Search

AbstractMenstruation is considered an off-limits subject in India where menstruating woman continue to face silence, discrimination and isolation. A mesh of patriarchal cultural practices surrounding the subject of menstruation places restrictions on girls and women who are menstruating. This paper explores the menstrual experiences and challenges experienced by teachers from a village located in a Kishangarh block in rural Rajasthan. Informed by qualitative research, the study reveals the irony in thrust to distribute disposable menstrual pads to adolescent girls in school while ignoring the needs of teachers. The study calls for the inclusion of teachers as key stakeholders in the design of school based menstrual hygiene management and awareness initiatives and programmes. [ABSTRACT FROM AUTHOR]

These two dimensions of abortion-related stigma continue to be evident in major political and legal shifts that negatively impact abortion access. This international collection of papers from contexts with variable social and legal restrictions on abortion, offers progressive insights into community activism, abortion-related healthcare, and community attitudes, including how women perceive abortion and value abortion care. Debates about human rights, the sanctity of life and the rights of the unborn continue to play out internationally, often placing women seeking abortion in the crosshairs of politicians, faith leaders, community members and others who consider abortion a moral ill rather than a health need. [Extracted from the article]

We started to develop the idea for this special issue based on a shared sense of familiarity in the early days of the pandemic. However, both HIV and COVID-19 are deeply implicated in global as well as identity-based health inequalities, as evidenced in vaccine distribution and morbidity and mortality rates. Ally Day's paper explores the making, in the midst of COVID-19, of a documentary film about a long-closed HIV hospice. [Extracted from the article]

There has been little exploration of the social and emotional wellbeing of young Indigenous populations who identify as gender and sexuality diverse. Given the vulnerability of this cohort in settler colonial societies such as Australia, Canada and the USA, wider investigation is called for in order to respond to their needs and aspirations. Using a scoping review, this paper maps existing research on the intersections of youth, gender and sexuality diversity, Indigeneity and wellbeing. The evidence points to the importance of historical and contemporary experiences tied to colonisation and intergenerational trauma. For young Indigenous gender and sexuality diverse peoples, heteronormative colonial value systems converge to produce environments characterised by racism, phobia and marginalisation. The evidence base includes deficit models based on trauma and negative outcomes. However, there is also an emerging body of research highlighting the resistance and resilience of Indigenous gender and sexuality diverse youth. [ABSTRACT FROM AUTHOR]

AbstractThe notion of ‘sexual justice’ has gained traction in academic and policy arenas in recent years. This paper presents a scoping literature review of the regimes of truth, following Foucault, of ‘sexual justice’ appearing in the scientific literature from 2012 to 2022. Thirty-eight papers were coded using (1) content analysis of the studies’ central problematics, the programmes referred to, and institutional location(s); and (2) thematic analysis of how the notion was deployed. Central problematics centred on (1) critiques of, or alternatives to, dominant approaches to sexual and reproductive health; and (2) highlighting injustices. As such, ‘sexual justice’ is fighting for legitimacy in the truth stakes. There is a distinct paucity of papers tackling the translation of ‘sexual justice’ into practice. South Africa dominates as the site in which papers on ‘sexual justice’ have been produced, but there is a lack of South-South collaboration. Two themes were apparent around which conceptions of sexual justice cohere. Firstly, sexual justice is seen as a vital, yet politically ambivalent goal, with neoliberal co-optation of progressive rights agendas being warned against. Secondly, sexual justice is viewed as a means, in which sexual justice is described as having potential to repair established frameworks’ shortcomings and oppressive legacies. [ABSTRACT FROM AUTHOR]

Medication abortion has been established globally as safe and effective. This modality has increased accessibility and the opportunity to centre individual autonomy at the heart of abortion care, by facilitating self-managed abortion. Previous research has shown how self-managed abortion is beneficial in myriad settings ranging from problematic to (relatively) unproblematic contexts of access. In this paper we explore the relationship between self-management and sources of support (including health professionals, family, and friends); as well as considering issues of reproductive control and autonomy. Drawing on qualitative, experience-centred interviews, we utilise the concept of social connectedness to examine how supported self-managed abortion was experienced in the United Kingdom during the COVID-19 pandemic. Overall, self-management was welcomed, with participants speaking positively about managing their own abortion at home. However, a sense of connectedness was crucial in helping participants deal with difficult experiences; and functioned to support individual autonomy in self-care. This paper is the first to examine factors of connection, support, and isolation, as experienced by those undergoing self-managed abortion in the UK in detail. Our research suggests a continued need to advocate for high quality support for self-managed abortion, as well as for choice of abortion method, to support patient-centered care. [ABSTRACT FROM AUTHOR]

Drawing on interviews with 40 Chinese gay academics, this paper reveals participants' concerns about conducting queer research in China. These include sexual-identity exposure, difficulty in publishing research and receiving funding, as well as marginalisation within university departments. Informed by Irvine's conceptualisation of sexuality research as dirty work, this research examines the operation of heteronormativity in the constitution of queer research as dirty work. It shows that heteronormativity is intrinsic to research censorship by authorities, as repressive politics pursue regime maintenance and regulate difference. It is argued that Chinese academia is a heteronormative space in which queer research is constrained by the institutions and the Party-state. By teasing out the nuances in participants' experiences of research censorship, this paper highlights the complexity of power at play, which is far from a one-way relationship of authorities exerting power over researchers. Institutions exert power over queer researchers and simultaneously submit to the higher-level power of the Chinese Communist Party political system; at the same time, queer researchers who are governed by heteronormativity and political control can express their agency and resist the censorship. [ABSTRACT FROM AUTHOR]

