Before her first pelvic exam, 23-year-old Farheen's mother took her aside and ordered her to refuse a pap smear her doctor felt was necessary, because she believed the procedure would damage her daughter's virginity. And Farheen's story is not an uncommon one. In South Asian cultures, misconceptions about women's health issues abound. Women's sexuality and reproductive health are kept firmly behind the bedroom door and often, unfortunately, out of the doctor's office. Whether it's because of a desire for modesty, lack of education about women's health, or the belief that discussing sexuality promotes promiscuity, South Asians are known for suppressing discussion about issues critical to women's health. This culture of secrecy prevents the dissemination of accurate information and perpetuates medical misconceptions than can have life-threatening consequences.

Silent dangers
A pap smear, the test Farheen's mother balked at, is a common medical screening procedure that can detect cervical dysplasia, a potential precursor to cervical cancer—a leading cause of cancer death in women. Unless any penetration is equated with loss of virginity, the pap smear should not affect a woman's status as a virgin. And it is rare that a pap smear will affect a woman's hymen, the thin membrane at the vaginal opening that many cultures consider proof of innocence. Yet there are many other activities—horseback riding, bike riding, gymnastics and other intense athletic sports—that can cause the hymen to break or perforate. While Farheen's mother believed she was preserving Farheen's purity, what she may not have known was that it was at the risk of Farheen's health.

But we can't completely blame our mothers—they've only passed on what was taught to them. According to Yoshita Pinnaduwa, women's project coordinator at the Asian and Pacific Islander Coalition against HIV/AIDS, the level of women's health awareness in the Asian and Pacific Islander community is low. "Generally, A&PI women are conditioned to not know their own bodies—to know one's own body is thought to be shameful," she says. Indeed, few desi women have been on the receiving end of the famous " the birds and the bees" talk from their parents. Although our mothers may assume that the sex talk can wait for the wedding night, the reality of teenage sexual activity makes that something of an anachronistic attitude. While desi parents hide their heads in the sand, their children fill the void with advice from friends who may be no more knowledgeable than they are. Sonia, 25, says, "My older sister and friends helped me understand what a period was, using contraception, etc. My mother never really had a formal or informal conversation with me regarding reproductive health."

Misconceptions abound
But that lack of conversation can lead to confusion. Despite sex education in schools (or perhaps due to government restrictions on the information they can offer), many students are confused about the consequences of sexual activity and unprotected sex. This confusion is augmented by the fact that in desi communities, women often mistakingly believe that they are not at risk. Pinnaduwa adds, "Asian women may not perceive certain diseases as those that affect them; HIV/AIDS and many STDs are among these diseases. Many South Asian women do not have access to culturally and linguistically appropriate HIV and STD prevention information, and therefore do not know they should get tested. Most Asian women in general are detected too late into their infection because of the lack of awareness."

In an era marked by the rampant spread of sexually transmitted diseases, ignorance can be a risky proposition. According to the National Institutes of Health, "aside from AIDS, the most common and serious complication of STDs among women is pelvic inflammatory disease, an infection of the upper genital tract." The population with the highest incidence of PID is teenagers who contract it via infection with gonorrhea or chlamydia. What's even more disturbing is that pelvic inflammatory disease has significant repercussions on a woman's fertility, as the disease has been linked to ectopic or tubal pregnancy and even infertility.

Controlling their fertility is another issue which desi women often keep undercover. Many South Asian women either obtain and use birth control without their parents' knowledge or pretend they are using it for non-contraceptive purposes. Sonia echoes that perception: "My mother thinks I am on birth control to keep my skin clear and period regulated."

Let's start talking
But the crux of women's health taboos in the South Asian community may be the lack of communication among desi women. After all, the only way to tackle the taboos is to challenge the aura of secrecy with education, advocacy and talk—lots of it. In fact, APICHA has devised a unique method to combat ignorance and spread awareness about HIV/AIDS and other STDs. After being trained in peer education, South Asian women go out into the community to spread the word. Pinnaduwa explains, "Group discussions have been masked as tea parties and women's gatherings that a peer educator organizes for her friends, family, co-workers or neighbors, where she gradually introduces the topics during general conversation."

Whether you're sexually active or not, helping to dispel myths about medical procedures and initiating discourse on taboo issues can save you—and the women around you. So, let's talk about sex. Let's talk about our bodies. Let's talk about our reproductive health. With our own lives at risk, it's up to us to break the cycle of silence.