Our Bodies, All Bodies by Public Health Zine

Our Our bodies, bodies, All All bodies bodies Sexual & Reproductive Health education

Tulane public Health zine

A NOTE FROM THE EDITOR what passes as "adequate" sexual and reproductive health (S&RH) education in our country is failing us all.

from learning information that is medically-inaccurate to being told straight up lies, entire generations have been robbed of leading healthy, informed, and empowered sexual lives. while strides have been made in advancing more comprehensive S&RH education for individuals with normative gender and sexual identities, the disparities in S&RH education and healthcare for LGBTQ+ communities (and further, LGBTQ+ communities of color) that persist are inexcusable. as a student-led publication dependent on submissions from an already limited pool of students, we want to acknowledge that this issue is far from filling the monstrous gap in all of our S&RH educations. but as students invested in lifting up inclusive and nuanced dialogue about health for ALL communities, we must and will work to be better with every edition.

thank you kindly.

index index Written Pieces Missing Pieces: Lapses in Sex Ed. Across the United States....4 Amanda Strang, Sophomore 0.1%…………………………………………………………..................8 Gabriella Burns, Senior Touch………………………………………………………..................11 Lauren Allen, Junior My Black Feminism: Reclaiming Reproductive Rights………..12 Juharah Worku, Junior Bad Sex Ed………………………………………………………........14 Various Authors Discrimination in Sexual Health: How the United States is Failing Transgender Individuals………..……………………....... 16 Fiona Kennedy, Sophomore Jarring……………………………………………………...................18 Matthew Weber, Junior SRH in the Field: Addressing Barriers to Contraceptive Use Among Adolescents in Nairobi, Kenya…………………………..19 Kelsey Williams, Senior Resources……………………………………………………….........22

Photos / Graphics Fiona Kennedy, Sophomore………………………………….16, Back Lauren Allen, Junior……………………………………………...........5 Margaret Maurer, Senior ………………………………………...Cover Nicole Shanks, Sophomore ……………………………………....6, 20

Student Staff Alexis Martin, Editor-in-Chief Fiona Kennedy, Editor Lauren Allen, Editor Nicole Shanks, Layout

Paul Trujillo, Layout Sarah Scribner, Editor Tessa Millare, Layout Zahra Saifudeen, Social Media

ByAmanda Strang

Requirements for sex education vary greatly across the United States, leaving many adolescents void of a comprehensive understanding of healthy relationships, birth control methods, STD transmission, and more. Though most people claim to support sex education in middle school and high school, curriculums across the nation are full of discrepancies. Some classrooms examine evidence-based research, others scare students with gruesome images and sexual horror stories, and some even teach abstinence-only messages. Despite 96% of females and 97% of males under the age of 18 receiving a formal sex education, the information shared within those classes is relatively unstandardized.1 The Centers for Disease Control and Prevention (CDC) recommends 19 sexual health topics to be covered in sex education classes. These include the benefits of sexual abstinence, the importance of correct and consistent condom use, and the discussion of sexual orientation. On average, only 38.3% of public schools grades 9 through 12 discuss all 19 recommended sexual health topics.2 State governments often dictate the requirements for sex education within the public-school system. Due to a lack of national regulation, state governments have the freedom to determine the depth, inclusivity, and accuracy of the information teachers distribute. For example, according to Guttmacher Institute, only 24 states and the District of Columbia require sex education in the public-school curriculum, and only 34 states and the District of Columbia must include HIV education. Furthermore, only 13 states ensure medical accuracy of shared information and only 2 states prohibit religious endorsement during sex education courses. More alarmingly, 3 states encourage negative discussions on sexual orientation, only 20 states expect condom and contraception use to be covered, and 27 states stress the importance of abstinence within a discussion about sex and HIV. 4

More alarmingly, 3 states encourage negative discussions on sexual orientation, only 20 states expect condom and contraception use to be covered, and 27 states stress the importance of abstinence within a discussion about sex and HIV. Louisiana is no exception to this education gap. In fact, Louisiana guidelines regarding public schools only require that abstinence and sex within marriage be stressed; other topics like healthy decision making, consent, and condom usage may be excluded. 3The sexual health knowledge gap is sometimes exacerbated by independent/private schools, which abide by different guidelines and can include or exclude many topics they please.