This paper explores some the difficulties in undertaking a large-scale systematic review of pornography research literature. Its authors come from different disciplines across the humanities and social sciences, and work within an interdisciplinary team. The research project aims to understand pornography's relationship with its audiences, particularly considering the relationship between pornography consumption and healthy sexual development. Offering a conversational account of research experiences on the project so far, the paper illustrates some key tensions and ongoing points of discussion in research committed to interdisciplinary scholarship, featuring disciplinary perspectives that do not easily correlate. We disagree on definitions, data-gathering methods and modes of data analysis. This paper does not aim to deliver solutions to these problems but presents two different voices describing our experiences of interdisciplinary porn research so far. In order to challenge and extend our disciplinary thinking, we offer an example of dialogue, and highlight the potential of listening across disciplinary frameworks. We encourage scholars from different disciplines to work together as this generates broader research perspectives and offers challenging conditions that can usefully interrogate and extend upon traditional research practice and methods. We hope this paper will generate further reflection among research peers about how best to strengthen interdisciplinary research practice, including, but not limited to, porn research. [ABSTRACT FROM AUTHOR]

This article explores the intersection of gender identity and sexual orientation in the narrative experiences of trans identified young people. Data were collected in collaboration with trans youth community centres in the USA, Canada and Ireland. Axial and selective coding procedures were used to examine the interplay between developing sexual orientation and gender identity. The relational language used by participants when explaining the process of negotiating and renegotiating sexual orientation prompted us to ground theory building in a framework of intersectionality, feminist concepts of 'doing gender' and peer mediated approaches to identity development. Two overarching themes were developed and are deconstructed in this paper: labelling and peer mediated self-consciousness. With respect to labelling, through the feminist concept of 'doing gender' we explain how trans youth navigated accountability to self, others and society as they negotiated and renegotiated sexual orientation labels in conjunction with gender labels. In relation to peer meditated consciousness, we examined how through relationship with peers, participants explored and internalised concepts important for sexual orientation formation. The paper begins to explore some of the ways in which gender identity and sexual orientation are interwoven, challenging the notion that they are fully autonomous constructs. [ABSTRACT FROM AUTHOR]

This paper critically examines the role of transnational AIDS networks and resources in the consolidation of one of the earliest identity categories, meti, used within an emerging Nepali LGBT movement in the early 2000s. It argues that political identity formation in resource-poor contexts with limited domestic support for queer organising has been a cumulative effect of transnational exchanges between activists and resource networks. Beyond this, the paper traces the emergence and changing meanings of meti to show how a seemingly Indigenous category is more closely linked to modern configurations of male same-sex sexuality in response to opportunities available for political mobilisation. The paper is based on secondary research and interviews with 71 participants and participant observation conducted during seven months of fieldwork in Nepal, and interviews conducted outside the country between 2016 and 2019. [ABSTRACT FROM AUTHOR]

This paper explores and theorises education-based workshops delivered in secondary schools in support of a relationships and sex education curriculum that aims to bring forth more positive understandings and experiences of gender and sexuality. We cast this work as a form of sexual health activism, with our paper deepening understanding of how the motivations of those engaged in this form of activism interface with the decision to invest time in this work. Based on interviews with 40 workshop facilitators in England and Wales we argue that this form of sexual health activism is motivated by facilitators' life experiences as well as the desire to make the world a better place. As such, this form of work can function as a means of 'caring for' both past selves and future generations, thus functioning simultaneously as a form of self-care and a form of 'societal care work'. Ultimately, these activities may be understood as a form of 'extra-clinical' healthcare practice, with leading gender and sexual health workshops serving as an important means of solidifying health students' identities as both healthcare providers and activists for social change. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Until recently, trans women have been subsumed within the category of men who have sex with men for HIV-related care. Following a 2016 UNAIDS report finding that trans women globally are 49 times more likely to be living with HIV than the general population, health programmes have sought to expand their reach to this key population. Yet, trans women are often treated as passive subjects to be recruited into programming or clinical trials for HIV-related care. This paper uses case studies of two community-based clinics in Thailand to highlight the agency of trans women in creating and implementing unique models for the provision of care that fit their needs and those of their local communities. By tailoring goals to be trans-specific and local, trans women at these clinics help destigmatise HIV-related care. This paper argues for the importance of engaging trans women as community stakeholders in HIV-related care and prevention and identifies suggestions for stakeholder engagement in programme design both in and beyond Thailand by focussing on local conditions. [ABSTRACT FROM AUTHOR]

Intersex people and those with variations of sex characteristics face significant health and social issues. This paper analyses the complexities of adult healthcare for this diverse population, including the root causes of deficiencies in care provision. Many minors with variations of sex characteristics are subjected to irreversible, non-consensual medical interventions, which can have negative effects on their health and wellbeing as adults. This 'emergency' approach to intersex paediatric healthcare has been challenged since the 1990s, but there is still a lack of understanding about how the paradigm affects adult care. This paper aims to raise awareness of the health challenges faced by adults with variations of sex characteristics. It identifies themes related to the challenges associated with accessing appropriate adult care, including the repercussions of childhood treatment, the lack of transitional services and psychological support, the limited general medical knowledge about variations of sex characteristics, and the reluctance to access services due to fear of stigma or past medical trauma. The paper indicates the need for more attention to intersex people's health needs as adults, moving away from attempts to 'fix' them as minors towards approaches which consider and provide for their diverse healthcare needs in a broader temporal context. [ABSTRACT FROM AUTHOR]

