On The Couch with Kyla Lawson Transcript

Maddy Stratten: [00:00:00] Hi, and welcome to another episode of On the Couch, where we collaborate with experts, practitioners, authors, advocates, and influencers to explore current social themes, sex positive topics, and share stories and insights that matter.

Winnie Adamson: This podcast was recorded on Aboriginal country. We acknowledge the traditional custodians of the lands that were never seeded on which we live, work, and record upon.

Maddy Stratten: We pay our respect to elders past and present, and to those who may be visiting our website or listening to our podcast today

Winnie Adamson: while listening. We encourage you to practice good self-care, and of course, check the show notes for further information

Maddy Stratten: wherever you are, whatever you're doing,

Winnie Adamson: enjoy this episode of On the Couch.

Welcome my name is Winnie Adamson, and today I'm joined by Kyla Lawson.

I am really excited to get in this chat with Kyla Lawson today, and I'd like to introduce her by using the concept of fields of existence and [00:01:00] coordinates of belonging. How does that sound?

Kyla Lawson : Sounds great, Winnie. Thank you.

Winnie Adamson: These concepts were introduced to us by Leah from Co-Culture and Communications, and demonstrate that our beings are a field of activity made up of stories we've been told , ancestors that have existed, the land under our feet and the places that we stand. And all of these forces form who we are in the moment as contextual beings. So, Kyla how do you define yourself and locate yourself, and what are your coordinates of belonging?

Kyla Lawson : I think this is such an amazing concept, and I actually went back and looked at Leah and what she was talking about, and I had this very powerful, pivotal moment of going, oh, I've never really thought about that.

I'd never really put these two together. Um, so I think if I look at my coordinates of being, I am a proud South African woman born and raised there, and if I close my eyes and think about kind of that coordinates of being, I think of Table Mountain. So anyone who's been to Cape Town or has seen images will have seen this [00:02:00] landscape.

The whole of Cape Town is dominated by this huge mountain, and it defines many people's experiences as Cape Townians because it anchors you. Uh, people will talk about the where do you come from in the mountain? Which side of the mountain do you look at? Like, where do you face when you're kind of going about your life?

And I think that has always like that is that deep anchor for me and that coordinance of belonging. So. All of a sudden I might just freak out and go, I need to find a mountain. Like there needs to be a mountain somewhere, and it's my pseudo table mountain. Or I will freak out big time and go, I need to go home.

And it's not until I kind of lay eyes on that mountain, I go, I'm, I'm home now. And I really resonated with Leah's conversation about that yearning for home or that yearning for that coordinates of belonging. Um, so I think that's, yeah, that for me is that, and then the, the definition again, oh, this is like a powerful concept of a, of working this out.

Um, so I was born and raised, obviously in South [00:03:00] Africa. I am an early eighties baby, so I was born into the apartheid era. Um, obviously if you are listening on a podcast, I identify as a white South African. So my experiences as apartheid is always going to be from a place of privilege and entitlement.

And I will not be the same as somebody who was living under the apartheid restrictions. Um. My parents and I might these days have very different political views. However, they deeply ingrained within me that everyone is treated equally and with equity no matter who they are, regardless of their skin color or their privilege.

And I think looking back now, I don't, I didn't realize or know that as a child that that was actually quite contrary to many belief structures or just the society in which I was being raised. Um, so I then also had the privilege of being around when Nelson Mandela became the first demo, democratically elected president of South Africa.

And that experience of being with a community of [00:04:00] people standing in, in this park with people singing and dancing and chanting and this sensation of hope and freedom and social justice that was kind of happening around me. And that rhetoric of are we all gonna be free? Are we all gonna be equal? I think really actually was a very pivotal experience for me.

And I, again, did not sort of clue onto that until I was much older. Um, and that I think, has developed a pathway for me in my career as a social worker and now as a health promotions officer and a project officer has always been about social justice and social equity and values, um, of lending my voice that often comes with privilege and power as a white woman in this world to people who might not have the capacity or the ability to speak then and there.

Um, so I think when I look back, that for me has been a very defining moment, um, and has kind of now [00:05:00] sort of almost come full circle that I'm now working in a space which is such a gendered space of women and HIV and the risks of acquisition and, and. Even just those broad global conversations about women's sexual and reproductive health.

Winnie Adamson: Yeah. Amazing. Thank you for sharing. I really love this concept 'cause I think it really gives space for us to talk and really get to know you as well because, um, we're often in this work because we're so passionate and where we've come from really reinforces that. So thank you so much for sharing.

It's really beautiful to hear. Um,

You started as a, a social worker for over 15 years working with women and children, both internationally, domestically with women's health and sexual reproductive health as well. Um, as someone with common interests with S-T-I-H-I-V, um, BBV Transmission and Societal responses to Reproductive Rights and [00:06:00] Justice, I'm really keen to get into our discussion today.

But to get started, Kyla, can you share a little bit of your current work with Women Partners of men who have sex with men, and what service you provide.

Kyla Lawson : Yeah, definitely. Um, so like you said, when the women, women partners of men who have sex with men as the program, I'm just gonna refer to it as women partners from now on because it becomes a bit clunky at times.

