The 1st Anniversary Issue: 11 Seconds Mag

What’s in a year? The easy answer is time, but that begs another question — what is time and how can we define it? If we were to explore it theoretically, then it’s really a dilemma of both relativity and quantum mechanics, so in the words of Einstein, the rate of time all depends on your frame reference. Such relativity, no matter how you slice it, suggests that we ought to really consider what our reference point is (and should be).

Time is, after all, a luxury that we often overlook. An expensive indulgence that we spend much of our youth trying to circumvent, shortcut, and manipulate. But whether we look at time as relative, or a unit of quantum measurement, or even as something else entirely, the truth remains...there are 60 seconds in a minute, 86,400 seconds in a day, and 31,536,000 seconds in a year.

And it is now time for us to celebrate those 31 million seconds, because 11 Seconds Magazine is officially a year old! If you told me a year ago that we would be here now, with 3 issues under our belt, an amazing, brilliant, and talented editorial board, and all of you, I would not have believed it. There’s always a fear that our creations will be nothing but monsters, entities that do not serve us or others well (an adage that none other than Mary Shelly herself gifted us). But, the truth is, I am so beyond proud of this magazine and every single piece of work that we have published so far, and I know that this is just the beginning.

All our writers and artists have not only showcased their talents, but also their vulnerability and their willingness to engage in a topic of healthcare that is so often shied away from. It is not easy to write about your life. Believe me, I would rather take writing thousands of fictional words first over exposing myself through the written word, and it is just as much a privilege as it is a meaningful challenge to do so. But the fact of the matter remains, the truth deserves to be shared, and these stories deserve to be told. So, I hope you enjoy our special edition Anniversary Issue, where we take a walk down memory lane, where we introduce ourselves to some new ideas, and where we challenge our notions and preconceptions. In doing so, I hope that we are all able to come out of this with the truth, the real story, and the reminder that time is a luxury that is worth spending on the right things.

Table Contentsof

NEW The Year of the ‘Girl’ The Inequitable Outcome of Women Seeking Healthcare in Today’s Society Menstrual Blood: From Crass to Crucial Reflecting on Resilience

Sowing Seeds for the Future of Fertility: Ejaculate Responsibly Life isn’t easy. Pregnancy isn’t any easier Tell Your Kids You Used to Be Thin What’s in a word? 11:11 Revolutionizing Vaginal Dilation Therapy: It’s Not a Sex Toy, It’s Medicine The Science of Snuggles: A Profile on KRIASH and Dr. Neetika Ashwani

I have this old habit, one that is so very hard to kick. It starts with a calendar. Surely an unusual place to start, but bear with me. When things happen in my life, as inconsequential as they may seem in the grander scheme of things and holidays and events, I make a note of it. I don’t just make a note of it, but I turn it into an anniversary of sorts – the excuse to celebrate the mundane is something that I believe we should never overlook. For example, December 2, 2020 did not actually mean much else to me, really, aside from another day of screaming babies, height measurements, and bandaids; I was wearing pink scrubs and I continued my work in the pediatric clinic as always. Yet, I still marked it on my calendar with some unconstrained gusto as “First Shot Ever Given.” It joined the growing list of random “holidays” I’ve marked in my calendar, a list of zany discombobulated ‘firsts’ that don’t really mean anything to anyone but me.

So, looking at the calendar this year, 2024 (which still doesn’t feel real or believable in the slightest), despite having lived every day since, I couldn’t quite believe 11 Seconds would be reaching a year. A full year of trying to right some wrongs and change the narrative. A tall order that I never anticipated taking on, despite my deep love for writing. So, when April 7, 2024 neared us, I knew I wanted to commemorate our past year together in style. It was another date of significance, marked in my calendar with that same sense of gusto and unabashed excitement. It’s been one year!

I’m a firm believer that all celebrations of any kind require reflection of the past and acknowledgement of the future. This section does both – it takes us on a new, unexplored journey of girlhood and all its grisly parts. We come out of it questioning what is just, what is history, and what is tradition, and I would want it no other way.

The Year of the ‘Girl’

By: Alex Epshtein

2023 was a notorious year for many things. Amongst international political tensions, missing billionaires and the rise of artificial intelligence, it was also an extremely successful year for social media. Following congress’ legal questioning of Shou Chew, the CEO of TikTok, in March of 2023, the app saw a 16% increase in users, a trajectory which is expected to reach 2 billion users by the end of 2024. With these new users came an array of new TikTok sounds, influencers, and trends.

Amongst these trends was the ‘girl’ aesthetic. This aesthetic created new concepts such as ‘girlmath’, ‘girl-dinner’, ‘girlboss’, as well as far too many new filters to track.

Which one were you? Doe eyes or siren eyes? Peach fuzz or strawberry skin? Foxy brows or skinny brows? Blueberry nails or baby pink nails? Coquette or alternative?

A girl could not just be a girl—you had to be all these things as well. And even more, you had to know how you compared to your fellow female peers.

This trend is now known as ‘girlification’.

From my research for this article (scrolling TikTok for hours on end), I identified three trends that appeared between the debut of 11 Seconds to the issue you’re reading today. Through a critical analysis, I hope to shed some light on the dark underbelly of what ‘the girl’ aesthetic became.

The first trend is ‘the rotten girl’. This was a trend which encouraged people to accept their burnout, stop ignoring their fatigue and lean into their bad habits. This includes putting off chores for a weekend, not taking out the trash, or doing

skin care and leaving your room in a mess, or alternatively, just ‘rotting’ in bed. These things aren’t pretty but we all face them in our lives. That’s why we love this content and these trends — because it’s relatable and comforting to see someone else going through the same thing as you.

But, as always with social media, there is a mound of unaddressed problems that arise with these trends. The routes of burnout, the longterm problems, potential solutions…so let’s take a slightly closer look at who is allowed to be a ‘rotten girl’.

“There is a mound of unaddressed problems that arise with these trends. The routes of burnout, the long-term problems, potential solutions…”

The first people who come to mind, pioneering the trend, are Madeleine Argy and Emma Chamberlain. They both have very popular podcasts and YouTube channels, with even bigger overall social media followings. Both Chamberlain and Argy are upper-middle class, which enables them to comfortably go ‘off-grid’ for a couple of days. They’re both sponsored by beauty and skin care brands, and model part-time.

Passively watching these videos, we often enter a bubble where we view this content without considering their lives outside of our screen. But what about the people we see every day who suffer from these exact same problems?

What happens if you’re in a cafe, or class, or uni and a ‘real’ girl sits next to you. She doesn’t have any makeup on, she hasn’t washed her clothes,

and she may not have taken a shower in a couple of days. Would you view her the same way you view the ‘rotten girls’ online, just because she’s not getting dressed up to go to the Met Gala? Perhaps, instead of labeling her a ‘rotten girl’, instead she suffers from chronic pain or depression, which prevents her from fulfilling basic tasks and leading to her neglecting hygiene. For her, ‘rotting’ is no longer a choice, but a consequence of her ailments.

If she began to document her daily life, without the brand deals and sponsorships and financial stability and luxurious mansions, would her content be received in the same way?

I don’t think so.

So, as much as we all love watching these videos online, it is important to recognize that this content is only being deemed acceptable online if you’re conventionally attractive or generally wealthy. These girls are then monetized by brands and romanticized by others, who may not have the same privileges as them, and yet we hold them to the same standard.

I want to stress that the issue is not with the ‘rotten girls’ themselves, but rather in the tension that lies between where you fit on the scale of conventional attraction, which dictates how ‘rotten’ you can be without being reprimanded for it.

Meanwhile, on the complete opposite side of the spectrum, this trend was closely followed by the ‘clean girl’ aesthetic. This trend opens the door into wellness culture, with products such as Bloom, Stanley cups, LuluLemon matching sets, Erewhon smoothies and 8-part skin care routines at the forefront.

Ironically, this trend was pioneered by the same girls.

While the ‘rotten girl’ was a rejection of all these ‘conventional’ capitalist and marketing trends, the ‘clean girl’ embraces them wholeheartedly. The wellness trend is very deep-rooted in marketing, with brands sending influencers their products to review and advertise on their pages, sometimes

Glossary

Girl Dinner: A meal made up of small side dishes instead of the typical main meal and side. It requires little cooking and is mainly made up of food items that may not serve as a filling meal on their own. Examples include: chicken nuggets, berries, crisps, chocolate.

Girl Math: A financial decision that justifies the purchase of an otherwise unnecessary item. For example, a daily ‘sweet treat’ under £5 is ‘free’, doing returns earns you money, spending less than you expected means you actually gained money you otherwise wouldn’t have had, and calculating the worth of expensive items based on cost per use (eg. my matcha cost me £20, but in the grand scheme of things, that means my daily matcha is only 12p compared to the usual £4.50 when buying it from a cafe).

Girlboss: One of the first trendy ‘girl’ terms to emerge online, referring to a female boss getting things done and making executive decisions in her personal or professional life.

Rotten girl: A girl who leans into her burnout and decides to forfeit doing basic chores in favor of resting in bed without doing something productive. For example, I can scroll TikTok for hours instead of eating regular meals/cleaning.

Clean Girl: The antithesis of the ‘rotten girl’, ‘clean’ girls tend to have a very modern, minimalist aesthetic. Their makeup, style, and daily routines are all refined to appear flawless. They often have a strict routine, wake up early to be productive/go to the gym, drink protein smoothies and eat healthy, balanced meals, ending the day with a long skin-care routine.

A Day in the Life: When a person posts photos or videos of their daily routine on social media so you get an insight of their ‘real’ life, beyond social media. For example ‘a day in the life of a uni student’ or ‘a day in the life of a girl in corporate’.

explicitly, but more often implicitly.

But as these products are being marketed by influencers, showing themselves using these products in their daily lives, viewers begin to see these seemingly ‘normal’ people whose lives were previously relatable and fun begin to blossom into success and luxury, taking these items on the journey with them. So, not only are these products being marketed, but they become deep-rooted in the aesthetic lifestyle these people lead. Viewers begin to buy them, not for the products themselves, but as hopeful keys that will unlock a door into the same lifestyle as these influencers, getting them one step closer to their ideal body, ideal look, ideal life.