In this paper, female sex workers tell stories of their interactions with health care providers (HCP) in four cities in the Republic of Ireland. While Irish society has made great progress in listening to the sexual stories of women that were historically silenced (e.g. stories of abortion, sexual abuse), sex workers have not benefited from this new climate. Regularly silenced by parliamentarians and non-governmental organisations who speak upon their behalf, sex workers are consigned within a narrative of victimhood and coercion. This paper draws from a participant action research study conducted in 2019–20 and explores women's motivations in whether to disclose their sex work, and the strategies deployed to conceal it while seeking access to sexual health care. These strategies included traveling beyond their own communities for health care and STI home testing. The paper identifies women, particularly, migrants who felt their precarious position made it impossible for them to be truthful about their sex work to health care providers, exposing them to greater health risk. The paper understands this marginality within a context of structural violence where sex worker health is shaped by institutional power relations creating unequal health outcomes but is also challenged by stories of solidarity. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper draws on an autoethnographic 'digital diary' which the author began after testing positive for HIV in July 2016, until May 2021, to critically assess (mis)representations of both the AIDS and COVID-19 pandemics in the media. Drawing on insights from art, literature, queer theory and social anthropology, the paper focuses on dominant moral and political discourses to show how narratives of blame, shame and guilt about viral transmission contribute to the stigmatisation of 'at risk' groups. Concepts of biopower and normative judgement are used to reflect on discourses which construct those who 'test positive' for HIV or SARS-CoV-2 as 'reckless', 'risky' or 'irresponsible' subjects. The paper also analyses notes on recent media appearances made by the author to discuss their participation in the PARTNER study, which showed that HIV antiretroviral therapy eliminates the possibility of HIV transmission, including reports in The Guardian, on BBC News, on Sky News, on Channel 5 News, and in the Metro. As the former had reported that the 'Covid-19 crisis raises hopes of end to UK transmission of HIV', portrayals of the two pandemics are compared to explore tensions between public health and individual responsibility as normative priorities. [ABSTRACT FROM AUTHOR]

Over the last twenty years, there has been a growing interest in measuring sexual wellbeing, including by a WHO/UNFPA working group in 2007, which sought clarity on key dimensions and asked for indicators of these to be devised. However, there remains a lack of conceptual clarity surrounding the concept of sexual wellbeing, which may create variation in what is being assessed and to what we are referring. This paper proposes one way in which to achieve conceptual clarity might be through the utilisation of a Capability Approach, thereby posing a new set of normative questions about what sexual wellbeing is. The central argument in this paper is for researchers, theorists and practitioners to focus more fully on a person's freedom to achieve sexual wellbeing within a particular social and cultural context. We suggest the kinds of data that might need to be captured to operationalise and measure such an understanding. By offering new critical insights, we hope to drive forward empirical and methodological development in the evaluation of sexual wellbeing. [ABSTRACT FROM AUTHOR]

Understanding heteronormativity through the 'lived sexualities' of single women in urban Bangladesh, who are rarely included in any discourse of sexuality, this paper looks at middle class women who do not conform to marriage normativity but who carve out a space of social respect, acceptance and happiness through a long process of negotiation and careful navigation. Taking the intersectionality of gender, class and sexuality as its focus—this qualitative study seeks to understand the tactics of avoidance and the strategic routes women employ in their everyday lives as they negotiate heteronormative prohibitions to pursue sexuality and pleasure. [ABSTRACT FROM AUTHOR]

AbstractMedical gendered racism in the USA has been and continues to be a significant issue for Black women across various healthcare domains, including sexual and pelvic healthcare. The experiences of Black women with Genito-Pelvic Pain/Penetration Disorder, characterised by pain with sexual intercourse, are particularly understudied in relation to medical gendered racism. This paper advances existing research on Genito-Pelvic Pain/Penetration Disorder by employing Black feminist thought and intersectionality as theoretical frameworks. We seek to conceptualise how medical gendered racism impacts Black women’s experiences with genito-pelvic pain and the quality of their healthcare. We offer a nuanced, culturally sensitive approach to doing so and to clinical practice, and provide actionable recommendations for healthcare professionals. This work aims to equip researchers and healthcare practitioners with the knowledge and tools to acknowledge, understand, and support effective treatment of genito-pelvic pain experienced by Black women in the USA. [ABSTRACT FROM AUTHOR]

AbstractReproduction is considered a core event in a cisgender heterosexual woman’s life. Several hierarchies exist within the field of reproduction, with reproduction being privileged among people from dominant races, classes, castes, ages, and abilities. In this paper, I explore uterine transplantion as an emerging mode of reproduction, which privileges the experience of pregnancy in addition to genetic relatedness, specifically within the Indian context. The focus is on the socio-cultural and economic discourses surrounding the marketisation of reproductive technologies and how these recalibrate social and familial dynamics concerning reproduction. I argue that the mobilisation of the language of reproduction as a right could potentially transform into reproduction as a duty. Reproductive biopolitics is used as a lens to think through the value of wombs in relation to the bodies they inhabit, and the pressures the marketisation of wombs puts on both recipients and donors. [ABSTRACT FROM AUTHOR]

AbstractThe increased popularity of swinger clubs across the UK in the past two decades has not been met with commensurate public health initiatives or interventions that engage with the relationship between swinger clubs and sexual health. Consequently, the responsibility for sexual health promotion within these establishments largely depends on the discretion of club managers. Drawing on data from semi-structured interviews with 10 managers from across the UK, the study suggests that the managers’ perceptions of the club-consumer relationship shape the nature of sexual health promotion. Three distinct approaches were evident in the research: those who perceive sexual health promotion as financially detrimental; those who see it as an individual rather than a collective club concern; and those who consider it as part of a broader social community responsibility. These findings highlighted an implicit beneficence of managers towards their customers; a shared assumption that an ideal consumer was heterosexual, partnered and in their forties; and differing perceptions of manager responsibility towards the sexual health of customers. The paper concludes by suggesting that the swinger community is a blind spot in sexual health discussion in the UK and that by talking to the managers of swinger clubs we can further develop our understanding of the area. [ABSTRACT FROM AUTHOR]