Um, but like we specifically chose that title to place Women at the forefront of the program in which we run. It used to be hosted in ACON about 20 plus years ago, and it was actually moved across to Leichhardt Women's Community Health Center where it's been hosted now for 20 years. Um, it is a New South Wales health funded program, and the priority is about preventing or reducing heterosexual HIV transmission for women in New South Wales.

And having it located within, like our Women's Community Health Center, which is the oldest of women's health centers in [00:07:00] Australia, I think sits really quite nicely with that because it's a women's health center run by women for women. And we are providing quite a unique and nuanced service for women within a space that is most typically about, you know, the men who have sex with men.

Um, and so we are trying to make sure that there's a, I guess like a soft place to land for women when they discover or believe that their male partners having sex with men. Um, so we do three streams of work. We do emotional and psychological support for women in terms of counseling. So we have, we are a team of 1.2 FTE, um, and two, we have two part-time counselors. Their role is providing the emotional and psychological support for women. Most often women are coming through to process this piece of information that they have now been given or have now, um, found out.

Um, and they have a, a range of emotional and psychological needs that are [00:08:00] obviously presenting through to the counselors. Um, then I do health promotion and my health promotion includes things like, um. Yeah, networking and in-service training and trying to raise awareness of this cohort. 'cause lots of health professionals don't, maybe, don't know about it or don't know enough about this population to feel comfortable and confident to respond to women who are maybe presenting to them for service provision.

Um, I'm also trying to kind of like step out of just sexual health and they're trying to do inservices with a, a range of professionals who come across women but aren't necessarily within like the sexual and reproductive health space. We use our website as a very large portion of our health promotion.

Um, and so we have on their information about sexual health, about the emotional needs of women. We do HIV testing awareness. Um, and then what I'm really excited about and very passionate about is that I was able to start last year, a women partners client advisory group. [00:09:00] So these are women with lived experience who are incredibly generous with their knowledge and experience and support for me in actually being able to co-develop resources. What they have expressed wanting is that for a woman around the world to come onto our website and to see herself and her needs mirrored in a way that actually really deeply resonates with her. So that's one of the ways we do health promotion.

Um, we have a Facebook page in which we are using health promotion techniques and tools as well. I produced a newsletter that I send out to, uh, professionals around New South Wales and also around Australia at the moment as well, which is really exciting. Um, yeah. And then thirdly, we also do capacity raising for professionals.

We run webinars. So on our website, if you log in, you can get access to a GP run webinar, webinars for social worker and counselor. Um, one that we've developed, which is how to disclose to children and young people. [00:10:00] And that is about supporting both parents and also professionals if the relationship is going to look different moving forward because of dad's changing sexual identity or sexual behavior.

How and when do you tell children and young people that this is happening? What information do you share with them? And then we are also releasing another one by the end of the year, which is for more generic for other health professionals and, but that also includes, um, specific information we've been now to, um, network with Refugee Health and Western Sydney Sexual Health to provide some culturally sensitive and nuanced ways of actually working with women who are not Australian born. Maybe not speaking English as a first language, where potentially they're coming from, uh, communities where talking about sexual health is so taboo, but how do we bring this up in a way that lands okay with them and that they feel safe and supported in that?

Um, so that's kind of like what our program [00:11:00] does. Um,

Winnie Adamson: yeah. It's such a unique, group um, can you break down a little bit of the terminology that you use at Women Partners?

Kyla Lawson : Um, I think there's a couple of key phrases. You know, like I mentioned before, just even having the name Women Partners is such an important for us, a way of actually placing the women at the forefront of the center which they're experiencing.

Um, I also think it's really important to note that not all men who are having sex with men are gay, identifying or bisexual identifying that there are many men out there who are heterosexually identifying who are having sex with men. And I bring that up and we talk about that a lot of women partners, because a lot of clients will come through to the counselors and say, oh, does this mean he's gay now?

And the counselors response needs to be about actually saying, well, he might not know that and he might not ever know that what is important for you to be able to unpack [00:12:00] is, what do you feel about this? What are your boundaries within the relationship? How can you make this relationship formation work or, or maybe not work for you?

Um, and I think this growing awareness and conversation about sexual fluidity is one, I think that needs to kind of be at the forefront of lots of people's mindsets because it's not so cut and dry of, I was heterosexual and now I'm not. Um, and I think another one that, uh, the counselors talk a lot about is this concept of betrayal trauma, which is this.

A theory that talks to the people that we are so close and intimate with, whether it's our parents or our partner or our children. Because of that connection and empathy and vulnerability that we show them their actions and behavior can hurt us and wound us so deeply. Um, and a lot of clients are coming through to the counselors for that support.

Now, betrayal trauma is not just specific to [00:13:00] women partners and men who have sex with men. Anyone who's in a relationship formation can experience betrayal trauma. But certainly for our women partners clients, they experience betrayal trauma because of the potential infidelity or the desired infidelity as well as trying to then unpack what does it mean that my male partner's having sex with other men or wants to have sex with other men? Um, so those, when I asked our counseling team, like, what should I raise about terminology? Those are the things that they said are actually really important for people to know.

Winnie Adamson: Yeah. Yeah. Thanks. That's clear. Um, it just made me think then too, um, can you actually share how you define women?

