In this episode, Dr. Rena Malik, MD and guest Dr. Tanaya Narendra, also known as Dr. Cuterus, explore the complex issue of ...

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How Doctors Profit Off Shame | Dhat Syndrome ft. Dr. Cuterus

you've mentioned that syndrome a couple times can you explain what that is for our audience so the idea is that it is a collective of symptoms you start experiencing when you masturbate and symptoms range from things like feeling depressed having Tremors in your hands not being able to concentrate so it's a range of um physical as well as mental symptoms and why it's very difficult to pin down what these symptoms are is because anything that if you're struggling with anything can be labeled as H and Roes you know if if you go to an alternative practitioner and you say that oh I'm having a lot of headaches and they'll tell you oh you masterate too much that WR um it's it's it's kind of like the equivalent of what his sta used to be in the in the olden times for women anything and everything can be that syndrome we have so much data to show that it is extremely harmful for the development of young people's minds to have this kind of shame in their body and around positive aspects of life like intimacy even with themselves that it's a little bit alarming that we haven't addressed this at a large scale yet but it's also important to recognize that this is an alternative medicine Theory and some of those practices are completely legal in India so uh there's a lot of quote unquote scientific validation that people believe is there because they are part of mainstream medicine here one of the most heartbreaking cases that I heard about somebody who was labeled to have D syndrome was this young person who he was trying to practice Sean retention which is something he learned about on the internet which is the idea that if you like you discussed that if you don't ejaculate you will somehow develop superpowers and you know you I don't know get more jacked or whatever and obviously if somebody is experiencing the mental health benefits like you mention then if if it works for you go for it but there is no evidence to say that this actually affects your physical health in any way and this young person was so obsessed with not masturbating or not ejaculating at all that he started experiencing nocturnal missions and he felt so disturbed by it he felt unhealthy and he started almost manifesting those unhealthy symptoms in his body because he was always stressed he was always worried he became anxious he developed a little bit of a blood pressure problem and he was eating too much to sort of self soothed and I just had a chat with this young man and I tried to tell him that you know this is just a normal part of your development and if it doesn't come out this way it's going to come out the other way so don't get yourself so worked up about losing your streak so to speak he had gotten to the point of no return like he was not able to believe all of the things I was telling him because he was so inched in this idea that losing seen is bad and that is the essence of thought syndrome losing seen is bad and it lead to ill health and I think the the bigger fear for me is that if you have let's say headaches or some other manifestation that now people don't know what to do so they're just labeling you with this issue and two they're not getting to the root cause of what's really causing your headaches or causing your symptoms like you could have some really serious problem you could have an ISM you could have I mean God knows what right you could have a whole host of different things and people are ignoring them and because they want to give you something that is like sometimes we don't know right sometimes it requires more investigation sometimes you need another opinion but nobody wants to say I don't know right A lot of people have a hard time saying I don't know and so they may say well I don't know so I'm going to call it that syndrome right and then that person goes misdiagnosed maybe they have a cancer maybe they have something really life-threatening and they've been misdiagnosed so that's that's really scary and then of course the mental health aspect of it is insane right for someone to feel so ill will of themselves because of something their body is going to do on its own is really sad and really tragic because now that person's never going to uh you know until their body stops having nocturnal emissions potentially and they just absorb it themselves they're not going to have a feeling of of well Wellness right they're going to feel ill forever and then potentially they're going to cause other problems because they're have so much stress and anxiety and then they're going to just go down this like Loop of tra trauma related health issues which we see so much of right and it's so hard to come back from that it takes a lot of dedicated effort and work and I imagine that in a place like India it's very hard to get people or practitioners who are actually understand that and manage that in a in a way that's appropriate yeah and I think it's Al that there's no delineation that's the word there's no delineation between people who practice evidence-based medicine and the people who practice alternative medicine that it's easy to get lost in the conflicting advice you keep getting because one kind of doctor will tell you you know this is totally normal and it's totally fine and the other kind of doctor will tell you oh no you're going to go to hell or you know physical your your physical health is going to go to hell it can be really perplexing as a as a person who is not from say a medical background or a scientific background to navigate through this Maze of conflicting advice and this really confounds the problem over here because you know the most famous doctor that you might know might be an alternative medicine practitioner so how do you decide what is the correct advice and how does somebody who doesn't come from a background know who to trust and I think that is the biggest challenge of Healthcare in India in my opinion yeah absolutely in terms of men who are trying to start exploring their own Sexual Health young men what sort of tips do you have for them in in being able to do this with confidence and you know sort of responsibility I think the number one thing is I'm very big on removing shame around the idea of our body so the number one thing is to tackle the internal life shame we have for whatever reason be it our family environment be it our social cultural environment be it our community where we come from whatever and kind of doing some inner work to understand why you're feeling so much shame around this once you've identified what might be some of the reasons try and work towards removing those regs from