The Power of Diagnosis

Ruby Campbell on 15 June 2020

Would it be ethical to give a patient suspected of a peanut allergy a peanut to eat to prove this hypothesis correct? To a certain extent, this is how I was diagnosed with vaginismus.

In a previous article ‘Why I feared penetration aged fourteen: Vaginismus’ I explain why painful penetration has been normalised. Vaginismus is a painful condition whereby the vagina tightens up just as insertion is attempted, the individual has no control over this. Upon realising that I owed my body a better explanation then ‘this is normal’, I visited my student medical practice. After describing my symptoms, an internal vaginal examination was established as necessary to deal with the suspected diagnosis of vaginismus. This is despite NHS guidelines stating an internal examination is ‘unlikely’ to be beneficial due to the potential pain and upset it could cause. Physical abnormalities or other conditions such as infections can be ruled out by visual assessment, with doctors needing to ‘take a quick look’.

This was not my experience of diagnosis. I gave consent for the internal examination to take place. This decision was made because I thought an examination was mandatory in order to receive psychosexual therapy. I was given the choice of having a female doctor and a chaperone present. She attempted to insert the speculum whilst I was hysterically crying. Gentle pressure was repeatedly applied to my legs as I attempted to close them. When she was able to insert the speculum into my vagina to the smallest extent, she confirmed the muscle tension that she was expecting to detect. I then had to ask her to remove the speculum.

I am not a doctor and am writing this exclusively from a patient perspective. I am extremely grateful to live in a society where I can receive free public healthcare. Despite this, I find it hard to understand why a GP insisted on an internal examination when other psychosexual conditions, such as delayed ejaculation, are diagnosed by GPs listening to the symptoms described. Why did I have to experience insertion in front of a GP to prove it was painful? Why didn’t a trained doctor conclude that due to my obvious distress leading up to the internal examination, that an external examination would be better suited? Why not acknowledge that if indeed I did have vaginismus, that the internal examination could further reinforce my association of pain with penetration? At 19 years old I started worrying about future cervical smear tests. I would often become tearful when asked if I wanted to do a STI swab at the practice. My simple statement of ‘no thanks, I can’t use swabs’ was once replied with ‘oh it only goes in a little bit’.

It is impossible to approach this subject without acknowledging the current context of COVID-19 and the incredible work of NHS staff. I was given exceptional support once diagnosed and am very grateful for the therapy I received. However, this specific experience unearths a systemic issue surrounding how female pain and body autonomy is viewed and valued in modern society. These views have undoubtedly affected the prioritisation of services in the NHS, and the importance of holistic approaches to sensitive diagnoses should not be understated.

It is also incredibly important to acknowledge the privilege I have experienced as a white woman within the NHS. Stereotypes surrounding black female sexuality, of their representation as hypersexual and promiscuous (See Hart’s 2013 article), establishes a power imbalance for black female patients in healthcare systems. It is a common discourse that black women are more likely to have STDs; therefore their pain can often be dismissed. One need only emphasise the case of Loretta Ross- a black female reproductive rights activist who fell into a coma in the 1970s after being wrongly accused of having an STD for months. She was actually suffering from an unrelated infection (See Starkey and Seager’s 2017 article).

Relationships between GPs and patients intrinsically revolves around power. However profoundly wonderful and pioneering the NHS is, it has to be acknowledged that it was built within a society where power has historically stemmed from white men, especially in the context of medical diagnosis. It is this power to diagnose, and the notion that to comply with such a diagnosis means to offer up one’s physical body, that needs to continually be assessed and held to account. To what extent, and why, do certain people have to prove their pain is valid?

For more information on topics discussed in this article see the sources below:

NHS vaginismus guidelines: https://www.nhs.uk/conditions/vaginismus/

Hart, T. 2013. Constructing Syphilis and Black Motherhood: Maternal Health Care for Women of African Descent in New York’s Columbus Hill.

Starkey, M and Seager, J. 2017. Loretta Ross: Reproductive Justice Pioneer, Co-founder of Sistersong Women of Color Reproductive Justice Collective.