Kyla Lawson : Excellent question. Um, look for our service if a woman identifies as a woman, then that's, that's what we respond to, so mm-hmm. We, that's all that really one of the eligibilities for our program is that she must identify as a woman and she must believe that her male partner is having sex with other men.

Mm-hmm. [00:14:00] Um, and, and that's really, you know, apart from the must live in New South Wales, like that's really our own service, our own, our only eligibility criteria.

Winnie Adamson: Mm. Yeah. Yeah. Awesome. Thanks Kyla

Yeah, the terminology I think is really important to start the conversation and I think leads really perfectly into talking about who are actually accessing the service. And the client group that you're working with. Can you share a little bit about the clients themselves?

Kyla Lawson : Yeah, definitely. Um, yeah, look, the predominant clients that we have identify as cisgendered heterosexual women who have believed that their partners are also cisgendered, heterosexual, identifying.

Those are, that is very much our, the commonality of the clients that we have. Um. We had 52 clients last year in 20 24, 20 25. And predominantly they identify as Anglo Australian, uh, with British Irish being the [00:15:00] second most common ethnicity identified. What I find really interesting is that the age bracket is between 60 and 64 and 45 and 49 is where we kind of have our two client groups most presenting.

And if you think about traditionally what's happening for women in those age brackets, you know, we've got a cohort of women who. If they are in the workforce are looking at retirement. Mm. Or if they are not in the workforce, their partner's looking at retirement, and you kind of have this preconceived ability or notion of what your retirement years are gonna look like.

Mm-hmm. If you suddenly then discover that your partner's having sex with men, what does that mean for your retirement or your, you know, like your golden years? Um, and for women who are like 45 to 49, a lot of them are perimenopausal. They sometimes don't know, or some of our clients will sort certainly have talked about this, this replication of betrayal and shock and the emotional impacts and what does that look like and feel like in the human body versus also [00:16:00] perimenopause and what does that look like and feel like in a woman's body.

Um, and often these women also have maybe slightly older children or young adolescents. Um, so you know, these women are coming through two very. Peak, uh, stages of their life for the support from our counseling team. Um, but also I just wanted to talk a little bit about like our website because we, because we're New South Wales Health funded, that means we only provide a service for people who live within New South Wales.

But we are contacted on a daily, sometimes weekly basis from people outside of the state, from Australia, states and territories and globally asking for support, asking for help, asking for counseling. Um, and so again, like going back to what I was saying before, the Women Partners Group, we are trying to make sure that our website actually provides a really comprehensive service for these individuals.

Um, so in like the 2024 to 2025 year, we had 5,300 [00:17:00] people visit our website but half are from Australia, the are other half are from international with America, England, Canada, um, and India representing where people are actually coming through and, and having traction with our website. So I think it, it speaks to that global need of being seen, being visible, being a priority population that is recognized and actually then having support options available for you.

Mm-hmm. Um, we have on our website as well where I was just looking last week, about 5% of the people who come through to our website are engaging with our webinars and our professional development space as well, which I think speaks to how many professionals really have a need or a desire to learn more about this population.

Um, and, you know. I'm definitely, I'm, I'm a qualitative person. I like the stories, I like the narrative. And so I think also really importantly on our website, it, we are seeing that , where we are having the most traction, where [00:18:00] people are spending the longest amount of time reading, um, resources, is actually what our client advisory group have developed.

So these women have been out to say, this is what I would've wanted to have seen. Let's try and create that resource. And now we're actually having that like iterative feedback because clients are engaging with it and they are reading it and they are seeing themselves on these resources. Um, you know, and, and things like, should I test for HIV or what is the normal reactions I should anticipate from betrayal?

And, um, you know, trust bro being broken. These are things that are really re resonating with clients both within Australia and also globally.

Winnie Adamson: Mm. Yeah. And it's so important to, I help people. By hearing other people in that same experience. Yeah, I think it really breaks down those stigmas and a lot of shame there.

It's really interesting to hear how much global traction the website gets and it shows that there really is a [00:19:00] need, not just here in Australia, but more broadly too, which is really interesting. Um, we talk about reaching out for support a lot in sexual and reproductive health space. And can you share why your clients initially reached out to the service?

I imagine, the initial contact evolves into the area once they are connected in the space, but what support services are they needing? I know you've mentioned a couple, but can you go into depth a little bit more about some of those?

Kyla Lawson : Yeah, definitely.

It's a, well, it's such a great question and it really made me stop and think about it myself. Certainly when people are reaching out for our, uh, to our program, they often will say, I'm looking for a support group, so I want to see other people with a, similar experience as me. So our counseling team do provide a support group, and that is very much about reducing the social isolation and the stigma associated with having lived experience of being a woman partner.[00:20:00]

The women are often looking for a safe place to land. They will speak to our counselors and say, I'm in shock. I am angry. I am, I am resentful. I don't know what this means for me. I dunno what this means for my family and for my children. I need a safe place in which I can unpack all of this, a place where I'm not going to be judged, where I, you know, my reactions can be normalized.