Discursive practices position Black women as racial, gendered, and sexual others. There remains a need to understand how Black women craft sexualities given this backdrop. This paper draws on sexual and dating advice from 30 semi-structured interviews to examine how cisgender heterosexual undergraduate women enrolled at a Historically Black College/University in the USA constructed and promoted heterosexualities. Neoliberalism, racialised risk narratives and notions of Black womanhood converge to frame how participants articulated their roles and the roles of women like them in maintaining sexual health and social status at the nexus of race and gender oppression, and in respect of aspirational Black feminine middle-class identities. Overarching messages in their peer advice revealed gender-specific expectations about sexual responsibility through self-reliance and sexual respectability through heterosexual monogamy. The present study expands sexualities research through an intersectional approach that examines the implications of racialised, gendered and classed meanings of Black sexuality and womanhood in an understudied population. Findings identify peer sexual advice as a rhetorical tool that simultaneously resists and reproduces power structures. [ABSTRACT FROM AUTHOR]

Research documents how abortion can be emotionally difficult and stigmatising, but generally has not considered whether and how involvement in abortion may be a source of positive emotions, including pleasure, belonging and even joy. The absence of explorations that start from the possibility of abortion pleasure and joy represents an epistemic foreclosure. Moreover, it highlights how social science literature has tended to emphasise the negative aspects of abortion care in ways that produce or amplify normative negative associations. In this paper, we investigate the positive emotions, pleasure and joy of abortion involvement by drawing on interviews conducted in 2019 with 28 abortion accompaniers in Argentina, Chile, and Ecuador about their experiences accompanying abortions after 17 weeks' gestation. Abortion accompaniment is a response to unsafe and/or inaccessible abortion whereby volunteer activists guide abortion seekers through a medication abortion. Interviewees described how the practice of accompaniment generated positive emotions by building a feminist community, shared intimacy among women, and witnessing aborting people claim their strength. Importantly, these positive emotional experiences of involvement with abortion were not distinct from the broader marginalisation of abortion but were, instead, rooted in its marginalisation. [ABSTRACT FROM AUTHOR]

AbstractAlthough frequently relegated to the periphery in conversations about gender-based violence prevention, the disabling impacts of traumatised subjectivity both affect survivors’ abilities to fully participate in sex and contribute to survivors being more than twice as likely to be sexually (re)victimised compared to peers without trauma histories. In this paper, we seek to crip and queer approaches to gender-based violence prevention, particularly consent education, by learning from 2SLGBTQ+ and disabled trauma survivors’ affective experiences of queer, crip sexual joy and the radically messy ways in which they establish their own care networks for deeply pleasurable sex through the principles of disability justice. Refusing pathologising understandings of survivors as those who need to be cured, we highlight traumatised subjectivity as emblematic of the ambiguity and ambivalence inherent in sex as well as the possibilities for caring, consensual sex that moves beyond the concept of consent employed in colonial, neoliberal capitalist societies’ binary (Yes/No) consent laws. Drawing on the work of crip and queer theorists such as Mia Mingus, Alison Kafer, Leah Piepzna-Samarasinha, and J. Logan Smilges, we reveal how disability justice principles, such as interdependence, collective access, and access intimacy, offer transformative understandings for anti-violence efforts. [ABSTRACT FROM AUTHOR]

In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs). [ABSTRACT FROM AUTHOR]

This paper describes the strategies used by Aboriginal young people to build positive relationships and sexual wellbeing. It does so to counter the risk-focussed narratives present in much existing research and to showcase the resourcefulness of Aboriginal young people. We used peer-interview methods to collect qualitative data from 52 Aboriginal young people living in western Sydney, Australia. Participants reported a strong desire to stay safe and healthy in their sexual relationships and to achieve this they relied heavily on oral communication and yarning strategies. Participants viewed communication as a way to gain or give advice (about bodies, infections, pregnancy, relationships); to assess the acceptability and safety of potential partners; to negotiate consent with partners; to build positive relationships; and to get themselves out of unhealthy relationships. Participants also discussed 'self-talk' as a strategy for building sexual wellbeing, referring to narratives of self-respect and pride in culture as important in establishing Aboriginal young people's positive views of self and as deserving of respectful and safe sexual relationships. These findings suggest that future programmes and interventions based on yarning could be well-regarded, given it is a cultural form of pedagogy and a strategy Aboriginal young people already use to build positive relationships and identities. [ABSTRACT FROM AUTHOR]

This paper aims to explore how pervasive constructions regarding a person's sex and gender identity in society and law limit the human rights of persons with variations of sex characteristics. Societal culture promulgates a binary (male/female) gender ideal which includes standards of normality for our bodies. People who do not easily fit these culturally constructed norms, such as persons with variations of sex characteristics, encounter numerous difficulties. The legal conceptualisation of 'sex' according to the binary maintains the medicalisation of variations of sex characteristics and reinforces the focus on sex 'normalising' treatment of children who are too young to provide their informed consent. The paper makes use of Belgium as an illustration. Not only is comprehensive legal research concerning variations of sex characteristics absent in Belgium, but the country has also been responsive to human rights claims regarding sexual identity in recent years. With regards to the sex assigning or 'normalising' treatment of persons with variations of sex characteristics, this paper argues that by accepting the substitution of the child's informed consent for the opinion of the legal representative in the absence of urgent medical necessity, Belgian law fails to protect the former's right to bodily integrity and best interests. [ABSTRACT FROM AUTHOR]

This paper draws on anthropological research exploring women's changing sexuality within an urban context of Tanzania. The women involved were participating in an HIV prevention trial and worked in bars, restaurants, hotels and nightclubs, or sold local beer or food in Mwanza city. In ethnographic fieldwork and interviews and group discussions with women, narratives about sexuality focused on gendered and moral discourses of sexuality, the commodification of sexuality, and emotions and intimacy in relationships. This paper discusses how women's sexual subjectivies are shaped by a city where social, structural and economic changes over an era of neoliberalism and AIDS has created both disciplinary and liberalising spaces in which gendered and moral discourses of sexuality have emerged. [ABSTRACT FROM AUTHOR]

