It's more than sex ed. For these young women, it's a movement for equality.

When writer Meera Subramanian traveled to India, she wasn't sure exactly what she'd find.

In an excerpt from her book, "A River Runs Again," she tells us what she discovered:

It was the girls who talked most passionately. Several spoke of becoming more comfortable with their bodies after having been taught what was happening to them, after resolving at least some of the mysteries of adolescence. They had lost their shyness by learning about the details of biology…


Scene from rural Bihar. Photo courtesy of Allison Joyce/Redux.

In rural Bihar — one of India's most impoverished states — Subramanian sat in a small brick one-room schoolhouse, listening to a group of local teenagers talk about their lives. One young woman in particular caught her attention...

Sobha was the most self-possessed. Her forehead was marked with a sparkly bindi that matched an S-shaped pendant hanging from her neck. She sat attentively as the others spoke, only once interjecting, “We should say the truth." But once she had the floor, she commanded the room. All distracted chatter stopped.

“'What sort of place is this?' you'll say if you come to my village. From Bodh Gaya, there's a river and a hill, and behind them is the village, like a cave. People were afraid to go inside. Even my father didn't want to stay in the village. It was claustrophobic." There had been changes, she said. Some villagers now had phones, and one road was being paved. She learned about the Pathfinder training course from village elders, who said all girls between fifteen and eighteen should attend.

Subramanian writes that Sobha and the other teenagers had just finished a three-day training on the basics of sexual health through an organization called Pathfinder International, led by two bold advocates, Pinki and Binod.

But “my situation was common in the village," [Sobha] said, “where each household might have six sisters, five sisters. So we made a group with at least one girl from each house. We took the training and then we went back home to teach others." She had to periodically gulp to catch her breath, as though she had been waiting a very long time to speak and felt the importance of each word.


Pathfinder mural in Bihar. Photo courtesy of Allison Joyce/Redux.

Sobha said she was able to get a Pathfinder poster of the life cycle of a human being passing from birth through adolescence, followed by marriage and a young couple weighing birth-control options, and later holding a child as it is being immunized. She used the poster to begin talking with others in the village. Pinki and Binod exchanged looks; they had no idea that one of their students had gone rogue and appointed herself as trainer.

When Sobha finished, Pinki asked if she would continue to work with Pathfinder to organize more training courses. Sobha eagerly agreed.

Subramanian was deeply moved by what she saw. These teenagers weren't just learning about reproductive health; they were learning to find their true voices:

We emerged from the small schoolhouse into an afternoon damp with mist. Though their hair was neatly pulled back and their clothes were modest, I saw the girls as powerful goddesses, devis eager for justice, who stepped in where the male gods were failing, determined to quietly, or not so quietly, dismantle a world that treats them as second-rate citizens.

Pinki and Binod. Photo courtesy of Allison Joyce/Redux.

As she continued her travels, Subramanian found even more reason to hope for a future of real equality and sustainability throughout India.

India is undergoing a radical test. Girls from all over South Asia are leaning in, tipping the balance, and hairline fractures are appearing in the ancient system of chauvinism. Whether sexual violence is on the rise or decline is difficult to know. Whether the aggression is men's bitter reaction to the power they perceive they are losing to women is likewise uncertain.

But what is known is that it is now news. The rise of both women and men who are unwilling to accept the status quo has been startling and encouraging. There are women who bring their daughters into the streets to protest, boys like Sanoj who fight for the rights of their sisters, men like Pinki's father who struggle to educate their daughters.

In her new book, "A River Runs Again," Subramanian writes about the real change happening — not just in Bihar, but all across the country. From villagers reviving a dead river to an engineer-turned-farmer bringing organic food to the plates of everyday Indians. And, perhaps most heartening of all, women and girls are taking the lead.

Everyone is thirsty. Girls and women, after centuries of serving tea to the men in their lives, are reaching for their own cups. I don't want to believe that power is finite. Let the teapot be topped off, let the servings be stretched. Because everyone is striving. In today's India, men and women, boys and girls, share each other's desires for what Pinki calls “self-independence."

Pathfinder training for local men in Bihar. Photo courtesy of Allison Joyce/Redux.

Maybe this is why Pathfinder has found that its trainings are substantially more effective when they teach young men and women simultaneously. It's not just about giving knowledge to the girls or teaching the boys to be respectful. It's about what arises in the ākāșa, that ethereal space between the two sexes. It's about what happens when their lives come together.

The stricter laws against rape that passed at record pace in 2013 might translate into less violence against women. And increasing government support for safety nets and social security could make aging parents less dependent on sons, helping to balance the economic scales that favor a boy child over a girl...

In a country that has historically discriminated harshly against women, both men and women are now coming together to fight for equality. Of course, there's still work to be done...