Why I Feared Penetration Aged Fourteen: Vaginismus

Ruby Campbell on 13 April 2020

At fourteen years old, I attempted to use a tampon for the first time. I thought that hysterically crying on the bathroom floor whilst I tried to insert it with the help of my mother was entirely normal. My response felt valid because I expected pain. Just as I expected pain when I attempted to have sex for the first-time years later. What I am learning to do now, at twenty years old, is to break this cycle of thinking.

It was after many attempts at having sex that my expectations of pain were matched. Initial attempts, whereby penetration was practically impossible, caused confusion, anxiety and a general queasiness. This feeling I can only describe as wanting to completely shut my legs and curl up into a ball. I remember setting myself goals of being able to use a tampon by age fifteen, then sixteen, which turned into seventeen and before I knew it I was attempting to have sex without any biological understanding of my own body. I couldn’t even use a mirror to look at my vagina as it made me too uncomfortable. When the slightest form of penetration became possible with a boyfriend, the searing pain it resulted in caused me to visit the doctors. A horrifically uncomfortable examination later, and I was diagnosed with a condition called vaginismus. This condition has gained recent attention due to its inclusion in Netflix’s Sex Education, whereby a college student named Lily has the condition and describes her vagina as a ‘Venus fly trap’. The technical definition of vaginismus is the involuntary tightening of the vagina due to muscle spasms that prevents penetrative sex, (or the insertion of a tampon etc) or causes pain during it.

Pain is not normal in sex. It is not something that schoolgirls should chat about to make them feel grown up because they are tolerating another female woe. ‘I cried for hours after I tried’. ‘I bled for like three days after’. But who is to blame us? We were educated about safe sex and consent (arguably) but not about pleasure or therefore lack of, specifically from a female perspective.

To an extent these conversations will always take place between kids and teenagers at school. However, I believe with the right education these inevitable conversations can have a positive effect. A curriculum including female anatomy, masturbation and pleasure could prevent painful sex being normalised for a generation of teenagers. I have experienced so much positivity from talking to my female friends about sex, but only in recent years (at least two friends I have met at university have shared with me that penetrative vaginal sex is impossible, or painful for them too). If these positive examples of communication can happen at an earlier age perhaps sex would be such a better experience for so many more women. Sex is not something that should only be discussed between a child and her parent, teacher or counsellor. Girls should talk to other girls about sex in an honest, non-sensational way so that women go on to have better sex.

Not everybody would have taken such a negative experience away from the way in which these conversations were framed in social circles. The way these conversations effect certain students and not others of course ties into other debates around self-esteem and confidence. After my diagnosis and a nine-month waiting list, I began psychosexual therapy through the NHS in Leeds (which after three sessions was halted due to coronavirus but nevertheless, I made substantial progress both during that time and beforehand with my partner). With the help of my therapist I have been able to establish that personally, I found many of these conversations intrusive at a young age. An initial intrusion surrounded pressure I placed on myself to be able to use a tampon for a surfing school trip in year nine. I have also been able to identify times in my life where I have felt a loss of control of my body, talking therapy for these examples have provided me with methods to retake control; with this article being one example. My therapist has also introduced me to physical exercises I can practise that aim to break the cycle of fear and pain. Certain exercises have been as simple as using a mirror to routinely look at my physical anatomy; I can now do this without my legs seizing up. There are several other methods and tools to treat this condition, and these along with being in a supportive relationship have vastly improved my experiences of sex and penetration in the last year.

However, this article is not explicitly about the discussion over methods post diagnosis. It is about the significance that surrounds fundamentally changing the notion that sex is something women endure.

Changing The Way The Cookie Crumbles

Anushka Searle on 6 March 2020

Statistics show that 83% of chefs in the UK are male, according to data from the Office of National Statistics employment in 2018. Time then to cover three incredible chefs, who have managed to force their way into the small demographic of female chefs to show that women can be successful in a culinary world.