Image Courtesy of Lauren Allen, 2018

Without accurate and comprehensive sex education, many students may find themselves uninformed, confused, and frustrated with their local school systems. The consequences of poor sex education extend far outside the classroom; rates of unplanned pregnancies, STD transmission, and sexual assault may increase as a result. Education is an essential tool for primary prevention. Failing to properly inform students about sex puts our entire nation at risk.

1. Martinez G, Abma J, Copen C. Educating teenagers about sex in the United States. NCHS data brief, no 44. National Center for Health Statistics. https://www.cdc.gov/nchs/pr oducts/databriefs/db44.htm. Published September, 2010. Accessed September 9, 2018. 2. Brener ND, Demissie Z, McManus T, Shanklin SL, Queen B, Kann L. School Health Profiles 2016: Characteristics of Health Programs Among Secondary Schools. https://www.cdc.gov/healthy youth/data/profiles/pdf/2016 /2016_Profiles_Report.pdf. Published 2017. Accessed September 8, 2018. 3. Guttmacher Institute. Sex and HIV Education. Guttmacher Institution. https://www.guttmacher.org/ state-policy/explore/sex-andhiv-education. Published September, 2018. Accessed September 9, 2018. 5

0.1% By Gabriella Burns

“That’s one doodle that can’t be undid, home skillet.” - Juno

The pharmacist asked me how I was doing, which only added insult to injury. Most women in their early twenties buying ibuprofen and a pregnancy test are not having a good day. I drove home listening to Gwen Stefani howl out feminist jams, hoping that I was overreacting, that the sneaking suspicion that I was pregnant was just another facet of my anxiety.

My housemates stood around me while I peed on the stick, all assuring me that there was no way I was pregnant. I stared out the window of our bathroom as we waited the requisite two minutes for the results. Those two minutes felt like an eternity, and my hands shook when I picked up the small piece of plastic that began the hardest month of my life. The little pink plus sign seemed to mock me. After an emotional phone call with my mom, in which she praised my “feminine intuition,” I headed to the Emergency Room.

SHOCK I stared numbly out of the window of the uber taking my boyfriend and I to the hospital. When we arrived, I explained my situation to the kind nurses in the ER. I thought that I was just on my period, which was unusual because I normally didn’t menstruate with my IUD. After two weeks of bleeding, I felt like there was something wrong, so I took the pregnancy test, and here we were.

I was concerned that it might be ectopic; after all, 50% of people with an IUD who get pregnant have an ectopic pregnancy.The doctors took me into the Finding Nemo-themed children’s ward of the ER to circumvent the long wait time, and I spent the next two hours being prodded and

poked for blood tests to the cries of young children in the rooms adjacent to mine. Time seemed to stall and race simultaneously as I waited anxiously for the results, blurring my memory as a smudge of carnal emotion.

TREATMENT After the invasive intervaginal ultrasound, taken in a dim dark room of the empty wing of the Radiology Department –– the hospital didn’t have a specialized OBGYN Department –– the doctors decided that it was likely a miscarriage, but still could be an ectopic. My boyfriend and I fist bumped when we heard the news, relieved that I would not have to receive more intensive treatment. For the next week and a half, I was treated for a miscarriage, taking medications intended to quicken the process. The peppy Walgreens pharmacist asked if I was pregnant when I filled the prescriptions, presumably because she’d seen the antinausea medication in the pile of pills I’d been instructed to take. “Not anymore,” I responded, grimacing in pain. At my second follow up, the doctors had a different diagnosis: this was an ectopic pregnancy, and I would require surgery the next day. I found myself gowned up and in a stretcher 12 hours later, waiting for the anesthesiologists to sedate me. As they reached for the vial that contained a relaxant, a nurse came running down the hallway to stop them. My doctor decided that my internal bleeding was not severe, so I could take methotrexate instead of having surgery and potentially removing a fallopian tube. Insurance wouldn’t have covered the surgery, and she even said that she didn’t want to bill me an exorbitant fee. Instead, I received two shots of the drug in my ass. The nurses warned me of the side effects, which are similar to those related to chemo because methotrexate is also used to treat cancer. I knew I was in for a fun week of cramping, dizziness, and vomiting. 9

AFTER THE STORM

"I have so many questions now that the experience is over..."

