today we’re asking what do you wish that you learned from your parents, in school, or even now? And when it comes to reproductive and sexual health as policy issues, what’s on the docket and on the ballot in 2021? Whose rights are at stake? 

Now, helping us to sort out these questions and to set the record straight are very important and special guests. Joining me in this episode is Kelly Davis, a maternal health policy expert and Vice President for Global Birth Equity and Innovation at the National Birth Equity Collaborative, an organization devoted to Black maternal and infant health. 

In this episode, you’ll also be hearing from Dr. Fatu Forna. Dr. Forna is a maternal health consultant, obstetrician-gynecologist, and epidemiologist. Dr. Forna has worked with the World Health Organization as their lead for reproductive and maternal health in Sierra Leone, and in the US with the CDC as a medical epidemiologist. 

Joining me also today is Mary Emily O’Hara. Mary is an LGBTQ media and policy expert, and rapid response manager at GLAAD. They are also an award-winning journalist specializing in LGBTQ+ issues, and have written for Teen Vogue, Vice, Rolling Stone, The Advocate, Al Jazeera, and at other outlets. 

Finally, you’ll also be hearing in this episode from Jennifer Weiss-Wolf. Jennifer is an advocate for menstrual equity and the founder of Period Equity, a legal organization devoted to achieving menstrual equity through advocacy and policy change. And so we’re going to get right to it and break down the taboos, and so I want to start first with Dr. Fatu Forna. Setting the stage for us, why are people so creeped out by periods and the taboos of talking about these issues? What do we need to do better?

00:02:49 Fatu Forna:

I’m not sure how it evolved to where, you know, as a society we have such a difficult time talking about periods to our children, and as we grow up to become adults, talking about it freely. For me, I got involved…you know, I grew up in Sierra Leone in West Africa, but it’s a similar story in many countries around the world where my parents actually never said anything to me about my body, the changes I would go through, about my periods, about sex, none of that stuff. So, as you can imagine, as a child it’s very traumatic, you know, to go through those changes and not understand what’s going on, you know, and I kind of figured things out, I had my older sisters and friends guiding me. 

But when I grew up, I wanted to be an obstetrician-gynecologist from a very young age, and when I became that doctor, you know, I decided that I was going to do my best to educate my patients, but also break that cycle for myself, for my children, and work to try to break that cycle for others so that, you know, we are more comfortable kind of guiding our children, societies, you know, to enter, to celebrate womanhood, and that’s where puberty parties came along that I put together.

00:04:31 Michele Goodwin:

You know, people also feel shame and embarrassment associated with their periods, too, and this is little girls, kids who are nonbinary, trans boys who come onto periods and can feel shame and embarrassment. How many of you remember wearing white and then there it is, this kind of red spot? 

And so, I also then wanted to know from Dr. Fatu Forna, why this period party, and what she’s learned from or gained from as a doctor, and also as a mother, by turning to celebrating menstruation and periods? And believe me, there are people who still don’t want to celebrate their periods, but let’s listen to what she has to say.

00:05:21 Fatu Forna:

Absolutely. I think, you know, having a period is a natural thing. You know, every…human beings, we go through this. Other animals go through this. So, it is a natural rite of passage. It shows growth. It shows maturity. It shows that you’re growing from a girl to becoming a woman, and those are things that are happening. You need to be aware of them and be prepared for them. 

And for me, that’s how I started puberty parties. If you look around in different cultures around the world, most people have some kind of celebration, whether it’s when girls become women, or boys become men, or just when people grow from when you were children to growing into the teenage years, there is some kind of celebration, and I think it’s because there is a need for us as humans to not only teach our children, you know, in a, you know, in a kind of standardized way, but to have a community support us. So, for me, puberty party was having that community come together, you know? 

As a doctor who, you know, I do this very well for my patients, but I have three daughters and a son, I actually found it a little difficult talking to my own kids. I think it’s something different about, you know, having intimate conversations about seeing your children as sexual beings or growing into becoming sexual beings, you have to make that mindset change to have it easy. So, I think that’s why those kind of celebrations, you know, developed, and when my daughters were going through puberty, I had written books about puberty and about teaching others, but I, and my daughters had read this because, you know, being a daughter of an OBGYN, you’re kind of forced to read all these books. However, I felt…

00:07:29 Michele Goodwin:

They can’t escape it.

00:07:31 Fatu Forna:

They can’t escape it, but I felt that children accept things and they understand things a little easier when they’re in a group, when it’s a lot of fun, when their friends are around. So, I reached out to a few mothers in my daughter’s class. She was around 12 at that point, and they were all so excited. They said oh, my gosh. I know I have to have this conversation. I haven’t done it. It’s difficult. This puberty party thing sounds amazing, and all we did was get together in a group. I put together the talks, the slides, the videos, had food and cake and music, and we all got together, 10 girls and their moms in a circle, and talked through a lot of these things, and you know, found that community and went through that process together.

00:08:27 Michele Goodwin:

Okay. It’s time to turn to Jennifer Weiss-Wolf because I’m interested in what’s led her to become an advocate for menstrual equity and the founder of Period Equity, a legal organization devoted to achieving menstrual equity through advocacy and policy change. 

So, we’ve heard from Dr. Fatu Forna about how to celebrate having a period, but the reality is that it can be hard to celebrate having a period when there’s period punishment, and what I’m talking about here are economic penalties, right? This sort of luxury tax that, yes, is put on tampons, where they can be out of reach for people who experience menstruation, including people who are incarcerated

What’s the equipment one needs when you’re menstruating, right? You know, there’s the tampon, and to be honest with you, not everybody knows how to use a tampon. There are stories of people inserting tampons with plastic wrapped around it inside their bodies, or remember the old days with the cardboard applicator? I remember in high school sometimes folks putting the whole tampon and the cardboard applicator in the vagina, up the uterus, and that’s just because no one’s told them any different. Their parents never explained to them, how do you use a tampon? 