Claire Saffitz

If you don’t know Claire Saffitz then where have you been? Not only is Claire Saffitz a trained pastry chef (though she recently claimed that she’s “not a chef”) and a contributing food editor of Bon Appétit magazine, she is also a YouTube sensation! Saffitz’ stardom began in 2017 when she began the show Gourmet Makes for Bon Appétit’s YouTube channel. The show consists of Saffitz trying to recreate popular snack foods as well as elevating the foods to a more gourmet standard. Indeed the rising popularity of Gourmet Makes was due to Claire’s relatable ‘low’ moments.

Claire herself stated in an interview with Mashable that “there’s some sort of transference from people, they get stress relief from watching my stress” and for anyone that has watched the show, this is certainly true. We are used to watching culinary shows where the chef is the expert and we absorb the information as viewers but it is Saffitz’s stressful cooking that engages us with content that has more entertainment value. It is certainly uplifting to watch Saffitz go through a rollercoaster of emotions, to then seeing her happy and relieved at the end of the episode. Therefore it is this emotional vulnerability, that is often deemed a ‘weakness’ in women, which has catalysed Claire Saffitz’s success.

Ravinder Bhogal

Ravinder Bhogal was born in Kenya to Indian parents and grew up in London. It is this mixed culture and heritage that has enabled Bhogal to create impressive fusion dishes and menus. Bhogal is not just a remarkable chef, for she is also an award-winning food writer, journalist, TV presenter, stylist and restaurateur. Her most impressive achievement is the opening of her restaurant Jikoni in 2016.

Jikoni is frankly an adorable restaurant with a cosy almost café-like feel to it and is designed in an overtly ‘feminine’ style, with a pale pink colour scheme and floral designs. However, it is not only Jikoni’s design that makes a statement but Bhogal’s menu too. Jikoni offers a variety of Asian comfort food, but with intriguing British, African and Middle Eastern twists, showing off Bhogul’s accumulation of travel and culture. The dish on the menu that appealed to me the most was the “Cold Silken Tofu, Peanuts, Puffed Wild Rice, Caramelised Foxnuts”, mainly because I was very intrigued by what foxnuts were, and also because it was one of the many creative vegan options on the menu. Bhogul’s interest in developing vegan dishes came about when her niece decided to become vegan. Consequently, Bhogul created a completely vegan menu for W London, which included her niece’s favourite, caramel tofu with garlic confit rice and chilli smacked cucumbers.

Samin Nosrat

Samin Nosrat introduces herself on her website ciaosamin.com with “Hi. I’m Samin Nosrat. I cook. I write. I teach” and while it’s clear and simple, it undoubtedly does not give Nosrat’s talent justice. If you’re a foodie, or simply have access to a Netflix account, then you need to watch Salt, Fat, Acid, Heat. The docuseries is based on Nosrat’s New York Times bestselling, and James Beard Award-winning book titled Salt, Fat, Acid, Heat: Mastering the Elements of Good Cooking, which is written on the premise that the way to master the culinary arts is to master these four elements. In the Netflix series, the four elements are explored through four episodes in four countries: Italy, Japan, Mexico, and her home in California, USA. Its success led to Nosrat becoming an international culinary celebrity.

Nosrat is recognised for her talent as well as her endearing personality (please watch “Brad Makes Focaccia Bread with Samin Nosrat” on Youtube). The Guardian even described her as someone that “projects the kind of charisma that fosters a sense of familiarity, allowing audiences to believe they know her”, which is very similar to the reason behind Claire Saffitz’s success.

Header Image Credit: Pexels

Should you shave your armpits?

Lauren Woodley on 8 February 2020

I, amongst others, wish to seek to find out why so many people find it repulsive when someone has made the personal decision not to shave their armpits.

As a female, I shall be focusing on the pressures that women face surrounding the shaving of underarm and other body hair. However, my overall belief is that for any gender, it should be your own decision to do whatever you want to your body. Only you control your body, and no one should force you to do anything you do not want to.

The history of shaving armpits

Women in the early 20^th Century did not care about shaving their armpits, in fact, it would not be surprising if a woman had lots of hair. The debate of shaving is a very modern issue, most likely developed due to the loosening of rules on how females dress, and the development of razor technology. By the 1950s, legs and underarms were targeted in ads and many women were encouraged, even expected, to be smooth, silky and stripped.