“Throw it. Just throw it.” My boyfriend and I were watching TV when an ad came on for my IUD. He and his housemates bought a projector, planning to toss empty beer cans at the wall when they got mad about sports. I chucked my empty beer can at the smiling woman on the screen; I was so upset at the device intended to ensure that I could live without worrying about the possibility of getting pregnant. I have so many questions now that the experience is over, questions that remain unsolved despite my obsessive, extensive, and detailed research both online and personally with my doctor. Why is there no male birth control pill? If my boyfriend also had the same 0.1% chance of impregnating me as I had of getting pregnant, would this have happened? Why aren’t there more effective methods of detecting an ectopic pregnancy? Why didn’t any of my doctors know when the bleeding and pain would stop? When will my hair grow back after my hormonal fluctuations caused chunks to fall out with the stroke of a brush? I hope that there is someone in the scientific community finding answers to these questions, because I never want anyone to experience what I just endured.

Bad Sex Ed

Discrimination in Sexual Health: How the United States is failing

We canâ&#x20AC;¦

Growing up in the South, intercourse and its implications were shrouded in mysticism. The rules were taught from trial and error rejection, and the times were jarring. Don’t talk. Don’t ask. Don’t look. Don’t do.

To never learn about the ticks and tocks, the motions and motives, was poisonous for the conscience and ignorance for the self. The condition displaced one from oneself, like a vivid nightmare of being lost and far from home. You may know why you are where you are, but you will never know where you are. The confusion overrides the intrigue, and this spell is simply cast by the demons of lust.

j a r r i n g by: matthew weber

What was good was bad, what was bad was also bad, and what was bad still felt really, really good. This conflict was inevitable. All labels categorized you as the imperfect among the perfect. For the self, you are destructive and shameful; the delay between what ought to be and what you are replaces your essence.

By Kelsey Williams Ngong Road Children’s Association (NRCA) is a NGO in Nairobi, Kenya that provides education and social support to children whose families are affected by HIV and living in poverty in the surrounding area. NRCA’s program aims to serve kids from age eight through their post-secondary education and into their first jobs. These children are some of the most vulnerable children on the planet, all of whom have witnessed family members suffer or die from HIV. However, many of them never learn about STIs in an educational setting. Additionally, like all young women, especially in developing settings, early and unplanned pregnancies jeopardize educational achievement and chances to reach economic self-sufficiency. Yet most school-based sex education in Kenya is abstinence-based, leaving young women uninformed and without contraceptive resources. Fifteen NRCA students have become pregnant in the past decade, and all but one have withdrawn from school. To address these issues, NRCA developed a Youth Peer Provider (YPP) sex education program, based on Planned Parenthood Global’s YPP program. Through this model , older students are trained to educate and counsel their peers on all topics of comprehensive sex education, including human development, communication skills, sexual health and STIs, and more. Additionally, anticipating that the program would fail if it created unmet demand for contraceptives, NRCA supplements the YPP program with a grant to fund contraception for students. I spent the summer in Nairobi working with NRCA to conduct monitoring and evaluation research for NRCA’s YPP program under the remote mentorship of Dr. Kissinger. We used surveys to monitor students’ knowledge and attitude changes, as well as focus groups to learn about students’ experiences with the program, ideas for improvement, and most importantly, to answer the question: 19

Why haven’t students sought out the available resources for contraception?

Image Courtesy of Nicole Shanks, 2018

We have not formally analyzed our data, but our major challenge is clear: understanding, then addressing, the multitude of barriers NRCA students face to using contraception, between initially learning about it in sex education and ultimately receiving (and then using!) it. Many of these barriers are likely hard to isolate and address independent of the larger social, cultural, and political structures in which they’re embedded. For instance, students’ concerns about infertility due to contraceptive use are nearly ubiquitous, and many young women are worried about their partners or families discovering that they use contraception. Some of these concerns are very familiar to American experiences, while others are extremely specific to NRCA students’ lives. However, that’s what’s exciting about this project—it’s not possible to succeed without allowing these students’ lived experiences to guide solutions. I hope that conclusions from forthcoming data analysis, in collaboration with NRCA YPPs’ efforts, will tangibly impact students’ control over their reproductive health.

