Woman's Hour - Baroness Warsi, Labiaplasty, secondary breast cancer and “Clustercore”

Episode Date: April 13, 2023

The conservative peer Baroness Sayeeda Warsi has criticised the home secretary Suella Braverman for using  "racist rhetoric".  She says her recent comments on small boats and grooming gangs have "emboldened racists".  Baroness Warsi held a number of ministerial roles in the coalition government before resigning in 2014. Anita asks her why she's decided to speak out now.If you’ve had breast cancer – what do you know about the signs the disease may have progressed? The charity Met UP UK says the information given to the 55,900 people diagnosed every year is very patchy. Every day, 31 women in the UK die from secondary breast cancer, which is incurable. In Greater Manchester every patient is provided with an infographic in their end of treatment plan, about signs to look out for. NHS England says it has adopted this in its guidelines but can’t mandate every health trust uses it. We speak to Jo Taylor from METUP UK and oncologist Carlo Palmieri from Clatterbridge Health Centre about why this is important.In November 2005 police constable Sharon Beshenivsky she was shot and killed as she responded to an alarm at a travel agent in Bradford. She was with a colleague PC Teresa Millburn who was also shot but survived.  Today, a 74-year old man is due to appear in court charged with Sharon's murder after being extradited from Pakistan. Anita speaks to Julie Langford, a journalist at BBC Radio Leeds who was at the scene the day after it happened.For the first time ever the British Association of Aesthetic Plastic Surgeons has begun collating data on the number of women undergoing labiaplasty where women want to reduce the size of the labia. It’s in response to the increased demand for the procedure which some fear could be driven by either body dysphoria or the prevalence of pornography. Anita Rani talks to cosmetic surgeon Dr Paraskevi Dimitriadi and psychologist Elizabeth Ritchie about the trend."Cluttercore" and "Clustercore" are the latest interior design trends popping up on social media. Minimalism is out, and rooms bursting at the seams with clashing colours and loads of knick-knacks are in. But it’s more than just having lots of items everywhere. You have to arrange the items in curated vignettes. So, how is it done? When does it become clutter? And, what's the history behind our desire to organise and curate? Anita is joined by Claire Bingham author of The New Naturalists: Inside the Homes of Creative Collectors, and Dr Vanessa Brown, senior lecturer at the Nottingham School of Art & Design at Nottingham Trent University.Presenter: Anita Rani Producer: Lisa Jenkinson Studio Manager: Bob Nettles

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BBC Sounds. Music, radio, podcasts. Hello, I'm Anita Rani and welcome to Woman's Hour from BBC Radio 4. Good morning, welcome to Woman's Hour. How would you describe your home decor? Are you someone who loves to collect knick-knacks and display them for all to see? What's your interior design style? What's on your mantelpiece or on your shelves? What do you display in your home and why? And what does it say about you crucially?

Is there something in your home you absolutely hate but can't get rid of for sentimental reasons? Are you someone who collects things because of nostalgia or are you brilliant at spring cleaning? No sentimental attachment to stuff and things and live in a clutter-free home. Tell me about your stuff. You can get in touch in the usual way. It's 84844. That's the number to text. You can also email me through our website.

You can contact me via WhatsApp. It's 03700 100 444. Feel free to leave a voice note if you want to. And social media, it's at BBC Woman's Hour. The reason I'm asking is because clutter is in at least it is if it's designed and displayed properly in your home jane cowell has already been in touch via twitter to say no style at all i have no vision never have i describe it as a big shed can you do better than jane 84844 the number to text then this morning we'll also

be talking about a new campaign to highlight the issue of secondary breast cancer, which is incurable and kills 31 women every day in the UK. The plan is to make people who get the all clear know what to look for if the cancer returns. And of course, your input on anything you hear on the programme is more than welcome. 84844, the number to text. Again, if you want to email, go to the website. But first, the Conservative peer, Baroness Saeeda Varsi, has criticised the Home Secretary, Suella Braverman, for using racist rhetoric. She says her recent comments on small boats and grooming gangs have emboldened racists. Baroness Varsi

held a number of ministerial roles in the coalition government before resigning in 2014. Well, I spoke to her earlier this morning. It's a frank conversation, which does contain some discriminatory language. I began by asking her why she'd decided to speak out now. I think when I was listening to those interviews about a week ago,

and I heard the way in which she used language which was neither caveated nor nuanced nor based in evidence nor given any explanation it just felt like race baiting and and initially I kind of listened to a couple of interviews and felt that they just came across as quite deliberately divisive. And then from Sunday night, Monday, my phone just did not stop ringing off the hook because people were appalled. And what I found quite surprising, Anita, was that the kind of people who were making contact and the kind of people who in the end went on to write these three quite specific letters from the medical professionals from the business community and from faith leaders were not the kind of people who normally get involved in politics get vexed about these issues make

contact with me on political issues interestingly many of them would be what I would consider to be traditional conservative voters but some of them even conservative donors. And the fact that so many people became so concerned about the language and the words that they started using to me was we're fearful of the consequences of this. And we feel quite vulnerable that I felt that I needed to speak out. You said in the article that you've written in The Guardian that her ethnic origin has shielded her from criticism. What do you mean by that? I think for too long, people have made comments about the kind of language that she used about migrants, refugees, small boats. You know, this issue two days ago, she was talking about gollywogs. It just feels like that people were quite reluctant

and individuals within the party said to me, it's really hard for me as a white man to call her out because she is an Asian woman. And it's odd for me to talk to her about racism. I feel like, you know, that's not my space. And I think there is a reluctance for white people to talk about racism coming from people of colour. But that shouldn't be, you know, the colour of her skin should not be some sort of bar to her being called out for racist rhetoric. And in a way, we're practicing cultural sensitivity when we fail to call out people of colour who display language, which is clearly racist.