Thankfully, as we entered the 21^st Century, it became more common for women to not feel like they have to shave, and many women now embrace the ‘au-natural’ look. It is more common to see celebrities with unshaven arms, and many women feel more comfortable to talk about it.

So should you shave your armpits?

No matter how much you may convince yourself, when you see an image of a woman with long underarm hair, you will subconsciously notice it and form an opinion. Yet, if it was about our male counterparts, there would be no disbelief.

I am guilty of doing this myself. A friend of mine recently decided to grow out her underarm hair and I naively pointed this out to her. Whilst I am completely supportive of her decision, I still brought attention to it. Why? Because, I suppose I wasn’t expecting it. Because, it is still not considered the ‘norm’.

It is seen as powerful and inspirational when a woman chooses to grow out her underarm hair. I think that it is a statement and takes a lot of confidence and bravery. From experience, people may pass comment. I personally choose not to shave my leg hair, and I have faced so much judgement from this decision in the past. Am I not womanly enough? Does body hair really change a person’s appearance so much?

The solution is to not say anything at all. Some people may think it is funny to pass comment, but it can make someone feel insecure and pressured into shaving their body hair, when it should not.

Of course, some women do prefer to be shaved and smooth. It is a luxury, can make you feel more confident, or they simply might not find their body hair attractive. There is nothing wrong with this either.

Shaving your body hair will always be your own personal choice. No matter what anyone says, it doesn’t make you any different whether you have body hair or not. So, as long as you are shaving your body hair for YOU and YOU only, then all women should support each other on the fight against the stigma of shaving armpit hair.

Gendered Award Categories: Outdated or Unrepresentative?

Anushka Searle on 11 October 2019

Anushka Searle writes in response to the announcement that the “Brit Awards ‘will review’ male and female categories”

The Brit award categories ‘British female solo artist’ and ‘British male solo artist’ appear outdated, as they reference the sex of the individual consequently isolating protentional nominees of other gender identities. In the light of Sam Smith’s recent announcement, that they identify as non-binary, it seems that award categories will need to adjust accordingly. Though, an issue arises when we consider how this could affect another minority representation. If the categories (mentioned above) were combined to form the non-gendered category ‘British solo artist’, would this mean that fewer individuals are nominated, leading to many minority groups being underrepresented? One must consider that we don’t live in an ideal world and that the music industry, and the media in general, are polluted with racism, sexism, and homophobia. Therefore, the solution cannot be to decrease the representation of some to increase the representation of others. Award shows must adjust to modern identity, however, everyone must be equally represented and purely judged on their talent. Most artists, especially smaller artists, are overjoyed just to be nominated. Therefore, we can’t decrease the nominees of two categories into just one, as smaller, struggling artists will be overshadowed.

Even though eradicating gendered categories does seem to be the best solution to include those of every gender identity, as a woman I find all female categories empowering. It’s exciting to simply focus on female creatives, and to allow them the opportunity to not be overshadowed, and to win purely on talent. Though it was empowering to witness Emma Watson become the first recipient of the MTV Movie and Television Awards’ category ‘Best movie performance’-as it has recently become gender neutral- I can’t help but be sceptical. If they had given the award to a male actor after changing the category to be gender neutral then there would have been outrage in the media, however, because it was awarded to a woman the MTV Awards were applauded. This suggests in my view that award shows are tampered with in order to be politically correct, whether there is a “public” vote or not. Combined categories therefore seem more iniquitous than separate gendered categories.

In the past, gendered award categories have been targeted as being ‘archaic and unnecessary’. However, “non-binary” is new terminology that has just begun to enter vernacular and therefore, it is unfair to use the word ‘archaic’, as the world has only just begun to understand what non-binary entails. It is also unfair to suggest that gendered categories are ‘unnecessary’, when in fact they have been necessary in order to increase the representation and support of female creatives. In conclusion, award shows need to be more representative of everybody. However, one must make sure that equality is always considered, and that changes made to represent one social group don’t diminish another grouping in the process.

Header image credit: Pink News