Um, we in no way, shape, or form condoned any messaging or rhetoric around homophobia, but it is also really important to better unpack some of this shock of how can this have happened to me? How did I, what, what, what was going on that this is now my lived experience that, you know, if we're thinking about our client demographics of age 60, some women have been married in a partnership for like 40 years.

What, like, what does that mean for my relationship? Was it a loving relationship this entire [00:21:00] time? Or, and you know, they have a lot of these questions that they need to unpack. And again, speaking of that betrayal trauma, that real soft place of, of wanting to make sense of that, for a lot of women as well, they are trying to work out and navigate a pathway forward.

Like, what does this mean for me? Can I stay in a partnership with this person? Do they want to remain with me? Do I want to remain with them? What can this look like? What about our children if we have them? It also makes people stop and think about societal views on same sex attraction and behavior. Are my, are my coordinates of belonging are they safe places for this disclosure to happen? Are my children at school gonna be exposed to homophobia? Are my family gonna be supportive? Um, you know, and the counselors certainly help women try and navigate that space of let's try and find a safe person for you to talk to. However, even in saying that this is this very ethical minefield, I guess [00:22:00] almost of navigating, because it's not her story to tell if he is engaging in same sex activities.

If he is what, you know, maybe wanting to explore his sexuality. It's not her place to tell that story. That's his story. Mm. However, if she can't share that with people, then she is silenced. Mm-hmm. And we know what silence and that sort of isolation stigma can do to somebody in their mental health. So can the counselors really try and help navigate and unpack that a little bit.

Mm-hmm.

Winnie Adamson: Yeah. I, I, it makes a lot of sense when you start really thinking about it and breaking it down. And it's interesting hearing you say that about, um, like it's not her story to tell because it's not, but at the same time it is because it is her lived experience of what she's going through, and that's really challenging to find [00:23:00] that line.

Um, do you find that some of the women are coming and they don't have anyone in their lives to talk to?

Kyla Lawson : Definitely. So

Winnie Adamson: that's why those services, especially those support groups.

Kyla Lawson : Yes. And and that's what the counselors, when I was talking to them last week about, they said, this is the thing that often drives women to counseling is , they want to better speak about this.

Mm. They want to actually better hear somebody else reflect their story back to them. To, to see that sort of replicated of it's okay to feel sad, it's okay to feel angry. It's okay to say I'm betrayed by this. Um, and, and it, it, I think it also allows women that safe place to kind of make sense of what are, what do they want their relationship to go forward rather than sometimes I think society makes women believe that they just have to run along with whatever their male partner wants them to.

Like, you know, we don't, sorry

Winnie Adamson: I've, um, I had also imagine, [00:24:00] um, for the men too, the experiences would vary quite a bit and often they might not wanna lose their relationship. Yes. Um, can you share a bit about the dynamics of that . Yes.

Kyla Lawson : There. Yes. Well, when it's like, it's such a great question and I think, um, I'm gonna answer it in two ways. When we think about society and the ability to disclose one's sexuality, there is often so much repression that happens.

Some men, both within Australia and in Women Partners, but also internationally in some of the research, like there's limited research. But the research that has been done on women partners experience overseas really speaks to if a man is reliant on his female partner to provide him with the, the protection of the cisgendered heterosexual normative identity.

When she potentially threatens that [00:25:00] or wants to destabilize that by saying, I know you're having sex with other men and I don't wanna be a part of this. This is not what I want my relationship to look like. There are elements and of, you know, coercive control that can happen financial and emotional abuse.

Certainly with the overseas research they have shown that there has been an increase in physical and verbal violence against women. Um, you know. All relationships can and do experience domestic and family violence. But I think how it can present within this particular cohort is it can be about, let, let's keep her silent, let's keep the normative ways in which we are living present so that I, I as a man do not have to disclose or I don't lose that safety of the heterosexual normative relationship I've entered into.

Mm. So certainly our counselors are always on the lookout for those signs of, of coercive control and financial abuse. Um. And I [00:26:00] think on the flip side of that, there's um, but there's a researcher Daley, who is mainly based in Ireland, and she did an amazing piece of research on women's experiences.

And what her research was talking about is that if we, if the couple, even if they choose to separate, if they can have mutual respect for each other, if they can have a mutual empathy for the each other's lived experience, if there is clear and transparent communication, um, if they both want the best for each other, regardless of what that might look like for their relationship, these two individuals can often walk out of this relationship or into whatever they decide what their relationship will look like with as little hurt as possible.

Mm-hmm. And they can maintain cordial relationships with that mutual respect going forward. Um, and that's certainly something that we are always trying to talk about of, you know, it, it doesn't have to be a pathway of pain, but both parties [00:27:00] really need to rather see the other person's lived experience.

And for a lot of men that can be that internalized homophobia and that internalized stigma. Um, but yeah.

Winnie Adamson: Yeah. Um, it's really, it's just, it's really interesting to unpack it. I think, um, and that internalized homophobia is so real and I can imagine for a lot of, um, like CALD communities too as well, and those where it's just not even something talked about or even educated.

