On a brisk morning last week, 19 young reproductive rights activists gathered in a second-floor conference room in Palo Alto as part of the Youth Champions Initiative. They had come to California from Ethiopia, India, Pakistan, Mississippi, and Louisiana for an intensive week of sexual and reproductive health training.
Clustered in geography-specific groups for a media training session, the YCI participants discussed the stigma that surrounds sex ed, how to report on rape, and what to do with Twitter trolls, all before noon.
The Youth Champions Initiative was inaugurated this year in honor of the David and Lucile Packard Foundation’s 50th anniversary, with the goal of bringing international young leaders to a Silicon Valley-like incubator focused on sexual and reproductive health and rights (SRHR). The goal is for young leaders to meet peers in other countries and learn new strategies to “shake up” the field, according to the program’s executive director, Denise Dunning.
During the incubator, YCI participants heard from SRHR experts (including Rewire’s Jodi Jacobson), visited the offices of Ideo and Mozilla Firefox, and brainstormed projects that would further the work they had begun at home. Innovation is the watchword at the new program.
Sex. Abortion. Parenthood. Power.
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“We often say, ‘Why aren’t young people using condoms?’ And then the solution is, ‘Let’s make the condoms bubble-gum flavored,’ as opposed to, ‘Young people aren’t using condoms. What radically different thing needs to happen in our space to change this?'” Dunning told Rewire.
The program is designed to help young leaders think in challenging, fresh ways about their work, while making connections and meeting colleagues. After the incubator, participants can apply for YCI grants to fund their newly designed projects.
Rewire sat down with four of the program’s participants to learn more about their work and what they hope to do in the future.
From a 21-year-old who first saw the need for sex ed when he was the only out gay man at his Catholic school in Louisiana, to the 27-year-old web editor of one of the most popular love and relationship sites in India, these young activists are leading local SRHR movements around the world.
Gayatri Parameswaran is the web editor for Lovematters.in, the first website in Hindi to focus on “blush-free information and news on sex, love, and relationships.” Originally from Mumbai, Parameswaran is an Erasmus Mundus Scholar in journalism, with a specialty in War and Conflict Reporting.
RH Reality Check: How did you first become involved in work around sexual and reproductive health?
Gayatri Parameswaran: When I was about 17, I stood very close to a friend who was going through an abortion. It was probably one of the most traumatic times in my life, although I didn’t have to go through it myself. We had to keep it secret, and the stigma around it was really depressing.
Rewire: Was your friend open in talking to you about it?
GP: She was open telling me about it, but no one else knew. We couldn’t tell her parents. We couldn’t tell anyone else. We found a gynecologist who didn’t require any personal information and agreed to do the abortion. After that, my friend said two things that stuck with me. One was that she wished she had known better. And the other was that she wished there wasn’t so much shame around what she had done.
In India, we really don’t talk about sex; it’s just a taboo subject. Not having information, as clearly illustrated by this case, doesn’t help. There’s no need to have this shame and guilt around everything related to sex.
When I was about 20, I was studying in Amsterdam and interning at Radio Netherlands Worldwide. In 2011, they were piloting a project called Love Matters, targeted to young Indians. I started as a blogger and contributor, and then my role kept growing. Now I’m the editor for the India site.
Rewire: What do you publish?
GP: The most important thing about the website is that we emphasize pleasure. We really believe that sex is about pleasure. That is one of the most important things that people leave out when talking about sexual and reproductive rights. We all know that the reason people have sex is that it’s fun, and it makes you feel good. If we don’t talk about that component of sex, we’re missing out on talking to a lot of people. By implying that sex is about pleasure, and by talking openly about sex being something we do to feel good, we imply that sex is not about violence. It’s not about abuse.
In most states in India, we don’t have comprehensive sex education. We have a “resources” section of our site where people can look up information and find answers to their questions. We want to develop an alternative comprehensive sexuality education guide.
Another important element of our website is “Auntyji,” our sexual, reproductive and relationship expert. She answers a lot of sensitive questions: “Is masturbation a bad habit?” or “Is menstrual blood harmful?” or “I feel like beating my wife. What should I do?” She is very, very popular. We get hundreds of questions every day.
Rewire: What do you do on a daily base?
GP: I coordinate writers, work on partnerships, and think about content strategy. This week, for example, is marriage and wedding week, where all of our content is focused on that topic.
We’re also thinking about new technologies and new ways in which we can reach out to people. The website is currently targeted at urban young people with Internet. So how do we reach people who don’t have Internet? This incubator has made me think about services we can offer—like SMS services—to reach young rural youth.