Well, what surprises you the most about what she said? Is it that it's coming out of an Asian woman's mouth or that it's a conservative policy? I think what surprises me is that on the one hand we're celebrating one of the most diverse cabinets in our history ever for any political party which is definitely something to celebrate it's great that the faces around the cabinet table now are more accurate accurately reflective of the faces that make up our country today but the other side of that is that we mustn't end up with a situation where the most diverse cabinet in our history is remembered for being the one that engages in the most amount of racial rhetoric. Some of the language coming out is something that would be more akin to what we would have heard in the 60s or the 70s.

And this is not the kind of cabinet that Rishi Sunak needs to be presiding over. This is not what his legacy should be. And that's why I said that, one, this is damaging for diversity and what diversity should actually be, which is when you get lots of different people around the cabinet table, you end up making much more hopefully thoughtful, considered policymaking because you are more understanding of difference uh but also it's not great for the conservative party because this will uh this tarnishes our brand and takes us back decades you know when so many of us have put in the legwork to detoxify the conservative brand and i've now got people writing into me who are Conservative members. My inbox,

my email inbox, text messages are heaving, Anita, with people who are saying, I'm a Conservative. I am increasingly finding it difficult to even associate myself with this party. Where have we found ourselves? It's interesting what you were saying about one of them, somebody who's talking to a white man saying he found it difficult. He didn't know how to speak to her about it. Is that why she's there to do the job and is saying the things that she's saying because on some level she can get away with it in a way that a white man can't and this is the question i keep asking myself anita is this deliberate party policy and i have been assured by very senior people within the party whom I respect and I

believe and I want to believe that this is not a deliberate campaign that this is not something that we will be seeing hopefully for the next 18 months as we run up to the general election and we won't see it before now which is before local elections so if it's not deliberate is this a a Braverman campaign? And then it makes it slightly easier to deal with because we're dealing with an individual rather than a whole party that thinks this kind of rhetoric is acceptable. And then the third issue is, is it that she simply can't find or isn't able to communicate on these very important issues. You know, what she was talking about here was the fact that half a million children in our country every year, Anita, are sexually exploited or abused. It is a tragedy that one in 20 children in our country have faced some sort of sexual

exploitation or abuse. That is a shame for every one of us. You know, these are all our children, this country's children. And what we need is a Home Secretary who is coming back with policies that don't just talk about locking people up after this has happened, but have a whole series of measures to protect these kids. You know, we should be working towards making sure that kids are not abused in the first place. And at a time when the vast majority of these children are being abused in their homes and by family and close family and friends and acquaintances, there was nothing on offer for those victims. And instead, she seems to find a way in turning almost every issue into some sort of cultural race war. I mean, we saw that with this landlord in Essex who had these gollywog dolls hanging in his pub and had posted on social networks.

They used to hang them like this in Mississippi not so long ago. And she managed to find herself on the side of the landlord and against the police. I don't know how she manages to get herself down these cul-de-sacs. And if it's deliberate, she's unfit for office. And if it's because she can't communicate, she's still unfit for office. Neither of them bode well.

I mean, the Home Secretary has been clear that all despicable child abusers must be brought to justice and she will not shy away from telling hard truths, particularly when it comes to the grooming of young women and girls in Britain's towns who have been failed by authorities over decades. She's also said the vast majority of British Pakistanis are law-abiding, upstanding citizens, but independent reports were unequivocal that towns like Rochdale, Rotherham and Telford, cultural sanctuaries have meant thousands of young girls were abused under the noses of councils and police. I mean, this is a statement that we've got from the Home Office. Yes, and this statement, I think, does backpedal from where she was a week ago. I think she has subsequently tried in statements to try and clarify her position. But let me break that down into a number of issues. Nobody is culturally sensitive about talking about this very specific form

of subset of subset of child sexual exploitation in very specific towns, which were high profile, in which there were very specific perpetrators. Indeed, I was talking about this in 2012, before Swela Braverman even was back. She wasn't even in Parliament. So, you know, the fact that she thinks she's suddenly arrived at this and no one before her has even raised these issues or looked at these issues or responded to them.

Off the back of statements that I was making back in 2012, Anita, we had a whole series of training programs around child protection communities got involved in fact on one occasion i remember mosques from across the country had friday sermons uh week after week at you know all these mosques on the issue of child sexual exploitation they wanted to take these issues on let that be no um uh misunderstanding about how seriously communities take this issue um and then you know what really kind of now this latest statement that she puts out at the end of repeating actually what isn't based on evidence because independent report after independent report even one that came out last year less than 12 months ago the linden report doesn't say what

she's saying um but i think what i find really patronizing after all of this inaccurate you know race-baiting language is she then says oh and let me say you know most british pakistani males are law-abiding citizens i mean the patronizing element of that you it's just, this is not the kind of way in which you expect a Home Secretary to speak. And I think had she come on a week ago, Anita, and said, look, I am concerned about all child abuse victims, which is what she's saying now. However, I want to put specific resource into a very specific form of child exploitation in some very specific high-profile cases in these particular towns with which have these particular paper traders which took place in the nighttime economy which overall when it comes to child sexual exploitation and abuse form a tiny minority

of children that are abused in our country which tragically is half a million and this is the way i'm going to do it you know what we'd all have been stood behind her saying how can we help it's the fact she chose not to do that she deliberately uses loose language and she deliberately makes racial kind of culture wars and she does it look when it comes to small boats when she talks about invasions when she talks about well she talks about billions wanting to come when she talks about yeah when she talks about invasions, when she talks about billions wanting to come, when she talks about gangs, when she talks about violence. But she's popular. This week is a typical example.

