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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]

In Vanuatu, the use of the terms such as ʻmen who have sex with menʼ (MSM) and ʻtransgenderʼ has increased over the past decade. This paper draws on twenty months ethnographic research in Port Vila, the country's capital, to analyse what happens on the ground when MSM and transgender categories are taken up to identify people or to narrate the self. The focus is on who uses these terms, in what ways they are experienced, and what is rendered visible (or not) by their use. This research departs from approaches framing ʻnon-heteronormativeʼ categories as related solely to gender and sexuality. It argues that MSM and transgender categories are used in various ways to refer not only to sexual practices and/or gender identity, but also to health risk behaviours, transactional sex and LGBT rights advocacy. The analysis offered suggests we view MSM and transgender categories as technologies that, depending on the interactional context, contribute to bureaucratic tasks or to maintaining or, on the contrary, changing established socio-political relations. [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]

Gender-based violence (GBV) is an all-encompassing term that speaks to acts or threats that may lead to physical, sexual or emotional harm to an individual based on their gender. This paper provides a scoping review of research on gender-based violence among Somali refugee women in different parts of the world. Using the socio-ecological model as a framework, we reviewed 30 empirical studies focusing on some form of GBV among Somali refugee women. We identified societal, community and individual factors contributing to the experience of GBV. We also discuss how these factors influence women's willingness to access care, especially healthcare and social services. The review reveals that oftentimes, institutions that work closely with this population have a limited understanding of how closely culture affects the willingness and ability to seek help about GBV. Based on our analysis, we suggest ways in which social institutions and healthcare providers can provide culturally-safe support to Somali refugee women who have experienced some form of GBV. [ABSTRACT FROM AUTHOR]

Adolescents and men are two populations that perform poorly within the HIV cascade of care, having worse AIDS-related health outcomes, and experiencing higher levels of HIV-related stigma. This paper explores institutional health system discrimination as experienced by adolescent boys with perinatally-acquired HIV, situating them within the social and gendered contexts of the Eastern Cape Province, South Africa. Life history narratives (n = 36) and in-depth semi-structured interviews (n = 32) with adolescent boys living with HIV aged 13–22 were conducted in 2017-2018. In-depth semi-structured interviews with biomedical and traditional health practitioners (n = 14), analysis of health facility files (n = 41) and clinic observations were also conducted. Together, triangulated sources point to an incongruence between the complex needs of adoelscent boys and young men living with HIV and their experiences within the health system. Two institutional discrimination-related deterrents to retention in care were identified: (1) lack of confidentiality due to health facility layouts and practices that visibilised people living with HIV; and (2) mistreatment in the form of shouting. This article contributes to the limited literature on the experiences of young men within the HIV continuum of care, focusing on how stigma influences how young men experience and engage with the health sector. [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]

Analysing survey data from 1,304 LGBTQ + young people in Australia collected in 2016, this paper considers key distinctions between the experiences of bisexual and pansexual participants, and lesbian and gay participants in relation to social media use and aspects of connection, harassment and mental health. Presenting quantitative data, illustrated by qualitative extracts, we found broad similarities in motivations for using social media and how participants connected to peers and communities. There were some statistically significant differences, however, in respondents' motivations for using social media and who they connected with on these platforms. Importantly, bisexual and pansexual participants reported more negative experiences of harassment and exclusion across all major social media platforms when compared to their lesbian and gay peers. Bisexual and pansexual respondents also reported poorer mental health experiences. These findings speak to the different impacts of discrimination and oppression that young people experience in everyday life. There is a need for focused attention on bisexual and pansexual young people in academic, policy and youth-work domains. Young people will benefit from more substantial school-based education on LGBTQ + identities - beyond the experiences of gay and lesbian people - to 'usualise' varieties of difference in gender and sexual identity. [ABSTRACT FROM AUTHOR]

In this paper, the sexual 'cleansing' of widows and subsequent inheritance is assessed for its socio-cultural significance. Although the practice has been well studied in the context of HIV in Sub-Saharan Africa, it has not been widely examined as an act of sexual violence against women. To address this gap, in-depth interviews were conducted with 27 widows aged 29 to 90 years in Siaya County in Southwest Kenya. A majority of participants stated the cleansing ritual was forcefully initiated, violently fulfilled, and frequently seen as rape. Findings from this study necessitate the identification of the cultural practice of widow cleansing as an act of violence against women. Doing so will facilitate the creation of a legal framework with which to act to eliminate the practice. [ABSTRACT FROM AUTHOR]