And so, now we turn to Jennifer Weiss-Wolf. So, Jennifer’s going to tell us why she decided to become an advocate for menstrual equity and break down some of these issues.

Rep. Grace Meng (center) and Jennifer Weiss-Wolf—both at podium—with advocates of the Menstrual Equity for All Act during its initial introduction in Mar 26, 2019. (Twitter)

00:10:03 Jennifer Weiss-Wolf:

What a great question, what a great discussion this is. I’m so happy to be here with you all. Yeah. I think that most people don’t grow up saying I want to be a lawyer who focuses on menstruation, and I didn’t either, to be honest, and for me, it was about six years ago that I just sort of accidentally discovered this notion that in my own community here in New York that for folks for whom they lack the finances or the agency to really be able to manage their menstruation, the equipment so to speak, as you say, to be able to afford things like menstrual products or to be able to handle their menstruation with just like the dignity of a clean bathroom, with running water, with the products that they needed readily accessible and available, discovering that that was actually happening in my own community. 

And I discovered it because a pair of siblings were collecting tampons and pads for a local food pantry, and I received an invitation to provide a donation to their project. I’m a lawyer by day. I’m a policy advocate by day, and the first, well, the first thing I did was sign up to donate because I was just so shocked and saddened and horrified to imagine this happening to anyone I knew, and to know that it was happening in my own backyard, and that there were folks who were clients and participants in this food pantry who had this need that wasn’t being met, but the second thing that really I stopped to think about was well, why? 

Why would this be something that was known to two kids who volunteered at the food pantry, and the food pantry didn’t have any recourses or a systematic way to address something it knew to be a need? 

So, from that moment on, I sort of started unpacking where menstruation fit into the laws and regulations and budgets and rules by which we live, and I was pretty, well, I guess I’d say I was stunned, although, you know, in retrospect, none of this is stunning. We’ve all grown up with the stigma and taboo and shame that surrounds menstruation, and we also have grown up I would say here in the United States in a fully unrepresentative democracy, as much as we like to tell ourselves otherwise sometimes. 

And when I had this recognition that menstruation really was not addressed in any productive way in our laws, either not at all, or in ways that are inconsistent with one another, without getting too wonky, from the Food and Drug Administration, to labor law, to benefits, none of it made sense. None of it added up.

00:12:56 Michele Goodwin:

And it’s kind of like a punishment, isn’t it? I mean, really, when you think about it, the legislator from Colorado, Leslie Herod, has just been so incredibly fabulous in terms of introducing legislation in Colorado to provide equity for period products in jails there because it’s a thing that folks don’t think about. Like, the United States incarcerates more women than any other country in the world, and with that we have folks who menstruate who are in prison who have had to engage in sexual favors with guards in order to get access to tampons, or have to show the guards, you know, why it is that they need a tampon, which is so incredibly invasive. 

Rep. Leslie Herod speaks about the need for free period products in Colorado jails. (Herod is a former “On the Issues” guest — listen here!) (Screenshot)

And then the products themselves are exorbitant. They cost exorbitantly in the prison commissaries, and so when you’re talking about equity issues, these are issues that range from the, you know, what’s called the period tax, the added luxury tax on tampons, to what happens to incarcerated populations.

00:14:06 Jennifer Weiss-Wolf:

Yeah. So, that was it. So, all of these ideas were swirling in my head, and I started researching and coming up with and discovering all the ways that menstruation had been utterly excluded or not acknowledged, you know, or worse, as you describe, that people are really forced to live and exist in circumstances that were utterly unsafe, unhealthy, and undignified, and so I started just trying to imagine what our laws would look like if they did the opposite of that, and if they acknowledged menstruation and considered it as a way to create equity or ensure equity for all. 

And so that’s what that’s come to look it. It’s been this whole agenda that’s included everything from considering menstruation for those who are detained or incarcerated or otherwise lack agency, to considering menstruation in schools and how schools address it, to considering taxation, to considering federal benefits, you name it.

00:15:18 Michele Goodwin:

Okay. So, now we really need to get into the thick of what exactly is Sex Ed 101, and especially at a time in which state legislatures have politicized the body, have politicized sex education. In parts of the world, if you’re 5 or 6 years old, you’re beginning to learn about your body in school, and yet in the United States, it’s become so politicized that there are states that banned sex ed or if they allow for sex ed, then it’s only abstinence-only teaching. And it’s in those very states where there are the highest rates of teen transmitted, sexually transmitted diseases or teen pregnancies, and so much more. 

So, Kelly Davis is a maternal health policy expert and Vice President for Global Birth Equity and Innovation at the National Birth Equity Collaborative, an organization that’s devoted to Black maternal and infant health. She is a badass, and so, Kelly Davis, she’s got to tell us, and she does, about what sex ed is and why it’s so important.

00:16:22 Kelly Davis:

So, comprehensive sexual education should actually be over the life course, right? So, there are ways to talk to children about their body parts. There are ways to talk about gender, sexual orientation, menstruation, attraction, all the things that come along with kind of sexual and reproductive fulfillment that in our society here in America, we start to think about in high school, often after the time that adolescents have begun their sexual journeys, right, and a lot of the stigma, the myths that Dr. Fatu Forna was talking about, have already kind of taken hold while folks are getting kind of, you know, Sex Ed 101. 

Also, across our states in the United States, and actually across the globe, what constitutes Sex Ed 101 is vastly different, right? So, I come from the Deep South, even though I live in the largest city in the nation, New York City, but where I’m from in Mississippi, you know, abstinence-only education, you’re not allowed to talk about or even utter the word abortion. They teach sexual education kind of as a binary where you can only be a male or a female, which we also know is not true. There are unlimited amount of genders and sexual orientations, and so really our nation does a grave disservice to sexual and reproductive health, and we see that. 

