Transcript
Speaker: Welcome to season three of the Guardians of Hope podcast. We are a community of parents, educators, health, legal, and tech experts dedicated to positively impacting children's lives. The thoughts and opinions of my guests are not my own. This is a platform for sharing. Welcome everyone.
Speaker: There are conversations most of us weren't taught to have about our bodies, our reproductive health, and what it means to truly advocate for ourselves in a medical system that doesn't always make it easy, especially for mothers. And if we didn't learn them, how do we teach our kids?
Speaker: Nikki Sapiro-Vinqir is an OB-GYN physician assistant with over a decade on the front lines of adolescent reproductive health, a reproductive rights activist, and the founder of Take Back Trust, a digital platform reaching up to 30 million people a month with trauma-informed evidence-based guidance for teens and marginalized communities. She's also the author of an upcoming book, We Deserve More.
Speaker: Nikki, thanks so much for joining me today. I'm so glad you're here. Thanks. I'm so glad to be here with you. Yeah, this conversation is really overdue. um and I want to start with something that surprises a lot of parents when a young girl should actually see an OBGYN for the first time.
Speaker: Now, what's the age range? What does that first visit look like? And how do parents set it up in a way that feels safe and not scary? Yeah. You know, and it kind of depends on the care and coverage that you're getting from the pediatrician. And so some pediatricians feel very comfortable having conversations about reproductive health and contraceptives and things like that. And if that's the case, then you don't necessarily need to be seen or your child doesn't need to be seen as early.
Speaker: But if you're noticing things that your pediatrician isn't handling appropriate or doesn't feel comfortable managing, then oftentimes it warrants a visit with an OBGYN or, you know, a clinician within that practice a little sooner.
Speaker: And things have changed a little bit. When we were younger, we started getting pap smears at age 18. Now the guidelines have changed so that we don't start doing pap smears until the age of 21. So that's always a really nice thing that I let people know because so often they've told their kids or, you know, a loved one, Hey, you're going to go see the gynecologist and they're going to do a pap smear and they get all nervous. But more often than not, for the first visit or even several visits, it includes staying fully dressed and just having this conversation and meeting and gaining that rapport. And I think that's such a difference than what it was like when we were younger, where it was like often you wouldn't go until you were 18. and then on that first visit you needed a pop smear. And so I think that that's a really important important lesson that we can be teaching and talking about is that those first few visits are really just kind of like a meet and greet to make sure that you feel comfortable there, which is nice.
Speaker: Yeah, it's kind of like when kids are in school and they have moving up day when they're starting a new grade. It's it's just warming up to the idea yeah um seeing this new doctor and, you know, and and figuring out what's happening with your body. So that's really important.
Speaker: Okay. Now you work with a lot of adolescents who come to you who have never had an honest conversation about their bodies. What are some of the gaps that you see most often and what do their parents need to understand about what their kids actually need to hear? Yeah. I think there's a tremendous gap in knowledge of language.
Speaker: of ability to be able to explain what's happening within our own bodies. And I think that that's something that we experienced as well. And one of the main reasons why we talk about using anatomical language, for example, with your kids is it's important for them to be able to know what they're talking about and know the areas that they're talking about. So for example, i have young kids, I have an eight, a six and a four year old. And from the very beginning, i have taught them anatomical language. And like last week, for example, my six year old daughter bumped into a stool and she screamed out, she's like, oh, my vagina. And I think for a lot of parents, that can feel kind of alarming and it can feel like inappropriate in a way.
Speaker: But the same way that the vagina is a body part, just like an arm would be like, that's actually the exact response you want from a kid. is you want them to have that knowledge of anatomical barred parts because you also want them, if anything inappropriate ever were to happen, to be able to come home and tell you explicitly exactly what happened and where it happened. And so I think for so many reasons for for being able to advocate for themselves within a clinical setting, for being able to keep themselves safe and protected from unwanted touch and being able to communicate that back, for reducing shame and stigma around those body parts and giving them really that kind of permission structure to use that correct language, I think is a really important piece.
Speaker: And then really giving them permission to be participants within their health care visits, really giving them permission to have the autonomy to ask questions, not just like take it at face value. Right. If they have questions, how do we bring those up while you're in the visit rather than just like sitting there and swallowing any questions you may have and then asking those at a later time? So I think all of those things are really important pieces that we can establish outside of the clinic before they even go into an exam room that really helps to improve you know their medical experience.
Speaker: Yeah. And let's talk about modeling as parents, um the way that a mother or even a father talks about their bodies and their health shape. um it um I'm sorry, and their health. It shapes what their daughter believes about herself, right?