Besides that, she's popular. A recent Times poll shows that she's the fourth most popular member of the cabinet. Yeah, and there were times when increasingly dangerous people were incredibly popular and they had a terrible impact on our world. And at that time, more than ever, it requires people in positions of authority and people who are privileged like me to have a platform to use our voice to speak out. Are you holding her to a different or a higher standard because she's a woman of colour? I think I've held her to a lower standard because she's a politician of colour. Anita, my husband always

accuses me of saying, he always accuses me and says, you know, you're always so much more lenient when you meet another woman of colour, because the sisterhood for me kicks in, right? Too many of us have for too long suffered too much racism and misogyny from all sorts of sides, but for us to kind of take down each other when we get into these positions. So I think, if anything, Anita, I've probably stepped back and stayed silent for too long on these issues. But there comes a time when you realise that the damage

this is doing to our country in the long term, cohesion between communities in our country is so great that however much it sits against my instinct in terms of the way I see other women of colour, I have no option but to speak out. That was Baroness Saeeda Varsi speaking to me a little bit earlier this morning. Later on in the programme, we're going to be discussing

a new home decor trend called Cluttercore. Well, based on a lot of the messages that are coming in the programme, we're going to be discussing a new home decor trend called cluttercore. Well, based on a lot of the messages that are coming in from you, cluttercore is very much part of your lifestyles already. Dawn says there's no coherent order in my house. I collect skulls. So there are many, many of those everywhere. Biggest is a minke whale. Smallest is a pygmy shrew. I want to know how you display them are they in a cabinet are they just dotted around the house and never mind the dusting my mum's going to all sorts of places um i collect buddhas and bells my buddhas have been acquired all over the world and i have to have been to to southern nepal where he lived the bell collection consists of silver ones brass

ceramic wedgewood you name it they have a wonderful sound when rung I'm sure they do 84844 is the number to text now on to our next item most of us hopefully know the signs to look out for when it comes to breast cancer but if you're one of the almost 56,000 diagnosed every year you may not have been told much about the signs of secondary breast cancer 31 women die every day from it in the UK. The charity MetUp UK, which campaigns for better awareness, wants every health trust in the UK to include details of secondary symptoms in every end-of-treatment plan. Currently, the charity says this is not being done on a systematic basis.

A useful infographic has been produced which spells out what to look for, and the charity says this should be passed to patients. NHS England has adopted it, but says it's down to individual health trusts to decide their policy. Well, to tell us more about this, I'm joined now by Jo Taylor. She's the founder of Metup UK. Welcome to Woman's Hour, Jo. Firstly, explain what we mean, I think, by secondary breast cancer for anyone who doesn't know. Yeah, secondary breast cancer. Thanks for inviting me, by the way.

Secondary breast cancer is when the primary disease, it's actually spread to a different, a distant part of the body. So these areas, more or less, are bones is the main area where it would go to liver, lung, brain, lymph nodes. These are the areas that need to be pointed out to patients. And that's what's included in the infographics. And there are two infographics. There's one for ductal cancer, breast cancer, which is in the ducts of the breast. And the other one is lobular cancer, which is more like a mesh or a web or a thickening. So again, the awareness campaigns where it talks about finding a lump don't necessarily cover all the different types of breast cancer. For another one, inflammatory breast cancer as well, that's redness, etc.

So yeah, these are the things that we need people to be aware of. So spell out exactly what you would like to see happen when it comes to alerting patients to secondary breast cancer. Yeah, we just need more of the alliances to be using the infographics. We know it's used in certain areas. I know it's used globally. It's actually translated my infographics are translated into explain explain what your infographic is because

it's radio so we're gonna have to paint a picture yeah so it is a pictorial kind of um you know um just gives it a picture of a man and a woman because obviously it can affect men as well but it is very rare it's mainly women who get breast cancer and it actually points to the areas where it would metastasize to and it gives the signs and symptoms the red flag signs and symptoms of these areas as well so for example you know if bone metastases you will be having pain in certain areas of your body you know in the big bones um brain metastases you know you could be feeling sick you could be feeling nauseous and you could be being dizzy so it's pointing out these areas so that people are aware, because what I've found is that patients are sent away with primary disease not knowing about this. So for them to not be aware, it's not empowering for a patient.

Just to let everyone know that you can see the infographic, we'll put it on our website so you can have a good look at it. As I mentioned in the opener there, Jo, the NHS England have adopted the infographic but says it's down to individual health trusts to decide their policy. the possibility in signs of cancer recurrence or spread is provided sensitively and that patients understand the importance of reporting any symptoms this is what they've said to us northern ireland wales and scotland also say individual trusts decide how to alert patients to the risk of secondary breast cancer some of those trusts have censors the written information they include if they provide something in writing isn't that enough no it's not um i've actually seen some of the information and it's not clear at the end of the day um what you've got to remember is that some people in the country only have a reading age of age nine now when they talk about hyperglycemia or you know other other issues that they're actually spelling out in the big long

words that they may not understand metastatic spine cord compression things like that they don't understand it and it's not clear just giving bullet pointed long names information is not clear enough to people who don't necessarily understand it. And I think it just gives more of a visual depiction of what they need to be actually looking out for instead of, you know, another leaflet, another bit of information that is put aside and ignored because patients do do that.