We see that when it comes to the really ballooning, the epidemic of sexual transmitted infections. We see that when we come to the Black maternal mortality and morbidity crisis, a main signal of which is fibroids, which are clearly related to periods, right, which we don’t really talk about, and so all these things build upon each other, and so when we’re talking about menstruation, really, we have to like take the gender kind of away from it because there are people across gender spectrums that menstruate. 

We talk about the products, you know, pads or tampons or other things that folks use in order to take care of themselves during menstruation, and then we really have to focus on eradicating the stigma which has come up, which is clear. The stigma exists for everyone who has a period, but if you have other marginalizations, it’s even more stigmatized, right? So, if you’re dealing with poverty, if you are a queer person, it’s stigmatized. If you’re a woman of color, right, it’s all these things, all these marginalizations kind of stack up on each other to make this very natural human function really taboo. And then in the secrets and the shame, that’s when we have, you know, unhealthy behaviors, which have been structurally created by the stigma and the marginalizations of our society.

00:19:14 Michele Goodwin:

Kelly Davis opened an important door in our conversation, and I was so grateful to have Mary Emily O’Hara on the show with us. They are an award-winning journalist specializing in LGBTQ+ issues and have written for Teen Vogue, Vice, Rolling Stone, The Advocate, Al Jazeera, and more, and you may know Mary Emily O’Hara from work at GLAAD, and the reality is that these are issues that are tough enough go through, having a period, not being able to afford the menstrual products, but there are added layers. 

There are added layers in terms of the attacks on LGBTQ kids that we’re seeing now in schools where they’re not even able in some school districts to use the bathrooms that are most appropriate for them and what they want, deny the opportunity to play on sports teams. There’s a lot of stigmatization and a lot of shaming that’s taking place, and that’s not being talked about enough. And children are enduring this, suffering through it, and so are their families that are seeking to be advocates for their kids, the moms and the dads, and we’ve seen some of these stories with children bravely testifying before state legislatures, saying let me be me. 

So, how do we think about these issues involving Sex Ed 101, menstruation, and other bodily functions as we’re thinking about LGBTQ youth, about trans youth? And so, Mary Emily O’Hara helped us to level set.

00:20:56 Mary Emily O’Hara:

Yeah. Thank you for raising such great points about that, Kelly, and for opening up that part of the discussion, Michele. I think there is a lot of considerations for LGBTQ people when it comes to sexual and reproductive health in general, and the main one really is a lack of education, a lack of appropriate care, a lack of understanding, and that does start with sex ed, which is the subject of today’s conversation. There’s only six states in US and DC that require sex ed in schools to even be LGBTQ inclusive. So, right away, kids growing up in school, not only are they not getting information about same sex relationships, about gender identity, about all these basic things, but they’re not getting into the nuance and the details here. 

So, for example, we know that many trans men and nonbinary people still have periods regardless…you know, people use varying levels of hormone treatments. So, some trans men starting testosterone might still get their periods for longer than others. For example, some trans men and nonbinary people might be on smaller doses of hormone replacement therapy and never stop getting periods, and trans women who are on estrogen and hormone replacement therapy often experience cycles and basically every other part of the period besides the bleeding. So, of course, trans women do not have uteruses and ovaries, but the hormones can still cause cramping, bloating, nausea, breast soreness, all of these other issues related to periods, and a lot of people don’t even have this basic information when they go into gender transition. 

They don’t necessarily know how it’s going to impact them in the sense when it comes to menstruation and periods and sort of period-like symptoms, and then of course lesbian and bisexual women have all of the same issues that all other women have when it comes to reproductive health. So, as Kelly raised, fibroids are an increasing problem, just hormones, period problems, increasing heavy bleeding, stuff like that. As you get older, perimenopause, menopause, access to products and care. So, yeah, it’s really just, it’s kind of a compounded problem, I think, when you get into LGBTQ people and their sexual and reproductive health.

00:23:36 Michele Goodwin:

This conversation was beginning to real the dangers of politicizing the body, politicizing sexuality, and so I wanted to turn back to Dr. Fatu Forna about the ways, the problems in which politicizing the body ends up hurting people.

00:23:57 Fatu Forna:

Yeah. I think as a basic human right, we have to understand that every human being deserves to have a healthy sexual and reproductive life. That is just a basic standard, and with that in mind, I think as a society we have to realize that when we’re bringing up children, we teach them how to cross a busy street. Now, that’s something that could be life threatening to them. We teach them to do all of these important things, but we neglect to teach them about their sexual and reproductive health, which is something that will impact you for the rest of your life, whether or not you choose to have children, your sexual pleasure, which is important for every human being, what diseases you could or could not be exposed to. 

So, it is really an important right and something that we need to provide, and when we politicize it, we take away from the ability of people to understand their bodies and to reach their optimal health status. So, one of the…and because of this, because of this framework, it’s not just something that’s in the US. It’s around the world that it’s politicized. Young people have difficulty getting the information they need to reach their full potential. So, as parents, as a society, we have to step up and fill that void, you know, and not just, for example, leave it up to schools. We’ve heard Kelly talk about, you know, Mississippi where, and there are many states like that in the US and countries like that where you can’t mention condoms. You can’t mention things to protect the health of people. 

So, I developed a framework for parents to help them talk to their kids about their sexual and reproductive health because this is something that you have to start with your children when they are babies, when they first start talking and learning the words, and you build up to it, but as parents, we have to keep this framework in mind, or as a community. 

Number one, you know, it’s called the three E’s framework: endorsement, education, and empowerment. Endorsement is important because we have to endorse, we have to promote a positive approach to sexuality, understand that human beings are sexual beings. It is normal for us to grow and develop and to have sexual feelings and to want to have a healthy sexual life. So, parents, communities, we have to endorse and promote that we are sexual beings and promote that positive approach. 