Kyla Lawson : Yes. Yeah, definitely. Yeah. And I mean, if you think about, uh, our demographics are very Anglo Australian. I don't believe in the slightest that there's actually a representation of the need within the community. But I think as you said, when you, when you then are looking at different lived experiences of the country of origin, you come from all the country of origin that your parents come from, the community in which you were raised, the society in [00:28:00] which you were raised, um, whether or not you ascribed to a religious belief or institution. These all dictate our thoughts and what is normative for us around same sex. Mm. Um, and a lot of cultures still to this day talking about sexual reproductive health is such a taboo subject. Yeah. You know, it can be seen within, maybe it's because we're all in sexual health, but for us it's so normative to, you know, you just kind of have a chat about, you know?

I know, yeah. Chlamydia your over lunch. Yeah. But you know, for lots of people in this world, you do not talk about that, not even with your healthcare providers. So then sort of stepping into those dynamics and trying to unpack even how, that's certainly something that I'm trying to work out is how do I engage with those community facing health providers who are working with women in a trusted formation, how do I get access [00:29:00] to these women just to let them know about our service? How do I do that in a very culturally safe way? And I have certainly learned that it's through the relationships in which I'm developing. So if I develop a strong relationship with you in the community and you develop a strong relationship with this woman, we have a very small chance.

But if she does disclose, there will be a safe, warm referral through to our service. Mm-hmm. Um, but Bernard Saliba is a lecture at UTS and the Kirby Institute, and he's been currently doing his PhD. And his PhD is looking at, um, Arabic men's experiences of MSM in in New South Wales. And, and it is just the most fascinating research because it really speaks to that culturally linguistically diverse experience of wanting to explore your same sex attraction or your same sex identity. And weighing up, I guess, the what do you stand to gain versus what do you stand to lose? Mm-hmm. Because in [00:30:00] conservative societies, you stand to lose your relationships. Your partner potentially access to your children, your friends, your family, your loved ones, the people who are your coordinates of belonging.

You might stand to lose that. And so the risks of then disclosing can often be so much greater than trying to live a discreet life. Life. Um.

Winnie Adamson: Yeah. Um, I wanna ask, are there any other services around Australia that offer similar support?

I know you're connected with Leichhardt Women's Health Center and that's where my mind goes to. Um, and you are really uniquely positioned within New South Wales, but as you said, there's more of a broader reach. Yeah. Um, where do you refer some of these people who maybe are outside of those areas or other support services?

Kyla Lawson : Yeah. Um, again, we need, this is I guess a space in which there needs to be a lot more movement. Um, certainly [00:31:00] Women Partners are, whilst the councilors work for both Leichhardt and Women Partners, Women Partner clients are our priority. So we, if they, if women are living within New South Wales. And on wanting in counseling, they're always top of the priority for the counselors.

However, lots of people are reaching out for support. To the best of my knowledge, I don't know of any other health funded services within Australia. Um, so what our counselors recommend for women is to get a mental health care plan and to engage with a private counselor or psychologist. We often encourage people to look for somebody who specializes in sex therapy or sexual identity relationship counselors because it, if you have that kind of nuanced view on, I guess, especially sexuality, I think people tend to get a much better service or a service that is very balanced from understanding his lived experience, but understanding hers and having that ability to prioritize [00:32:00] her needs and her wellbeing as I important as his.

Um. For people who are wanting peer-based support, there is OurPath, which is based in America and Straight Spouses, which is based in the UK. Mm-hmm. Again, those are peer-based supports. A lot of people really need that peer-based support though, and, and really, um, relish the support that is given. My understanding was that there was, um, a couple of, uh, grass-based roots programs in China, but I've tried to find out whether they're still operating and like it's been quite challenging to find these are the places that we refer people to.

So I think it speaks, again, very globally to the fact that there is a need and there are not, to the best of my knowledge, not services out there for this particular population.

Winnie Adamson: Mm-hmm. Yeah, definitely. Thinking of, um, you know, sending people to, like you said, psychologists and counselors is so important, but having that understanding [00:33:00] of sexuality. Yes. And um, and I think this moves us really nicely into talking about the shame and stigma and prejudice, 'cause it does underpin mm-hmm. So much of why this work is happening and is important. Yeah. Um, yeah. Can you share a bit, furthermore into the shame and stigma?

Kyla Lawson : Yeah, definitely. Oh look, I mean I could talk for like two hours about this, but I think if we are trying to unpack what, what sits behind for a woman's experience, we really have to actually understand what is happening for the male in her life. And like I've mentioned and talked about what society believes around same sex activity and same sex relationships really, I think, sort of underpins that.

If we think historically or even currently, like there are many parts in this world where same sex behavior or same sex relationships are illegal and you face jail time and sometimes, you know, death [00:34:00] sentences. So there's these really, um, punitive and negative views around same sex activity even within Australia, like Leichhardt is in the, inner west of Sydney.

We like to think that in the, in the west of Sydney, that we are this liberal, accepting everyone is same here, experience and it might be compared to other parts of Australia, but you know, there is still se there are still people within the population that do not agree with same sex , relationships. Um.

And I think like speaking before about the risks that people lose, like people stand to lose a lot for when they disclose their same sex attraction. And I think that that really can sort of, it can manifest into that internalized homophobia and, and internalized shame for a lot of men where, especially if they are living within the cisgendered uh, [00:35:00] societies and communities where that is that normative pathway.