Source: CDC.gov

Resources Online O.school Working with a community of professionals such as gynecologists, dating coaches, sex educators, and therapists, O.school provides a safe, anonymous space with thorough and medically accurate videos, articles, and live streams. Insta: @odotschool Website: o.school

Get Smart b4 U Get Sexy A comprehensive sex education program that provides prevention and intervention resources for youth and young adults (ages 1230) particularly those who are African American, Black, female, in foster care systems, and/or at high risk for sexually transmitted infections. Insta: getsmartb4ugetsexy Website: http://getsmartb4ugetsexy.com

Oh Joy Sex Toy *NOTE: SOME CONTENT NSFW* Puts sex ed in the form of easy-to-understand, fun, and medically accurate comics on a variety of topics Website: ohjoysextoy.com

Afrosexology

The purpose of Afrosexology is to educate, explore, and reclaim Black sexuality and to promote Black self empowerment through sexual liberation without various resources such as workshops, worksheets, speaking events, and their blog, Pillow Talk. Website: http://www.afrosexology.com/

Planned Parenthood A trusted health care provider, an informed educator, a passionate advocate, and a global partner helping similar organizations around the world, Planned Parenthood delivers vital reproductive health care, sex education, and information to millions of people worldwide. Website: plannedparenthood.org

HEART Women and Girls HEART promotes sexual health and sexual violence awareness in Muslim communities through health education, advocacy, research and training. The work is culturally-sensitive and Website: heartwomenandgirls.org developmentally appropriate 22

Killer and a Sweet Thang A firsthand account of how millennials love and live in an everchanging digital landscape; KAAST contributors write from personal experience about the growing pains of holding intersectional identities in the 21st century.

Blogs/Forums

Insta: @birds.bees, Website: killerandasweetthang.com

Auto Straddle A lesbian-owned queer women’s media and a trans-friendly website aiming to create an accepting and supportive environment for lesbian, bisexual and queer trans women. Website: autostraddle.org Insta: @autostraddle

Scarleteen A diverse, inclusive space strongly and actively committed to making and keeping a space that feels as safe as possible for everyone, which honors the diversity of human sexuality and identity; a queer-friendly queer-owned-and-operated, and inclusive space. Welcomes users of all gender identities, belief systems, ethnicities, economic classes, relationship constructs and languages.

Website: http://www.scarleteen.com/ Insta: @scarleteenorg

GenderQueer.me A resource blog for non-binary people; platform used to amplify non-binary experiences - through this themed series, they collected over 50 stories in less than a year! Anyone is welcome to contribute a post, vlog, comic strip, etc.

Tabú

Apps

Website: genderqueer.me Insta: genderqueer.me

Provides a youthful, educational take on sexual education and health; The app has four different sections: Home, Feed, Q&A, and Basics.

This is not a fully-comprehensive list of resources, but we hope it provides a jumping-off point for folks to continue learning how to be an empowered, Healthy, and safe sexual being. If you are however interested in helping us develop this and future resource pages, email us at tulanepublichealthzine@gmail.com 23

The The Public Public Health Health Zine Zine (PHZ) (PHZ) presents presents an an evidence-based, evidence-based, comprehensive comprehensive snapshot snapshot of of pressing pressing campus campus health health issues issues through through aa bi-monthly bi-monthly theme. theme. We We are are aa publication publication dedicated dedicated to to creating creating aa campus-wide campus-wide conversation conversation around around student student health health and and wellness AND wellness AND CENTERING CENTERING NUANCED NUANCED AND AND OFTEN OFTEN UNDERREPRESENTED UNDERREPRESENTED NARRATIVES NARRATIVES IN IN PUBLIC PUBLIC HEALTH. HEALTH.

Our next issue will be centered on Health in Incarcerated Populations. Want to get involved? Please contact us at tulanepublichealthzine@gmail.com DISCLAIMER: This is not an official Tulane University sponsored publication. The views and opinions contained herein by the various authors do not necessarily reflect the official views, opinions, or policy of Tulane administrators, staff or faculty. All material contained herein are the views and opinions of students, and may not reflect the views of all students on campus.