your life because you can keep working on the problem on your own but until you remove your triggers you know those issues are going to keep chopping up so it's kind of weird that my first advice is always do some inner work to understand but uh it's it's really essential and then once you have an idea around how you feel about sex because your brain is your most important sex organ once you have a little bit of an idea then it's easier to be able to work on yourself and on your desires one of the easiest things you can do to learn about your own body is masturbation and how I always think of it is that if you get a table from Ikea and you have to build it on your own versus having an instruction manual it's easier always to build it with an instruction manual and when you know and you've explored your desires and your uh fantasies and your ideas of what sex is supposed to what you want sex to look like it's always easier to build that intimacy with your partner versus two people trying to figure out things where they don't both know a lot another very important thing is working on the shame again to include regular STI screamings in their life in their sexual life in their AC ity because we think that if it's an STI it's going to show up with some hor symptoms or you'll have like a massive temple on your shaft or you'll be really itchy and while that may be the case in some places in most cases you don't see any symptoms for nsdi until it really ascends for then creates more infection in your body and you can see the after effects of the of how it ravages through your body essentially and removing non just of Shame around it but also including the idea of regularity in there that every time you have a new partner you go through a streaming and you make sure you're safe coupling that with regular funding use for any kind of sexual activity be anal oral or vinal Sex Is Fundamental holy Tri sector in my opinion no I agree I always say safe sex is hot sex so if your partner feels safe you know they're going to they're going to be able to be themselves and not be nervous during the encounter C that they might get something right and then you know I think in India I can only imagine that STI screening is filled with judgment maybe that's a misconception on my end but is that the case like you go and you're like someone's looking at you like oh okay is that Am I Wrong tell me I'm wrong not just that but but also struggling to find a provider will give it to you one of the most one of the things that I got a lot of hate from the medical community in India FR was that I kept telling them you have to speak to your patients and ask them if they're sexually active instead of asking if they're married and people were like no this is not appropriate they shouldn't be having sex at the SE if they haven't gotten married I remember I was at a conference for it was a contraception in abortion access conference and we had a panel where people were being asked that you have a 19-year-old unmarried girl that comes to you with an unwanted pregnancy what do you do and I think about six of out of seven doctors six doctors on the state replied and said we will call their parents oh my God and it was my mother who went up and she was like actually no she's like she's an adult so she can make that decision on her own and people were really angry about it because they were like you know you're teach the wrong models to young women of the country and my mother had to sit down with to a panel of gynecologists no l and explained to them that if this is what we learn this is the this is the lit teaching we get in our medical education that you have to ensure your patient is safe and you have to ensure your patient is healthy before you ensure if they're morally okay and your definition of morality is different from theirs so there is so much stigma and judgment associated with the idea of sex and if you are coming up with the SDI the automatic assumption is that you must be quot UNC promiscuous that is why you're needing to come out with you know getting tested because you've got an infection because clearly you're practicing it wrong you know there's just so much weight associated with it that uh it it's a big deterrent in allowing people to go to access that care in the first place and when they don't go to access that get in the first place and say they're not judged there no Avenues you know there's such few centers available for getting an STI screen that it's alarming and we have a major Sexual Health crisis in the country and I don't know what on being this you know that's really sad that's really really tragic I would hope that by now I mean I think we know India has changed a lot since when my parents were kids and grew up in India and and it's very obvious that young people are sexually active like I think people are open about it more so than ever before right and I mean watch Indian movies like it's very obvious that like things have changed and so it's shocking to me that people are digging their head in the sand and not you know acknowledging this do you feel like the younger generation of doctors are being more open is it just like the older generation I mean even if they want to be open the environment that you train in is really impactful so even if you want to you know be open to this idea you're just surrounded by people that are telling you no sex is dead so it has to have some impact it's very difficult to decipher if this person will be open to communicating about their sexual activity without stereotyping them so if say a person comes to you wearing a s and they have their head covered are you going to ask them are you married or you going to ask them are you sexually active without stereotyping them based on their attire and the way they speak it's a very nuanced conversation and this this overhaul will take a lot of time because very often if you're having a person that is coming to you do your clinic to have a conversation around this if you ask them and if they're not married and if you ask them a question like are you sexual active they might get seriously offended and violence against doctors is a major problem in India particularly in the part of the country that I live in so there's no way of predicting if this person will get up and smack you across the face so wow yeah it's a really difficult conversation to have so challenging these ideas around morality and sex especially in the clinic is a very nuanced and a very difficult conversation that sounds like being a p patient is hard and being a doctor is hard if you want to do the right thing absolutely wow if you enjoyed this clip from the Rea Malik MD podcast and you want to see more check out the full episode with Dr Tan dendra right here

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