Education is what we’ve been talking about. We do have to educate our young, our children, our teens, our young adults, you know, and give them the information they need to be able to have a healthy sexual and reproductive health, and most importantly, empowerment. We not only have to endorse and give them the education, we have to empower people to take charge and to protect their own sexual and reproductive lives because, you know, only you can do it for yourself. So, politicizing it I think takes away from all of those things, and we end up having children, young adults, and adults who don’t have what they need to have healthy sexual and reproductive lives.

00:27:57 Michele Goodwin:

Okay. So, we promised to get down to basics. So, here are some basics. I wanted to know about, what’s a condom? What’s a vagina? What’s a penis? And so, let’s take a listen to one of my show’s producers, Oliver Haug, telling us about what’s a vagina? What’s a penis? And then we’re going to hear from Dr. Fatu Forna about condoms.

00:28:21 Oliver Haug:

The penis is a reproductive and sex organ that’s made up of spongy tissue. The spongy tissue fills with blood during sexual excitement, a process known as an erection, or getting hard. Urine and semen pass through the penis. 

The vagina is a stretchy passage that connects the vulva with the cervix and the uterus. It’s where menstruation comes out of the body, a baby comes out of the body through childbirth, and/or one place sexual penetration via penis, finger, sex toy, et cetera, can happen. During menstruation, it’s where tampons or menstrual cups are placed.

[Editor’s note: These definitions were borrowed from Planned Parenthood’s online glossary, where you can find more helpful sex ed definitions.]

00:28:58 Fatu Forna:

So, a condom is a sheath. Sometimes it’s latex, sometimes it’s made up of different substances. It’s kind of like a protective barrier that you can put over a penis if you are having male to female intercourse to protect…it’s really to keep the skin from touching each other so that secretions don’t touch, and it has two, you know, main things. One is it protects you from sexually transmitted infections. So, it keeps the skin from touching, and some infections you can get just by, you know, the skin of the penis touching the skin of the vulva area or touching on the inside of the vagina. 

Condoms can be used to prevent pregnancy, as well as to prevent the transmission of sexually transmitted infections or diseases such as HIV. (Courtesy of Pleasurebetter via Flickr)

So, protects you from sexually transmitted infections, but it also keeps sperm from getting in contact in the vagina and going into the uterus and meeting the egg and forming a baby. So, it helps to protect from pregnancy. We also have condoms not just that go on top of the penis, but that go inside of the vagina to protect, you know, so the woman can put in a condom themselves. So, really a condom is an example of something that you can use to keep yourself from getting pregnant when you’re not ready to, and also to protect yourself from sexually transmitted infections.

00:30:25 Michele Goodwin:

But wait, wait, wait. There’s even more to think about in terms of how one uses a condom, and it’s possible that people who are heterosexual, people who are gay, people who are nonbinary may be thinking about using condoms in different kinds of ways, and so this is when Mary Emily O’Hara then interrupts. 

Now, Mary Emily O’Hara, as you know, is an LGBTQ media and policy expert, and they are also a rapid response manager at GLAAD. I’ve told you that before, but what you also need to know is that they’ve written for Teen Vogue, Vice, Rolling Stone, The Advocate, Al Jazeera, and more, helping to level set just thinking about how we should be thinking about Sex 101, how we should be thinking about inclusive language and inclusive thinking with regard to sex and sexuality.

00:31:19 Mary Emily O’Hara:

Sorry. Could I interrupt just really quickly? I hate to be the person that just butts in and interrupts, but I just want to state again, see, this is the kind of thing that we do encounter when it comes to LGBTQ inclusion in sex education is things like the idea that a condom is just for penis to vagina sex, for example. Condoms are used by gay and bisexual men for anal sex as well, and also for anal sex by heterosexual couples, and also for use on toys with women who sleep with women, and trans people. 

There are so many different uses for condoms, but when we talk about these things, part of sort of sexual and reproductive health equity is making sure that we recognize, for example, that all different kinds of people have periods. So, we don’t use terms like girls bleeding, girls, you know, having their first period because we need to recognize also that trans men and nonbinary people also have periods. When we talk about condoms, we need to make sure that we talk about everyone who is using them and why, and why it’s so important to talk about that inclusion, that gay and bisexual men face incredibly high rates of HIV risk, and so condoms are very important and it’s very important that we talk about the kind of sex that they’re having when we do talk about condoms. 

I just wanted to throw that in there to make sure we are keeping in mind the sort of LGBTQ inclusive, the different genders, different body parts, and the different anatomies that people do have, and the different ways that they have sex and use these products.

00:32:58 Michele Goodwin:

Mary’s right. These times demand greater inclusivity, more nuanced thought, a broader and expansive view about how we understand, how we define these very things, and so back to definitions. Let’s talk about a tampon. What’s a tampon?

A tampon and applicator, separated. Tampons can be used to soak up vaginal bleeding during menstruation. (Wikimedia / Creative Commons 3.0)

00:33:14 Fatu Forna:

So, a tampon is, can be made from different substances. You know, it could be, you know, cotton based, cloth based. It’s a, you know, it looks like the shape of a finger, and it is a substance that you insert, can be inserted in a vagina when, to kind of soak up the menstrual blood, so that the menstrual blood does not come out, and for example, soil your clothes or soil your underwear. So, it’s something that people use during a period to help soak up menstrual blood, and you know, just help to manage menstruation.

00:33:59 Michele Goodwin:

Okay. Okay. I know a lot of you know what a tampon is, and a lot of you know what a sanitary pad is, but come on, why is it that it’s called a sanitary napkin? What’s napkin-ish about it? Maybe there’s some logic to this, and is there a difference between a sanitary pad and sanitary napkins? All right. So, we’re learning again from Dr. Forna.