They don't want to read anything. They just want to have something visual to see. That makes it obvious. I'm going to bring in Professor Carlo Palmieri, who's a consultant oncologist at the Clatterbridge Cancer Centre in northwest England. Welcome to Woman's Hour. In 2020, NHS England produced a document which said everyone should have information on the signs and symptoms of recurrence when they come to the end of their treatment. Do you know if this is happening? Good morning, Anita, and good morning, Joan.

Thank you for raising this really important subject on your programme. So I think first we need to take a step back to think about when women get diagnosed with early breast cancer, because often when women are diagnosed with early breast cancer, many get treatment to prevent recurrence. And what we must remember is that the vast majority of women with breast cancer in the UK don't suffer recurrence so that's really important to remember that. So when we see patients with early breast cancer at risk of the disease coming back and we look at the size of the tumor and number of lymph nodes to make those decisions we have a discussion with women around the need for such treatments and why we give it. So when I have that discussion, I explain that the aim is to prevent recurrence.

And in that conversation, often women and men will ask, where will it come back to? How might it present? So the discussion around recurrence and how it might present happens very early on, and even in the early stages when we discuss early treatment. So that's point one. And then when it that happens as consultants and specialists we will discuss where it may spread to and actually how it might present when women finish their their treatments when i see a patient finishes their treatments

i will have a discussion saying you know we've completed your treatments there was always a concern it may come back but hopefully the treatments we give them will prevent that however these are things to look look out for i try to use later and i think joe makes a very valid point that communication is so so important in our interactions with patients and to making sure the information is both understandable and joe makes some very important points around reading age and then it's provided such patients understand it so i will signpost to various organizations breast cancer now has information and joe's got a beautiful graphic so we we signpost and we try to make it as understandable possible i think we're getting better clearly there's always room um for improvement so that

discussion around recurrence symptoms happens all the way through right at the from the very beginning when we present with their early disease we've had a message in from somebody i just want to read it out um they've said i was diagnosed with secondary breast cancer pre-covid i was 28 and presenting classic symptoms of cancer that had spread to the bones i was assessed nine times within a month and turned away from two gps two physiotherapists and nurses in the end i collapsed due to pain and couldn't walk for seven months i was bed bound if i was aware of the red flag symptoms i would have pushed harder. And that just fits in with a survey by the charity Breast Cancer Now that was conducted in 2019,

I'm sure you're aware of it, that found around 20% of patients were treated for another health condition by their GPs before they were eventually diagnosed. Are you seeing patients who could have been spotted earlier? I mean, I think there's always room for improvement. And I think the key thing is there's the knowledge of improvement and I think that the key thing is there's the knowledge of the patient education patient as well as other other non-specialists I'm a oncologist I specialize in this it's my area so the key thing is is general practice a GP see lots of patients lots of conditions if they see a patient's had a previous history of breast cancer with a cough that cough is likely to be a chest infection, not secondary breast cancer. So the way it's like pigeons and peacocks, it's more likely to be a pigeon than a peacock.

The issue is, is if the system persists, if the symptom is unusual in some way. So that lady who texted in where she's presented multiple times, if I see a patient more than once or twice with the same symptoms I ask myself is this something else are we missing something so I think it's that knowledge and thinking of my colleagues where a patient presents more than once or twice the symptoms around actually is it what I thought it was should I rethink what the diagnosis is so and that unfortunately does happen but I think that speaks to people seeing the same GP, continuity of care, that often prevents these issues. But unfortunately, it does happen, there is always room for improvement. Can I just come in there? There's an issue with,

with GPs that, I mean, even the system, it will not flag up that a patient has had primary breast cancer, for example. You know, so when a person's coming back with an issue, they should understand that, you know, they need to be looking out for signs and symptoms of something, you know, of secondary breast cancer if they've already had a primary diagnosis of cancer, no matter what cancer it is. And these are the stories that i'm hearing lots of patients are going to gps patients are being sent to physios to actually be treated for

a back problem or whatever i could give you one um example there that this young woman who was only 38 um actually died of secondary breast cancer but she'd been back to the gp and they sent her to a physio and she had um metastases in her hips in her spine and in a pelvis and she was she was walking with a stick you know so so there's something wrong when somebody's had a previous diagnosis but also what you've got to remember is that the um the awareness campaigns don't also pick up patients with de novo disease and de novo means being uh you know finding metastatic or secondary breast cancer straight away they don't even find a lump. Carla what what could help with this could people get scans for five years would blood tests or longer term scans help okay so just a couple of things so again when I see a patient at the end of their

early breast cancer journey I say a couple of things first I say if they have problems they can contact us directly patients don't need to go directly to the GP the NHS long a long-term plan gives a commitment for patients to be able to access treatment rapidly or if they're worried about recurrence. That's the first thing I say. I don't mind a patient paying my check. Over what time frame can they come back to you? They can come back whenever. I mean, we have an open door policy. It's patient directed follow-up. That's point one if patients are worried. i've seen excellent examples of care where patients had back pain and the physios ordered the mri that's picked up the disease so we we do have you know people being aware of disease and acting on it and ordering scans um and then there's the education these breast cancer now i've done a lot of work with gps educating gps to to make