“Viewers begin to buy them, not for the products themselves, but as hopeful keys that will unlock a door into the same lifestyle as these influencers, getting them one step closer to their ideal body, ideal look, ideal life.”

These products are marketed to you in a way that when your lifestyle does not encompass at least some of these ‘routines’ or habits that you see online, then you are not aesthetic enough.

We’ve all fallen for these traps before. Personally, it’s been with flavored matcha, and overnight chia puddings, which really aren’t all that delicious, but I did think they would make my day at least a little brighter. However, once again, we see an entire demographic of people being excluded from these trends. But, you are no less valid if you cannot afford these things, if you cannot access them, if you cannot use them.

Remember, those people online are being paid to use these products, being paid for every person who watches them use the products, and being paid when their viewers buy the products. Just as you have work, this is theirs, no matter how luxurious it looks, you are not the same.

Again, I’m not saying it’s all bad. I’m just encouraging you to take everything with a grain of salt. This branding is so structured around

marketing perfection, that it makes you forget all the other non-material aspects in your life that dictate your level of happiness.

That one new lipstick is not going to suddenly negate that you still have to revise for that exam, you still have depression, and you still have to pay rent.

Finally, the last trend I wanted to discuss here was ‘a day in the life’. This is perhaps my favorite trend of 2023.

Once again, pioneered by the ‘rotten’ girls and the ‘clean’ girls, these are short videos where we get a small snippet of what their lives are ‘actually’ like. We see them ‘rotting’ in bed, or doing their makeup (with only Charlotte Tilbury products), or getting ready for bed, with their 8-step skin-care routine.

This is potentially the most difficult time to remember that these people we see on social media every day are actually influencers. This is how they earn their money, and we are their consumers. Consumers of their content, their media, their products.

And yet, we find these videos so comforting. Especially when we see them near a place we live, trying out a new coffee shop, or taking public transport. We do those things too! They’re just like us!

But, there is also a fine line between relatability and comparison. We trust that they are being honest with us, that we are watching the best and worst parts of their day. We trust that the new coffee they tried was just as good as their usual order. We trust that their makeup doesn’t smudge the entire day. We trust that they do wake-up at 6am and have a productive 8-hour work day every single day. We forget the hours of post-production editing, the money spent on a ‘day out in the city’, and the omissions of everything else. Social media feeds into both our obsession with transparency and our constant deprivation of it.

As apparent from these three trends, we must be mindful of all the different lifestyles and different privileges that people experience in their daily lives.

Who is excluded from these trends and narratives? 2023 also saw a huge surge in transphobia and racism, with creators such as Veondre, Dylan Mulvaney and Jory on TikTok all having to take social media breaks due to receiving deaththreats and masses of hate online. They were also partaking in the above trends, alongside creators like Madeleine Argy and Emma Chamberlain, but they were not received in the same way, or accepted in those communities equally.

It’s so easy to blindly follow these trends and scroll for hours, but it’s extremely important to think critically about how these trends affect the wider population, who don’t fit the conventionally attractive, wealthy mold of popular influencers. 2024 is beginning to see a change to these narratives and trends. Creators have taken ‘skin

product’ breaks, where they have documented their progress for two weeks, with most results being overwhelmingly positive. The queer community is fighting back too, especially more recently with the release of Mulvaney’s new song: ‘The Days of Girlhood’, which upon release sparked the attention of thousands of transphobic voices.

There is no set amount of experiences that define whether your life falls under the umbrella of ‘girlhood’ or not. Girlhood is not one lived experience. It is not one person’s life. Every lifestyle has intersectional differences, whether it is meeting societal standards of beauty, monetary success, valuing aesthetic drinks over tasty ones, or trying to follow these trends, there is not just one version of ‘girlhood’, or one way of being a ‘girl’.

TheOutcomeInequitable of WomenHealthcareSeeking in Today’s Society

By: Abby Hyson

In the landscape of medicine in the 21st century, the pursuit of equitable healthcare for women remains an ongoing challenge; particularly more so for those who often encounter numerous obstacles on their journey to wellness. From systemic biases in clinical research to workplace inequalities and informational barriers, women face a plethora of challenges that impact their access to quality care, ultimately leading to poorer overall health outcomes. It’s time to confront these disparities head-on and create a multi-pronged approach to close the health equity gap. By addressing barriers to comprehensive and ongoing patient care, societal perceptions and stereotypes, dismantling biased notions in healthcare, policy changes, and advocacy efforts, there can be immense positive change ahead for women pursuing healthcare guidance in today’s society.

Transportation, language, and monetary barriers significantly impact women seeking medical care. Limited access to reliable transportation can prevent patients from attending appointments or accessing essential services such as primary care, specialty visits, and even lab work appointments. This disproportionately affects women who may bear the majority responsibility of caregiving and household duties. Language barriers further exacerbate these challenges, hindering effective communication between patients and healthcare

providers; thus putting roadblocks in the way of comprehensive care plans. To put this in perspective, about one-third of U.S. hospitals fail to offer interpreters to patients who speak limited English. With each additional appointment that is in the queue of a patient’s health journey, proper and consistent translation services get lost with the coordination of an extensive health plan. Additionally, the gender pay gap further strains the monetary barrier for women in being able to afford necessary treatments, medications, and preventive care. The slow progress in closing the gender pay gap over the past twenty years has yielded + $0.04 in the amount a woman earns for every dollar a man does; meanwhile, medical costs for consumer goods and services rose by about 80% within the same timespan.

Moreover, the healthcare journey for women often entails a frustrating cycle of specialist visits, escalating costs, and substandard outcomes. Women frequently find themselves shuttling between specialists, primary care, and lab visits, with each visit adding to the financial strain. For example, if we look at endometriosis, the average diagnostic delay is seven to nine years. Women are being passed around from multiple specialists to primary care providers, all which have different views on what their specific care plan should look like. The lack of comprehensive insurance

coverage for certain treatments, such as laser hair removal for conditions like polycystic ovary syndrome (PCOS), further expands the issue. As a result, women may resort to seeking free alternative therapies or information from nontraditional sources, such as social media platforms like TikTok, to supplement their healthcare knowledge.

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As a result, women may resort to seeking free alternative therapies or information from non-traditional sources, such as social media platforms like TikTok, to supplement their healthcare knowledge.“

The journey to a diagnosis is often filled with obstacles for women, with research indicating that women are frequently misdiagnosed or face delays in receiving a proper diagnosis compared to men. One study even suggested that across 770 different disease types, there was an average delay of four years for women to get diagnosed compared to men, suggesting that this phenomenon is evident across various medical conditions, ranging from cardiovascular disease to autoimmune disorders and mental health conditions. Despite experiencing comparable symptoms, women are frequently dismissed or trivialized, leading to unnecessary suffering and prolonged illness.

Informational barriers also impact women’s access to accurate and comprehensive healthcare. The quality of care a woman receives is contingent upon the knowledge and expertise of her healthcare provider, sending women to get more second opinions than their male counterpart. However, accessing reliable and up-to-date medical information remains a challenge, particularly when clinical guidelines and research fail to keep up with demand for said medical information.

Clinical barriers, rooted in historical biases and systemic exclusion, further preserves disparities in healthcare outcomes. The underrepresentation of women in clinical trials until 1993 resulted in a limited understanding of how medical

interventions affect female physiology. Even within the realm of menstrual health, product efficacy was evaluated without using human blood until only a few years ago. This oversight not only undermines the validity of research findings but also neglects the unique healthcare needs of women.

Additionally, focusing clinical trials solely on a male human body leads to misdiagnosis and delayed treatment for women. For example, heart attack symptoms in women may present differently than those in men, leading to underrecognition and undertreatment of cardiovascular disease in women. One study found that women who presented with the symptoms of chest pain at an emergency department waited approximately 11 minutes longer to see a doctor or nurse than men who presented the same symptoms. These clinical biases put an emphasis on the urgent need for gender-sensitive medical education and research protocols.

Societal perceptions and stereotypes surrounding gender and health also play a significant role in perpetuating disparities in diagnosis and treatment. Women are often portrayed as overly

emotional or hypochondriacal, leading healthcare providers to dismiss their symptoms or attribute them to psychological factors rather than looking for the root cause of underlying medical conditions. This dismissal not only undermines women’s experiences but also contributes to the perpetuation of harmful gender stereotypes within healthcare settings.

“Women are often portrayed as overly emotional or hypochondriacal, leading healthcare providers to dismiss their symptoms or attribute them to psychological factors rather than looking for the root cause of underlying medical conditions.“

Work-related barriers further compound the challenges faced by women in healthcare. The absence of adequate time off for conditions like endometriosis or menstrual-related diseases/ symptoms forces women to navigate their health needs within the confines of a workday designed around a typical male hormone cycle. Unconscious gender bias in the workplace perpetuates disparities in promotion, salary, and access to accommodations for health-related needs. The difference in postpartum leave between men and women reflects a need for a larger societal shift within the United States as it reinforces gender roles within the workforce.

Addressing these disparities requires a united effort from stakeholders across the healthcare ecosystem. Policymakers must prioritize initiatives that dismantle systemic barriers to care, including transportation subsidies, comprehensive language interpretation services, and equitable reimbursement structures. Employers must implement policies that accommodate women’s health needs, including flexible work schedules, paid leave for menstrual-related symptoms, and awareness training to reduce unconscious bias.

Healthcare providers should undergo training to recognize and address gender biases in clinical practice. This includes incorporating genderspecific attention into diagnostic and treatment protocols, as well as fostering a culture of

inclusivity and respect within healthcare settings. Additionally, investing in research that prioritizes gender diversity and inclusivity is essential for advancing our understanding of women’s health and improving positive clinical outcomes.

Equally important is the need for greater awareness and advocacy from patients and communities. Women must feel empowered to advocate for their health and well-being, challenging stereotypes and biases within healthcare settings and demanding equitable treatment and access to care. To do this, women must not be afraid to discuss taboo and stigma ladened conversations, as well as demand more from their physicians and specialists to order specialized tests that will ultimately help them get to the root of their symptoms. Empowerment can also come from the people they surround themselves in, as well as, digital tools that are shared amongst friend groups and family members. A WHO report showed that digital health technologies can improve women’s health tremendously, and when shared, starts a ripple effect that can be quite effective.