Sexting has generated considerable public and professional interest with concerns centring on young people, and potential harms to mental and sexual health. Little research thus far has explored the practice among adults and none has focused on the cultural norms relating to the emotional experience of sexting across different ages and genders. We conducted 40 semi-structured interviews with a diverse sample of adults aged 18-59 years in Britain on the role of digital technologies in participants' sexual lives. In this paper, we draw on the accounts of 34 people with experience of sexting. We identified three main themes in participants' accounts related to the emotional aspects of sexting: (1) trust, (2) desire/intimacy and (3) shame. Under each theme, we identified motivations, 'feeling rules', and examples of 'emotion work' relating to the self, the other and the dyad. We conclude that there are shared cultural norms that constitute what appropriate sexting should feel like. Interventions aiming to minimise harms arising from sexting need to build on commonly held cultural conventions regarding the 'rules of the game' concerning feelings as well as behaviours. [ABSTRACT FROM AUTHOR]

Contraceptive providers play an essential role in shaping contraceptive decision-making and care, with the potential to constrain patients' agency. This is a particular concern given the rising hegemony of Long-Acting Reversible Contraception (LARC) and growing evidence of negative patient experiences of LARC promotion and provision. Despite this evidence, little research has considered health providers' perspectives. Drawing on interviews with 22 contraceptive health providers in Aotearoa New Zealand, this paper explored their professional identity construction, focusing on meaning-making in instances of conflict between providers' and patients' priorities and agendas. Guided by feminist poststructuralist theory, the discursive analysis highlights common rhetorical strategies used by participants to (1) justify the use of coercive practices to encourage LARC uptake, and (2) in turn, negotiate positive identities. Findings show how participants grapple with the reproductive politics structuring contraceptive care, including established understandings of the purpose of (long-acting) contraception and contraceptive providers' roles vis-à-vis provision and promotion. The findings point to limitations on contraceptive agency, despite the unanimous endorsement of rights-based voluntary care. Extending the critical literature on LARC and contributing to the under-researched area of contraceptive coercion and agency, the findings of this study have important implications for the delivery of contraceptive care. [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]

How distancing requirements in the COVID-19 pandemic transformed intimate relationships is under-researched. Against the backdrop of research on the HIV pandemic, the paper departs from the assumption that decreased legitimacy of intimate arrangements and subjective worry about the likeliness of infection may reduce the frequency of multiple sexual contact and intimate well-being during the pandemic. Based on findings from a quantitative study which included measures of risk perception, frequency of contact with sexual partners and communities, concealment, as well as relationship quality in Austria and Germany, this paper examines sexual behaviour in association with relationship status and sexual identity. Analysing data from a convenience sample of 4,709 respondents, of whom 24 per cent identified as LGBQA+, 2 per cent as non-binary, and 6 per cent as consensually non-monogamous, bivariate analysis found significant differences in social distancing, frequency of contact with sexual communities and satisfaction with current sex life. Text analysis of the survey's open-ended responses indicates monogamisation due to declined legitimacy of less conventional intimate arrangements during the pandemic. Findings point to the importance of the sexual morality that defined pandemic experiences in times of HIV for understanding normative pressure on intimate life during COVID-19. [ABSTRACT FROM AUTHOR]

Drawing on qualitative research in Dar es Salaam, Tanzania, this article explores how men who engage in sex with other men perceive their interactions with healthcare providers, and how they would prefer healthcare services to be organised and delivered. The paper describes the strengths and weaknesses men associate with private and public healthcare; the advantages and disadvantages they associate with dedicated clinics for sexual minority persons; what they conceive of as good healthcare services; and how they would characterise a good healthcare worker. The paper also presents recommendations made by study participants. These include the view that health services for same-sex attracted men should be developed and delivered in collaboration with such men themselves; that health workers should receive training on the medical needs as well as the overall circumstances of same-sex attracted men; and that there should be mechanisms that make healthcare available to poorer community members. We analyse men's views and recommendations in the light of theoretical work on trust and discuss the ways in which same sex attracted men look for signs that healthcare workers and healthcare services are trustworthy. [ABSTRACT FROM AUTHOR]