You fall in love with somebody or you find somebody that you can tolerate for the next 60 years. You partner with them, you have children, you have a dog, you have a house. If you don't want to go down that pathway or you know that that's not actually who your identity is, it's, you know, that's a really difficult space to kind of step out of.

Um, and so I think when you kind of then look at all of that, what it takes for men often to disclose or to discover. I mean, a lot of our clients discover, um, things that kind of let them know that their partner's having sex with other men. So some more often than not, it does seem to be that women will discover something, whether it's a Grindr or a account or an uh, you know, um, a prep prescription or somebody tells them that this is what's happening.

Um, so I think that that [00:36:00] kind of underpins for women partners that stigma. But I think if we then kind of break it down further into women partners, actual lived experience, a lot of these gendered viewpoints and societal beliefs kind of also then become a little bit more front and center because she can have the same or similar experiences to him.

She can fear societal judgment or rejection from the people that she loves. She can fear for her children's wellbeing and for safety for them, or their, their exposure to homophobia. But, um, you know, a lot of our women partners, clients will speak about the fact that people, if they do tell, can have this real, like the shame and blame for her of this belief of like, well, how did you not know? Or, um, you know, if you were an inverted commas a good enough wife, this might not have happened. Or if [00:37:00] you were maybe more sexually adventurous or you engaged in sexual preferences that he wanted to, you know, there's a lot of that kind of blame on on her.

Mm-hmm. Um, and there also still seems to be this real belief structure that women should not rock the boat. They should turn a blind eye that men will be unfaithful and, and whether he's been unfaithful with a male or a female, should it matter? And, and you just need to kind of keep the status quo, keep your family the way it always has been.

Um, and so a lot of our women partners clients are, are battling some of those sometimes internalized belief structures that they might ne necessarily have ever known, that they actually held themselves. Plus the societal belief structures around same sex activity as well. Yeah. So there's a, there's a lot there and I think there's a lot of avenues and opportunities and intersections for, um, for homophobia and, and that stigma and prejudice to kind of come to the forefront.

Winnie Adamson: Mm-hmm. [00:38:00] Yeah. And you can see why that can play into some of those domestic violence Yeah. Related spaces. Yes. Um, with their internalized homophobia. Mm-hmm. Yeah, definitely. Um, I wanna spend a bit of time exploring the gendered impacts of HIV and STI transmission and those societal responses to reproductive rights and justice.

Um, you are particularly passionate about this intersectionality of women's lived experience on these issues of health promotion perspective and looking at that role of prevention. Um, we know that the research shows that women are disproportionately affected by STIs throughout their lives compared to men due to multitude of reasons such as physical, female anatomy, social, cultural, and economic factors.

Can you share a bit more about your passion in this area and talk us through the reasons why women partners are disproportionately [00:39:00] affected by s STIs and HIV transmission, and what are some of the gaps in their health and wellbeing?

Kyla Lawson : Again, Winnie is such a good question.. Um, I think one of the really, for me, one of the key ways in which I think the gender disproportion shows through is, particularly in New South Wales, is what we know about the women who are at risk of, or who are acquiring HIV. Um, you know, New South Wales Health have a HIV strategy and every year they release their data on who is acquiring HIV and kind of trying to break that down.

Um, in 20 24, 30 people who identify as women acquired HIV, which is three more than the year before and eight more than in 2022. Uh, the same time period, 57 people who identified as heterosexual were diagnosed with HIV, which is again, an increase from 48 people in 2023 and 38 in [00:40:00] 2022. Um, and more than half of those diagnoses were Australian based acquisition.

Now, the reason I kind of bring that up is because when I read that data, I look at that and I go, I have so many questions. Again, I'm a qualitative person. I want the narrative around this. But I'm like, I, what I'm always intrigued is, is like, where are these women living? Like how did they acquire HIV? Um, was it a late stage diagnosis?

Was it an early stage diagnosis, um, with the heterosexual transmission? I think we need to know more. I think we need to unpack and we need more data around this because when we have the data, we can then provide health messaging. We can provide targeted support. You know, we can increase that narrative of.

Women, whilst your risk of HIV in Australia is much lower than it is globally, and it might be lower than if you are, say within the MSM population, you are actually at risk. And like, let's [00:41:00] change that narrative into one of empowerment and knowledge and, and sexual health kind of empowerment strategies.

Mm-hmm. So I think that to me, like the lack of, or the limited data really speaks a lot to that kind of gendered experience. Um. I think in particular, if I'm looking at the women partners experience, majority of our clients believe that they are in long-term heterosexual, cisgendered, monogamous relationships.

And, and you know, if you kind of listen to the broader conversations about who is at risk of sexual health and STI transmission, typically you don't fit within that if you are long-term married, right? Mm-hmm. And so a lot of women don't know about their risks because they don't know that their partner's having sex outside of the relationship.

They are then also relying on him listening to those health key messages and then engaging with safer sexual health practices. [00:42:00] Um, and so, and for a lot of women, it's really confronting to be told by our counselors, Hey, listen, as part of like a really comprehensive response, we always encourage people to go for sexual health testing and including HIV tests.