00:34:18 Fatu Forna:

Yeah. People can use the term interchangeably. Again, a sanitary pad or napkin, also usually made of cotton or cloth, and it is something that people put on their underwear during a period. Same concept as a tampon, but it’s on the outside and it soaks up that menstrual blood, so it doesn’t seep through underwear and clothes. It is something, you know, that people can use so that you can go around your regular activities during a period, and it’s something it’s important to talk about because, you know, not just in industrialized countries, there are countries around the world where people use other things, not just the sanitary napkins or cloth. 

You know, women use grass. Women use other substances because they might not have, you know, access to these products, and in some places when you don’t have access to sanitary napkins or pads, people who have periods are severely impacted. They might not be able to work. They don’t go to school. They stay home the whole week and don’t leave their house because they don’t have something to protect them from soiling their clothes and managing what is going on.

00:35:44 Michele Goodwin:

So, listening to a conversation like this with Dr. Forna, with Kelly, with Jennifer, with Mary, and I couldn’t help but think that these aren’t the conversations that are taking place every day and they should be. 

And so in thinking about this with Kelly, I wanted to know, given her experience working in public health in New York City and so much more, how can we get beyond the stigmatization and the shame? How might Kelly see the effects of this social and political discrimination that’s impacting real people in their real lives, and how can we fight something as intangible as shame when it has such real-world impacts?

00:36:31 Kelly Davis:

Well, thanks for that question. I feel very strongly that it is our government’s and NGO’s and also individually our leadership’s responsibility to really dismantle racism, gender oppression, and homophobia, right? We can give out free tampons, which is absolutely necessary, especially for those folks that are living in the criminal and justice system, who are in foster care, who are dealing with poverty, or other forms of discrimination, but really the root is identifying why folks that are capable of pregnancy, why women of color, why people outside of the gender binary or people that are gender expansive continue to move through life without having the medical service or the human rights that everyone’s talking about, having menstrual products because it’s a function, a body function, it’s a part of a human right. 

And so really getting to the root and dismantling those things is really the only way that we’re going to move forward with totally eradicating all of the disparities that we see related to menstruation, related to sexual and reproductive health, including but not limited to maternal mortality, HIV, other STIs, infant mortality. All of these things have a common root that I know that the folks here on today’s podcast are really devoted to dismantling. 

So, when it comes to sexual education, we’ve talked about this earlier, creating national systems that say starting in elementary school that appropriate sexual education should be a part of folks’ everyday lives inside of our public school systems, which we know is more than likely to be experienced by people who are low income or people of color who utilize our public school systems. Certainly, in the city that I reside, New York City, that’s the bulk of the students inside of the system, right. 

But who has access to comprehensive sexual ed, sexual health? And in New York City we’re very blessed to have like school-based health services, right? So, I can get Plan B if I’ve had unprotected sex and I do not wish to be pregnant. Inside of the school system, I can get gender affirming care, but even that’s not universal, and New York City, and you know, other states that have I would say more Democratic leaning legislatures or folks that have a better public health infrastructure have those, when we know across the nation, and then also across the world, that that is not available, but let’s be clear. There’s a reason. 

There’s a reason that all of this is politicized. The idea is that if we keep the power, if you are a person who menstruates, if you are a woman, if you are a person of color, if I can keep you from reaching your full potential as far as wealth, as far as schooling, as far as community involvement, right, what does society earn? What does capitalism earn? What does structural racism earn by not having folks be able to fully participate in society, right? That means that power can remain concentrated in the hands of wealthy white cisgender men, and we see that in every aspect of society and every aspect of healthcare, right? 

We’ve heard a lot about racism in healthcare, particularly during the COVID-19 pandemic, not just here but across the world. If you’re looking at who’s dying in Brazil, if you look what’s happening in South Asia, if you look at who’s died here in the United States, and it applies the same ways that racism, sexism, gender oppression, homophobia show up in COVID is how they show up in sexual and reproductive health, right? It’s why certain states, states that have majority indigenous Native American and Black people, like the South, like the Southwest, continue…

00:40:37 Michele Goodwin:

Former Confederate states.

00:40:39 Kelly Davis:

Yes.

00:40:39 Michele Goodwin:

Yeah.

00:40:39 Kelly Davis:

Continue not to invest in sexual education for children, adolescents, and young adults.

00:40:46 Michele Goodwin:

Okay. It’s getting hot in here, and rightfully so because Kelly is telling it like it is. She is reporting, rebelling and telling it like it is because she’s exposing the kinds of questions that so many in our audience want to know. For example, why is it that the United States is the deadliest place in the developed world for a person to be pregnant? Why is it that it’s safer in Saudi Arabia or in Bosnia to carry a pregnancy to term than it is in the United States? The very places that she’s talking about are places where the death rates associated with carrying a pregnancy to term are just simply alarming. 

I mean, nationally, Black women are three and a half times more likely to die during childbirth and delivery than are white women, and it only is more dramatic, and those figures are exacerbated if we’re looking at places that have made it very difficult to get access to sex education, reproductive health, or to be able to get an abortion, you know? Just a quick news sweep and you’ll find that there are articles that say that Texas is the deadliest place in the developed world for a person to be pregnant. We have to explore why that is, and we know education makes a huge difference. All right. So, and back to education, Kelly mentioned Plan B. So, we need to figure out what that is.

00:42:12 Kelly Davis:

Well, thanks for asking that question. Plan B is a pill or a series of pills that you can take after having unprotected sexual intercourse if you are wanting to prevent an unplanned or unwanted pregnancy. It used to be very marginalized, have marginalized availability. Back when I needed to use it 10 years ago, you had to ask a pharmacist and show your ID. 