Rewire: What are your personal goals for your own work?
GP: I wish I could have a conversation openly with my extended family about these things. There is still so much taboo and silence around topics related to sex and sexuality and gender and reproductive health. If I sat in a room for dinner with my cousins and aunts and uncles, and could speak openly about what I do, that would be a great day.
Rewire: What has been your family’s reaction to your work?
GP: My parents, and my brother—my close family—is very supportive. They understand very well the importance of what I do. That’s not the case with my extended family. I’m not comfortable talking about what I do with them. So I kind of skirt the issue, and say, “Uh, I run a website, it’s journalism.”
Rewire: Has there been anything particularly surprising about your work so far?
GP: None of us at LoveMatters expected it to be doing so well. We have more than half a million people on our social media sites. We are having a global impact in what we’re doing. It started in one room in the Netherlands with three people sitting down and saying, “Let’s talk about sex.” Now it’s become this phenomenal success.
Rahul Kumar Dwivedi is a campaign coordinator and special correspondent for Citizens News Service, a rights-oriented media organization based in Lucknow, India. He currently coordinates Vote for Health, a campaign focused on youth participation and activism around health issues.
Rewire: How did you first become involved in reproductive and sexual health work?
Rahul Kumar Dwivedi: I was born and brought up in a disconnected part of India, and there were several instances in my life when I wanted sexual health counseling, but there was no one I could talk to. I had a feeling that my sexual and reproductive health and rights were being denied.
For example, when I had my first sexual experience at the age of 15, neither of us knew anything about safe sex practices. There wasn’t any time for preparation. When I realized that she might be pregnant—though she was not—the lack of information fueled my anxiety and depression. I thought about the possibility that things could have gone in an unintended way. The guilt slipped towards shame, and I even thought about committing suicide.
When I moved to Lucknow in 2002, I got involved in a youth network called Indian Society Against Smoking, and later joined the Citizens News Service in 2008. Then my own understanding of sexual and reproductive health grew. I started leading Vote for Health, a policy, advocacy, and communication campaign that addresses structural drivers that negatively impact health and development outcomes. We work in schools and colleges. Eventually the Indian Society Against Smoking merged into Vote for Health.
Rewire: Have you faced any challenges when trying to bring this information into schools?
RKD: We find it very difficult to convince school administrations to prioritize sexual and reproductive health issues. They often say that there is no need for such discussions with the young. Rather, they want to talk about less controversial things, like anti-smoking. There is a culture of silence around sex and sexuality. There is an unavailability of safe places, which makes it even more difficult for youth to come forward and demand their rights.
Rewire: How has your work expanded since 2008?
RKD: I’ve gotten more involved with the issues. I organized Rights and Responsibilities Summer Training Camps to identify young leaders in Lucknow and educate them about sexual and reproductive rights. Since 2008, I have conducted at least seven or eight training sessions. That means I have trained more than 100 young people on what policies empower them and how they can seek information.
Rewire: What makes the Citizen News Service unique?
RKD: At the Citizen News Service, we do a lot of policy and advocacy initiatives, and we focus on involving the key populations that are affected. We engage with people living with HIV, people living with Hepatitis C or tuberculosis, people living with diabetes, with women, young people, transgender people, men who have sex with men. We document their voices and disseminate them on social media platforms.
Rewire: What are some of your personal goals for your future work?
RKD: I want to enhance the visibility of young voices. Young voices should be recognized, and young peoples’ participation in these issues should be meaningful, not just tokenistic. Somehow we need to break this culture of silence around sex and sexuality. Until and unless we break the silence, I don’t think there will be any sustainable impact on sexual and reproductive health and rights.
When I grew up, there was limited information available around sexual and reproductive issues. Nowadays there is increased access to information. That is of course good, but there are also caveats. There are now unreliable sources of information, such as pornography. That means it’s even more critical to work on these issues. That is why I am advocating and educating on this issue, and trying to build youth competence. Young people are not only part of the problem, but they are also part of the solution.
Michael Byer is a research and communications assistant at Louisiana Progress, a statewide advocacy organization. He has also helped organize the Louisiana Queer Conference, and was a past intern at GLSEN.
Rewire: What is your involvement in this program?
Michael Byer: I’m a research and communications assistant at Louisiana Progress. Louisiana Progress is a progressive statewide advocacy organization trying to do movement building in order to change Louisiana into a more progressive state. [Laughs] It may be a shock to people that we’re not.