In India, traditional social practices around marriage, such as non-involvement of prospective brides in choice of partner and timing of marriage, child/early marriage, dowry and purdah, compromise women's agency at the time of marriage and may also affect contraceptive practices in marriage. This paper examines the associations between traditional marital practices and contraceptive behaviours, including women's control over contraceptive decision-making, couples' communication about contraception, and ever use of contraceptives, among married women aged 18–29 years (N = 1,200) and their husbands in rural Maharashtra, India. Multivariable logistic regression was used to examine the association between these marginalising social practices and family planning behavioural outcomes, adjusting for demographic and parity confounders. Wives who were the primary decision-makers on who to marry had higher odds of ever having communicated with their husband on pregnancy prevention (AOR 1.76, 95% CI 1.16-2.68), and ever using modern contraceptives (AOR 2.19, 95% CI 1.52-3.16). Wives who were the primary decision-makers on when to marry also had higher odds of ever having used modern contraceptives (AOR 1.86, 95% CI 1.21-2.93). Women's involvement in marital choice may facilitate couples' engagement related to family planning, possibly via the establishment of better communication between partners. [ABSTRACT FROM AUTHOR]

A noticeable tendency in the first generation of scholarship on sexual orientation and gender identity/expression (SOGIE) in Africa has been the focus on urban or modern institutional settings. A dominant theme is to document people's struggles against stigma, fear and violence to better inform interventions to strengthen human rights and sexual health for all. In some cases, unintentionally, the impression conveyed of Africa is of a continent with cultures that are uniformly, hostile to SOGIE rights. The present study arises from a large survey among boys and men in KwaZulu-Natal, South Africa that problematises that impression. The study revealed unexpectedly high levels of same-sex sexual experience among boys and men in a mostly rural, culturally conservative setting. Following from that revelation, we conducted in-depth interviews to gain insight into their lives. Informants did indeed recount many incidents of discrimination and violence and admitted to sometimes severe emotional health problems. Yet they also spoke of finding love, acceptance, allies, resources, humour and hope for the future. In this paper, we tease out key themes from the interviews in relation to trends in the scholarship. [ABSTRACT FROM AUTHOR]

Based on one-year's ethnographic fieldwork, this article unpacks experiences of assisted reproductive technology (ART) among queer parents and queer wannabe parents in Guangdong, China. Although existing state regulation on the use of ART and birth planning tends to deny parenthood to single and queer people and further limits their ability to form legible family units, queer parents who have had children through ART are growing in number in urban China. This research delineates how state and cultural conventions, together with market and economic conditions, have shaped queer individuals' decision making regarding whether, when and how to have children. Findings make an original contribution to studies of the use of reproductive technology in Chinese queer lives. Narratives regarding how queer parents employ ART services unscramble links between sexual citizenship and reproductive agency, as individuals make consumer choices and reproductive decisions synchronously. The paper also explores alleged LGBT-friendly ART companies and the image of a desirable 'rainbow baby' they have created. Chinese queer parents' participation in assisted reproduction has destabilised the dominant hetero-reproductive family matrix while simultaneously contributing to stratified reproduction. [ABSTRACT FROM AUTHOR]

Vasectomy is considered a permanent form of contraception for men that can help reduce reproductive inequality. Its underutilisation in the context of the threats it may pose to perceptions of traditional masculinity has been closely investigated, but the lived experience of the procedure itself has been largely overlooked. This paper examines the experience of having a vasectomy in Israel, focusing on the recommended form of anaesthesia. Drawing on 15 semi-structured interviews with Israeli men who have experienced vasectomy, we found that the choice of anaesthesia has a significant impact on the meaning and experience of vasectomy. Unlike the widespread use of local anaesthesia during vasectomy in other countries, vasectomy in Israel is performed almost exclusively under twilight sedation administered intravenously. Based on our findings, we argue that framing vasectomy as an operation that requires sedation is related to views of masculinity and reproduction. Our data suggest that vasectomy in Israel is constituted as a potentially traumatic event, and anaesthesia is employed to protect patients from feelings of embarrassment and discomfort. We conclude that the prevailing method of sedation perpetuates the silencing and marginalisation of vasectomy as a contraceptive method, and consequently, its very limited accessibility in Israel. [ABSTRACT FROM AUTHOR]

Interactive community-based theatre is used to engage with audience members and allow for free exchange of ideas relevant to context. It aims to bring about a new understanding of an issue while challenging people's attitudes and perceptions. Its application within the field of sexual and reproductive health has been limited, particularly in low and middle-income contexts. This paper presents the rationale for a research-arts partnership in Jordan and describes the process and some lessons learned from the development and country-wide performances of a research-informed interactive play. The play, Mish 'Ayb (Not a Shame) was designed to address social barriers to accessing sexual and reproductive services in a patriarchal society. The sensitive portrayal by Jordanian actors of real-life scenarios pertaining to specific health issues encouraged identification of the audience with the actors, thereby building trust. This process helped to uncover cultural norms that facilitate and impede people's access to health services and information. Qualitative research designs that incorporate interactive theatre present a strong potential avenue to explore sensitive topics related to sexuality, particularly in patriarchal contexts. [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]

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.)