The over-the-counter emergency contraceptive “Plan B” pill can cost up to $50-60 — a cost that is much too high for many. (Wikimedia commons)

Now, I went to Target yesterday and it’s in the aisle with the condoms, with the tampons, which is a result of a lot of advocacy. It’s now often freely available inside of school-based health centers, particularly in places where sexual education is more liberal and you’re allowed to mention unprotected sex or abortion. Oftentimes, you can find Plan B, but still, it’s expensive, right? Yesterday in Target, I saw that it was 40 American dollars, and we know that folks, for some that that is cost prohibitive. 

However, it is also covered by Medicaid in certain states, particularly states that have Medicaid expansion through the Affordable Care Act, and so if you find yourself in need of Plan B or you had a night on the town or early morning and you’re thinking that you might be at risk, it’s something that you can take. But one thing to clearly state is that there are different types of pills, and if you are overweight, particularly over 180 pounds, some of the pills are less efficacious than other pills. So, you might want to talk to your healthcare provider if you have questions, even though it is currently available over the counter.

00:44:15 Michele Goodwin:

Okay. I hope that you’ve been taking notes because there’s been a lot that we’ve covered in this episode, and there’s even more work to do, but we’re not finished yet, and it’s really important for me to turn back to Mary and Mary’s work at GLAAD, and Mary’s work as a journalist because they have consistently worked to set the record straight. And there are real questions that continue to exist even beyond this program about the ways in which we teach sex ed, and what’s missing in terms of teaching it in a holistic, inclusive, and belonging way for LGBTQ youth, and quite honestly, how we relate to young adults and adults, too, in thinking about health and the body, the language we should use, the inclusiveness that we should invite. So, here’s what Mary had to say about that.

00:45:18 Mary Emily O’Hara:

Yeah. Absolutely, and first, I just wanted to mention that I do identify as nonbinary, and my pronouns are they/them. So, as a member of the community myself, I think that I have a sort of dualistic perception here in that I have access to some of the data, of course, around trans and LGBTQ health and what’s missing, but also an anecdotal experience through the community, through friends, partners, loved ones, to know what people experience on a daily basis when they seek and receive healthcare. 

And I think as I mentioned before, one of the main issues that we’re dealing with is a lack of education across the board, the fact that there’s only six US states that mandate that sex ed be LGBTQ inclusive is a huge problem because from the very beginning what’s happening is LGBTQ youth are not seeing their issues reflected back at them, and they’re not getting the most basic education in terms of what happens to your body, what you might need during sex, how sex can be defined as different things for different people depending on their attraction and who they have sex with, but also depending on their anatomy and how their anatomy might be different from other people. 

So, that’s one major issue that we’re always fighting. And then this year, of course, in terms of state legislation, there were so many anti-LGBTQ state bills introduced around the country, and while many of those focused on restrictions against trans people, especially trans youth, which we’ve seen, I feel like most people at this point are familiar with all of the state bills that are attacking trans youth’s access to sports and healthcare. 

A ‘Protect Trans Kids’ demonstration in front of the White House in February 2017 to protest the non-science based policy of segregating LGBTQ children in public schools based on the schools’ determination of their gender identity. (Ted Eytan / Flickr)

But then there’s also bills that are trying to ban LGBTQ inclusion in sex ed very specifically, and then there’s other bills that are what we call Don’t Say Gay laws, which mandate that teachers and educators in schools not be allowed to refer in any way to LGBTQ people. So, these kinds of laws are already in place in many states across the country, and what happens there is that it’s actually illegal for teachers and educators to mention anything about being LGBTQ in schools. 

So, your history teacher, for example, might not be able to inform students about the Supreme Court ruling that legalized same sex marriage around the country, or they might be able to teach about someone like Harvey Milk, but never mention that he’s gay, and when you have things like that happening in schools, you’re getting this double whammy of not being taught that queer and trans people even exist, but then also if you are an LGBTQ youth yourself, you’re really in the dark, especially if your family of origin or your caretakers at home are not affirming and you can’t safely be out or have anyone to talk to about these issues at home, and then you go to school and you’re not learning anything there either. And I think that that’s definitely something that leads to problems for people as youth and also later in life. 

And then when it comes to the healthcare system itself, obviously we’re battling an enormous slate of state laws that are attacking youth access to affirming and appropriate gender transition care, which is one issue, but then we have an ongoing issue where queer and trans people encounter a medical system and medical providers who are often not informed about the most basic levels of our care, and that’s not just for trans people. 

I think it’s more egregious for trans and nonbinary people, but it can also be true for lesbian and bisexual women, gay and bisexual men and boys, you know, really anyone going to the doctor who might not fit the typical cisgender heterosexual model of living and existing. We often find that doctors don’t know our issues, don’t understand what to do with our bodies. A lot of trans people find that they have to educate their doctors about the most basic levels of their healthcare, or even that they’re turned away from care for things that are otherwise universal and innocuous just because they’re trans. Many trans people have had the experience of a doctor telling them I’m sorry, I don’t know how to treat you. I don’t specialize in this, when they’re going to the doctor for something as simple as a broken arm, or you know, cold symptoms or something like that. So, there’s…

00:50:06 Michele Goodwin:

It’s just plain old discrimination that’s packaged…it’s a proxy for discriminating.

00:50:12 Mary Emily O’Hara:

It is a proxy for discrimination, but it’s also, I mean, it’s a lack of education. I think that there’s doctors and medical providers that would like to feel that they’re informed to provide a trans person with basic care.

00:50:24 Michele Goodwin:

But somehow, they think that the broken arm, an arm isn’t an arm.

00:50:29 Mary Emily O’Hara:

Exactly. 

00:50:30 Michele Goodwin:

So, what else is going on there?

00:50:31 Mary Emily O’Hara:

You know, a few years ago there was an article going around that referred to it as “trans broken arm syndrome,” right, because it’s the idea that a trans person’s body is somehow so fundamentally alien or so fundamentally different, when in reality, you know, we’re all human. We all have a cardiovascular system.