Additionally, community-based organizations and advocacy groups play a crucial role in raising awareness about gender disparities in healthcare and advocating for policy changes that promote gender equity and inclusivity. Volunteering with local programs in the immediate community to help push awareness forward is a great starting point. There are also larger health equity groups that have a plethora of information, such as Allies for Reaching Community Health Equity, Center for Health Equity and Place, and the National Collaborative for Health Equity.

Ultimately, achieving health equity for women requires a holistic approach that addresses social, economic, and cultural factors that shape their healthcare experiences. By acknowledging and actively working to dismantle the barriers that hinder women’s access to both quality care and outcomes, we can move closer to a healthcare system that prioritizes inclusivity, equity, and positive health outcomes for all. It’s time to bridge the gender gap in healthcare and pave the way for a healthier, more equitable future for women everywhere.

Menstrual Blood: From Crass to Crucial

By: Preksha Kukreja

The first time I realized that the world did not care for menstruation, I was 12 and trying to manage my first period in an all-white school uniform. Fighting the urge to look over my skirt for red splotches every time I stood from my chair drained me. Liquid white-out took on the role of safety net in my backpack. My mom would wrap spare sanitary pads in printer paper, because newspaper wraps would have been too obvious of course.

Myth, ignorance, and insensitivity surrounding menstruation have long been used to justify othering. Period shame has seen women relegated to provisional huts, sometimes without sunlight, in a practice called Chhaupadi in Nepal. Pads and tampons are not only expensive, but also heavily taxed in much of the world, including 21 states in the US. Arguably, the world’s perception of Auntie Flo has not changed much.

One of the ways it is being brought to public discourse is through stand-up comedy. While men have been making variations of the same PMS jokes for ages, the advent of the female comedian has brought with it an unabashed exploration of the realities of menstrual cycles. Cameron Esposito and Michelle Wolf have done it masterfully. They gave us relatable images - what it looks like to be a woman on her period in the office, smiling through the pain, pretending to tie shoelaces but actually looking for blood stains. A female interviewer went on to admit that her first

thought on listening to Esposito in 2016 was, “oh no, we’re going there?”

But, solidarity has never been achieved in the struggle for gender equality. Period leave is one such divisive issue. While the concept of letting the body rest while it bleeds is certainly justified and enticing to many, it is hard not to view it as yet another argument for cis male superiority. Many have also raised the point that only a small percentage of menstruators have debilitating menses, usually attributable to medical diagnoses like endometriosis or fibroids. However, these conditions remain vastly underdiagnosed and the pain associated with them ignored for years. A recent article published in the New York Times shed light on the savage approach of the Maharashtrian sugar industry in dealing with its menstruating employees. Trapping them in a vicious cycle of debt, contractors force female labor to undergo hysterectomies so that they can continue to undertake hard labor without the bother of periods and women’s health checkups. Early menopause and its negative effects are left to the wayside, not even worthy of afterthought.

Public opinion and the resulting urgency it can generate motivates scientific research. This is evident in the spur of much-needed research on Alzheimer’s disease. As a woman in medicine, it is baffling to me that menstruation, a phenomenon experienced by over a quarter of the world’s

population, is so understudied. A quick PubMed search reveals that before the year 2000, the total number of articles with “menstruation” or “menstrual” in the title was 360. For “cardiac”, it was about 48,000.

It didn’t surprise me then, when a mentor shared the following anecdote: at a medical (nongynecological) case conference in a renowned academic hospital, male physicians failed to identify a picture of period blood. The reason: it was brown in color. This blood, long deemed impure and unworthy of notice, is now being studied as a potential screening tool for cervical cancer. Qvin, a startup spun off from the Stanford University research group that has pioneered this direction of research, collects menstrual effluent (blood including vaginal secretions and endometrial cells shed during menses) in their patented sanitary pad to analyze for several biomarkers, including CRP (inflammation), HbA1c (diabetes), and TSH (thyroid health) among others.

This is a departure from the long-standing approach of studying menstruation as an exception to pregnancy. Emily Martin, an anthropologist has notably mentioned in The Woman in the Body that medicine views menstruation as a failure to achieve pregnancy. Given that the total duration of menses over the course of a lifetime is approximately 7 years and the average fertility rate, far lower at 2.3 children per person of childbearing capacity, it is safe to say pregnancy is the exception to menstruation.

In the last few years, especially after the onset of the COVID-19 pandemic, physicians and scientists have also shaped public discourse. Dr. Tanaya Narendra, known popularly as Dr. Cuterus, is a doctor based in India who talks about all things menstrual and sexual health through her Instagram page. Researcher Kate Clancy has published Period, a blended account of her work and interviews with menstruators.

These conversations can lead the change in destigmatizing menstruation and learning more about the process, not as an ancillary to reproductive health, but as its core.

Reflecting onResilience

By: Kira Zizzo

As a woman navigating the landscape of women’s rights and health, it’s crucial to conceptualize breakthroughs and setbacks within a broader context of societal progress and ongoing challenges.

Breakthroughs are shown in moments of triumph, where advancements are made in medical breakthroughs and representation. These milestones serve as beacons of hope, signaling positive change and paving the way for a more equitable future.

Alongside these triumphs come setbacks, which have manifested as legislative rollbacks, persistent gender disparities, systemic barriers to healthcare access, and cultural norms that perpetuate inequality. These setbacks are disheartening and frustrating, but they also emphasize the ongoing need for advocacy, activism, and solidarity among women.

As a young woman, it’s essential to approach both breakthroughs and setbacks with a critical yet hopeful mindset. Celebrate the victories, but remain vigilant in addressing the persistent challenges that affect women’s rights and health. Educate yourself about the issues, engage in activism, and amplify the voices of marginalized communities. By actively participating in the fight for gender equality and advocating for improved healthcare access, young women can contribute to meaningful change and help shape a more just and inclusive society for future generations.

We must extend a hand (or two) to other women, offering support and solidarity in this shared struggle. We’re at a point where it’s crucial to lift each other up and embrace our collective strength. It’s a constant fight for the betterment of women and we must be unrelenting.

These challenges and changes can be our catalysts for growth and empowerment. In these moments of transformation, we truly discover the depths of our resilience and the boundless potential of womanhood.

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Over the course of one year, we have published over 45 unique pieces. These pieces, be it writing or art, capture quintessentially real human experiences, lament difficult moments of dismissal and pain, speak to hope and change and revolution, and everything else in between. To commemorate our year together, and our three issues of the past, I couldn’t help but urge my wonderful editorial board to go back down memory lane and each pick a piece that resonated with them, for whatever the reason may be.

We ought to share and reshare what means something to us, because as someone once said, writing, as a craft, is derivative. Good writing inherently comes from good reading. You, readers, have been a part of our journey since day one. This magazine would not exist without you. You’ve seen us grow and blossom and evolve, so I hope you won’t mind too much that we had to bring these pieces back to you. Nostalgia is, after all, life’s greatest yearning, so yearn with us as we revisit why these pieces are so important and so impactful.

No Opting Out: Why ShouldParents Not Opt Their Children Out of Sex Ed

By: Ramya Chunduri

As an On-Scene Advocate at a domestic violence shelter, I saw firsthand the effects of missing sexual education. Jessica walked into the hospital with bruises in all the places I once did. Her black eye, lacerations on her face, and arms, and wrist constraint marks gave me flashbacks of what I buried. She believed what was told to her—her rape didn’t count because she was drunk. She shouldn’t wear short skirts. This is what a comprehensive sexual education could have prevented. There should be no grappling with the truth for survivors. No parent should go through the pain when they realize their attempt to protect failed. The sooner we realize that sexual education plays a key role in preventing sexual assault and intimate partner violence, the sooner we can reevaluate opt-out policies.

The “Me Too” phrase coined in 2006, but popularized in 2017 necessitated conversations at public schools around the country about how consent is addressed. Even now, it inspires me to speak openly about my own experience. I was sexually harassed and assaulted, and I did not have any sex education until the 11th grade. Optout policies continue to prevent comprehensive sexual education for all students. As of 2020, 35 states and the District of Columbia allow parents to opt-out on the basis of providing parental autonomy. However, as of August 2020, only 29 states and D.C. have required that sex education

is taught in any capacity at all.

While comprehensive and repetitive sex education is a proven form of violence prevention and harm reduction, Massachusetts schools do not mandate that sex education be medically accurate, nor does it mandate curriculum on HIV/STIs, abstinence as an option, information on consent and healthy relationships, or abortion. Given that the COVID-19 pandemic has already complicated the sexual, social, and mental health of adolescents (by increasing online intimacy, sexting, sexual firsts), sexual health information must be properly shared and taught by professionals to better navigate this growing virtual sexual landscape.

1 in 3 women and 1 in 5 men in Massachusetts note being raped, and/or a victim of interpersonal violence. 50% of women and 25% of men in the state report experiencing a form of sexual violence that isn’t rape. But there is no requirement that sex education teachers need to undergo specific training or coursework before teaching students in Massachusetts. Parental notice is also explicitly necessary while parental consent is not. Upon notification of sexual education, parents may opt out on behalf of their children.

If schools are the only site for formal sexual education, then opt-out and opt-in policies will only lead to adolescents seeking information out

elsewhere; the pandemic is enough evidence of students doing so. Is it safer to receive primary and introductory sexual education in a formal setting or with friends the same age, pornography, or google? Are they comparable? Research shows that having sexual education in formal settings like school before the age of 18 is a major protective factor to avoid sexual assault during college. Hence, parents being able to opt out of school sex-ed when offered could be more detrimental for the future of our youth.

But if sex education is crucial to the sexual health and well-being of children, and a majority of parents believe that it should be taught in schools rather than by themselves, then why is sexual education not prioritized?

Unlike Massachusetts, New Jersey, which has had the lowest rate of rape for more than a decade, has laws that require students to learn about consent and through a sexual assault prevention program, about intimate partner violence. It is the state with the most robust sexual education curriculum in the U.S. and this reflects how low its rates of sexual violence are compared to the rest of the country.