them more aware to pick up because again our colleagues in general practice do excellent work. They're under great pressure. Most women who go back to a GP with a problem, it will not be the breast cancer coming back. The issue is spotting the patterns, which is something unusual, a cough in the middle of summer with nobody having any chest infection

that's dry that persists. So it's that education, something that doesn't settle quickly that comes multiple times so it's that pattern recognition and education which is so vital to making sure that women as brought up in the breast cancer now report don't have to attend multiple times for the the diagnosis um joe joe i actually want to bring you in because i'd like to sorry joe but i'm you can i want you to say what you're going to say but i'd also like you to share your story because you have secondary breast cancer i'd like to know how you found it yeah can i just come back to carlo really yeah um in relation to

people um going back to the oncologist a lot of um um hospitals now use what's called a stratified pathway. And they're basically sent off after a year with an end of treatment summary, or maybe not, and not advised about these things. So it is, it depends. There's inequalities around the country that doesn't always happen. Which is what you're doing. You're saying... Which is what we're trying to do. we're trying to help people to be aware and gateway c is a gp portal that is used for gps to learn about signs and symptoms and the red flag signs and symptoms infographic is on there but i don't know whether all gps use that kind of um you know ability to to learn about secondary breast cancer because again what carlo said they are general so they don't know everything and we understand that but my um my story is that

i was 38 and on maternity leave and i had a five-month-old baby and a nearly two and a half year old son um and um i found a lump I thought it was to do with breastfeeding because I'd had a lump before I thought it was just a blocked um duct and went to the GP straight away um after finding it um on the Monday morning found it on the Sunday went to the GP uh on the Monday she referred me and I was diagnosed with you know within two weeks with primary breast cancer so that was 16 years ago and but then after that seven years later I was then re-diagnosed with secondary breast cancer and it wasn't that I wasn't aware of it mine was found really odd that a friend had actually

messaged me to say that she'd found a lump in her neck. She thought it was secondary breast cancer. I checked my neck, found a lump and then found another four. Ended up having, you know, a check with my oncologist then. And then it was diagnosed with diagnosed with a you know a recurrence of secondary breast cancer so i've been living with that for the last nine years now and you've got yeah you put all this work in pretty well yes good and now you've done all this work with the infographic because you want people to say that the um you know the the issue is that many patients die quite quickly. You know, the median life expectancy is two to three years, which isn't, you know, that's not a chronic disease. This is a terminal disease. This is why we've got 31 women dying every day.

Can I just say that clearly, I mean, Jo's done wonderful work and patient advocates like her are key to our breast cancer community. I mean, in the UK, we're blessed with patient advocates like Jo who contribute to education, but also to helping clinicians design studies and research are really important. The other point to make, I think, is important because we've probably got lots of listeners on the program who are living with secondary breast cancer, family members, close friends. While Jo makes the point that this is an incurable disease, women are living longer with this disease. We've made great strides in treatments. The data and studies showing that women are living longer and survival is improving. That's been reflected in the increasing numbers of women

living with breast cancer from recent research that we've done so the the message is a positive one for women living with secondary breast cancer joe's example of living many years with with secondary breast cancer we are getting better at treating it women are living longer and strides and advances in medicine and research i mean that's happening and increasing to happen so i think we need i think that's an important i think that isn't no i just no i think that's an important message to get out to lots of people listening but also just to say because we are running out of time on this that joe your infographic is available for anybody who wants to have a look at it it's on our website now and i'd like to thank you both for speaking to me on this topic this morning thank you anita joe

taylor professor carlo palmieri lots of you getting in touch about this. Catherine said, I had primary breast cancer in 2020. It was a small lump with no lymph nodes affected. I had a double mastectomy and two and a half years later, secondary extensive bone cancer was detected by chance.

I had no information or warning of this. Well, like I said, the infographic and we will put some links to other bits of information for you on our website. On to my next item now, though. Do you remember the case of police constable Sharon Beshnevsky? In November 2005, she was shot and killed as she responded to an alarm at a travel agents in Bradford.

She was with a colleague, PC Teresa Milburn, who was also shot but survived. Well, today, a 74-year year old man is due to appear in court charged with Sharon's murder after being extradited from Pakistan. West Yorkshire police said he's been charged with murder, robbery, two counts of possessing a firearm with intent to endanger life and two counts of possessing a prohibited weapon. Well Julie Langford is a journalist at BBC Radio Leeds and was at the scene the day after it happened. Morning, Julie. Good morning. Tell us where you were when this happened and what it was like when you went to the scene.

Well, it was a bad day for Bradford. It was just a routine afternoon. PC Sharon Beshanivsky, she was 38 years old. She'd been a police officer for nine months. She was out with her female colleague, Teresa Milburn, who was a police officer with more experience. They get a with her female colleague, Theresa Milburn, who was a police officer with more experience. They get a routine call

to go up to a travel agent just out the city centre of Bradford. Everybody in Bradford knows where it is. It's Morley Street. It's between the ice rink and the Alhambra, if you can envisage it. That's right indeed.