Human service non-profit organisations (HSNPs) looking to improve the representation of clients in the work of their organisation may decide to hire people with lived experience as peer providers. This paper looks at how HSNPs that provide services to sex workers make decisions about hiring those with lived experience of sex work as staff. To address the issue, the following questions were asked: 1) how do HSNPs make the decision to hire sex workers as staff members; and 2) if hired, how are individuals actually involved in the organisation? The study aimed to answer these questions using open-ended interviews with 64 staff in HSNPs in the US Midwest that indirectly or directly provide services to sex workers. Findings indicate that while many organisations hire individuals with lived experience in sex work, the expectations placed on these individuals vary considerably depending on the perceptions other HSNP staff have about sex work. When HSNPs hire individuals with lived experience to further their organisational agendas with respect to sex work, they should include sex workers in a substantive and inclusive way to minimise organisational bias and ensure sex worker views are accurately represented. [ABSTRACT FROM AUTHOR]

Sex work is perceived as an undesirable activity in India. It is widely believed that sex workers are either the victims of trafficking or have taken up sex work out of compulsion. Furthermore, it is often assumed that people who pursue sex work live in brothels or solicit customers outside their homes. Drawing on findings from an ethnographic study of the Kanjar community of northern India, this paper argues to the contrary. Veering away from accounts of individual women as victims, this paper focuses on dhandha (sex work) as a 'legitimate' community practice. For the Kanjars, sex work is a traditional occupation with a long complex history and a distinct subculture embedded in its economic structure. For those involved, the family economy is based on the labour and earnings of unmarried women who earn income as dhandhewalis (sex workers). Sex work may not be an option that Kanjars choose, but it is certainly a practice that they are neither ashamed of, nor apologetic about. Their positive, if not defiant, attitude can be understood in the context of the specific subculture of the Kanjars. The term 'subculture' as used here being specific to the community and its traditions, as distinct from dominant mainstream Indian culture. [ABSTRACT FROM AUTHOR]

Women selling sex often face challenges in raising their children in the context of significant socio-economic difficulties and the social stigma inherent in sex work. This paper is based on a cross-sectional qualitative study that explored the dual roles of motherhood and sex work among female sex workers enrolled for ongoing HIV prevention and treatment services in the Sex Workers Outreach Programme (SWOP) clinics in Nairobi, Kenya. We examined women's experiences and coping in negotiating and managing the dual roles of motherhood and sex work. In-depth interviews were conducted with 39 women randomly selected from 1,000 women included in a baseline behavioural-biological survey conducted in October-November 2020 as part of the Maisha Fiti study. The analysis focused on themes related to motherhood and making a living: (i) entry into sex work; (ii) childcare arrangements; (iii) ensuring respectability for their children; and (iv) pursuit of safety and security. Findings from the study show women's entry into sex work was necessitated by poverty and a lack of reliable sources of livelihood to support their children. While performing their motherhood roles, the women demonstrate agency in navigating through their stigmatised conflicted sex work role to be able to provide for their children. [ABSTRACT FROM AUTHOR]

In Australia, the response to HIV, hepatitis C and hepatitis B has largely been through the constructed category of 'blood borne viruses' which treats these viruses as an interconnected set of conditions with respect to their mode of transmission. In this paper, we explore how people understand their viral infection, and compare the logics underpinning these different understandings. In-depth interviews were conducted with 61 participants who were either living with a blood borne virus or were the family members of people living with them. Our analysis reveals that the viral infection was often described as 'just a condition that needs to be managed', albeit in potentially exhausting ways. This understanding hinged upon a biomedical logic in which viral invasion was seen as causing illness and in turn necessitating biomedical intervention. In contrast, some participants with hepatitis B presented their infection as a condition unintelligible through Western biomedical logics, defined instead by symptomology – in terms of 'liver disease', and/or 'liver inflammation'. This focus on symptomology calls into question the soundness of prevention and management responses to hepatitis B based in biomedical logics and reveals the extent to which living with a virus involves multiple, sometimes incompatible, cultural logics. The different logics underpinning HIV, hepatitis C and hepatitis B reveal shortcomings of framing these viruses together as a coherent single construct. [ABSTRACT FROM AUTHOR]

This paper addresses the role emotions play in the social assemblage of medicines and technical processes in the response to the HIV called pre-exposure prophylaxis (PrEP) for HIV. We describe a series of stages and processes in the social construction of PrEP in Brazil from the run-up to the launch of the initiative by the Ministry of Health to the subsequent implementation of the strategy by public health services. To understand the meanings and symbolism assigned to this biomedical technology, we examined the hopes underpinning scientific, government and non-governmental narratives, clinical processes and health policy. The social trajectory of PrEP was influenced not only by these hopes but also by fears and concerns about the impact of this approach to HIV prevention on lifestyles and modes of sexual governance. The evidence used in this study comes from interviews with health professionals and AIDS activists, anthropological fieldwork, scientific articles and documentary analysis. Our findings provide important insights into how emotions have shaped the meanings assigned to PrEP and shed light on the complex game of negotiation involved in defining responses to the HIV epidemic. [ABSTRACT FROM AUTHOR]

The burden of maternal mortality in sub-Saharan Africa is the highest in the world. As high fertility rates present an increased risk to women's health, programmes and services have been put in place to increase access to family planning. Several studies have identified sociocultural factors as limiting access to family planning, including male resistance and women's low decision-making power. However, these studies have often used a behavioural approach that anchors barriers to access in women's attitudes or motivations. In 2019, a qualitative evaluation of a family planning programme using a behavioural approach was conducted in rural Uganda, focusing on women's attitudes and unmet needs. With hindsight, we realised that our evaluation was insufficient to adequately capture barriers that extend beyond women's motivations. This paper shares three case studies that we analysed using a structural health vulnerabilities approach. Our analysis highlights political, economic, social and cultural structures that can impede access to family planning. Using a structural health vulnerabilities approach, we identify structural barriers which have their roots in the local realities women face and propose context-specific structural recommendations. Finally, we contrast our initial results with findings the case studies presented to highlight the relevance of taking structural vulnerabilities into account in future family planning programme evaluation and women's sexual and reproductive health studies. [ABSTRACT FROM AUTHOR]