Resistance remains. Some local government officials have responded to the rash of rapes by suggesting India lower the legal age of marriage to help curb such crimes. “Boys and girls should be married by the time they turn sixteen," they argue, “so that they do not stray." In the face of such logic, the problems can seem intractable. But traditions can be lost in just a single generation. So can the beliefs that it is necessary to marry off your daughter at the onset of puberty and that it is her fault if she does not deliver a son, and do so immediately.

Pathfinder materials. Photo courtesy of Allison Joyce/Redux.

...but Subramanian has seen firsthand what happens when people defy expectations and find their own voices:

I have seen the shift in my own family. My Indian grandmother was married at the age of ten. Her four daughters were married in their late teens and twenties. My father, one of her middle sons, completely broke rank, marrying an American when he was thirty. I wasn't married until the tender age of forty-four and have chosen not to have children. Among my cousins' grown children who remain in India, arranged marriage remains the norm, but some are holding out against matches they're not willing to accept. Each generation has had fewer children than the one before it, and the levels of education for both males and females tick upward. Our population growth is stable.

But we are a family with relative means. For the vast majority of Indians still struggling to survive, larger structural changes are needed. They are within reach. Kerala once had the highest population growth in India, but since 1971 it has invested heavily in women's education, accessible family planning, and comprehensive health care. With neither threat nor coercion, the fertility rate more than halved in a single generation, from over four to under two…

Those teenagers in Bihar are part of a whole new generation. It starts with education...

To stabilize population growth is to rally for literacy, because reading and understanding words on a page develops the same skills needed to read and understand our own bodies. Through this knowledge comes power and autonomy. And speech. The girls I met in Bihar ... spoke in feisty voices, their excitement coupled with impatience as they told the stories of their lives. What they found was that learning how to speak — to a husband, a mother-in-law, a doctor, a police officer — is a powerful tool. With this transformation of a private voice into a public voice a public identity is born, one prepared to dissent and stand up for oneself.

“People ask us, 'Why do you go to these meetings? Do they give you something?'" Reena Kumari, an eighteen-year-old Bihari girl told me. “I say, 'When you go to pray, do you get something?' They say, 'Well, that one girl who did the training met a boy and ran away.'" She laughed, and continued speaking quickly, in a strong voice. “We argue back — you had her for fifteen years and they had her for three days and you're saying we influenced her?" she said.

“There is a flaw in your nurturing, not in our friendship."

“You fight back with their parents?" I asked.

...and it ends with a new generation that can speak their minds and own their futures.

“Hum bolti hain!" she said. “We speak up! Before training, we didn't know anything, but after, we do. We learned how to find the right words to negotiate. There are so many changes."

Scene from rural Bihar. Photo courtesy of Allison Joyce/Redux.

To negotiate such changes is to ask for everything you want, knowing you might only get a fraction. It is to remain unflinching as you look forward into the future of India's women and girls and the generations they will bear. The path ahead is difficult, littered with obstacles, still under construction. But I can imagine the youth I met in Bodh Gaya [in Bihar] growing up in this new India, their India, moving forward down this road… They shape the way as they go. They link their fingers, they quicken their pace, and their voices, rising up into that space between spaces, are unafraid.

Since his first hit single "Keep Your Head Up" in 2011, award-winning multi-platinum recording artist Andy Grammer has made a name for himself as the king of the feel-good anthem. From "Good to Be Alive (Hallelujah)" to "Honey, I'm Good" to "Back Home" and more, his positive, upbeat songs have blared on beaches and at backyard barbecues every summer.

So what does a singer who loves to perform in front of live audiences and is known for uplifting music do during an unexpectedly challenging year of global pandemic lockdown?

He goes inward.

Grammer told Upworthy that losing the ability to perform during the pandemic forced him to look at where his self-worth came from. "I thought I would have scored better, to be honest," he says. "Like, 'Oh, I get it from all the important, right places!' And then it's taken all away in one moment, and you're like, 'Oh, nope, I was getting a lot from that.'

"It's kind of cool to break all the way down and then hopefully put myself back together in a way that's a little more solid," he says.

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Since his first hit single "Keep Your Head Up" in 2011, award-winning multi-platinum recording artist Andy Grammer has made a name for himself as the king of the feel-good anthem. From "Good to Be Alive (Hallelujah)" to "Honey, I'm Good" to "Back Home" and more, his positive, upbeat songs have blared on beaches and at backyard barbecues every summer.

So what does a singer who loves to perform in front of live audiences and is known for uplifting music do during an unexpectedly challenging year of global pandemic lockdown?

He goes inward.

Grammer told Upworthy that losing the ability to perform during the pandemic forced him to look at where his self-worth came from. "I thought I would have scored better, to be honest," he says. "Like, 'Oh, I get it from all the important, right places!' And then it's taken all away in one moment, and you're like, 'Oh, nope, I was getting a lot from that.'

"It's kind of cool to break all the way down and then hopefully put myself back together in a way that's a little more solid," he says.

Keep Reading Show less
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Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."