And so, you know, so close to the city centre, it was some sort of robbery that had gone wrong and both officers were shot and Sharon Beshanivsky fell and and died at the scene now I was working on the breakfast show at the time so I'd gone home but I got a phone call saying right tomorrow morning you're not in the studio go to Bradford so I went to Bradford in in the radio car and um the scene

was all completely taped off but what surprised me and it genuinely stopped me in my tracks was this mountain of flowers up against a wall that that people had um brought and continued to bring we're quite familiar with this sort of site nowadays i think 18 years ago it was it was um quite surprising deeply. And people were coming up and putting flowers there while I was standing there all morning. And there were tears in their eyes. And it genuinely was a real, awful shock for Bradford. What do we know about Sharon and her family?

How long had she been serving? I believe she had been a PCSO before. I might be wrong on that. But I know she wanted to be a police officer and she'd got to the age of 38 before she'd actually made that happen. So she was a very keen newbie, really, if we're honest. She was a mother of three and a stepmother of two children.

And it was just such a... So unexpected, as I see. These two women police officers went to work of two children. And it was just such a, so unexpected. As I see, these two women police officers went to work one morning and one of them didn't come back and the other came back shocked. And Bradford, frankly, couldn't believe what had happened, really. I mean, the ripple effects were felt around the country. I think the whole country couldn't believe. But why do you think the local community reacted in the way they did to this particular case?

I think, to be honest, it's because there were women. There were two women police officers trying to do good. And suddenly this had happened. There's a marble memorial stone at the spot where Sharon Betanivsky fell. And I think that people notice that it bears testament to what happened to her. And then it reignited as these things do the whole argument about our police officers, should they be routinely armed, an argument that, you know, continues to go on today. But I think at that time, 18 years ago, that these two women had both been shot, it really did ignite that to a level that, you know, people who had perhaps previously,

you know, cherished our police officers being there by consent, not being routinely armed, and thought, well, if this is going to happen, maybe, you know, it's like America. What are we going to do about this? So there was anger as well as sadness. And it all seemed so pointless. This was, you know, a robbery on a travel agent. And this woman has lost her life. And her family had lost her. Absolutely terrible. I mean, her family did not court any sort of media attention. Her husband was very quiet, very dignified, and had to just

then get on with raising these five children by himself, which must have been an unimaginable ordeal. Julie, thank you very much for speaking to us about the case and remembering Sharon Beshnevsky as well this morning.

That's Julie Langford, journalist at BBC Radio Leeds. Thank you. On to my next item now. There's talk about something that we thought might interest you here at the Woman's Hour Office. It's about some new statistics collated by the British Association of Aesthetic Plastic Surgeons. As well as the data on breast implants, tummy tucks and butt lifts, there were figures on the number of women opting for labiaplasty, a procedure when

women want to reduce the size of the labia minora. Those are the two inner skin folds that surround the opening of the vagina. There you go, a bit of a biology lesson for you. The data was collated for the first time because of the dramatic increase in the number of labiaplasty operations. I recently caught up with Dr. Paraskevi Dimitriada, who's a specialist cosmetic gynecologist, and psychotherapist Liz Ritchie to talk about the trend. And I began by asking Dr. Dimitriada about what the surgery involves. Yes, a labiaplasty is a surgical procedure and we remove the excess skin of the labia minora or the labia majora. So who's coming to have a labiaplasty? What sort of people, what range of age and why are they coming? There are multiple reasons that ladies are looking for a labiaplasty.

Some of them is for cosmetic reasons, so the appearance. They want to change their appearance and feel more confident with their sexual partners. Some ladies, they are looking for labioplasty for comfort reasons. Let's say a rarer or somebody who is cycling can sometimes be very uncomfortable if they have excess skin that's protruding out of the labia majora, the external lips. And there are ladies that they have labioplasty because they are horse riding. So it are different reasons. Most of the time, they are mixed reasons.

So they feel less confident about their appearance in the area, as well as they have a degree of discomfort. Ladies, they come at all different ages, like from 20 years old until later in life, like 55, even 60 years old, that have done labioplasty. And this is because with AIDS and with menopause, the quality of the tissue changes

and they slightly become less elastic. Combination with a little bit of dryness in the area due to menopause can be a reason for a big discomfort. Liz, I'm going to bring you in here. Part of your work is about assessing women at one Harley Street clinic if they've been referred for counselling, but that's usually for breast augmentation or reduction. Yes.

The question, I guess, I'm thinking, and I'm sure lots of people listening to this are thinking, why? Why are women increasingly opting to have this surgery? I think it's multi-dimensional, really. I think there is increased accessibility to have private cosmetic procedures. So therefore, it becomes easier for women and men, of course, as well. But obviously, in terms of labiaplasty, we're speaking specifically of women. I think really, it's affected by things like contemporary public grooming trends and standards. And of course, it's also about, which is the real, I suppose, the real issue is how women perceive their bodies. Now, I understand in terms of labioplasty, there may well be some real clinical reasons to have this treatment.

But I think there can also be distortions in terms of body image, which of course, there can also be the presence of body dysmorphia disorder. And it has been said that 76% of patients who have BDD, body dysmorphia. Body dysmorphia disorder, yes, are present within the cosmetic surgery population. So I think that in itself is quite worrying because of these trends. I think probably, you know, it is things like there is an evolution in cosmetic procedures

and that, of course, gives men and women the opportunity to change who they are. So I suppose, fundamentally, it is about that potential to be moving away from our real selves to a made up ideal, if you like, who we think we should be. So, Dr. Dimitriadis, what kind of conversations do you have with these women when they come in to talk to you about it? And do you, you know, do you straight away provide them with the labiaplasty if they want it, or do you send them off for counselling? What discussion happens before the operation? First, I have definitely refused procedures when I see there is no issue in the area.