Based on a diary writing exercise, this paper illuminates the complex ways in which sex workers in Ukraine actively work through and manage stigma in their daily lives. Pushing beyond the notion of stigma as a static and fixed psychosocial designation that can be readily measured, we argue that stigma is actively confronted by sex workers through various forms of gendered emotional and physical labour that enable them to recuperate a sense of moral personhood. This notion of moral personhood is often tied to wider gender-specific values pertaining to caregiving and motherhood. [ABSTRACT FROM AUTHOR]

Until 2018, abortion in the Republic of Ireland was banned in almost all circumstances under one of the most restrictive legal regimes in Europe. The main solution for Irish women and pregnant people seeking abortion services had been to pursue care abroad, typically in clinics in England. In this paper we focus on the hardships of waiting for abortion care experienced by Irish residents leading up to their travel for appointments in England in 2017 and 2018. Based on in-depth interviews with 53 Irish women collected at three British Pregnancy Advisory Services (BPAS) clinics in England we analyse women's experiences as they navigated an 'environment of secrecy' in Ireland. This included making specific secrecy efforts when navigating travel arrangements, conversations, movement, health records, and the travel itself. Despite the expansion of abortion access in Ireland in 2018, the need to travel abroad continues for many women. We argue that the continued need for secrecy when women have to travel abroad for care perpetuates this important phenomenon's invisibility. This argument also applies to other countries where abortion access is restricted, and women are forced to travel for care. We also caution against the presumption that all Irish residents are able to travel internationally for healthcare. [ABSTRACT FROM AUTHOR]

Abortion is a common and safe gynaecological procedure. Yet in film and television it is disproportionately represented as risky, violent, requiring hospitalisation, and affecting young, white, wealthy women. This reinforces stigma, fear and misunderstanding surrounding the procedure. While the majority of television storylines still inaccurately portray abortion, a small minority are directly showing abortion and presenting it as a positive decision. This paper analyses four such storylines in the television shows Sex Education, Shrill, GLOW and Euphoria, as well as media discourse around these plotlines, to understand how contemporary, 'feminist' television shows are representing abortion. The paper argues that contemporary television is increasingly representing abortion in an empathetic way that upholds women's choice to access the procedure, but that these portrayals can be read as post-feminist. Individual choice and empowerment are prioritised in these shows at the expense of showing the complex and unequal power structures that affect how women make reproductive choices. 'Feminist' television still prioritises the abortion storylines of young, white women who face no obstacles to abortion access and so the realities of abortion are still not fully represented on screen. [ABSTRACT FROM AUTHOR]

This paper explores attitudes of staff, residents and family members towards sexually diverse persons based on data from the first national study of its kind in Aotearoa New Zealand. The study was a two-arm mixed-method cross-sectional study using a concurrent triangulation design. The quantitative arm included the results of 433 staff surveys related to knowledge, attitudes, behaviours and beliefs about sexuality, intimacy and ageing. The qualitative arm included interviews with 77 participants including staff, residents and family members. This paper focuses only on sexual diversity. A generational cultural effect was noted among all respondents; younger participants expressed the most open and accepting views of diversity. Residents were aware that they mostly held the views of their generation; nonetheless they also looked to staff to set the tone. Staff held varying views and felt that residents would be less accepting; some staff felt the issue of intimate relationships was not something they were willing to discuss at intake. Facilities will want to establish policies about sexuality and intimacy and communicate those policies and practices to staff, residents and family members. Facilities may also wish to consider specific educational events about sexual diversity for residents. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic fieldwork in rural Tanzania, this paper shows that teenage girls' opportunities for sexual agency are shaped through assemblages of normative girlhood and appropriate sexuality. Whilst girls themselves negotiate and resist the disempowering affects of such assemblages, as shown through vignettes which illustrate the experiences of three girls who were involved in the education project where fieldwork took place, their capacity to do so is linked to the broader networks of relationships within which girls were situated. Taking friendships and religious affiliation as examples, I show how relationships can generate the conditions for girls to resist assemblages of norms and expectations that structure sexuality and girlhood - but may also reinforce them. This paper counters prevailing narratives on teenage girls' sexual agency in developing countries as inherently lacking, requiring external recuperation in the form of education and 'empowerment', and explores the implications of a relational framing for interventions which seek to genuinely expand girls' sexual agency. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals (SDGs) and the proclaimed vision of leaving no one behind are lauded for their transformative potential in redressing inequalities. Yet, too few are interrogations of the root causes and underpinning structures that keep uneven development in place. This paper reflects on this omission in relation to sexual and reproductive health and rights (SRHR) drawing on over three decades of professional experience in advancing SRHR enriched by literature sources. Engaging with the theme of the 9th Asia-Pacific Sexual and Reproductive Health and Rights Conference - Leave NO ONE Behind! Justice in Sexual and Reproductive Health, it asks what it would take to realise the pledge of universal access to SRH services and rights. With a focus on Southeast Asia, the paper offers an account of context-specific drivers of disparity and exclusion that preclude the attainment of comprehensive SRHR for all, and especially for stigmatised and marginalised groups. It then discusses the paradigm shift that needs to occur if the ideals of inclusiveness and equity as promised by the SDGs are to be attained in and through SRHR. [ABSTRACT FROM AUTHOR]