Speaker: So what does healthy modeling look like? What have you seen? And what are some good examples? Yeah, I mean, we've talked a lot about this as a culture and society when it comes to like dieting, for example, right? We know that the way that moms talk about their bodies and the way that moms talk about their diet directly is correlated to the way that our kids and our daughters shape the way their their bodies. at their diets. And so I think really paying attention to the ways we talk about our body. You know, my kids will talk about my butt and they'll say, you have a big butt. And I correct them and I say, I have a strong butt, right? We really want to encourage them when we're shaping language to shape the way they think about these. And that can start at a young, young age, right? And the same thing, you know, around the way we talk about our body is the same way we talk about listening to our bodies, the same way we talk about pain, the same way we talk about illnesses where our kids are sick. You know, of course, it's easy to dismiss them and and kind of move through it. but really encouraging them when they're telling you i have a stomachache or if they're telling you my head hurts, what hurts, right? Like really using those moments to kind of pull out that language from them also so that they're able to better hone and better able to kind of dis describe things. And it starts with us. So when we have headaches, explaining to kids exactly what's happening, you know, and I think that that's such an important way that we can model is when when we're hurt, when we're sick, when we're in pain, also sharing this is what's hurting and this is how I think this impacts me.
Speaker: In the same way that we would want them to show up in clinic to advocate for themselves is the same way that we as parents can show up in our own homes. Completely right. And that leads me to my next question for you, Nikki. Medical dismissal is something you tackle head on in your book, We Deserve More. I want to learn more about how you take on that approach in your book um and how we teach our daughters to advocate for themselves in medical settings and the role that we play when we're in that room together.
Speaker: I know personally and lots of other women have gone through this and are going through it. It's a very big issue in our country. So I'd love to hear your thoughts. Yeah.
Speaker: I mean, the first thing I recommend in terms of, you know, as a parent being in the room with a kid during a medical visit is letting them take the lead. And you can do that starting at a really young age. So with my kids, anytime I go to the clinic, I let them talk 100% of the time. And I'm only there really in case things go awry. And even my four-year-old, he just had strep throat, for example. And we went to the doctor and the doctor was like, what hurts? And he looks right at me because my son is four. And i was like, absolutely not. Right. And I just like redirected it to my four year old. So it it's, of course, easier for us to answer those questions. It takes less time. We are sensitive that we're in a rush when we're in the doctor's office. But that doesn't mean that we should bear the burden of that. Right. I think we need to always be thinking about, well, what is this experience for our kids like and what does that shape
Speaker: their ability to advocate for themselves in time. And so I think you know even the little moments of the strep throat visit for my four year old, letting him be able to completely communicate his needs at age four is only going to enable him to be able to communicate his needs as he gets older. And so I i think talking about the visit before you go in, let's say we're going back to the idea of the strep throat. you know With my four-year-old before the visit, I'd said, okay, what is it you want to tell the doctor? oh my throat hurts. Okay, great. What questions do you have for the doctor? and
Speaker: and his first question was, can I go on the trampoline? right like Whatever it is, you want to make sure no matter how ridiculous to you those questions may seem, that they're able to ask those questions and really giving them the opportunity to do that. And if they didn't, then what you can do is remind them, hey, crew, you had, that's my son's name, hey, you had asked me whether or not you'd be able to go on the trampoline. Do you want to ask the doctor that question again? right you're really circling back with your child to, hey, I know these are your concerns and I know these are your questions. Let's talk about them beforehand and then let's make sure we address them in the visit.
Speaker: And the exact same thing goes for with gynecological care with our daughters as they get older. And if we start doing this when they're younger with things that are less sensitive less stigmatized, right? Like the strep throat visits, they're going to be that much better able to advocate for themselves when it comes time to talking about things that are more sensitive. when it comes time to discussing birth control, when it comes time to learning about, you know, different vaginal sense or discharge or all these things that we're taught as a not to talk about, they're going to feel that much more equipped to be able to have those conversations with clinicians. And so I think it's really supporting them starting at a young age across the board in every spectrum of healthcare so that when it does circle back to reproductive healthcare, care that's not an anomaly for them.
Speaker: Yeah. And it gives them the confidence to handle when they're being dismissed or at least identifying that they may be being dismissed by a professional. Yeah.
Speaker: And I think, you know, it if you're noticing, right, first of all, when we come back to the gynecological visits, I think the most important thing to ask when we're talking about, you know, being with your teen in these visits is, do you want me in the room or do you not want me in the room? And making sure that they feel fully comfortable with either decision, that they're not going to get in trouble one way or another from you for what they choose. Right. yeah And I think, You can show up in your support in a multitude of different ways. And that can look like being in the visit or that can look like taking them to the visit or that can look like just following up after being like, hey, how did that go? Or really just asking them what they need and trusting them fully in that moment. that they're going to be able to advocate for themselves with a clinician and with you, right? Like that's the main thing is you want them to feel comfortable both with the clinician and with you as their guardian or parent.
Speaker: Absolutely. Now let's talk about your organization. You founded Take Back Trust to reach teens who often fall through the cracks entirely, including children in foster care, um what So let's talk about that first. Give me a little bit of info about your organization and what you do. And then I'll go to my second question.