New Jersey achieved this by implementing significant policy changes to sexual education in June 2020. These changes ensured that sex education curricula would incorporate conversations around gender identity and abortion. According to Patricia Teffenhart, the Executive Director of the New Jersey Coalition Against Sexual Assault (NJCASA), the reason behind these changes is because sex education is proven to be a resiliency factor for sexual violence and therefore contributes to the overall well-being of adolescents.

Sexual violence occurs at alarming rates for teenagers and college students, most of which could be preventable if schools focus on educating children of all ages about boundaries, respecting them, and creating a culture of care versus carelessness. It’s not about eradicating all opt-out options immediately, but rather learning more about why opt-out policies do more harm than good for the youth of America and how we

change this.

While thinking about sexual education, I thought about my first. The first time I learned about reproductive organs was in biology class. Then, it was in health class – in the tenth grade. The first time I saw these organs in a non-sexual way was as a senior patient care technician when inserting catheters. What the overly academic introduction to reproductive organs provided me with was a dearth of information for when the time actually was to come. In fact, it scared me off from truly understanding. It didn’t protect me, but rather made me vulnerable to sexual violence.

So, here’s a first for us all to consider: destigmatize, destigmatize, destigmatize. Talk about it, because talking about it in a safe environment doesn’t cause sexual behavior. It educates and reduces the risk of finding out through experimentation with the wrong people at the wrong time, and/or after violence.

When I was younger, maybe we talked around it at home, or with friends discreetly through innuendos that I didn’t understand, but it wasn’t explicit, and it wasn’t enough. Repetition is required. While it might be uncomfortable, do it anyway before it’s too late. Ask questions, talk, learn, and listen.

Kira’s Pick

This piece is incredibly important and powerful in advocating for comprehensive sex education in schools. It highlights the crucial role that proper sex education can play in preventing sexual assault, intimate partner violence, and promoting overall sexual health and wellbeing among teens. This article serves as an important call to action for parents, educators, and policymakers to prioritize comprehensive sexual education as a crucial tool for protecting young people, fostering healthy attitudes towards sexuality, and preventing the longlasting trauma of sexual violence.

Ramya illustrates the importance of sex ed from both heartbreaking and analytical standpoints that leave you thinking about the piece days later.

Oh, shit.

By: Amanda Sheehan

I saw him in the corner and I thought he was handsome but I’m safe with my friends so why was I looking? Maybe for attention or, better yet, to fall into the big arms and the blue eyes he was looking back at me with - oh, shit. I was looking too long. He noticed and approached me while I’m stuck in the corner of the room.

Hours go by, we get progressively more drunk and high on wine and weed and each others laugh but I don’t want to leave my friends, so why was I still there? Maybe because I couldn’t help but fall into the trance of safety he made me feel for the first time in a long time - oh, shit. I was feeling too much. He noticed and invited me back to his dorm.

I remember hearing that he was the nicest guy at the party and there’s no reason to say no except that I don’t want to leave my friends so why would I say yes? Maybe because I couldn’t help but fall into the routine I couldn’t seem to break where I sleep with men who think I’m pretty - oh, shit. He realizes I can’t find my friends and need a safe place to crash so he holds my hand on the way.

Oh, shit.

I was crying before during and after and there were so many reasons to say no except that I’m stoned and drunk and confused and hateful towards myself because I didn’t want to leave

my friends so why didn’t I stop him from falling into me? Maybe because I was stuck - oh, shit. He knows I can’t say no and keeps going.

I saw myself in the mirror the morning after, shocked and horrified that I was never really safe even though I was with my friends so how did this happen to me? Maybe .... wait. I suddenly realize that I couldn’t remember if he’d been safe - oh, shit. I was thinking aloud and he thought for a moment and said no.

Oh, shit.

Oh, shit because how did I let this happen? Oh, shit because my friends felt safe to leave me with the nicest guy at the party? Oh, shit because I thought I was safe with the nicest guy at the party. Oh, shit because how could he have not been safe? Oh, shit because it’s positive. Oh, shit because I’m broke and in college and have my whole life ahead of me. Oh, shit because no one cares because I didn’t say no Oh, shit because we live in a state where I can’t get help even if someone did. Oh, shit because I’m stuck. In a dorm. And the nicest guy at the party knew that I couldn’t say no. Oh, shit because we’re stuck. In a state. Where a guy in a different kind of party decided we can’t say no to what happened after we couldn’t.

oh, shit.

Liz’s Pick

I can’t fully articulate fully how I feel about this piece. Although, it’s one of the shorter works featured in 11SM I think it’s one of the most startling. Within the first few sentences you’re struck with a deep feeling. Amanda shares feelings of of being frustrated, scared, shocked, confused, angry and so much more — but through the bolded words and repetitive nature there is a roar. And that’s why I’ve read this piece so many times.

Oh, shit.

Oh, shit.

Oh, shit.

Oh, shit.

Oh, shit.

Oh, shit.

Aesthetic nonconformity

By: Jacki Huntington

“Aesthetic nonconformity”: that was my medical diagnosis. As I read through the informed consent paperwork in the days leading up to my cosmetic surgery, I laughed out loud alone in my apartment. I was about to get a septorhinoplasty, a nose job that would address both the appearance and the function of my nose. It was a procedure I’d coveted since puberty transformed my face into something more austere than I comfortably identified with.

I had moved to Mexico City some months prior. After smoking weed one night and looking at myself in the mirror for too long, I realized that in all of my years of disliking my nose, I had never even attempted to have a consultation with a plastic surgeon. I realized, too, how much cheaper a nose job would be in Mexico compared to American pricing. In my stoned contemplation, I gave myself permission to abandon my pseudofeminist allegiance to my birth nose. After all, wasn’t it just a hypocritical coping mechanism in a world of shifting norms, advancing technology and consumerist delights?

I found a plastic surgeon with before-and-afters that I liked, and I began to prepare myself. What does it mean to conform aesthetically? A medical diagnosis of “aesthetic nonconformity” suggests an objectivist view of my “need” to bring my features to comply with a set of proportions. It implies that a variety of plastic surgeons could see me for a consultation and come to the same conclusion. However, in aesthetic medicine (as in medicine generally) these diagnoses are a bit more subjective than that, with the patient making a request to which the clinician must respond. Aesthetic medicine, in a subjectivist light, could be considered a “medicine of desires,” as some Italian researchers have pessimistically put it in

a 2015 opinion piece in the Archives of Plastic Surgery. However, the truth of this medical pursuit of aesthetic conformity and, yes, beauty, lies somewhere in between those two poles of “subject” and “object” in a relational space. I liken this relational aspect of beauty to Rachel Alsop and Kathleen Lennon’s concept of the “expressive body”– something we can modify in order to change the way that we relate to others and them to us.

In addition to changing my nose, by the suggestion of my surgeon, I opted also to shorten my philtrum (the skin between the upper lip and the nostrils) with a procedure known as a bullhorn lip lift. This, in concert with the septorhinoplasty, would reconfigure the proportions of my face into something softer, rounder, more feminine and –I suppose – more aesthetically conformed. What could be possible, I wondered, with a slightly different face, one that better fit my subjective view of myself? How would it change me? How would it change how others see me? Ultimately, how would it change my lived experience?

The manifestations of normative aesthetics have changed throughout history. Similarly, aesthetic surgery has changed as a practice and a profession dramatically in the past 100 years. In recent decades, one’s collection of natural beauty traits have increasingly come to be viewed as a rough draft to be revised. The body, as sociolinguist Anne-Mette Hermans wrote in Discourses of Perfection, is marketed more and more as something malleable – a “project.”

As someone socialized and identifying as femme, my “project” is lifelong. My interventions in pursuit of beauty can be viewed on a spectrum. On the

innocuous and socially acceptable end, there’s skincare, fashion, physical exercise, makeup, diet, and the braces that wrested my crooked pre-teen teeth into line. On the more stigmatized end there is the nose job, the lip lift, the Botox I once had injected into my jaw to make it slimmer, the “baby” Botox I had injected into my forehead just to see how I liked it, and whatever might be next (a brow lift?). To acknowledge this spectrum of stigma is to acknowledge the social utility of objective medical language in describing beauty.

For example, many people couch their aesthetic rhinoplasties in medically necessary language to avoid appearing vain – a trait that is apparently still frowned upon in Western culture. As I have noted, my own nose job was, in fact, advantageous to my breathing capabilities, and perhaps I could have petitioned for its medical necessity for the sake of insurance coverage. However, if I’m honest, I would have lived with my crooked septum if only I had liked the appearance of my birth nose.

Psychology, of course, is at the heart of this pursuit of beauty, but the economy is, too. My willingness to consume products and technologies that allow me to modify my body – objectively, subjectively and relationally – is indicative not just of my pursuit of a beautiful body, but my pursuit of a beautiful life. If we reframe beauty as a form of capital (social and otherwise), we can understand why it is pursued both as a commodity and a desired outcome in a medical context. Still, the gray area between the subjective and objective – the “elective” and the “medically necessary” – makes people uncomfortable. I mean, as a feminist, it certainly makes me uncomfortable, which is likely why I am so attracted to writing about it.

The queer-ish feminist argument against cosmetic interventions in pursuit of beauty goes something like this: By enabling the transformation of “aesthetically nonconforming” people to conform, we narrow not just the definition of beauty, but also the spectrum of acceptable “expressive selves.” It makes normative beauty a social imperative, which is twisted.

And I get that. I really do. I get it, but I also got cosmetic surgery.

Alex’s Pick

“Aesthetic Non-Conformity” by Jacki Huntington is a piece that resonates a lot with me. I felt myself laughing with the author, at the absurdity of the categorization of her surgery; at the absurdity of the world and its obsession with looking a particular way. The piece lived for me, passed the boundaries of the article. It made me consider the wider implications of this categorisation, from the existential questions Huntington posed in the piece, her experience post-surgery, and far beyond too.

The most frightening aspect of this article was realizing that even in the medical field, having this label betrays that there is, in fact, an overall standard of ‘aesthetic conformity’, no matter how much our current world tries to quench it. As we progress in our world, and we try to strive for inclusivity, we are also growing all the more desperate to find our own communities.

At the end of the day, Huntington’s surgery was done out of necessity, rather than cosmetics. So, what happens when people need gender affirming care? What about burn victims and amputees or the wider disabled public? I wonder what’s written on their surgery forms… and whether their scars and stories are also reduced to mere representations of ‘aesthetic non-conformity’. Does one surgery really have the power to wipe the slate clean?