Again, a lot of women might not. Might have been a, a very long time since they engaged in that. Or if you are, you know, a 64-year-old woman, you might never have gone into a sexual health clinic before. You know, the conversations we have now about sexual health are vastly different than was happening 30, 40 years ago, to my understanding.

Um, and then I think lastly, um, you know, again, globally prep, the pre-exposure prophylaxis is used as a empowered strategy to prevent HIV transmission. The knowledge of that in Australia is quite limited. Um, so Caroline Laden, Catherine McPhail have been doing some really interesting work in that space of [00:43:00] understanding women's knowledge of Prep their.

I guess the, the desire to use prep, um, the barriers to having that prescribed to them. Um, and a lot of healthcare providers don't know that cisgendered women are able and eligible to be using prep. Mm. I mean, the ASHM Guidelines for prep prescriptions have recently become updated. So I, my knowledge is that historically it used to be if you were at risk of HIV transmission, you could be prescribed prep.

Now it's, if you ask for it and you are medically suitable, then it should be prescribed. Mm-hmm. But I think that this is a space that look not for, it's not for everyone. Right. Not all women are going to be like, yes, please sign me up for prep. But I think it needs to be part of that, uh, like the, the sexual health tool belt in which women can find themselves saying, I'm gonna dip into this.

I'm gonna dip into that. This is something that I can use if I, if I want to.

Winnie Adamson: Yeah, definitely. Um. [00:44:00] Absolutely. It makes me think of our episode that we had end of last year, um, and if you do listen to that episode with women and HIV, it's, you know, you do hear those stories and those personal stories which are really powerful and really important .

Yes. Um , I guess continuing on the train of STI and HIV transmission, um, and you know, these women not necessarily fitting into those priority populations and so they're not going to the sexual clinics as you said. Um, can you talk a bit more about how your service actually do that sport? I know you said the councilors encourage testing, but can, do you mind sharing a little bit more about that?

Kyla Lawson : Yeah, definitely, definitely. Um, I think first of all, like you mentioned, Winnie our counselors talk to women about their potential sexual health risks, and that can often be done in a very sensitive way of, you know, [00:45:00] because I think the, the way I view this is you have to identify with the fact that you may have been exposed to s STIs or HIV for a lot people, that's a very deeply confronting experience to go through. So the counselors will gently kind of take 'em down that pathway and try and support them to decide where to go. For some people going to their GP is the most natural thing in the world.

They have a really close relationship with their gp. They trust them. For some people, they're like, I will not go to my gp. I, maybe they belong to the same community with me, whether that be a CALD community, whether that's a remote location. They're like, I do not believe, or I fear that my GP or my healthcare provider will not keep my confidentiality and privacy safe and secure.

And so then they will talk to 'em about, well, you, these are the options, whether it's online testing or, you know, going to the publicly funded sexual health clinic. Certainly when I started this role, which was [00:46:00] only about 18 months ago, we were hearing a lot of conversations from women coming back and saying, I went to the, the clinic.

I, I tried to get into the clinic and I wasn't able to. And what we were finding is that women weren't knowing how to actually, I identify themselves as a sexual health priority population. Mm-hmm. So we worked with SHIL the Sexual Health Information Link and developed a a, a script that from the show providers, they were able to say yes, like we think this would allow reduction of barriers and for women found that it was an easy enough phrase to be, to say my husband is, or my male partner is having sex with me and with men and I would like a comprehensive sexual health test. Um, we are certainly hearing more anecdotal evidence coming back that women are able to get into clinic sometimes.

I think it very much depends on like where you are around New South Wales. Um, but we are also now kind of, I guess increasing some of this knowledge for clients [00:47:00] because we are certainly hearing that say, um, women might not be, um, given comprehensive sexual health test. Sometimes healthcare providers are picking and choosing what they think should be part of the sexual health test.

And so it's not actually a, a for all, I guess, possibilities. They might just pick and choose one or two. Mm. Um, so we are trying to upskill women. We are trying to upskill healthcare professionals. Um, and, we are also trying to, I guess, influence policy and make changes in that capacity. So, um, I have been able to engage with the New South Wales, HIV, um, the new strategy that's come forward.

Mm-hmm. I've been able to kind of give feedback on that and certainly, um, the feedback has been about where do we incorporate cisgendered women? Where do we incorporate women in general? Where do we incorporate women partners? And just trying to get. I guess those, those intersections more readily [00:48:00] addressed because I , I think New South Wales has done so phenomenally well within the MSM space, but if we want to get to the zero transmission mm, we need to look at the people in places in between.

Mm-hmm. Like those areas that haven't really kind of been targeted. So that's really been something that, um, has been a really exciting place to, I guess, step into that advocacy role. Mm-hmm. Um, we are also. We are also currently working on a multi-stakeholder, um, journal article that we are in the process of hopefully having published.

Um, and we have had some really phenomenal support with, UTS and the University of Wollongong, University of Sydney, Western Sydney Sexual Health, Positive Life and lived experience clients, both of women living with HIV and women partners. And that has been looking at those holistic needs of both wellbeing and health.

