Why British Asians are Ashamed of Discussing Reproductive Health

In British South Asian households, reproductive health remains stigmatised. It is a silence so pervasive that it is actively preventing men and women from seeking life-changing medical care.

While the community places immense value on lineage and family, the biological struggles involved in creating that family, from infertility to chronic gynaecological pain, are frequently swept under the carpet to protect “izzat” (honour).

This fear of judgment is not just a social inconvenience but a medical hazard, causing significant delays in diagnosis for conditions like Endometriosis and low sperm count.

Instead of consulting doctors, many individuals suffer in isolation, terrified that a medical label might tarnish their marriage prospects or social standing.

We explore how deep-rooted cultural stigma is compromising health outcomes in a community that ostensibly values family above all else.

A Double Life

In Desi culture, marriage is almost immediately followed by the expectation of children. It is a linear progression ingrained in us from childhood: study, marry, have children.

When that line breaks, the silence that follows can be deafening.

And for those with reproductive health issues, cultural norms can make patients reluctant to seek help.

This observation is echoed by specialists.

Dr Anupama Rambhatla, an obstetrician-gynecologist and infertility specialist, said many South Asian patients face challenges that extend well beyond biology:

“I do have quite a number of South Asian patients who come to consult me.

“Infertility care in general is not something that is talked about in South Asian families and communities.”

For women like Seetal Savla, this silence manifested as a suffocating isolation.

After suffering a miscarriage and enduring unsuccessful IVF cycles, she felt compelled to hide her pain to maintain the image of a perfect life.

She said:

“Keeping this a secret made me feel like I was living a double life.”

“I was portraying a carefree, adventurous existence digitally, while healing a broken heart and drowning in a sea of fertility drugs in real life.”

Her experience highlights a common reality: the pressure to maintain a facade of a “perfect” family life often overrides the need for emotional support.

Dr Rambhatla notes that “acknowledging fertility struggles and confronting family expectations around childbearing can be especially difficult”, often requiring immense courage just to step into a clinic.

This delay is critical; live birth rates for British Indians undergoing IVF are reportedly lower (around 9.1%) compared to white British patients (22.7%), a disparity partly fuelled by delaying treatment due to stigma.

The ‘Gender Pain Gap’

While infertility is hushed up, conditions like Endometriosis and Polycystic Ovary Syndrome (PCOS) are frequently brushed off or normalised.

Research indicates that British South Asian women are significantly more likely to suffer from PCOS, with prevalence rates as high as 52% in some community studies, compared to just 22% in white Europeans.

Despite this staggering statistic, diagnosis is often delayed because symptoms like weight gain or excess hair growth are viewed through the lens of marriageability rather than health.

Neelam Heera, founder of Cysters, a charity supporting marginalised people with reproductive health issues, points out that the community often blames the woman for these biological realities.

She explained: “Anything that has a detrimental effect on fertility is seen as the fault of a woman.”

This toxic narrative means young women often hide their symptoms, fearing they will be labelled “damaged goods” before they even reach marriageable age.

Similarly, Endometriosis sufferers face a wall of dismissal.

In some South Asian households, severe period pain is viewed as a rite of passage, something to be endured quietly rather than treated medically.

The myth that “pain improves after marriage” persists, causing women to suffer for years without a diagnosis.

Saffiyah* struggled for months with severe pain before being diagnosed with Endometriosis. Her journey was complicated by the condition and the additional struggle to be heard by medical professionals.

She told DESIblitz: “In my personal experience as a Pakistani woman, I’ve felt I have had to over-explain myself to white doctors.

“Every time I go to speak to a doctor about the pain, I am afraid they won’t believe me.”

Dr Rambhatla emphasises that education is the only way to dismantle this specific form of shame:

“I spend a lot of time focusing on education because I think that it’s really important that they understand what normally happens during a woman’s menstrual cycle.”

When patients understand that their pain is a biological anomaly, not a personal failure, they are better equipped to advocate for themselves.

Male Reproductive Issues

If female reproductive health is met with silence, male reproductive health is considered non-existent.

Male infertility accounts for roughly half of all fertility problems, but in British South Asian communities, the blame almost invariably falls on the woman.

The concept of “izzat” protects men from scrutiny, while women are subjected to invasive tests and social judgment.

Priya*, who experienced such blame, recalled:

“I knew it wasn’t my ‘fault’, but after years of hearing the whispers, you start to doubt yourself.”

“The worst part wasn’t the gossip; it was seeing the guilt eat away at my husband. I wanted to protect him, so I took the blame. It made me angry, but I love him. What else could I do?”

For Desi men, virility is often conflated with fertility.

A diagnosis of low sperm count or motility can be perceived as a direct attack on their masculinity.

Consequently, men are less likely to discuss their struggles with friends or family, leading to what researchers call a “silent burden”.

In many cases, a couple will claim “we” are having trouble, or the wife will silently shoulder the burden of “unexplained infertility” to protect her husband from the “shame” of a low sperm count diagnosis.

Haroon* said: “At every family gathering, it’s always, ‘Any good news yet?’

“They look at you, then they look at your wife.

“You can feel them quietly judging you.

“You just smile and say, ‘Soon’. But inside, you’re crumbling.”

The Clock vs The Career

A new tension is emerging for the modern British Asian woman: the conflict between career aspirations and the biological clock.

As more women from the community prioritise higher education and financial stability, they are pushing back marriage and childbearing – a choice that clashes violently with the traditional timeline expected by elders.

Dr Rambhatla said: “They’re trying to establish their careers, and a lot of them are doing things that require higher education and longer periods of training.”

She noted that many women are delaying childbearing into their 30s, often unaware that fertility declines sharply after 35.

This has led to a rise in interest in egg freezing, yet this too is shrouded in secrecy.

For an unmarried South Asian woman to freeze her eggs is to admit that marriage isn’t imminent, a declaration that can invite pity or gossip from the community.

Dr Rambhatla added: “They know that they’re going to delay childbearing, so they want to freeze their eggs so that they can have a better chance of preserving their fertility for the future.”

Physician Geeta Nargund argues that we must normalise these choices through education:

“Knowledge is power. It allows women to make decisions and plan their lives.”

By framing fertility preservation as a smart medical decision rather than a “backup plan” for failed marriage prospects, the narrative can be shifted.

Dr Rambhatla adds that by explaining procedures as simply “manipulating what happens naturally”, she helps patients see fertility care as a tool for empowerment rather than a source of shame.

The barrier to reproductive healthcare in British South Asian communities is not just about access to doctors; it is about access to the truth.

Stigma, shame, and a cultural preference for silence are actively preventing men and women from getting diagnosed and treated for common, manageable conditions.

When we allow “log kya kahenge” to dictate our medical choices, we are choosing reputation over health.

As long as conditions like endometriosis are whispered about as “women’s troubles” and male infertility is conflated with a lack of masculinity, the gap between needing help and seeking it will likely persist.

And while medical science has advanced to offer solutions for almost every fertility challenge, these innovations are rendered useless if patients are too afraid to be seen in a waiting room.

Ultimately, the cultural habit of prioritising reputation over physical well-being creates a cycle where treatable conditions are allowed to spiral into life-altering crises.

The “taboo” label attached to reproductive health serves only to maintain a facade of perfection, leaving individuals to navigate the difficult reality of their biology in a solitude that tradition demands, but medicine warns against.