In the quiet hush of a bookshelf’s embrace, I seek a tome, where wisdom may find its place. With each turned page, a thoughtful spark ignites, A journey of insights, in soft, whispering nights.

We would love nothing more than to share some of our favorite reads, books that have been thoughtfully crafted and are thought-provoking, all the same. We hope you enjoy these selections, and who knows, maybe our suggestions will take the winning spot on your TBR. Why, you might ask? Just trust us on this one.

Sowing Seeds for the Future of Fertility: Ejaculate Responsibly

By: Katarina Cook

Though it takes two to tantrically tango, we continue to view pregnancy as a woman’s problem. After all, conception is housed within the female body, but this biological fact has denigrated what should be an equal partnership.

In a society that’s rapidly reevaluating the norms around women’s health and reproductive responsibilities in heteronormative couples, it’s crucial to recognize the roles everyone plays in this dialogue. Particularly following Roe v. Wade’s overturning, the conversation around gendered responsibility in baby making, intentional and accidental, has become more pertinent than ever. While traditionally, the “onus of reproduction” has heavily fallen on women, it’s time to shift the narrative and look at the collaborative role men can and should play in both the achievement and prevention of pregnancy. For men, taking an active role in contraception isn’t just a gesture of support; it’s a step towards more shared responsibility and a gift to both yourselves and your partners.

“It’s time to shift the narrative and look at the collaborative role men can and should play in both the achievement and prevention of pregnancy.”

One of the most straightforward, yet profound ways to do this? Take some inspiration from the surge of American men who this year, wrapped their shaft with a nice ribbon to tie off the Vas Deferens! Suggesting more widespread vasectomy might seem unconventional at first glance, yet it opens up a much-needed conversation about male involvement in contraceptive practices. It’s a dialogue that extends beyond mere participation, urging men to consider how they can actively contribute to a more balanced approach to reproductive health.

From my two years of experience as the male fertility analyst for the Alta Bates IVF program in Berkeley, California, I’ve been deeply embedded in family creation and know the minimal role that men are expected to play in a process that, biologically, requires two halves. Our social gender roles have overshadowed scientific evidence in

reproduction for no great reason. This was most evident in my role when the vast majority of our patients (who desperately wanted children and to hence achieve pregnancy) were either unaware or apathetic to the critical importance that sperm plays in conceiving a viable fetus or experiencing recurrent pregnancy loss. For a tangible example, alcohol consumption negatively impacts sperm quality for even 3 months after abstaining. Women like myself from a young age have been solely expected to oversee the prevention, maintenance, and stimulation of pregnancy, but the end of Roe has now elevated the urgency of young men needing to buckle down for the task of unloading the ammunition from their load.

“The end of Roe has now elevated the urgency of young men needing to buckle down for the task of unloading the ammunition from their load.”

As a young woman, I wish to reiterate that we do more than our fair share. So much so that female birth control option purchases account for a hefty 90% of the $8 billion American contraceptive market. In fact, this has been so ingrained that contraceptive purchases are economically inelastic for women; among sexually active women avoiding pregnancy, lacking health insurance coverage only dropped contraceptive usage from 90% to 81%.

As Gabrielle Blair has brilliantly demonstrated in her 2023 book debut Ejaculate Responsibly, our American norm of disproportionate reproductive responsibility was already ridiculous, but has now turned dangerous.

Blair opens her book by citing the fact that overwhelmingly so, most elective abortions are caused by undesired pregnancies in cisgender heterosexual relationships. In 28 carefully composed arguments, Blair demonstrates that despite men’s comparatively 50x higher fertility potential (think fertile window 24/7 vs. 24-hours monthly), women are expected to surveil their highly unpredictable ovulation, and MUST assume any number of the consequences of a pregnancy,

“Blair demonstrates that despite men’s comparatively 50x higher fertility potential (think fertile window 24/7 vs. 24-hours monthly), women are expected to surveil their highly unpredictable ovulation, and MUST assume any number of the consequences of a pregnancy, whether that be abortion, adoption, parenthood, or miscarriage. Men can walk away. Where ejaculation occurs matters, because of the genetic potency of billions of sperm.”

“If you’re skeptical, remember that we expect girls (even before legal adulthood) to take similar, if not larger risks, for our future fertility with ubiquitous contraceptives that we purchase. For example, the 60% higher risk of ectopic pregnancy from an IUD could lead to a fallopian tube rupture, automatically halving the chance of natural pregnancy.”

whether that be abortion, adoption, parenthood, or miscarriage. Men can walk away. Where ejaculation occurs matters, because of the genetic potency of billions of sperm. Numerous (mainly) male politicians and anti-abortion advocates could’ve taken immediate proactive steps without any legislation: getting and encouraging vasectomies!

But don’t women have such better, less drastic options for contraceptives than men?

While this may be true in terms of pharmaceutical interventions comparable to the Pill, and there are better options on the horizon, the vasectomy is the one tried-and-true method. Men may initially recoil at the thought of clamping the Vas Def, but we mustn’t view vasectomy as a castrating neuter. Last year was the 50th anniversary of the vasovasostomy, the preferred reversal method essentially reattaching the adapter cord of the Vas back up to the gamete-generator. Did you know that combined with microsurgery, Stanford Urology now has a reversal rate of 90-95%, and an Arizona clinic published outstanding success at 99.5%? Sperm can be easily collected and frozen, unlike eggs, which require a longer and more invasive extraction. Hypothetically, a man could have a vasectomy at a young age and freeze enough sperm to safeguard against the possibility of failed reversals should he want children later in life. If you’re skeptical, remember that we expect girls (even before legal adulthood) to take similar, if not larger risks, for our future fertility

with ubiquitous contraceptives that we purchase. For example, the 60% higher risk of ectopic pregnancy from an IUD could lead to a fallopian tube rupture, automatically halving the chance of natural pregnancy. Estrogen-based contraceptives accelerate the growth of uterine fibroids, which affect up to 70% of women, obstructing conception and increasing obstetric complications.

Are you a man who’s read this far and still is not down to vesicate your virility? Remember ol’ reliable: the male condom, which effectively prevents 98% of pregnancy (which is BTW 1.5x more likely to kill than traffic accidents…think about the lives you can save when you think a condom doesn’t feel as nice).

If you’re still scratching your head (or balls) thinking about why you would ever sever your manhood or take on the additional responsibility of conception planning, remember it as a gift to yourself by taking control of your potential family’s future. I wish to say that it is a privilege to have the medical norm that I can expect lifelong support from gynecologists, starting in my teens, but many males might not interact with a similar physician counterpart until their later years, facing ill health. Understandings of men’s reproductive health currently lags behind research in the female domain by about 10 years, so why don’t you push your doctor, your friends, your colleagues to start planning with that penis more. If you don’t want to snip it, then slap a rubber on it. Or, just share a read: Ejaculate Responsibly.

Life isn’t easy. Pregnancy isn’t any easier

By: Sahana Narayan

A Review of A Lot of People Live in This House by Bailey Merlin

Bailey Merlin wears many hats. A long-time contributor to 11 Seconds Magazine, with thought-provoking pieces that are effortless and glide off the page, like Riding Lessons, No, We Won’t Keep Our Voices Down, and Experiential Learning, she touches on different phases of womanhood, serializing pivotal moments from shaving to menstruation to that very first gyno appointment. No, We Won’t Keep Our Voices Down pays homage to her southern roots, questioning the harm hushed whispers about abortion cause.

Merlin’s knack for embedding the truest, most jagged pieces of the human experience is not singled out to just her pieces for us, though we are so forever grateful to be the platform that gets to showcase them. No, her debut novel, A Lot of People Live in This House, published May 2023 can be heralded for much of the same.

Set at the cusp of the COVID-19 pandemic, those blissful and naive days of February 2020 before things drastically changed, Merlin spins a tale of Rachel, who after many months of travel with her husband Job, comes to Boston to live in an intentional living community – a house with characters ranging from the eccentric and jolly houseowner to the funny grandmother in her 70s.

Merlin shares, “before they are going on like the

last leg of their trip, Joe says to Rachel, I think it’s time for us to put roots down again, we need to be around people, we need to become humans again.”

So, inspired by Merlin’s own experience in communal living, this literary dramedy follows Rachel as she, begrudgingly, comes to embrace community, making the move ahead of Job, who will soon get stuck in India due to the lockdown.

At this point, you might be wondering – how does this storyline work? Do we really need to read about the pandemic too? Haven’t we lived through it enough? And well, while the latter is true, and the last four years have been exceptionally unprecedented, A Lot of People Live in This House does one thing rather brilliantly – it gives us a reason to reflect. Months ago, when I first read the book, I, too, was hesitant about what reading about the pandemic could mean, as a plot device but also as a suddenly confrontational truth – did I also need to consider the true effects of the pandemic on my life?

Merlin does this wonderfully, spinning a tale full of life during a time that was otherwise characterized with plenty of despair.

“It was a really unique experience, because while other people were talking about how lonely they

“Merlin does this wonderfully, spinning a tale full of life during a time that was otherwise characterized with plenty of despair.”

were, or how stressed they were, or couldn’t get toilet paper and couldn’t get resources, I was not having the time of my life, because we were all living in a state of constant fear and, and the fear of the unknown, but I was having game nights; I was having Chopped cooking nights where we would take all the stuff that was about to expire in the cupboards and trying to make new dishes out of it.”

While some of these lighter moments make themselves known in the book, Merlin shares candidly that an unintentional response to the book has been how fascinated people are about intentional living itself.

“Some folks are now interested in communal living because of this book…and that’s been really encouraging to see because personally, I think more people should live together, whether it’s a collection of houses on the same property, or the way I live, which is in one house.”

While Merlin writes this merry band of characters who are all so unique and distinguishable, she does something particularly well, she engenders a sense of community, successfully achieving the renowned trope of “found family” with ease. In doing so, she sets readers up for the perfect emotional fallout, necessitating not only our investment in these characters and their lives during a time that we can so wholeheartedly relate to, but our acute instincts in trying to parse through Rachel’s grief, trauma, and anxiety.