We’re trying to do it on lots of broad levels. A lot of what we do is statewide policy advocacy as well as education by hosting forums. There’s a huge barrier as far as progressive media goes to talking about what is happening. It used to be that there were media who had to come to the legislature and who could put a check on a lot of these things, but there are only maybe two or three reporters now. And so we do a lot of broad-ranging things.
Rewire: When you say you’re an advocacy group, is it specific to sexual and reproductive health?
MB: No, it’s way broader than that. For example, during the next legislative session we’re going to do things on racial profiling, we’re running a version of ENDA (the Employment Nondiscrimination Act) in Louisiana, we’re doing things on foster care and child care, and we may do something on juvenile justice. We are trying to figure out what we’re going to do about sexual and reproductive health during this legislative session too. We’re working closely with the people at Planned Parenthood to talk about what to do there.
Rewire: What inspired you to do this kind of work?
MB: A lot of it was my own personal experience. I went to a Catholic school in New Orleans and was the only out gay kid in my grade. It was an all-male Catholic school. That informed me about how the system I was in—the Catholic school system—was not set up for someone like me to succeed. I had to search for support.
I remember being in our health class, and they were saying, “You can’t have sex until you’re married.” And I remember initially thinking, “Well, I can’t get married. They’re not talking about me. They’re not talking about ways that I can be healthy.” The only time they brought anything up about gay people was when they talked about how gay people were impacted by HIV or how gay people have higher rates of HIV. But there was no connection about what to do about it. No one ever told me how I was supposed to care for myself. No one had ever taught me that. And the only thing they said about sex is if you’re not married, don’t do it.
And so I would have people who would come up to me and ask questions. For example, a close friend came up to me and she said, “My boyfriend and I had sex.” I said, “OK.” And then she says, “I have to ask you a question.” I said, “OK.” Now, she went to an all girls’ Catholic school—Catholic schools are very prominent in New Orleans—and she said, “So if you ‘pull out’ you can’t get pregnant, right?” And I said, “No!” And she slammed her hand on the table and said, “No one ever told me!” So I’m passionate about this because we have been denied crucial information that would give us control over our lives.
Here’s another example: In college, at Louisiana State University, I went to the doctor because I had gotten a call from someone I had slept with saying that he had contracted chlamydia, and that I was the last person he had slept with. So I was freaking out and thought, “What can I do? What are the steps I can take to do something about this?” So I thought I’d go to the health center.
So I’m at the health center and telling the provider about this. She said, “We can get you tested.” I said, “OK, great.” So she said, “You’ll find out the results tomorrow.” Later she calls me and she says, “It’s negative. You don’t have chlamydia.” I said, “OK, great. This is awesome.” And she said, “Yeah, I know. I was surprised too.” And I said, “What?” And she says, “Well, considering you sleep with men.”
Rewire: Well that has nothing to do with anything!
MB: Right. Providers weren’t given ideas about what compassionate care looks like. And so I’m really turned off by going to the people who are supposed to be treating me. Schools weren’t set up to help me. The health-care system and doctors weren’t set up to even react to the things that were happening to me because of this lack of information. And that’s why I’m passionate about this. I got so frustrated and worn down and exhausted by stuff happening on a day-to-day basis. Not just to me, but to friends around me. I have friends who tried to get birth control, and providers would make them take all sorts of tests and would say all sorts of insulting things about the people who were trying to get care.
Rewire: So you’re really focused on providing accurate, reality-based information to people about sexuality education, and at the same time making sure that the people providing that information and care are doing it in a compassionate manner?
MB: Well, we are focused on the legislative level and trying to improve it there. If we can change the conversation at that level, and get people at that level to change and have conversations in their communities, that will lead to broader change.
Louisiana Progress is doing very broad things. We’re doing movement-building at the ground level and then also trying to do it in the legislature because people have written the legislature off. They say, “Well you can’t do anything there. There’s nothing productive that can ever happen there right now because of the makeup of the legislature and because the forces are too strong.” So we’re trying to get small wins because we can only have small wins at this time.
Rewire: Where do you see yourself in five years?
MB: Hopefully I’ll be getting out of law school. But I don’t want to practice; I want to do policy. I like law a lot. Even tweaking very small things has a huge impact on people’s lives. Trying to find little ways that we can have a huge impact. So, for example, at Louisiana Progress last year, one of the finalists for the Youth Champions Initiative was able to pass a bill that made it easier for homeless families to access childcare in Louisiana. It only affected 100 families. That was the target. But it was altering the way we were using a federal grant at the state level. Small stuff like that related to broadening access is something that I hope to be able to do in Louisiana.
