you are not broken

Dr Marlena du Toit is a busy woman, constantly in consultations or the

operating theatre, but she is always eager to talk about her work. Du Toit

runs her own clinic in Belville, where she specialises in gynaecology and

sexual health, and she has a lot to say about women’s sexual wellbeing in

South Africa.

 

As a veteran of the healthcare profession, she is quick to highlight the

lack of resources - “I’ve been in private practice for the last 13 years and

in that time, I realised I had nowhere to send my patients who had sexual

problems,” she explains. “There was no one in the medical field from the

Western Cape that was available to assist me.”

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Du Toit resolved to help her patients herself, completing a course in

Europe (at the only available school of sexual health for SA doctors at

the time). Now she uses her training to tackle some of the most pressing

issues facing women, like the societal taboo of having conversations

around sex and the body.

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“Patients sense that their doctor is not open to discuss anything sexual, and they don’t even try. And it’s silent out there-Where do people go?”

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Providing a safe and comfortable space for women and their partners to seek clinical advice on seemingly ‘shameful’ issues, has become a key aspect in the training of future sexual healthcare professionals, Du Toit explains. Sex-related conversations are another crucial topic. “We’re all here because of 

sex. The stork is the biggest myth of all and still we don’t talk about it.”

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The sentiment is shared by Dr Marlene Wasserman, a clinical psychologist and sex therapist, who

regularly speaks on radio about sexual health and education. She says the stigma around sex stems from

the early school years. “The kids are not getting comprehensive sexuality education - They’re missing

that whole piece of what should be education, which is around values and critical thinking and

decision making and respect,” Wasserman says.

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 She points to how industries like the beauty and fashion sector affect us as consumers, malforming the

way we think about our own body image and sexual wellbeing. It’s a problem that Dr Du Toit has

experienced herself, especially within the context of South African society.

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“We come from a very patriarchal view on life in South Africa. I’ve had couples where the man would

be having sort of a tummy – and his wife would be beautiful. And when you talk to them, he would say

that he wouldn’t ever consider dating a woman that’s overweight, but the same rules don’t apply to him.

And I think that’s quite hard on women.”

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Du Toit believes that in order to diminish the atmosphere of shame around women’s bodies it needs to be talked about first. “For me, communication is a big, big thing. We need to be able to communicate respectfully with one another.”

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“It's all about education” agrees Wasserman. “We’ve got incredible legislation here in our country. It’s there

but we don’t have infrastructure to enforce it.”

 

As a solution, healthcare professionals have taken to the online space to bridge the gap between doctors and

media consumers, with one such South African page on Instagram called ‘Knickersinanot’ seeking to help

further educate beyond the clinic spaces where Du Toit and Wasserman operate. Periods,

sex ed myth-busting and body image are some of the many topics covered on the page, featured in colourful

and informative graphics.

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Contacting @Knickersinanot through Instagram, we found the face and name behind the virtual account –

Dr Stephanie Roche, currently working in a rural hospital in Mozambique. “Work is crazy, and we are so

understaffed here,” she shares over Whatsapp - but she remains enthusiastic about her online project.

The 27-year-old doctor puts the origins of her page back to her Catholic upbringing and recognising the lack

of sexual health information available for South African women.

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“I had a really privileged upbringing, I was surrounded by really incredible mentors and a very supportive

family…however I did notice that the one thing that was really lacking was exposure to sexual and

reproductive health information.”

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Roche points out the number of social media accounts and online pages on the internet that espouse

sex advice and sexual health tips, but without proper evidence-based information. “I think that having incorrect information is more damaging than having no information,” Roche says. And this is the mentality that inspired her Instagram page, @Knickersinanot.

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 “I wanted to fill a gap to make sure that young people like myself, especially young women who had grown up in religious or conservative environments had enough information to make power choices about their own health.”

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Knickersinanot became a way for Roche to share medically sound health information and education on typically

stigmatised or taboo topics like sex and mental health. “My final year of med school, a lot of friends and family

members were asking me information about their own bodies and their own sexual health. Whether or not

you’ve had a secondary education or a tertiary education, you can still have difficulty accessing reliable

information.”

 

Roche says that in her career as a doctor and now an administrator of a sexual health page the biggest sexual

health concerns for women are related to ideals of what is normal.

 

“The number one theme that has come through over and over again – ‘is my body normal?’ – ‘Is my body

beautiful?’ I just feel that in so many sexual reproductive health conversations and consultations and I

think that is what underlies all the shame,” Roche explains.

 

It's a pervasive issue in her work and Roche has garnered a keen understanding about the source of insecurities

stem, linking the problem to the overwhelmingly similar kinds of bodies we see in our everyday media.

 

“We’re so exposed to one specific body – it’s the same body on TV, when you watch porn, it’s the same body when you’re on Instagram. And so many bodies are hidden. That’s what we want to promote: the idea that nobody should be hidden, that all bodies are beautiful and that what is ‘normal’ is variation.”

 

For the foreseeable future, Roche says she will be hard at work in rural hospitals, providing medical care to women who desperately need it. But as a doctor who has seen “loads and loads of bodies over the past few years”, Roche’s advice for South African women is simple: “Your body is beautiful, just the way it is. There is no question about your body that someone hasn’t asked before and there’s absolutely no shame in asking and being curious.”

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