What's Up Down There: Cross-Cultural Attitudes to Vaginal Health (Women's Health Matters article) (Web resource; WHM resource) Author: Janice Pearson Organization: Women's College Hospital, Women's Health Matters When the editors of the magazine Black Woman and Child decided to explore the cultural and systemic barriers to getting women of African descent to talk openly about vaginal health, they opened a candid dialogue from the community. Nicole Osbourne James is the publisher of Black Woman and Child magazine and a member of the Family Advisory Council in Women & Children's Healthcare at the Scarborough Hospital in Toronto. She began by telling her audience at the 2008 Women's Health Matters Forum & Expo in Toronto that the first thing she learned from the dialogue was that ‘a Black woman doesn’t have a vagina.’ No, she has a ‘pum pum,’ ‘ting ting,’ ‘tom tom,’ ‘fanny,’ ‘cookie,’ or ‘cho cho,’ among many other colourful names. The women who participated in the dialogue said they were given these nicknames to use during childhood, and they often became a lifelong habit. About the only other thing that anyone remembered being told was ‘keep it clean,’ she said. Not talking about the vagina The word ‘vagina’ was definitely not a term favoured by the women around her. Some said it was too grown up, too vulgar and even ‘too white.’ Whatever the vagina was called, fathers never talked about it and mothers taught their daughters to never talk about it. The first time it might come up as a topic was typically when a young girl began menstruating. Osbourne James said that far from the expected ‘you’re a woman now’ chat, women reported that their mothers often seemed angry and gave lectures and warnings about boys and pregnancy. ‘No boys, no babies’ was the message a lot of the women reported. That, and: ‘Study your head before you open your legs.’ When girls started menstruating, some families began introducing taboos. Girls might be asked not to cook during menstruation, to bathe less or be last to bathe, and this led to feelings of being ‘dirty down there.’ In some cases, women developed negative feelings about babies because they were told babies could ruin lives. What about sex? Vaginas are also for sex, of course, and another question was about the women’s first time. Women reported that their friends were usually the first to know. ‘They make you think everybody’s doing it. So you do it and find out no one is,’ she said. As for parents, everyone knew that telling them would lead to disapproval. The potential for pleasure was also not talked about and certainly not between mother and daughter, particularly when it came to masturbation, Osbourne James said. Calling the doctor as the last resort If they developed health problems related to their vaginas, the women said they generally didn’t like talking about it. They self-diagnosed, used their own therapies and used a doctor as the last resort, fearing judgment. Breaking the silence Osbourne James encouraged the audience to share their views with each other and begin the much-needed breaking of silence. We may struggle with cultural beliefs, but we have to empower the next generation, she urged. We can call it whatever we want, but we must talk about it. Black Woman and Child magazine has plans for future dialogue. There will be more discussion groups and events to raise awareness of culturally specific issues by personalizing them for women and their culture. The forums will hopefully make people feel more comfortable and realize that they are not the only ones affected by the silence, Osbourne James said. This presentation was based on an event held by Black Woman and Child in December 2007, which invited seven black women to participate in a discussion about their attitudes towards vaginal health. The results were published in the Spring 2008 issue of the magazine. Editor’s Note: Written by Janice Pearson, childbirth educator and freelance writer who currently divides her time between Toronto and London, England. Coverage of a session at the 2008 Women's Health Matters Forum & Expo. Related Resources: More coverage of the 2008 Women’s Health Matters Forum & Expo can be found here. For more information about Black Woman and Child magazine see its website. Purpose:  Consumer information/support; Health information Information Source:  Hospital/Clinic Geographic Origin:  Canada Language of Resource:  English Groups:  Black/African/Caribbean women Last Reviewed by Women's Health Matters:  January 27, 2009