What’s frustrating is that the people who could change the state leave. There’s a shortage of people who are committed to broadening access in a lot of the areas we are working in. The people with a lot of resources end up leaving. The people who stay are the ones who are really committed to the area or have family and never left. I want to leave and see how other places work, and then come back.
A big problem is that people don’t know what other people have in other places. If people only knew the amount of public resources that are available in other areas of the country, people would be protesting in the street every night! People would be so angry.
Rewire: What kind of things would you like to see change in Louisiana?
MB: The oil companies in Louisiana have bought the legislature. They’ve bought every statewide elected official. And so people were shocked when a Democrat from Louisiana—Mary Landrieu—was basically acting as the personal spokeswoman for the oil and gas industry, doing the Keystone XL pipeline. Oil and gas companies have been able to get away with so much for a long time, and have been able to buy politics, and have bought a lot of the politicians.
Even in a local school board election in Baton Rouge, Aramark—a private prison company—is contributing to make sure that someone who is pro-charter schools wins the election. We know that charter schools disproportionately punish students of color. We know they punish LGBT students more than non-LGBT students. They will put more people in prison, so Aramark donates to them.
Our politics have been bought. It’s pay-to-play. People don’t realize what is happening: that our state has been bought and sold to the highest bidder, and the highest bidder is the oil and gas companies and other corporations. So anything that happens that’s good is good for them, and it’s not good for everyone at the ground level. So people don’t even realize what’s happening, because everything seems great: We still have our food, we still go to church on Sunday, everything about our lives is the same, even though it’s not. Things have changed dramatically.
Rewire: What do you think needs to change in the sexual and reproductive health field?
MB: In sexual and reproductive health, I think the important thing is that we haven’t trusted people about where they are. If someone says, “I’m LGBT,” we don’t trust them. If a woman says she needs to have an abortion, we don’t trust her.
One of the problems is that there are faith leaders who have taken over the conversation and have said, “This is what God says, and if you don’t do this, or if you talk about it, you’re going against God’s will.” So we need to take back that conversation. There are tons of faith leaders who have been shut up by a lot of what’s happening and have been told that their view is not actually the Christian or mainstream view. They’ve been shut out of the conversation. If we can get them to to show up at places like the legislature or talk about it in their communities, that will have a dramatic impact on a lot of what’s happening in the state.
Neha Mankani is the monitoring and evaluation manager at Aahang, a Karachi, Pakistan-based sexual and reproductive health and rights organization.
Rewire: What does Aahang do?
Neha Mankani: There are two components: We work with teachers to build capacity and provide life skills education in schools and with community workers who talk to the community about marriage, family planning, and nutrition. And the other component involves working with health-care professionals to train their faculty members on the provision of a client-centered approach, and on STIs, and things like that.
Rewire: What got you interested in this line of work? What was your inspiration?
NM: When I got out of undergrad, I just wanted to be in the development sector because it was all I knew, but then I became interested in Aahang because it’s one of the few organizations in Pakistan focusing on sexual and reproductive health, and I was really intrigued about how one works on sexual and reproductive health in Pakistan—I just wanted to know. Then I started working there, and the kinds of things I would see in the field were just so interesting, like being able to train female welfare workers on a better client-centered approach and how to talk to their clients. They would tell us all these crazy stories, like this woman who came for an abortion six times in eight years because her husband kept “renting” her out to his friends. Just in that year-and-a-half that I was initially there, I heard powerful stories. So public health, reproductive health—this is what I want to work on.
Rewire: You mentioned training female welfare workers: Welfare means a different thing to many people in the United States, so can you explain what you mean by that?
NM: A female welfare worker is a community health worker who provides basic primary health-care services and contraception and basic reproductive health services.
Rewire: When you talk about a client-centered approach, what do you mean by that? Is there an approach that is the opposite of that?
NM: Yes, physician-centered is the opposite of client-centered. Client-centered is about talking to people with respect and dignity—asking questions and ensuring that there’s going to be follow-up to treatment protocols and making patients feel comfortable. It shouldn’t be a scary situation for clients; clients should keep using health services.
Rewire: In the United States, abortion is a very taboo issue and I imagine it’s probably the same in Pakistan. Can you tell me some of the challenges you face in trying to do the work that you do?
NM: There’s a lot of challenges working on these topics. In life skills education—that’s what we provide in schools—it’s actually a very neutral curriculum. We don’t really talk about sex. We talk about puberty, communication, negotiation, and decision-making. But even getting that curriculum into rural areas is really challenging, because if people misconstrue what we’re trying to do, we can get shut down.