I have sent many ladies for assessments. So the usual complaint is, as I said earlier, it's a combination of discomfort as well as feeling less confident when we are with a sexual partner. But that's the interesting one, isn't it? Feeling less confident when you're with a sexual partner, because where does that come from? Who is making them feel less confident?

You know, and why are they feeling less? Isn't that the minefields that we're discussing? Yes. So usually I ask them, has anybody commented badly about the area? Has anybody made you feel bad about the area? And usually the answer is no, I have it on my mind. I am not like I can really enjoy being with my sexual partner just because I have excess skin.

I'm not talking about a mild case. I'm talking about like severe cases. So there is hypertrophy sometimes of the labia minora. That can be related maybe to polycystic ovarian disease. That can be related to slightly higher testosterone levels. But it's actually true that some ladies that have a really long labia minora, that can be a reason for feeling uncomfortable, even during sexual intercourse. I wonder, and this is a question for both of you,

how much of this is being fuelled by the images women are seeing in pornography and wanting to change their appearance? Yeah, I think there is that increased possibility that women do want to change their appearance according to those cultural or sexual norms. And I think that's very present within the pornography industry. So I think that definitely is high up there in terms of being a contributory factor. And what do you think about that? What do you think about that? If that is a contributor, you said cultural and sexual norms. Well, the word norms in this context is, there's a big question mark, isn't there? Because who is setting the agenda for what is normal in pornography? Yes, absolutely. And I think when we talk about norms, what we're talking about is social expectations. And of course, that can make an awful lot of women

feel under a lot of pressure. It's going towards what I would call the idealisation, in terms of labiaplasty, for example, it's the idealisation of women's genitalia. And I think that is particularly present in the pornography industry. But of course, not just that. My concern is this increased demand for these surgical procedures or cosmetic procedures which is now occurring and this industry is constantly growing. Are there any risks involved Dr Dimitriada? Of course there are risks I mean that there's a main risk of risk of infection that is a risk for every procedure because yes of course there are cases that ladies complain about scarring, pain or even amputation of the labia minora that can cause dryness or recurrent thrush infections. And also, what about, because I was reading a report in the Royal College of Gynaecologists that said the labia minora tissue also plays a really important part in arousal.

So surely that could have a very detrimental effect. That's right. That's why it's very, very important to choose a neurosurgeon that has the right knowledge and knows the anatomy area. Because obviously, yes, the labia minora is connecting on the top with the clitoris. So if somebody goes really, really close and removes all the tissue below the clitoris, then of course there is a problem with secession, urinary sexual intercourse or even chronic pain.

Dr. Dimitriada, if a woman is coming to you and the labioplasty is not clinically necessary, some people may think that this is just another form of FGM, female genital mutilation. What do you think about that? So the reasons for FGM is obviously to increase the pleasure of the man and to reduce the pleasure of the woman. So it's a completely different approach. Labioplasty, we just remove the excess skin in the area. So if somebody does not need labioplasty, I personally try to see what is the reason behind, first of all, because as a doctor, I don't only assess the genitalia area, I assess a lady, a woman.

As myself, a woman and a mother of two girls, then I would definitely, I wanted the doctor one day to my daughters to assess her as a whole body, not only mind and body, not only the genitalia area. So I have quite long conversations, that's why my appointments are 45 minutes plus, to try to explore why this lady is looking for glapioplasty. What is the reason? And of course, as I said earlier, I have refused procedures. When it's not necessary, I just say, I'm sorry. I can't really do the procedure.

And then I send them to a specialist. I send them for counseling with a psychologist or psychiatrist. And what do you think,, what about counselling? Because I was just thinking about how common so much plastic surgery now is and actually for fillers it's absolutely normal. And you know women don't have to have counselling. It is a fashion.

It's a trend. It's a look. It's a certain look. Yeah, it is a trend. Of course that could be regarded as a sweeping statement but it is a trend because it is increasing. This industry is growing. But of course, my concern is in terms of this particular procedure, this is a sort of psychosexually significant body part. So I think any mental health issues should always be explored. And I think, you know, as we've just discussed, I think I probably would recommend that this was part of the criteria for surgery. And I think there needs to be also be an awful lot more education around these procedures

to counteract, if you like, social and cultural stereotypes. And I mean around, for example, genitalia. And I think what also needs to happen is that there needs to be much more awareness of genital diversity, which is needed to decrease these surgical procedures. And I absolutely agree that there's some that are clinically necessary. But I think where we need to be going with this is much more in the direction of women's self-acceptance. And I think to be exposed to more diversity, if you like, I think that's the right direction to go in. Because I think the danger at the moment is that female sexuality is directly defined by pervasive cultural attitudes and, of course, social media pressures. And what that does, it oftentimes distorts women's own

body image. And of course, where they then go with that is we go into the arena of unrealistic expectations. And of course, when there are unrealistic expectations, then that leads to conditions like body dysmorphia for example fascinating conversation there now 84844 is the number to text if you want to get a message in about anything you hear on the program next um we're talking about home decor scandi minimalism is out the latest design trend there are hashtags clutter core or cluster core but what do they mean what's it all about well here to give us some top tips and an insight is Clare Bingham, she's a journalist, brand consultant and the author of The New Naturalists Inside the Homes of Creative