When I interviewed Merlin, I admitted (perhaps sheepishly) that Rachel is not a character you can like until you get halfway through. Now, that’s not to say she’s an inherently dislikable character, but rather, a complicated mosaic of feelings that we often shy away from expressing. In some ways, Rachel represents our own apprehensiveness as readers; in others, she’s a mystery with a past that we are willing to see through, someone we want to root for, so much so that she finally gets a good hand dealt to her.

Okay, readers, from here on out, major spoilers of the book will be a part of this review. You have been advised, so please read at your discretion.

An unexpected central tenet of A Lot of People

Live in This House is the arresting grief that can arise after the loss of a child. With this comes many poignant moments about fertility, pregnancy complications, and the more grisly side of birth that is often overlooked in popular discourse. When Merlin was asked if this was always going to be a major plot point in the book, she shared:

“I always envisioned Rachael and Job suffering from the loss of a child. I thought that it might have been at the beginning a very traumatic miscarriage in which something like an accident had happened but the more I talked to one of the people who lived in the house at the time, who was an OBGYN, we were talking more about what can happen. What is the worst case scenario to a fetus as it is growing? What are the genetic implications? What happens when something is wrong?”

It’s quite obvious that these stories are hardly shared in creative fiction or otherwise. We don’t often want to really entertain the traumatic possibilities of pregnancy, as it is often easier to parrot the narrative that pregnancy is an easy and happy time for everyone. Merlin takes this and turns it on its head, creating depth in Rachel’s characterization and making her grief not a prop but a very real entity that has influenced her life. To make matters more complex, Daniela, another favorite character, is introduced to us as heavily pregnant and very happy. We don’t know yet why Rachel has such an averse reaction to this fact, but it does make the reader oh so curious.

“We don’t often want to really entertain the traumatic possibilities of pregnancy, as it is often easier to parrot the narrative that pregnancy is an easy and happy time for everyone. Merlin takes this and turns it on its head, creating depth in Rachel’s characterization and making her grief not a prop but a very real entity that has influenced her life.”

“Daniela was always going to be a foil for Rachel, and because of that, I always knew that she was going to be pregnant, and that she was going to have the most perfect pregnancy. Everything goes well, it looks easy. But I was actually surprised when Daniela revealed that she had lost a child in a very similar fashion before and that it was the worst time in her life. And that she saw the same sort of grief in Rachel the moment they met. And I had no idea until honestly, like a chapter before we got there,” Merlin shares.

Through these characters who have been broken in the past, we see rather explicitly that pregnancy isn’t always what we think it’s going to be. The assumption that it’s going to be this easy, natural thing, not only overlooks fertility struggles at baseline, but also completely diminishes the very real and very hard consequences of non ideal outcomes and Merlin was very mindful of this. Dedicated to striking a curious but careful balance, she conducted extensive research on Trisomy 18 and with it came a burning desire to raise awareness of the impacts of it.

Truthfully, when I first approached Merlin for an interview, it was after I had read her book in its totality. It was sitting on my shelf for months and I had stalled at Chapter 3 because life got in the way. On a night shift at the hospital, I was assigned 1:1 observation of a patient and it was the perfect excuse to finally speed through the book. I was equal parts heartbroken and satisfied when I neared the end, taken aback at how Rachel’s grief opened herself to finding community again.

To me, there were many major climactic moments in the novel; we have the plotline of Job trying to get back to Boston, with all the lockdowns and flight grounding making it an endeavor that required as much help as possible. Through this, we see Rachel finally accept help from her housemates and actually fold herself into the community. We also see the very real dynamics between the characters, as the two who are healthcare workers sequester themselves in the chalet on the property, to keep everyone safe, and the struggle of isolation that comes from it. And it is within these moments of camaraderie and catastrophe that we see the culminating moment

for Rachel and Daniela themselves, when Daniela goes into labor in the nursery.

The scene is, in the best ways, a complete comedy of errors. Daniela and Rachel are painting the nursery, or at the very least, putting some finishing touches on it, when Daniela admits to having been feeling weird all day. Ergo, contractions. Suddenly, you have six people involved, and none of them have delivered a baby; one character on Facetime giving her medical advice from afar.

Merlin laughs as she recounts the scene itself, “it’s probably one of the funniest scenes that I’ve ever written, while also being one of the most emotionally touching. I feel so connected to the scene, because my worst fear is having to deliver a baby without having any know-how.”

“It’s probably one of the funniest scenes that I’ve ever written, while also being one of the most emotionally touching.”

I feel compelled to not give you anymore spoilers, because I want you to experience the hilarity of Merlin’s cast of characters. You will cry, you will laugh, and you will, undoubtedly, become very very attached. There’s a resonance that’s deeply embedded into the pages, that you get to explore while simultaneously discovering Rachel’s trauma and anxieties, and the ways in which life is never and will never be perfect.

A Lot of People Live in This House is a masterclass on balancing the universality of an experience – one as astounding and impossible as a global pandemic – and the realness of human behavior, which will always be flawed and multifaceted. Not once do you ever question the realness of these characters and when you get a chance to read it, I hope you find them as deeply moving as I did.

Tell Your Kids You Used to Be Thin

By: Maryelien Goodman

Nausea. Vomiting. Exhaustion.

These symptoms are no surprise to anyone familiar with pregnancy. They’re common and often disappear on their own.

But sometimes they don’t. Both times I got pregnant, I experienced ongoing, gut-wrenching nausea vomiting for the entire length of the pregnancy. It felt as though my doctors and nurses had one lens to evaluate the health of the pregnancy—the baby’s growth and development—and as long as that was on track and there was no acute risk to me or my baby, nothing else mattered.

With my first pregnancy, the nausea came around week seven. It was intense and relentless. I threw up first thing every morning, usually on the side of the road while walking my dog. When I got home, I would nibble crackers and sip Gatorade. Sometimes it worked. Often it didn’t. I usually threw up once more before heading out to work. At work, where I kept soothing teas, such as peppermint and ginger, and easy-to-digest snacks to help me get through the day. I always brought a toothbrush and toothpaste to keep in my drawer, rarely making it through the workday without throwing up again.

“This is totally normal and nothing to worry about,” the doctors reassured me, after they measured the baby’s growth and saw it was progressing normally. “Just make sure you’re eating because the baby needs nutrients to keep growing!”

They said it would get better in the second trimester.

It didn’t.

Finally, in week 13 or 14, the doctor prescribed the anti-nausea medication Zofran and Zantac for heartburn. The drugs helped with the nausea, but I kept vomiting. Sometimes it was just bile, dark orange and extremely bitter. I can still remember the taste.

And yet, the pregnancy progressed as it should. Finally, after 63 grueling hours of labor, I delivered

a beautiful, healthy baby. As exhausted as I felt, I thought the doctors must have been right, that my symptoms were just part of the normal course of events because everything had worked out. Those first weeks with a newborn were brutal. I was dehydrated and weak, both from the excruciating labor and from the nine months before. I had gained 20 pounds during my pregnancy, but within two weeks of giving birth, I lost 25 pounds. I was gaunt, thinner than before my pregnancy. At our first six-week check-up, I mentioned how hard it was and how depleted I felt. The midwife smiled and nodded sympathetically. The baby looked healthy, and I was mobile. Tiredness was part of being a new mom. No follow-up was needed. I muddled through the following days and months. Sometimes I felt like I was moving through a haze, but it got easier over time, and it certainly helped that my baby was delightful.

When I found out I was pregnant again 15 months later, I hoped my experience would be different. This time, I made it about nine weeks before starting to throw up. Because of my hard-earned knowledge, I asked for Zofran earlier.

“This happens often,” I was told. “It usually stops in the second trimester.”

Never mind that I had already been through this once, and it hadn’t.

After I threw up enough though, they relented and once again prescribed Zofran and Zantac. Again, it helped with the nausea but I kept throwing up, violently. My toddler saw me throw up so often that he started to mime vomiting in his play. Despite this, when I went for prenatal care, the nurses checking me in would chastise me for not exercising.

My husband traveled for work often during that time. I became so concerned about my health that I would ask my sister to make sure she heard from me at least once a day and if not, to come to the house to check on me. I didn’t want to asphyxiate from vomiting and have no one there to take care of my child. The dehydration got so bad from all the throwing up that I had to go to the hospital twice, where I needed two bags of fluid each time.

“It’s not easy having babies,” the doctors and nurses told me.

Luckily, my second child was also born healthy. The labor wasn’t as long, and I was thrilled that the nausea was gone. Once again, I had gained 20 pounds but lost 25 right after. This meant that I was now 10 pounds lighter than before my first pregnancy.

“You’re so lucky you didn’t gain weight,” numerous people—including nurses—told me. I wanted to scream. I felt lucky to have two healthy kids; I did not feel lucky that my ribs were showing or that my weight was a result of constant vomiting.

I also felt as though my concerns were dismissed throughout my two pregnancies, written off as just an overly anxious new mom-to-be. For example, nobody followed up with me about the effects of 18 cumulative months of throwing up violently. But my body bore witness to the trauma. When I went to a new dentist, she mentioned the damage to my teeth and asked if I had ever suffered from bulimia. (I hadn’t.) I also started waking up with terrible hip and back pain. On walks, those pains would flare up, no matter how much stretching I did. When I leaned against the counter in the kitchen, my stomach ached.

“I also felt as though my concerns were dismissed throughout my two pregnancies, written off as just an overly anxious new mom-to-be.”

Searching for ways to heal on my own, I found a trainer who ran Mommy and Me workout groups. As she did for all new moms, she evaluated me and discovered that I had diastasis recti—the separation of the abdominal wall that can be caused by pregnancy and rapid weight loss. She also felt a knot in that area and said before I did any exercise with her, she wanted me to be cleared by a doctor, given that frequent vomiting

and dehydration can cause lasting issues. When my PCP felt the knot, she referred me to a hernia doctor. After a five-minute, $625 consultation, the Mass General hernia doctor said I didn’t have a hernia. When I pushed back and asked what I could do, given that I was experiencing pain, he shrugged his shoulders.

“Tell your kids you used to be thin.”

I burst into tears. After years of feeling like I was screaming into a void about my health issues, this was the last straw. I felt humiliated. With that one sentence, he made me feel like my health and well-being were irrelevant and that the only thing that mattered was some idea of how I should look.