While transitioning gender historically precluded many transgender people from conceiving (more) children, there is now the option to undertake fertility preservation. However, the uptake of this option to date has been low. In order to extend existing limited research on the topic, this paper draws on responses to a questionnaire survey provided by 409 transgender and non-binary adults in Australia, which explored their experiences related to fertility preservation. The paper specifically focuses on the experiences of 295 participants who responded to open-ended questions about their experiences with, and views of, healthcare professionals in regard to fertility preservation. A thematic analysis indicated that healthcare professionals undertake a range of roles with regard to fertility preservation, some viewed positively (e.g. as providers of information), and some viewed negatively (e.g. as potential gatekeepers). The paper concludes by arguing that professionals need to ensure that transgender and non-binary people are provided with enough information, support and opportunity to make an informed decision about fertility preservation. The discussion includes a consideration of interweaving factors, particularly costs, and recommendations for further research that may inform clinical guidelines and training. [ABSTRACT FROM AUTHOR]

Drawing on testimonies from oral history interviews, this paper analyses the implications of pre-exposure prophylaxis (PrEP) practices for gay men in England. Through perspectives on biomedicalisation, the paper focuses on three aspects relevant to the construction of technoscientific identities in the realm of HIV prevention: (i) the question of agency of PrEP users in the context of what has been defined as a biomedical intervention, (ii) practices of freedom framed within neoliberal narratives of personal responsibility versus responsibilisation and (iii) the governance of risk in the era of biomedicalisation. The paper concludes that biomedical governmentalities, even those shaped by the rhetoric of personal responsibility, can be understood as rationalities linked more to solidarity and care of the other. Despite this, the use of PrEP in England is also giving way to the configuration of new sexual scenarios shaped by zero-risk mentalities. It will be important to remain alert to the implications of zero-risk scenarios for HIV-related stigma.RésuméEn s'appuyant sur des témoignages provenant d'entretiens centrés sur des histoires orales, cet article analyse les implications des pratiques de la PrEP chez les hommes gays en Angleterre. À travers les points de vue sur la bio-médicalisation, il se concentre sur trois aspects de la construction des identités technoscientifiques dans le royaume de la prévention du VIH : i) la question de la capacité à agir des utilisateurs de la PrEP dans le contexte de ce qui a été défini comme une intervention biomédicale, ii) les pratiques de la liberté, encadrées par les récits néolibéraux sur la responsabilité personnelle, versus la responsabilisation, et iii) la gouvernance du risque à l'ère de la bio-médicalisation. En conclusion de leur article, les auteurs soutiennent que les << gouvernementalités >> biomédicales, y compris celles qui sont déterminées par la rhétorique de la responsabilité personnelle, peuvent être comprises comme des rationalités plus en rapport avec la solidarité et le souci des autres. Malgré cela, l'usage de la PrEP en Angleterre laisse la place à la configuration de nouveaux scénarios sexuels déterminés par les mentalités du risque zéro. Il est important de rester attentif aux implications des scénarios du risque zéro au regard du stigma lié au VIH.ResumenA partir de testimonios obtenidos a través de entrevistas de historia oral, el presente artículo analiza las repercusiones de la PrEP (profilaxis preexposición para el vih, por sus iniciales en inglés) en las prácticas de hombres gais en Inglaterra. Partiendo de perspectivas sobre la biomedicalización, el artículo se centra en tres aspectos pertinentes a la construcción de identidades tecnocientíficas en el ámbito de la prevención del vih: i) la cuestión de la gestión (agency) de los usuarios de la PrEP en un contexto identificado como de intervención biomédica; ii) las prácticas de libertad enmarcadas en narrativas neoliberales de responsabilidad personal versus responsabilización; iii) el manejo del riesgo en la era de la biomedicalización. El artículo concluye que los manejos biomédicos, incluso aquellos moldeados por la retórica de responsabilidad personal, pueden entenderse como racionalidades vinculadas más con la solidaridad y el cuidado de los demás. A pesar de esto, el uso de la PrEP en Inglaterra está cediendo espacio a la configuración de nuevos escenarios sexuales determinados por esquemas mentales de riesgo cero. Debemos permanecer atentos ante las implicaciones que conllevan los escenarios riesgo cero para el estigma vinculado con el vih. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic research, this paper explores self-understandings among same-sex attracted men in Harare along with the local terms such men use to refer to themselves as well as their adoption and modification of globally circulating sexual identity labels. All study participants related to some of the labels that are prominent in the present-day, western-inspired global discourse on same-sex relations. However, they were rarely understood in the exact same way that is represented as typical in the 'west', indicating that when understandings and labels travel, they are not simply copied and pasted into new contexts. In Harare, being gay was closely interwoven with considerations about one's gendered self, and many same-sex relations were gender-structured. At the same time, this characteristic appeared to be a matter of emerging dispute, as it was sternly criticised by some. The history of political homophobia in Zimbabwe shone through in many stories and could be identified in some of the local terms used to refer to gay people, some of which had been invented to conceal from outsiders what they laid bare for insiders, and others of which had sting and mocked those in power for ideas and rhetoric perceived to be misguided or bizarre. [ABSTRACT FROM AUTHOR]

AbstractUnsafe abortions contribute significantly to maternal mortality and morbidity in Ghana. To reduce this, in 1982 abortion laws in Ghana underwent reform to broaden the conditions under which abortion is accessed. Although, evidence in other contexts highlights the contribution of violence to women’s experience of unwanted pregnancy and abortion, such evidence is limited within the Ghanaian abortion literature. This study aims to fill that gap. Informed by phenomenology, interviews were conducted with 10 women who had experienced various forms of violence leading to unwanted pregnancy and unsafe abortions. Participants were recruited between June 2017 and March 2018 in the Ashanti region of Ghana where they sought hospital care for unsafe abortion related complications. Participants mentioned intimate partners as the main perpetrators of violence. Financial challenges were also identified as important in increasing women’s vulnerability to violence. Verbal abuse from health workers contributed to denying women access to safe abortion. This paper advances dialogue about the ways in which women’s experience of violence from intimate/non-intimate partners and healthcare workers impacts their overall abortion experience. It advocates the empowerment of women to enable them to leave violent relationships, and the retraining of health workers to enable them to adopt respectful and empathetic care practices. [ABSTRACT FROM AUTHOR]

