A Commentary on Women's Health and Sexual Education for Adolescents

 This was originally published in Maeflowers on Medium Aug. 4, 2023

 

Women's Health Means Adolescents, Too

Preventing sexual health education leads to ignorance about bodies

This particular topic is one that seems academic but actually hits close to home. In this politically rife time of book banning and abstinence-only approaches to education crossing swords with hot-headed discussions about abortion, maternity care, and birth control, it seems we’ve completely lost the plot. Let me tell you a story…

Step back 30 years

Fifth grade was my first year in public school. I had gone to a small church-affiliated school up until that point. We had a very small library of approved books. I had advanced through the curricula for math and reading so I’d go to the older kids’ classrooms for those subjects. We had a full hour of “Religion” every morning and Chapel on Wednesdays. I had never heard of “Health class”. There were 3–5 kids in my class depending on which year it was. It seemed perfectly normal.

I transferred to public school and there were five classrooms of 20 kids each in my grade. We moved between remedial, normal, and gifted classrooms for different subjects and if you needed to be moved up or down you missed what you missed. It was chaotic and inefficient compared to where I had come from. But one day, early in that first semester, they divided the girls and boys into two different classrooms and gave a health presentation about our bodies. I learned about menstruation for the first time — I had my first period just a couple weeks later.

If it hadn’t been for that health presentation about my body in public school, I would’ve woken up one morning thinking I had been mauled in my sleep. As it was I was shocked that it was actually happening. How traumatic to not know what you’re own body is capable of!

I was staying at an older cousin’s house — so she had the supplies I needed and it was all normal to her. I thought I’d have to explain it to my mom because it had never been spoken of — instead she had a party waiting for me to welcome me to womanhood. I was mortified and so very very confused. If it’s such a huge thing, why didn’t I know about it?

The point

Too often we leave young people out of topics that affect them. Under a misguided attempt to shield some mythical concept of innocence, they are left vulnerable to fear, misinformation, and unintended consequences.

Everyone deserves to know about their body so they can make decisions about their health. Despite the stigma that sex ed introduces children to sex (a natural part of life they’re going to see, hear, talk about, and experience eventually anyway), such programs may be the only information an adolescent receives about a major event in their physiological (and psychological) development. Everyone should be armed with factual information about pain, bloating, mood swings, fertility, and cancer, among others.

Adolescents go through major changes, and sometimes they can lead to life-altering shifts. Menstruation should not be a mystical “welcome to womanhood” surprise. Pregnancy should not be a mystical “you’ll feel better once the baby comes” experience. Menopause should not be dismissed as the end of a woman’s worth or hysteria.

Just this year (2023), Washington, DC became the first education jurisdiction in the United States to have specific menstrual health education standards. The. First. Welcome to the 21st century.

Til death are you dismissed

It’s not just the young who are ignored. Last year, a clinician at the MayoClinic stepped up to start working on menopause awareness. Not only should women going through “the change” know what to expect and what needs a doctor’s keen eye, there are treatments to make the transition easier and help adjust risk. This is important not just for comfort, but for health and quality of life as the hormones that cause menstruation and menopause have varying associations with cancer. Birth control also plays a role in this risk, with newer versions (progesterone-based) offering protection against uterine cancer but potentially increasing breast cancer. Genetics likely plays a role, which means research is needed. But we’ve traditionally struggled to have female cohorts in studies, now we want them to focus on female-only disorders?! Yes, it’s going to be an uphill battle.

The North American Menopause Society can be a starting point for anyone looking for a doctor or treatment for their hormonal transition.

Sex ed is necessary

We need sex ed — the children need it. Right now, schools are the best way to reach a large swath of the population at the right age to ensure that puberty and its ramifications don’t surprise anyone. But I’d suggest classes in communities for adults as well. Maybe at hospitals, like the classes for expecting parents, only it’s basic anatomy and hygiene. “Human Body 101”. We all have a body, even as children. We need to learn how to live with it. Why it’s so shameful to recognize that is beyond me.

If you’re looking for more information, I highly recommend the books written by OB/GYN Dr. Jen Gunter, particularly The Vagina Bible and Menopause Manifesto.

Also see the statistics on the harm of abstinence-only education at the Guttmacher Institute and the School of Public Health at Columbia

Baby it's cold outside

As we head into Thanksgiving and the winter season here in the Northeast United States, snow and cold temperatures are becoming standard fare. But letting the kids play outside or trying to clear the driveway to get to work means being prepared to prevent cold-related health problems.

Be sure to know how to prevent against hypothermia and frostbite:

Frostbite by Eli Duke, Wikimedia

• Wear warm clothing that covers your skin, especially as the wind chill values drop. Dressing in layers is helpful so you can adjust between different temperature settings without exposing your skin to the cold.
• If you become covered in snow or your clothing gets wet, get inside where it's warm and remove the wet clothing.
• Limit your time outdoors - yes, Frosty won't build himself, but he can be built in shifts so the kids' fingers and toes have time to warm up.
• Be aware of the signs and symptoms so you can stop it before it starts!

Be safe out there!

Eastern equine encephalitis risk

EEEV in a mosquito saliva gland

Eastern equine encephalitis (EEE) is caused by the eastern equine encephalitis virus (EEEV), which is transmitted by infected mosquitoes. As implied by its name, the virus primarily affects horses, but human cases sometimes occur. The Centers for Disease Control and Prevention (CDC) in the United States considers EEE one of the most severe mosquito-borne illnesses because its mortality rate is approximately one-third of all individuals who develop EEE. The disease has a sudden onset with swelling and inflammation of the brain (encephalitis), causing headache, fever, chills, and vomiting. However, only 4 to 5 percent of human infections with EEEV are thought to actually develop into EEE.

The transmission cycle of the virus tends to occur in and around swampy areas, including the freshwater hardwood swamps of the Unites States - the Atlantic and Gulf Coast states of the United States have endemic areas of virus transmission, and the endemic areas also now include around the Great Lakes. Wetland birds are infected with EEEV, which then infects the mosquitoes that bite them. When the virus is present in high enough quantity in the bird population, mosquitoes that bite humans may also become infected, allowing them to spread the virus to humans. Horse epidemics of the disease tend to occur in Summer and Fall. The CDC has received reports of only an average of 6 human cases of EEE per year in the United States. Since 1964, the most number of cases in a given year was earlier this past decade with nearly 25, and the average reported per year appears to be increasing.

Florida, Georgia, Massachusetts, and New Jersey have reported the most cases of EEE (neuroinvasive EEEV infection) since 1964, and were some of the earliest areas of the country affected by the disease. However, between 1964 and 2010 cases of EEE have also been reported in individuals living in Wisconsin, Michigan, Indiana, Pennsylvania, New York, New Hampshire, Rhode Island, Delaware, Maryland, Virginia, North Carolina, South Carolina, Alabama, Mississippi, Louisiana, and Texas (see a distribution map). The breakdown of number of cases per year per state available from the CDC indicates that the areas of viral transmission have been spreading since 1964.

Massachusetts is considered particularly vulnerable to the chance of an EEE outbreak. The density of residents, coastal area, history of EEE cases, and confirmed presence of EEEV in mosquitoes in a number of counties in the state create a situation that requires preventative measures to avoid human transmission. Outbreaks occur in the state every 10 to 20 years. The last outbreak in Massachusetts was 2004 to 2006.

States that have not previously had experience with EEE may be even more at risk because they do not have the surveillance system in place to monitor the viral load in mosquito populations. The economic conditions of some areas may also hamper proper preventative measures. As horse outbreaks occur (as in Michigan in 2010), the risk of human infection increases in any area of the country.