Maybe my reaction made him feel uncomfortable, or maybe he realized what he said was inappropriate. Whatever the case, he tried again. “Listen, we just don’t have the research or knowledge about most postpartum issues.”

That assessment certainly seemed to fit with my experiences pre- and post-partum, and honestly, with being female in general in the medical world.

Because I was having no luck with doctors, I decided to take matters into my own hands. I went back to the Mommy and Me trainer, who worked with me to strengthen my core. Since then, I’ve met with other personal trainers who specialize in women who have been pregnant, recognizing that our bodies have different needs. Over time, I’ve gotten stronger, and the pain has gotten better, allowing me to once again carry out the activities I love doing.

But I’m not back to where I was. Just a few months ago, more than eight years after my second child was born, I was diagnosed with Barrett’s esophagus, which means I have tissue scarring around my esophagus. I am now at a higher risk for esophageal cancer and so will need to be screened every three years. There is no way to know for sure the cause, but repeated vomiting is listed as a likely one.

Today, when I reflect on my experiences, it takes me right back to how powerless and dismissed

I felt. I thought writing it all down might feel cathartic, but instead it just makes me feel sad. I don’t blame the individual doctors or nurses. With the exception of the hernia doctor, everyone I met was wonderful and caring. When they asked how I was doing, I believe they were asking sincerely.

“But our medical system is broken. The way insurance works means doctors don’t have the time to ask follow-up questions. As long as I wasn’t suicidal or suffering from a lifethreatening situation, they had to keep the appointment moving. I understand why they didn’t follow up.”

But our medical system is broken. The way insurance works means doctors don’t have the time to ask follow-up questions. As long as I wasn’t suicidal or suffering from a life-threatening situation, they had to keep the appointment moving. I understand why they didn’t follow up. Collectively, our society hasn’t put sufficient time or resources into women’s health care. There is a reason that pregnancy and childbirth are some of the highest rates of death for women, and yet there doesn’t seem to be an urgency in making sure that we as a society are taking care of women.

I was very lucky. Despite how sick I felt, neither I nor my babies were ever in any acute, life-threatening situations. That is not the case for everyone, and I do know that the providers would have jumped in to save me and my baby. I appreciate the care they gave to me, and I honestly don’t know if there is anything that could have been done to avoid the lasting damage. I just wish the medical system allowed them the time and resources to help with all of the complexities of perinatal experiences.

Opening Pandora’s Box: A Profile on Maryelien Goodman

By: Sahana Narayan

Writing nonfiction, that is, writing about your life is not easy. A professor of mine once told me that when you write about yourself, you have to reinspect your interiority to the story. Are you the real protagonist? How do you endear yourself to your audience? Better yet, how do you embrace fallibility with sheer abandon? I don’t actually have answers to those questions; I didn’t then and I don’t know. But, I do know that we must consider, especially with a platform like 11 Seconds Magazine, what it demands of a writer to share such personal and vulnerable moments from their life.

“Tell Your Kids You Used to Be Thin,” is a story about a difficult pregnancy fraught with atypical nausea and vomiting, a piece that in many ways shares an experience that is not all that happy. In fact, the reader can absolutely detect a deep struggle of dismissal and pain within the story and it urged me to sit down with Maryelien Goodman, the writer behind the piece, to learn more.

When asked about the process of writing itself, Goodman shares, “I have to confess that I was a little hesitant to do it, simply because it was not a pleasant experience for me, what I went through, and it made me very upset, kind of how I was treated with the doctors, and I just didn’t really want to think about it again.”

In fact, it was actually her sister, Sarah, who convinced Goodman to write the piece. Sarah, a writer who has always seen the act of it all to be rather therapeutic, thought this would be something worthwhile for Goodman. Goodman, a therapist herself, could follow such reasoning, admitting that this was the first time she had written something personal in years.

The essay carefully takes us through Goodman’s

pregnancy experiences, first by getting us comfortable with what we all know to be very basic and “normal” symptoms of pregnancy – nausea and vomiting. But, we soon learn that this was anything but.

“It’s interesting, actually, as I was writing it, I just felt very angry. To be honest, I guess it’s as a therapist, I was like, I clearly have some unresolved stuff about this, you know, because I was really sick. And I don’t even remember if I put it in the article, but like, they have since diagnosed me with Barrett’s esophagus, which means like, I’m at higher risk for esophageal cancer, and there’s scarring from all the throwing up. And it’s just, it’s like, the gift that keeps giving,” Goodman shares matter-of-factly.

Pregnancy, often touted to be this natural process that is easy and joyous and complication-free, is in-fact a major medical event. It should not be considered so lightly.

“It just felt like my health was not prioritized at any step of the process, from the moment that I got pregnant until now. And that’s just very hard for me. And I mean, it’s a lived experience for many people,” shares Goodman.

Despite how sick she felt constantly, there was no reason to raise the alarm, according to her doctors, because the baby was still fine. It is an odd game to play, pitting two lives against one another, weighing their importance, but it characterizes a much larger struggle in obstetrical care – the maternal-fetal divide.

Of course, Goodman’s piece doesn’t only speak to the convoluted ways in which we view a woman’s body during pregnancy but it also points to this

distinct idea of what an ideal female body should look like. In fact, she peppers her piece with truths of how various people, including nurses, told her “You’re so lucky you didn’t gain weight.”

There’s this assumption that arises with a skinny body, as one that is equated to health. When further compounded with pregnancy, the assumption becomes, if the baby is fine, the woman is fine too.

Goodman shares, “now, when I lost 20 pounds, I was skeletal. I was emaciated. And then the hernia doctor who said, tell your kids used to be thin, I don’t even know what that was supposed to mean. You know what I mean? Like, I don’t even know where that came from. But it was awful, and humiliating. And I cried in the office.”

For Goodman, it was not only her health that was at odds with what her doctors were telling her, or failing to tell her, but it was that they took on a sort of invisible quality. She clearly had no reason to complain if she was still skinny. As if that was enough to warrant the suffering her body went through, day in and day out.

This dismissal is not new. It is not unique to pregnancy care either.

Even Goodman, as a therapist, shares that “I work with a lot of women. But women who are dismissed, you know, who have depression, anxiety symptoms, but also often have a lot of physical complaints as well, like fibromyalgia, that often goes hand in hand with complex trauma. And so I certainly think that was actually part of how Sarah convinced me to write it. I feel like my story is just one of many.”

Women are and have been historically dismissed in medicine, often told their symptoms are “in their head,” which can be traced back to prehistoric times. Goodman shares her experience as one anecdote in a much larger mosaic of truths; there is something inherently broken in the system. In our conversation, she even shared a moment in her postpartum period after her first pregnancy, where she said something that for all intents and purposes should have been flagged. “They asked how I was doing. And it was I said something like, as a therapist, I was like, I shouldn’t have said that. I wasn’t suicidal, but like, I wasn’t doing great, you know, like, I wasn’t in a good mindframe. And I remember that the doctor didn’t follow up. But they should have.”

The system is complicated, and time constraints and limitations often do more harm than good. The care that needs to be provided often isn’t. It’s a truth we must bear if we ever want to change it and it is work like Goodman’s that actually sheds light on it. While her story might just be one of many in the grand scheme of things, it speaks to a resonant and specific experience that she faced, that cannot help but make readers angry for her as well.

Though Goodman candidly shared her initial hesitation with writing the piece, she also admitted to me at the very end of our conversation, “I enjoyed talking about it more than I enjoyed writing it. It’s interesting to me also, I don’t know, this felt more therapeutic. Like, it felt good to talk about it.”

If we don’t write it or talk about it, we will get nowhere. It is the vulnerability of these stories, and the privilege we have of sharing them, that push us towards change.

Maryelien Goodman.

What’s in a word?

By: Alex Ephstein

How do you define sex?

I always ask this question when the topic of gender arises. It seems to be the easiest way to grab a person’s attention when other arguments begin to fog their brain. Sex often has that effect in the modern world, being the taboo topic that it is.

The answers may change slightly, but most of the time it’s some variation of ‘penetration’ or ‘penis entering vagina’ or ‘sperm fertilizing egg’. Notice any patterns in all of these answers? The male subject always takes an active role, while the female takes a passive one.

What if we switch the narrative? What if instead of ‘penis penetrating vagina’ it becomes ‘vagina enveloping penis’? That sounds awkward, doesn’t it? Uncomfortable to say or to think about, when in reality this is just an alternative description for the same activity. Even still, why does it unsettle you to think about sex this way? Why do we shy away from discussing women in an active way, during sex or any setting at all?

If any of these questions intrigued you at all, I recommend reading Amanda Montell’s book: ‘Wordslut’.

If those previous questions sparked your curiosity, if they made you smile or even feel a little squeamish, you should read this book. Not only will you laugh out loud and nod and scratch your head, Montell picks out words and phrases that we use every single day, and turns them on their heads.

Just think to yourself, what other things do you say mindlessly, every day that you’ve never considered? All words have hidden histories, and Montell’s book can help you uncover at least some of the stories behind your everyday language.

11:11 is a time of not just synchronicity, as per numerological tenets, but also a sign meant to signify a specific and special moment in time. While the statistical basis of seeing 11:11 cannot be explained simply, largely because there is no way to average out human behavior like that and even if you were to pursue a Fermi estimate, such cheeky mathematical computations do not really describe the meaning behind such phenomena. Even if we were to look at this purely psychologically, as a cognitive bias of frequency, a la BaaderMeinhof, that explains the frequency of it happening, not the assigned meaning of it. So, instead, I urge you to escape into a more wondrous and fantastical school of thought – perhaps 11:11 really is just a random moment of meaning, one that cannot be calculated orascertainedusingournormalrules;onethatmaybeimpervioustoour own cognitive biases and yet retain value all the same. With this in mind, I am thrilled to announce the official launch of The 11:11 Column, a series of profiles that do just that – look at the moments of special meaning in women’s health, be it philanthropy, biomedical innovation,creativity,advocacy,ormore.As a magazine founded on the principle

Revolutionizing Vaginal Dilation Therapy:

It’s Not a Sex Toy, It’s Medicine

A Profile on NIH Award Winners MiaFit

Every year, the National Institute of Health (NIH) calls undergraduate students to compete in the DEBUT (Design by Biomedical Undergraduate Teams) challenge, which asks for students to consider design as a solution for some unmet health need. In a nationwide competition, only 9 teams are awarded something, with 5 additional teams recognized via an honorary mention. Suffice to say, anything involving research and the NIH is something we should pay attention to.

