Exploring sexuality related mental health issues in females

PhD candidate interviewing girls in Edmonton’s Pakistani-Canadian community

Sexual health and mental health are inexorably linked in adolescents but in some cultures, these are stigmatized topics that are never discussed. For some teenagers, that lack of communication and support can be devastating.

Neelam Punjani, a third-year PhD candidate in the University of Alberta’s Faculty of Nursing, has begun her graduate project looking at the relationship between sexuality, reproductive health and mental-health issues among adolescent girls in Edmonton’s Pakistani-Canadian community.

Punjani obtained her nursing education in Karachi, Pakistan and then worked for four years as a volunteer sexual and reproductive health advocate in her home country. In Pakistan, sexuality and reproductive issues are rarely spoken about in the home or in school.

“I never knew about menstruation when I bled the first time, my mother told me afterwards,” Punjani recalls of her adolescence in Pakistan. “When girls have their first period, it’s frightening for them if they don’t know about it and what it is. That’s what happened to me.” 

Sexuality and reproductive health issues can include confusion about sexual orientation, questions about masturbation, sexual intercourse and sexual abuse, hormonal changes and body image, and physical symptoms such as vaginal discharge or infections. While these are concerns experienced by adolescents everywhere, in cultures where there is little communication or support surrounding these issues, isolation and stress can lead to low self-esteem, anxiety, guilt, depression and even suicide.

“Everywhere in the world, including Pakistan, suicide rates among adolescents are increasing,” says Punjani. “But do we know why?” 

Experts usually point to mental health, but Punjani wonders if these mental health problems are caused by a lack of education related to sexuality. 

“My research is going to give a clear picture of how many adolescents are actually going through such problems and if these kinds of problems exist, do we have any kind of solution?”

Working with the Indo-Canadian Women’s Association in Edmonton, Punjani has begun recruiting girls between the ages of 14 and 19 from the Pakistani-Canadian community to participate in her research project.

She has begun her interviews, and the conversations have already included some surprising and disturbing findings that she hopes may lead to useful recommendations. Out of her research, she hopes to develop patient-centred educational interventions for adolescents, parents and teachers, to provide more support for those suffering from mental-health issues related to their sexuality.

In the future, she would like to extend her research to adolescent boys if she has a chance to do so. But she wanted this project to focus on girls because they are the most vulnerable population. “Sexual and reproductive health continues to elude many girls, and many are denied the right to make safe and informed decisions that affect their health and well-being.”

Neelam Punjani is supervised by Elizabeth Papathanassoglou and Kathy Hegadoren. Her Graduate Studentship project is funded by supporters of the Lois Hole Hospital for Women through the Women and Children's Health Research Institute.

Lois Hole Hospital for Women