00:51:02 Michele Goodwin:

Okay. At this point in the episode, you’d be forgiven for your mind being blown by these incredible guests, or your fingers being a little bit numb because they’ve been scribbling notes, or because you’re kind of ticked off. Ticked off because in 50 minutes we’ve been able to cover more than what young Americans get in 4 years of high school. And some of you may be feeling that it’s a crying shame, as they would say, as my grandmother would’ve said, the fact that there are kids that have no idea and are not learning about their bodies, and then you reconcile that against the fact that the United States leads all industrial nations in terms of teen sexually transmitted diseases, and we know if those are untreated they can be deadly later on in life. 

And we can look at the high rates of teen unintended pregnancies when compared to peer nations and see that the United States is way off the mark there, too, and so much of this comes down to education, which kids are being denied. But you also might be pissed off just by the fact that people who experience menstruation have to pay a penalty or a tax because that’s what their bodies do, by having to pay this luxury tax on tampons, and you might be ticked off that in jails and prisons across the country right now, there are people who have to do sex favors in order even to be able to get access to a tampon. 

These are realities in our country, and so I wanted to turn back before we end this show to Jennifer Weiss-Wolf, because she’s been working and writing and advocating in this area, and some might say what does law have to do with it? But as she’s going to tell us, it actually has everything to do with this topic area.

00:53:05 Jennifer Weiss-Wolf:

Well, in some ways, the law has everything to do with it, and it’s an opportunity to do so much in our society. It’s an opportunity to actually rethink the roles by which we live and reset the game. It’s an opportunity to think more broadly about representation and what it looks like and what it doesn’t look like, and it’s also an opportunity I think ultimately to change our values, to change the norm. 

By changing laws, you not only can sort of impact the broadest swath of people potentially, but you also can create a value system or a values language and say affirmatively what it is that you are for. In the case of menstruation, it’s actually been, it’s been kind of extraordinary to see how quickly and readily lawmakers have been willing to consider this, and you had mentioned Representative Herod from Colorado, and there are many, many, many in all 50 states, and even in Congress, who’ve been willing to take this on. 

Now, it’s still piecemeal and it’s still baby steps, because while you referenced before the circumstances, for example, of people who are incarcerated, which obviously the plight goes far beyond managing menstruation, but that is one of the indignities and one of the injustices. 13 states in the past couple of years have actually legislated something so basic as mandating menstrual products, and we could maybe say that that is an advance because that wasn’t the situation before, but on the flipside, that means that there are 37 states that still do not. And same is true of addressing all of these other sort of policy, you know, policy items that have made it onto the legislative floors, whether it’s examining the sales tax on menstrual products, whether it’s considering education and schooling and menstruation, whether it’s considering the safety of menstrual products. 

So, all of that is an opportunity to educate, to advocate, and to change hearts and minds while we change laws, and that’s just policy, and maybe for another day the conversation could be about the law because the law is a slightly different lever as we look to the courts, as we look to jurisprudence, as we look to the roots of what make these various regulations and policies doable and achievable and considerable in the first place. And there is kind of an entire trove of untapped law when it comes to looking at everything from the 14th Amendment, to Title X, to the various ways that we’ve considered ideas of gender and discrimination in the law and folding menstruation into that, and that’s something that I’ve started to do through my organization, Period Equity, as well, and that is a whole other conversation.

00:56:06 Michele Goodwin: 

All right. As we began wrapping up the show, I just couldn’t help but think that we needed to do it again. There’s more information for us to digest, more for us to learn, and there are going to be some questions that even experts may not know and may say yeah, we need to learn more about it, such as how do trans men experience menopause? How do we address in a healthy way the sexual activities of individuals who are living in nursing homes, who are seeing spikes in sexual transmitted infections at nursing homes that are providing care and housing for people who are in their 80s, and it turns out they’re getting sexually busy there, too? 

There’s much for us to learn about human sexuality and there’s much for us to stop feeling ashamed about and to be a little bit more liberated about in terms of our bodies in order to keep them healthy and safe, in order to be preventative, and here’s what Mary had to say about that.

00:57:10 Mary Emily O’Hara:

You know, again, this is where we encounter the need for more data and research, and also the frequency with which LGBTQ people have to inform their doctors because it’s…I know we’re talking about menopause right now, but there’s really so many different things that get missed in the community. All individuals with a uterus or a cervix or breasts or a prostate gland really need to be offered regular preventative and diagnostic screenings for those organs, and that so often gets missed with trans people and LGBTQ people in general. 

I mean, trans men can get ovarian cancer. Trans women can get breast cancer, and when it comes to menopause, we’re talking about different variations of it in the different communities, right? So, some trans men might choose to have a hysterectomy and essentially go through surgical menopause, which is what happens quite suddenly after a hysterectomy if the ovaries are removed, and that’s something that people really need to be prepared for and understand how that can impact their body, especially if they’re undergoing hormone replacement therapy. You know, people need to go into transition care understanding their own fertility, whether they want to have their eggs or sperm banked and harvested before they undergo transition related surgeries. 

So, there’s so many different factors to consider there, and I feel like the biggest issue really is that most doctors, and honestly, you know, most people in general, don’t even know some of the things that do happen to trans people’s bodies, like for example, we talked about trans women having period symptoms, everything but the bleeding, trans women getting breast cancer, needing to get breast exams as well as prostate exams, and when it comes to menopause, you know, when you have estrogen and progesterone, whether they occur naturally or whether those are hormones that you’re taking for replacement, you’re going to have a lot going there with all the different shifts, and you’re going to need a lot of education from your doctor to know how to manage those things.

00:59:39 Michele Goodwin:

After a long and nuanced conversation, it was time to wrap up with our silver linings, and I was so absolutely grateful to my guests. I started with Kelly.