Collectors and to explain the history of it is Dr Vanessa Brown, the history of clutter, senior lecturer at the Nottingham School of Art and Design at Nottingham Trent University. Welcome to you both. Clare I'm going to come to you first, tell us what it's all about. What is cluster core or clutter core? Morning. Hi. It's maximalism under a different name, but more than a use of colour and pattern, which is perhaps what we're more used to, it's driven by a passion for objects. So this sort of emotional connection that you have with things around your home that you've accumulated over the years and then displaying them in interesting ways. What does that mean in an interesting way? Can you not just put it out? Well, lots of our listeners are on board with this. It looks like they've been they've been doing cluster call for decades. So what do you mean by displaying them? How are we supposed to be displaying them how are we supposed to be displaying them um well there's a fine line between collecting and hoarding i guess so it is the look is highly stylized so like looking around

my house night it's every corner every surface is an opportunity to style you know it might be a chair so it is quite sort of high level in that way but it when you have a lot of stuff, they need ordering. So if you can contain these items, whether in a display cabinet or whether on a bookcase or on a tea tray, that's a nice way of, they tend to look good. So we should be investing in display cabinets now, should we? Because I don't think everyone has a display cabinet, do they?

No, and they feel quite dated as well, but it would suit certain homes. I mean, a bookshelf on its own is, you know, good storage is essential because that way you don't have to have everything out all at once and you can rotate things. And it's also good to have balance. So you might have one room where it is full of all your collections and it's nice to have a sort of breathing space in the next room, so one room that's more calm as well.

Vanessa, where can we trace our love of knickknacks back to? What's the history of this? Well, it's really fascinating, but there's a long history actually of class identity and distinction that this kind of directly relates to. So you know in aristocratic homes there would obviously be a kind of long-standing tradition of accumulation of valuable objects and display of those to shore up the status of the historical family. Then in the industrial revolution with the expansion of the middle classes, there was an opportunity there for more people to engage with this kind of, I suppose, curatorial

sort of process in the domestic sphere. And then, of course, alongside that, the increase in mass production of cheaper versions of these things, which is really where we find ourselves now, where for most people, there is some level of potential to engage with this. Obviously, it depends an awful lot on how much capital you've got. An interesting development of the 20th century is also the idea of kind of the second-hand collector, the kind of bric-a-brac, mania idea where there's a scope for kind of narrating the self and curating the self in a way that isn't necessarily about massive expense, but is actually about an expression of your taste. And historically, we've seen an interesting shift from the kind of status associated with the class of your birth to the fashionable status of someone who has the kind of style and kind of cultural capital in order to make the right choices to say the right kind of

things about themselves for the moment. I think that's really interesting contradiction here because the look of a cluttered interior is something that speaks about historically about history and about continuity. But what we have now is a kind of interesting situation where, especially through social media, people are invited to... Replicate. Yeah, and to display a kind of fashionable look that may be quite temporary. You know, it might not last that long. Yeah, Claire, that's coming from people.

Clustercore is from TikTok, isn't it? Inspired by people's love of homes of female characters in popular culture. Yeah, absolutely. And, you know, more than magazines, this is a way for us to look inside people's, you know, ordinary homes. Like you get a sense of their character that's coming through rather than a sort of a magazine page interior,

which is very much a house style. I find that really interesting because it's not, you know, as Vanessa was saying, you know, historically, this is about preserving things that say something about your life, but what we've got to now is people just wanting to replicate

the homes of people on social media or in popular culture that they like. But where's the individuality in that? Where's the actual passion for interior in that? There's not. There's not the same way. So whereas this is, it's like a souvenir of your life. So whether all these found things, you go on a nature walk and you bring something back and then you can display it when you get home. Or, you know, things that you've brought back from holidays. All of these things are just so personal and how you group them together.

You know, it's you know, it's really nice to be surrounded by things that you love. Why, Vanessa, do you think that, because apparently millennials were drawn to minimalism, why is there this divide now where Generation Z are interclutical? What's happening specifically with them very quickly? I think there's a very obvious kind of pendulum swing of fashion going on here. We live in a culture of novelty and distraction. So we want to make a change. So for each generation, there's kind of idea of rebellion. That also suits the kind of consumer culture and the fashion culture that we live in because it prompts new purchases a kind of minimal aesthetic has reached in the last, I don't know, 10 to 20 years, kind of mainstream dominance with aesthetics of brands like IKEA.

So it makes sense that a newer generation is going to react against that. But I also think it is part of this compulsion to display your life online and to look interesting. Thank you. Just to look interesting. Right, thank you. Just to look interesting. We all want to seem like we have interesting lives. Thank you so much. We've run out of time, sadly. Vanessa, Claire, thank you.

Join me tomorrow because I'll be talking, asking if the traditional hen party is dead at 10 o'clock tomorrow morning. That's all for today's Woman's Hour. Join us again next time. I'm Anita Arnand and over the next 10 episodes for bbc radio 4 we're going to be exploring a somewhat tricky title princess join me as i speak to guests like the comedian sharpat korsandi and presenter charlene white about their favorite princesses we're going to be unpacking scandalous and fabulous legacies, sharing the stories behind some of the most incredible princesses in history.

Join me, Anita Arnand, for Princess on BBC Radio 4. Listen on BBC Sounds. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake.

No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.