Team MiaFit, which consists of four enthusiastic and passionate students, Stella Kotsiabakis, Ritika Singh, Melina Tsotras, and German Gonzalez participated with their Senior Design Project from the University of California, San Diego (UCSD).

Winning $15,000 from the National Cancer Institute as part of the DEBUT challenge, I came across their research rather serendipitously. Far be it from me to stop reading an interesting research poster on Linkedin and this one caught my attention rather quickly. Team MiaFit’s invention is a mechanotherapeutic intravaginal dilator for vaginal stenosis specifically.

severely decreases in cases of VS) and reduce pain and discomfort.

Over half a million people are diagnosed with gynecological cancers and 88% of them suffer from VS; current VDT options are less than ideal due to their cost or the pain that they inadvertently cause. So Team MiaFit wanted to change this, by creating an expandable, portable, and affordable vaginal dilator.

With just a summer of dedicated research and a literature review before a year-long development process, Singh shares that that was when “all of us became really passionate about the project, because we realized what a lack there is in women’s health research, especially in bioengineering. We were looking at papers that dated back to like the 80s.”

When they examined the market for what was standard for VDT, they came across two specific problems – high cost for mechanical dilators or a series of dilators in increasing size that could sometimes do more harm than good.

Now vaginal stenosis (VS) occurs when the vaginal canal is shortened or narrowed significantly, often as a direct byproduct of pelvic radiation treatment. A rather painful complication that can impact intercourse and limit gynecological pelvic exams, it’s something that warrants treatment that is effective and meaningful. That’s where vaginal dilation therapy (VDT) comes in, the only way one can improve elasticity of the vaginal canal (which

“A woman will progress in size as she gets more comfortable with her current size. However, this type of method is really uncomfortable and can actually be quite painful for the patient. And upon talking to one of our professors about this, we learned that it can impart a lot of stress on the patient’s vaginal canal, which can end up causing more scar tissue and cause the condition to get worse,” shares Singh.

So, in an effort to mediate between the harmful effects of continuous dilation, which can cause the aforementioned increase in scar tissue, and discrete dilation, Gonzalez shares, “our [design] is a balloon shape that can conform to the anatomy of the person using it.”

“Our [design] is a balloon shape that can conform to the anatomy of the person using it.”

Adapting work from the lab that the team partnered with, the most revolutionary and novel part of their design actually was the handle itself.

“We wanted to address somehow the fact that there’s a very low compliance for people using these kinds of devices because of the pain, the discomfort, and also the stigma associated with it. Because at the end of the day, a vaginal dilator looks like a sex toy. So trying to transform the experience into a cosmetic experience was something that we thought of,” Kotsiabakis shares.

“There’s a very low compliance for people using these kinds of devices because of the pain, the discomfort, and also the stigma associated with it.”

Indeed, VDT not only suffers from the fact that it is often painful and hard to access due to cost, but there often remains a stigma attached to it, by virtue of gynecological cancers and conditions being highly sensitive in nature.

Attaching the balloon to a better designed handle was not all that Team MiaFit focused on.

“You can go in between sizes and balloons, for example if you have really severe stenosis, you are obviously using the very smallest one. Within the handle, we have a vibrator, which has been shown to help with comfort when you’re using it. Users are able to control inflation, deflation, and the pressure sensor will record measurements for women to see their progression on a report that

shows up on their phone,” says Tsotras.

To ensure that this was possible, the team not only designed the handle and dilator cap, but also a bluetooth-enabled app that would ideally help determine pressure thresholds, to help aid a woman’s doctor in monitoring progress and adjusting treatment protocols.

To further increase accessibility, the team prioritized portability as a highly desirable feature. Gonzalez elaborates, stating “one of the biggest differences between what the lab was doing versus what we started doing was that the lab was trying to create a benchtop device that you’d go to the doctor’s office for. But that didn’t make any sense. We realized this needs to be done at home, this needs to be portable, it needs to fit in a woman’s hand, and it needs to be easy to use.”

And of course, all this research (or truthfully, the lack thereof on vaginal stenosis, its incidence and prevalence) all revealed more to the team – VDT is not only useful in the case of VS, but rather it can apply in cases of vaginismus, dyspareunia, menopause, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, gender affirmation surgery, and any other congenital disease that affects the vagina or hymen.

Through the NIH award and grant, Team MiaFit will get a chance to learn how to commercialize their product, and further develop it for additional testing, since they have only tested it ex vivo on healthy porcine vaginal tissue (which yielded impressive and promising results).

Interestingly enough, when I first spoke to the team, they were all pursuing their individual ventures post-grad, sequestered away in zoom squares across the country. Singh is pursuing a PhD at Virginia Tech, focusing specifically on the biomechanics of the vagina, Kotsiabakis is currently at MIT pursuing a masters degree in finance and financial mathematics, Tsotras is pursuing a masters in data science at NYU, and Gonzalez is working as a research and development engineer at UCSD.

Kotsiabakis shares, “like, we’re all kind of taking

different avenues. But we’re all pursuing things that I think if we want to come back together, in a year or two years, we’re going to be in a really good position if we want to commercialize this and really start impacting as many people as we can with this device.”

Suffice to say, though their paths are no longer directly aligned, the team’s natural and diverse interests may serve them well should they pursue this project further. We can only hope that thoughtful researchers like Team MiaFit will continue to change the women’s health landscape today and everyday. And hey, you never know, before you know it, you might see a MiaFit device near you.

Melina Tsotras (left), German Gonzalez, Ritika Singh, and Stella Kotsiabakis.

The Science of Snuggles: A Profile on KRIASH and Dr. Neetika Ashwani

In the 1970s, skin-to-skin contact between newborns and mothers was investigated as a potential intervention that would improve both maternal and infant outcomes. In the 1990s, it became linked to the general bonding hypothesis, which posited that such contact would ultimately improve bonding and caregiving. Eventually dubbed “kangaroo care,” the practice now has widespread proven effects, including increasing breastmilk production, reducing stress, and is particularly effective among premature and lowbirth weight infants in the NICU.

As a clinical researcher in neonatology, the clinical trials I work on actually have skin to skin care as a major metric that we’re interested in improving overall. So, when I came across Kriash, I was immediately intrigued.

Founded by Dr. Neetika Ashwani through the Columbia University StartUp Lab, Kriash is a med-tech startup that is focused on improving kangaroo care, through a proprietary wireless monitor that tracks vitals and length of skin-toskin contact time.

To get here, Dr. Ashwani has had quite the journey.

“I started working in a government tertiary hospital back in India, in Hyderabad, and I worked over there for almost four years in the NICU. And so basically, my work was, obviously as a clinician, but I’ve always been a keen researcher,” she shares.

Thought Dr. Ashwani’s roots are in pediatrics and neonatal medicine, she knew that she wanted to expand her scope, first through evidence-based

implementation and evaluation research, to improve breastfeeding rates, decrease rates of sepsis, all in a manner to ensure to scalability and sustainability.

“I’ve worked in the most resource restricted place. And if we were able to do it over there, it was very challenging, because you had to explain to the nurses that if you do it, it’s going to be beneficial to you, the parents, the babies, everyone.”

Eventually. Dr. Ashwani made a transition, working at UNICEF, the World Bank, and IQVIA, in roles that focused on implementing these quality improvement activities. At one point, she had 250 hospitals directly under her purview.

But the idea of skin to skin care, specifically, continued to elude her. In fact, she comments, “I saw that there was no tracking time or duration, because again, this practice says, do it for X many hours, it will give you the benefit. But we don’t know how many hours we have done.”

Compounded with the complexity of the NICU specifically, where the tiniest and often sickest babies reside, connected to wires and monitors of all kinds, oftentimes skin to skin care is put to the wayside simply because it is complicated to make happen. How do you still monitor them and ensure everything is good while improving their outcomes and the mother-infant bond?

So, as all good researchers do, Dr. Ashwani turned to piloting a study. Here, she had mothers write down the time that they started and ended kangaroo care, but like you may expect, this

approach is prone to error and forgetfulness. It’s not a foolproof method to capture the data behind kangaroo care. Despite this, they were still able to have consistent and positive weight gain and increased confidence in mothers who now felt like they were able to understand their own baby’s reactions.

Dr. Ashwani plans to take this to the next level; by actually building, designing, and piloting wearable wireless technology that tracks kangaroo care globally, she hopes to actively reduce the time spent in the NICU, improve mother and infant outcomes, and reduce hospital burden. In fact, she already has plans to pilot this in sites in the US, India, Australia, New Zealand, and Kenya.

Eventually she hopes to phase this to being directly integrated with a hospital EMR (electronic medical records) system. She’s a tireless advocate for newborn and postpartum health, even launching a podcast, titled “Bump, Birth, and Beyond: The First 1000 Days of Life” on Spotify.

Critically, when asked about the ways in which this type of medical technology can change the way we approach maternal-infant care, Dr. Ashwani shares a vision of revolution.

“When I started researching, it’s evident that physiologically, it’s helping the babies. But what about the mothers? Where is the mother in kangaroo mother care? There’s hardly any information available related to postpartum depression, right, hemorrhage, postpartum bleeding; babies are important, but so are the mothers. This is a vulnerable time for them as well. I’m not leaving the newborn side, but I’m also tapping into the mental health and the physiology part of the mothers as well.”

Dr. Ashwani has no plans to stop anytime soon, and if her recent 1st place in Entrepreneurship and Innovation from Columbia University’s Career Design Lab is any indication, we can only hope that Kriash will bring this type of nuanced and improved neonatal care to all hospitals worldwide.

“When I started researching, it’s evident that physiologically, it’s helping the babies. But what about the mothers? Where is the mother in kangaroo mother care? There’s hardly any information available related to postpartum depression, right, hemorrhage, postpartum bleeding; babies are important, but so are the mothers. This is a vulnerable time for them as well.”

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