00:59:52 Kelly Davis:
I mean, the silver lining is that we continue to innovate and hold each other inside of community, right? So, all of the things that we’ve talked about, whether they be in policy around sexual education in schools, whether they be around organizing to have affirming care inside of hospital systems and dignity as we walk through the world, I feel so encouraged. The silver lining has always been the organizing power of community, particularly for me and my work and all this work around sexual and reproductive health, let’s not forget that Black and indigenous Native American women and feminine folks, whatever you’re talking about, are most likely at risk because they’re dealing with multiple systems, and yet they continue to organize. 

We continue to have sex. We continue to express pleasure and joy through our sexual lives, through our emotional lives, and that, for me, is always the silver lining, that we continue to seek joy and organize even in the midst of some pretty, pretty restrictive and toxic systems.

01:01:01 Michele Goodwin:

Oh, Kelly, and do I not hear you. You make me think of my maternal grandmother, who was from Mississippi, like you’ve mentioned of yourself, and who would always talk about you don’t let anybody ever steal your joy. That’s like a Black woman’s mantra. All right. Mary, what’s the silver lining?

01:01:18 Mary Emily O’Hara:

Well, I think the silver lining in terms of LGBTQ healthcare is that it is becoming safer and more inclusive for LGBTQ people every day. We are seeing increases in education, increases in visibility, and just communities speaking out. LGBTQ youth today have the internet. They’re not completely in the dark. They have ways to find things out, even if they’re not getting that information at home or in school. 

And I think when it comes to trans, well, not just trans health, but LGBTQ health and sexual health in general, we’re seeing a lot of new tech and companies and inventive ways for people to sort of fill these gaps in people’s needs, whether it’s a company like Lorals that makes essentially dental dam wearable underwear, or whether it’s companies like Folx and Plume that supply trans healthcare digitally for people who can’t get access to hormone and affirming care where they live, but they can use these apps to get hormones delivered to their home or to get the letters that they need for a name change, things like that. 

So, we’re seeing the community really step up and step in, and I think, you know, just as people have said, that’s kind of a beautiful thing, and it’s how we see progress and advancement in general is the community stepping up, organizing, taking things into their own hands, and saying we need these changes. We’re going to do it ourselves if you don’t do it, and then sort of inspiring the market and the healthcare industry to catch up from there.

01:03:01 Michele Goodwin:

And Jennifer, silver lining?

01:03:04 Jennifer Weiss-Wolf:

It’s so hard to do anything but just build on those two answers. As somebody who’s maybe a little bit more remote in my own work, who considers things through sort of this strange compulsion to value the law, the idea of melding all of this, of melding community, of melding activism, of melding advocacy, of melding innovation with the power that the law has had in our society, for better and for worse, and to use that as a force of good, is…excuse me…is my own, it’s sort of like my only vision and my only hope, and every time I have one of these conversations, all I can think about is how much true extraordinary power exists when we are all together with these gifts. So, thank you to everybody on this discussion. It has been such a true privilege to listen to you all, and that is my silver lining today as well.

01:04:06 Michele Goodwin:

And Dr. Forna, I’m going to let you dance us out because I have taken such pleasure and joy from seeing the advocacy and the work that you’ve been doing and the lives that you’ve been touching. So, silver lining?

01:04:20 Fatu Forna:

Silver lining for me is information. We’re in the age of information. We have the internet, and that’s allowing marginalized people to figure out what’s going on and learn from it, even if they, if information is withheld from them. If we withheld information from kids in schools or their parents don’t talk to them, there is a way for them to find that information. 

You know, I’m talking to you from Sierra Leone where 80 to 90 percent of young girls are circumcised. They have their clitoris cut off. They are not able to achieve their full potentials when it comes to sexual and reproductive health. Well, there is a change. We now have a global community where people are learning about their bodies and learning about their function, and girls are standing up and saying oh, wait, we need to have this conversation. This is not something we need to do, and we’re seeing a change where those rates are decreasing with modernization and with information. 

So, for me, the silver lining is the world being able to connect and get information. It doesn’t matter where you are, if you have access to the internet, you have access to information, and whether you’re queer or whether you are a young girl living a village in Sierra Leone or a young Black woman in Atlanta, you have information to connect and improve your sexual and reproductive health. 

01:05:53 Michele Goodwin:

Guests and listeners, that’s it for today’s really exciting episode of “On the Issues with Michele Goodwin.” I want to thank my guests, Jennifer Weiss-Wolf, Mary Emily O’Hara, Kelly Davis, and Dr. Fatu Forna, for joining us and being a part of this critical and insightful conversation, and to our listeners, I thank you for tuning in for the full story. We hope that you join us again for our next episode where we will be reporting, rebelling, and telling it like it is with special guests tackling critically important issues. 

For more information on what we discussed today, head to MsMagazine.com. Now, if you believe, as we do, that women’s voices matter, that equality for all persons cannot be delayed, and that rebuilding America, being unbought and unbossed, and reclaiming our time are important, then be sure to rate, review, and subscribe to “On the Issues with Michele Goodwin” in Apple Podcasts, Spotify, iHeart Radio, Google Podcasts, or Stitcher, wherever you listen to your podcasts. We are ad-free and reader supported. Help us reach new listeners and bring that hard hitting content you’ve come to expect by rating, reviewing, and subscribing. Let us know what you think about our show, and please support independent feminist media while you do that. 

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This has been your host, Michele Goodwin, reporting, rebelling and telling it like it is. “On The Issues with Michele Goodwin” is a Ms. Magazine joint production. Kathy Spillar and Michele Goodwin are our executive producers. Our producers for this episode are Roxy Szal and Oliver Haug. The creative vision behind our work includes art and design by Brandi Phipps, editing by Will Alvarez and Marsh Allen, and music by Chris J. Lee. Stephanie Wilner provides wonderful executive assistance.