Because certainly I think the, the data that is out there, and it's amazing that there is research into this [00:49:00] space, very much looks at just the sexual health, whereas our clients lived experience says we are more than just that. We have emotional needs, we have psychological needs, we are women, we are parents, we are mothers.

Like our needs are more comprehensive. Hmm. Um, so we are really. Hopeful that that will allow us to, I guess, to advocate for that more holistic viewpoint if we are able to kind of get that piece published. Yeah. So watch the space. Great.

Winnie Adamson: Yes, absolutely. It's great to see. I excited to, um, read it. Yes. And also we'll link it out to our people.

Um, thinking about our listeners actually, um, of health and community workers and social workers, community members, how can we improve the work that we do to ensure we're supporting women and their access to health and support information and services like Women Partners?

Kyla Lawson : Um, I think [00:50:00] just even knowing about this priority population, I think holding that in your, the forefront of your mind when you were working with women when you were working with men who are partnered with women, um, knowing about the service, knowing that we are there, we are always very happy to consult with people. Um, whilst professionals can't refer clients through to us 'cause we need women to self refer. Mm-hmm. We are always there to, to, to have those conversations with people if they aren't sure if they're doing the right thing or they just wanna come be a sounding board, we are very happy for that.

Um, I think more broadly, I think we need to have an increase in advocacy for sexual health testing to be broadened for the clinics to be increase in funding. Mm-hmm. I think from my knowledge, sexual health clinics are so under the pump all of the time. They're not able to meet the needs of the populations that want to go there or that need to go there.

I think in my personal opinion, if you [00:51:00] are a sexual being and you're engaging in sex, I think you should be allowed to go into the sexual health clinics from a health promotions point of view we do a lot of conversations with people about the importance of sexual health testing, and you work with people and you share this news about why it's important and why it's an empowered position to take about your own sexuality and you know, you can get people to the door of the sexual health clinic and if there's a barrier there, what then? Like you may have lost that person. Yeah. Um, and so I think there needs to be, I think there needs to be more support for the sexual health clinics in general. Um, again, I think the intersections of where HIV and STIs are, are the transmission.

I think we need to be more focused on that. Um, and really, if you live in a state that isn't New South Wales, can I ask you to advocate for a service such as Women Partners? I think the importance of having it to be health funded I think really is important because again, like [00:52:00] we are ultimately funded for a health need, but so is mental health and emotional health like and physical health, the impacts of stress and, um, you know, impact on our, our health wellbeing.

But you know, so advocate and, and request and you know, and we are happy to talk to you if that's what you wanting to do in that space as well.

Winnie Adamson: Yeah, definitely. I think this has been an incredibly eye-opening episode of On the Couch, and . It's really incredible to hear work and how much you are moving this space and helping these women who are kind of invisible priority population. And we are really, it's really exciting to see that it's continuing to grow. Um, so thank you very much. Thank you.

And continue your amazing work. Um, but I'd like to hand over you, Kyla, for some final thoughts. final takeaway messages.

Kyla Lawson : Um, it has been an [00:53:00] absolute pleasure and privilege to be here, so thank you for the invitation. Um, been able to talk about HIV and women's health is just two of my passion projects, so it's been an absolute delight, I think.

Um, final thoughts. I think we as society have a long way to go in normalizing same sex relationships. Um, I think that. Uh, that growing acceptance and that growing conversation about everyone has the right to live an authentic life. They deserve to have a relationship in whatever consenting, safe formation it looks like for them.

I think we will, we, yeah. We need still a lot of growing and movement in that space. I think until we can do that, the women partners experience and, and men who are married to women who come out later in life and say, I'm lesbian, I'm gay. That is gonna continue to happen. Mm-hmm. Um, I think that we need to normalize sexuality and sexual [00:54:00] health more broadly, again, of being able to say, if you are a sexual being, having access and equitable access to sexual health testing is really important.

I think. Especially for women where we seem to only kind of have sexual health testing if you fall within that priority population or if you are a cisgendered woman when you are, you know, having a baby. Mm-hmm. Those seem to be like those two spaces. I think we just need to make STI and HIV testing just part of like your regular visit to a gp.

Oh, you're here for your cholesterol check. Cool. Like, let's also just do an STI check while you're here. You are here giving blood anyway. Yeah. Um, and finally I think we need to have a growing conversation about women in the HIV space and not from that fear based, oh, you are at risk of saying if you are engaging in sex, there are ways in which you can keep yourself safe.

Mm-hmm. Whether it's condom use or advocating for yourself in that space, or engaging with prep, you are at risk [00:55:00] and you also, uh, have the ability to protect yourself sexually.

Winnie Adamson: thanks for listening to On The Couch. We create this podcast because we are allies in actively challenging discrimination, microaggressions and exclusionary behaviors.

Maddy Stratten: We wanna create spaces where people feel safe to share their thoughts, knowing that they'll be heard and respected. Such an environment fosters collaboration, innovation, and contributes to a more inclusive society.

Winnie Adamson: Follow us on your favorite podcast platform. That way you will receive every new episode when it's [00:57:00] released. You can also help us grow the podcast by giving us a rating and leaving us a review.

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Winnie Adamson: On The Couch is made by the team at Caddyshack Project.

Until next time, peace, love, and protection.