At the start of December, I held my first workshop for the women in my community - the Sikh community. At first, I was afraid that the stigma around pelvic health would work against me. I had avoided talking about my job because of the taboo that it carries in my community and because some conversations just had not gone “right.”
Surprisingly - with the exception of someone taking down my posters (don’t worry, I made them bigger and brighter!) - nothing else happened. Even more surprising was the number of women who registered and attended. This was an uplifting moment for me as I was finally able to share my passion with so many women who could benefit from the information and were eager to learn.
I had actually started my pelvic health physiotherapy journey because of the healthcare discrepancy I saw in my own community. Women in my own friends circle, born and raised in Canada, were not aware of healthcare options that could improve their health and sexual health outcomes. No one told them - simply because “we don’t talk about it”.
When I started working at my first job, I noticed more and more people (not just women) seeking me out specifically to talk about their sexual or pelvic health concerns. But, regardless of their cultural, racial, and/or religious differences, there was one overarching theme contributing to the decline in their sexual and pelvic health: “we just don’t talk about it.”
It was also during this time that I first started noticing a trend that propelled me into my sexual health educational journey: men and women in my own community were starting to share with me that they had childhood sexual trauma experiences. I was shocked and wondered ‘what is going on here?’ I couldn’t even fathom that this could be happening in my own community; but I realized it’s largely because “we don’t talk about it”.
But, doesn’t that just make the problem worse?
With the goal of breaking this cycle of silence in mind, I started preparing for my first workshop by diving into the research. Here’s a little bit of what I found:
- Widespread pain is reported more in South Asian communities as compared to white Europeans in the UK (Palmer et al., 2007). some text
- Pain education needs to be delivered with cultural competency and understanding in mind (Bostick et al., 2021)
- South Asian women also have a twofold increased risk of developing gestational diabetes (Farrar et al., 2015).
- South Asian women have 10-20% higher prevalence of self-reported pelvic girdle pain compared to western women (Robinson et al., 2024)
- South Asian women have a higher risk of stillborn near full term (Davies-Tuck et al., 2023)some text
- Interestingly, this risk is reduced with increased fetal monitoring as women get close to full term pregnancies (Davies-Tuck et al., 2023)
- High levels of intimate partner violence in South Asian communities are reported. This results in poorer physical health, depression, anxiety and directly influences lifestyle factors (sleep, appetite, energy, and wellbeing) (Hurwitz, Liu, & Raj, 2006)
- Sexual health research is lacking in our community (Punjabi specifically) (Brijnath et al., 2024)
But do you know what I found most commonly across all topics and databases that I searched?
Silence.
Now, anyone who knows me or has worked with me knows that I am a MEGA nerd - I love research and I love learning. But what does one do when there isn’t enough information about a topic? The topic that we are so passionate about? The topic that we know needs to be addressed? Research is only helpful if we have people willing to share their experiences, but the problem is, “we don’t talk about it.”
What we have to remember is that the healthcare disadvantages for a community do not disappear when “we don’t talk about it”. Our health as a community does not improve when “we don’t talk about it”. Research will not drop out of the sky to support us if “we don’t talk about it.“ We do not and will never have the ability to support our own communities when “we don’t talk about it”.
So let’s TALK.
Say the uncomfortable things. Start small, with your families and friends. Find healthcare practitioners who can help you understand the uncomfortable things. Ask questions and BE CURIOUS.
Let’s not shy away from the topics we have been made to believe are shameful. We all have a role in improving healthcare in our own communities.
And, if you are feeling overwhelmed or confused, I am here to help!
Warmly,
Bhawan Sekhon