Speaker: Yeah. So Take Back Trust is a web-based platform, and we also have a social media presence where we are reaching people and helping them before, during, and after their visits to make sense of it. And we have a provider visit planner so that you can come up with questions to ask your clinician at your upcoming visit. And we also have lots of different information on there, whether it be information about about contraceptives or about abortion or about the landscape that we find ourselves in.
Speaker: We also have Take Back Trust for Men, which is made to help educate men on reproductive health care so that women don't have to carry the burden of educating them. We have Take Back Trust for Survivors, which leans very heavily into people after sexual assault, whether it be acutely after or in the months and years that follow, talking about what it is like to be a survivor that then re-engages in the healthcare system, right? Because we know that can be very triggering for people.
Speaker: And then we have Take Back Trust for Teens, which looks specifically at the teen and youth experience right now. And we really aim to try to combat some of the myths and disinformation that we see online right now.
Speaker: Oh, totally. That's so helpful. What do caregivers in non-traditional family structures most need to understand about supporting young people's reproductive health?
Speaker: Yeah, I think that one of the pieces is that for many children that are adoptees or in the foster system, we know that health care can feel like another hurdle to overcome, that it can be inconsistent. And I think that that's a big challenge as we think often about the medical system being very consistent.
Speaker: And for those within a foster system, it's not necessarily the case. And so I think that we cannot assume that access or trust is inherent within that system. And I think that that's an important piece. So how do we create more trust? How do we enable, you know, more trust?
Speaker: yeah, comfort within the system. And I think it's really leaning into that autonomy piece and really working with an individual to say, hey, you know your body best and you have the autonomy to choose x y and Z. And I think when we think about it that way of empowering the individual versus leaning on the medical system as the end-all be-all, that's a much stronger solution for non-traditional families.
Speaker: Yeah. And how did you come up with the name Take Back Trust? That's a great question. um So it's an ode to Dr. George Tiller, who was a abortion provider and was murdered for being an incredible abortion provider. And he had worn a pin on his white coat every day that said trust women.
Speaker: And that's a really, really powerful quote and saying within the abortion movement. And in 2024, Kamala Harris was the first sitting vice president or president to ever visit an abortion clinic. And when she left that clinic, her words were, we must be a nation that trusts women. Right.
Speaker: it was believed to be an ode to Dr. Tiller. And so that became part of my rallying cry in 2024 was, you know, becoming a nation that that trusts women.
Speaker: And I launched Take Back Trust in 2024 after the election. and it was very much this idea of, you know, we're we're in a ah time period for reproductive health care that is challenging.
Speaker: And how do we empower ourselves? How do we kind of take back some of the narrative? How do we, you know, that trust women concept that Dr. Tiller had so boldly fought for, how do we actually do that? And I think a lot of it comes with autonomy and trusting ourselves first.
Speaker: Absolutely. Good for you, Nikki. but yeah So one last question for you. um For parents who want to do better, and I'm laughing because I know I have a teenager myself and it's's it's not easy. so for the parents who just don't know where to start, maybe bodies were never talked about at home or they're just uncomfortable approaching, um what's the single most important first step Yeah, you know, I would say probably just going back to the anatomical language and and really kind of like talking about it as it is. And I think if you were raised in a household that did not do that, it's going to innately feel uncomfortable when you hear your kids say anatomical language and really working within ourselves and within our own mentalities. to break down any of those stigmas that we hold when our kids say things that are different than the way that we would have said them or our parents wanted us to say them. And I think that's the best way that we do empower them ah starting at a young age, right? And then as they get older, really really just making sure that they know that they can trust you and come to you. And it might be something that surprises you.
Speaker: and I think that there are moments where if you are committed to being a safe space for your child, you may have to say, I need a moment and I will come back to you with an answer. And that's okay, right? Like it is okay as parents not to know everything. And i I didn't see that modeled for me. And so I think that that's one of the best things that we can also give our kids is the ability to say, i trust you. i feel honored that you share that with me. If you don't have an answer, that's OK. Let me figure it out with you, right? Like being a teammate and a partner with our kids as they get older, I think, is one of the best ways that we can really help them in terms of medical self-advocacy and their experience in the health care system, too.
Speaker: Sure. okay Nikki, what is your website so I can share it below? Yeah, the website is takebacktrust.com. You can find me on social media at Nikki Vink.
Speaker: So it's at N-I-K-K-I-V-I-N-C-K. And then the book is called We Deserve More, or How Reproductive Healthcare is Broken and What We Can Do About It. So it really talks about the background of reproductive healthcare care in America, how things are broken, how things are changing, and ways we can learn to advocate within it.
Speaker: Perfect. Nikki, thank you so much for your time today. It was great meeting you and talking to you about what you do. Thank you for having me, Cynthia.