AbstractThis article offers a critique of the dominant secular/sexual paradigm in the Netherlands by focusing on everyday experiences of sexuality among Turkish-Dutch women. A secular approach towards sexuality rests on the fictive duality of a sexually liberated, progressive majority Dutch and a conservative cultural ‘Other’. This paper argues that despite scholarly work challenging the secular/framework within which minoritised women’s sexuality is problematised, cultural stereotypes continue to persist in Dutch populist discourse and everyday life. Based on life story interviews conducted with eight women, it illustrates the specific ways in which normative expectations are imposed on minoritised women based on perceived religious or cultural differences. These expectations constitute a ‘script’ that is imbued with cultural stereotypes. Dissonant moments emerge when my interlocutors fail to conform to the ‘script’. In contrast, when their choices validate these expectations, they are interpreted as a reflection of their ‘cultural background’ instead of being seen as instances of agentic behaviour. These processes further reify dichotomies in the form of sexually liberated and oppressed as the choices these women make are never seen as individual expressions of sexuality unless they openly contest these expectations. [ABSTRACT FROM AUTHOR]

AbstractThis article examines how intrauterine device (IUD) self-removal is framed in online sources containing the views of contraceptive providers. While research has explored power and knowledge hierarchies in clinical interactions between contraceptive users and providers, and has highlighted the safety of IUD self-removal, little is known about how self-removal is represented by providers in accessible online sources that may be relied upon by contraceptive users for information. A discourse analysis of 42 provider-generated online sources found that provider authority over contraception is reinforced through biomedical constructions of risk and safety in framings of self-removal. The data reveal how the sharing of self-removal experiences between IUD users via online platforms was perceived to threaten contraceptive provider expertise, resulting in the dismissal of users’ experiential knowledge. While some sources were supportive, the framings of self-removal discussed in this paper typically mirror the unequal power relations of in-person contraceptive user/provider interactions. The sources analysed therefore demonstrate how power and knowledge hierarchies are reproduced and extend beyond clinical interactions to the digital context, reflecting broader socio-structural controls over bodies, knowledge, and reproductive decision-making. [ABSTRACT FROM AUTHOR]

AbstractThis paper uses Ambiguous Loss Theory to explore the anticipatory and ambiguous losses and stressors surrounding the decision to come out as Lesbian, Gay, Bisexual, Transgender or Queer. Purposive sampling was used to administer a survey to 429 individuals who identified as LGBTQ+ about their coming out decisions and experiences. Data were coded and three major themes were developed: (1) the need for psychosocial safety (fear of being disowned, shunned or abandoned); (2) experiences of anxiety, depression, emotional stress, and shame; and (3) the pursuit of authenticity, self-discovery and liberation. Findings from the study indicate that coming out for LGBTQ+ individuals in the twenty first century remains accompanied by challenges and fears, both before and after the process, which significantly affects individuals’ health and safety. In the longer term, despite the challenges, stressors and losses identified by participants, most reported that disclosing their sexual orientation had greatly improved their health and mental well-being. [ABSTRACT FROM AUTHOR]

AbstractIn 2022, a global outbreak of mpox (formerly ‘monkeypox’) emerged in non-endemic countries, including Australia, predominantly affecting gay, bisexual and other men who have sex with men. Public health advice on transmission and isolation emerged rapidly from different sources, sometimes conflicting and producing uncertainty. Using the concept of ‘counterpublic health’, which acknowledges the incorporation of official science and experiences of affected communities into embodied practice, this paper investigates how people affected by mpox in Australia managed risk of transmission and navigated self-isolation. In-depth interviews were conducted with 16 people: 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay and bisexual men living in Australia. Participants thought critically about public health advice, often finding it restrictive and unresponsive to the needs of people with mpox. Participants’ decisions about reducing mpox risk and isolating often drew on experiences with other infections (i.e. HIV; COVID-19) and were made collaboratively with the people closest to them (e.g. partners, friends, family) to sustain relationships. Future public health responses to infectious disease outbreaks would benefit from identifying more opportunities to formalise and embed mechanisms to obtain feedback from affected communities so as to inform responses. [ABSTRACT FROM AUTHOR]

Girls' education has for many decades been central to the global development agenda, due to its positive impact on girls' health and wellbeing. In this paper, the authors revisit boys' attitudes, behaviours and norms related to girls' education, following the Samata intervention to prevent girls' school dropouts in Northern-Karnataka, South India. Data were collected from 20 boys in intervention villages before and after the intervention, and analysis was undertaken using a thematic-framework approach. Findings suggest that while boys did hold some attitudes and beliefs that supported girls' education and delayed-marriage, these remained within the framework of gender-inequitable norms concerning girls' marriageability, respectability/family-honour. Participants criticised peers who sought to jeopardise girls' respectability by teasing and community gossip about girls-boys' communication in public. Boys who rejected prevailing norms of masculinity were subjected to gossip, ridicule and violence by the community. Boys' attitudes and beliefs supported girls' education but were conditional on the maintenance of gendered hierarchies at household and interpersonal levels. Social norms concerning girls' honour, respectability and the role of boys as protectors/aggressors appeared to influence boys' response to girls' school dropouts. Future interventions aiming to address girls' education and marriage must invest time and resources to ensure that intervention components targeting boys are relevant, appropriate and effective. [ABSTRACT FROM AUTHOR]