We’ve had instances where we’ve worked with organizations, and someone in the community thought we were providing sex education, and the programs shut down for a little while.
As for abortion: We have a couple of projects dealing with abortion. And that is really difficult. We always frame it in the context of post-abortion care. We don’t ever really say “abortion services,” because there’s so much stigma associated with talking about abortion and talking about sex. So there are a lot of constraints. I know that we’ve trained providers on provision of post-abortion care services; they’re trained, and they want to do it, but there are such strict policies in place that they’re actually really nervous about it.
Rewire: What kind of policies?
NM: Policies against the provision of abortion.
Rewire: So abortion is legal in Pakistan?
NM: Yes. Abortion is legal in Pakistan, but only under certain circumstances. You can do it for rape, incest, and health of the mother.
Our projects are mostly not about promoting abortion, but about working with physicians to ensure that all the women who are dying of post-abortion complications because of things like coat-hanger abortions—to make sure that doesn’t happen.
Rewire: So you’re not involved in the actual provision side—you’re involved in training people on how to care for women who have already had abortions.
NM: Yes. Like using misoprostol to deal with post-abortion complications. We also do a lot of value clarification with providers because they can’t even do post-abortion care until their values on abortion are clarified.
Rewire: What does “value clarification” mean?
NM: We do these exercises with providers: We make them look at their own values and figure out why they think that way about abortion.
Rewire: So you’re trying to reduce providers’ personal stigma so they’re not transferring their attitudes about abortion to their patients?
NM: Yes. It’s been really effective because afterwards they turn around and say, “There have been a lot of times I’ve turned women away because of something that I thought.” What we do is train them to be able to separate what they think themselves. It’s the difference between being a provider and your personal attitudes.
Rewire: So basically you’re trying to change the way these people think about abortion so they’re not furthering the stigma for women, either by turning them away or treating them poorly while providing care for them?
Rewire: Tell me a bit more about why this work is important in Pakistan.
NM: Right now adolescent sexual and reproductive health is a really big issue for Pakistan, for a number of reasons. The biggest reason is that the population under the age of 25 is so large, and we really need to take advantage of the demographic dividend before it turns into a disaster.
Also, the schools we work in, where we’re providing comprehensive sex education, are lower- to middle-income schools, and our evaluations have shown us that the work we do is really impacting girls’ lives there. Girls have come back and told us, “After this program, I negotiated with my parents about staying in school for one more year,” or “I convinced my aunt not to get my cousin married at age 16.” We’ve had parents say, “I trust my daughter more, so I let her go out to the market by herself, because she seems more confident and she seems like she knows what she’s doing.” So really interesting things are coming out of this program.
The other part is that we have learning forums to get teachers to share what their experiences have been. Teachers are equipped much better to deal with cases of sexual violence in schools, and they tell us stories about how girls have become more confident and are telling them what’s been happening with them. There are a lot of stories about violence in the home. People will say, “My neighbor came in and abused me,” or “This person would touch me, and I never had the confidence to talk to anyone about it before, but now I’m telling you.” The teacher can intervene and make sure the girl gets what she needs.
Rewire: So it’s beyond just health care. It’s more of a holistic approach.
NM: It’s a package.
Rewire: It’s also a feminist approach, in terms of teaching girls about their own liberation and teaching them to be confident.
NM: Right. It teaches them to say, “This is what I need, and this is why I think I need it. We do a lot of work on early marriage prevention, and the strategy we’re taking is to go to schools and empower these girls, and give them the skills they need to talk about these things with their families. Even just bringing it up with their families, that’s a critical step—to say, “You know what? I don’t want to get married at 15.” Sexual violence, sexual abuse, and sexual harassment are other things that these girls have become better equipped to deal with.
Rewire: Did you find in your own life that there was a struggle to get advanced education? Was there any push-back from your family?
NM: No, there wasn’t any push-back really. That’s also been interesting for me—to think that these things have been really easy for me, but it’s not easy for a lot of people.
It’s really interesting that in Pakistan there aren’t that many in the development sector and there aren’t that many people who have a solid enough background to be able to work on it properly. That’s why I feel like it’s really important to keep working on it.
Rewire: What do you want to be doing in five years?
NM: I am really interested in maternal health. So I’m going to be in training to become a midwife. I’m going to start that in a few months. And then I want to combine my maternal health technical knowledge with my public health knowledge and develop programs with the proper technical skills.
The above interviews have been lightly edited for length and clarity.