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.)

Sex work can offer a quick way of making money and is the only profession in which women may earn more in fewer hours when compared to other available jobs. However, most studies with sex workers in India are based on socially biased assumptions about sex work; that is, women are either coerced or trafficked into sex work. Limited attention has been paid to the voices of non-brothel-based sex workers in India. Drawing data from a larger ethnographic study conducted between December 2009 and July 2010, this paper analyses how women sex workers operating from non-brothel-based sex work settings in Kolkata, India, foresee their future. Unlike the popular 'victim imagery' of women sex workers in the Global South, this study found that women are not passive recipients of the trade; instead, they employ agency - sometimes transgressing the normative boundaries and at times reinscribing these boundaries to secure a future for themselves and their families. Therefore, to promote HIV preventive behaviour programmes reaching out to sex workers, non-governmental organisations (NGOs) must proactively inquire about women's future plans and assist them in materialising their future goals, which are mostly concerned with their children's future, a life free of stigma/shame, and financial security in old age. [ABSTRACT FROM AUTHOR]

Patterns of HIV prevalence in Kenya suggest that areas where various cultural practices are prevalent bear a disproportionate burden of HIV. This paper examines (i) the contextual effects of cultural practices (polygyny, male circumcision) and related sexual behaviour factors on HIV prevalence and (ii) the extent to which specific cultural practices in a community/county might explain existing ethnic variations in HIV prevalence in Kenya. The analysis applies multilevel logistic regression to data from the 2012/13 Kenya AIDS Indicator Survey. The results reveal striking ethnic variations in HIV prevalence in Kenya. The prevalence of polygyny in a community is positively associated with HIV prevalence, while a higher level of male circumcision in a county is protective for both men and women. The effects of these factors are stronger for men than women at both individual and contextual (community/county) levels. These cultural practices and associated risk factors partly explain existing ethnic differences in HIV prevalence in Kenya, but there remain significant ethnic variations that are not explained by these cultural practices or related sexual behaviour factors. These call for stronger empirical evidence to offer stronger theoretical explanations and inform effective policy and practice to address HIV epidemic in adversely affected communities in Kenya and similar settings in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

AbstractIn this study, exploratory research on self-determination using Indigenous research methods provided a model to help heal trauma and discuss recovery for traumatic sexual experiences. The methods and healing were based on a Cree worldview. Informed consent and questions were developed by the principal investigator prior to the research commencing. Eleven co-creators had the opportunity to revise questions, discuss the research, speak the Cree language, and participate in one-to-one interviews, group meetings and ceremonies. They also had the chance to review the transcripts and approve/disapprove the content, provide guidance on sacred knowledge and suggest terms to use, and co-author the paper, if they chose and three did. A Cree concept was developed from the work, namely, nehiyaw isecikewena which involved promoting self-determination and sovereignty alongside recovery. [ABSTRACT FROM AUTHOR]

AbstractRecent decades have seen an increasing gap occurring between the ‘desired’ and ‘actual’ family size of middle-class and professional women. This situation of ‘unrealised fertility’ and ‘incomplete families’ carries implications at a population, but also couple and individual level. This paper explores how middle-class professional women make decisions about partnering and parenthood and how these are shaped by a contemporary neoliberal feminist discourse which articulates the possibility of ‘having it all’ through engagement in careful life planning, appropriate self-investment, and by drawing on new technologies of reproductive biomedicine. Informed by semi-structured interviews with UK and US women conducted at two different points in time, it explores how they approach and experience the process of relationship formation in the face of age-related fertility decline. It also examines how the use of social egg freezing shape their romantic and family building expectations but also their interactions with (potential) partners. In doing so, it explores how gendered cultural dating scripts and unequal gender power relations shape the formation and progression of intimate relationships in a manner which can disempower women as they age. It therefore questions whether egg freezing may be the ‘great equaliser’ that some have hoped. [ABSTRACT FROM AUTHOR]

AbstractThis paper explores the definition of, and perceived community attitudes, toward kudanga, a Swahili street term for a type of transactional sex practised in Dar es Salaam, Tanzania. Rooted in economic and gender disparity, transactional sex increases adolescent girls’ and young women’s vulnerability to HIV and gender-based violence. We sought to understand perceived community attitudes about kudanga, and how the internalisation of norms surrounding gender-based violence relate to the experiences of young women who practise kudanga. Using qualitative data from focus group discussions with 37 young women, we found that community perceptions of kudanga were largely negative, and those who engaged in it were looked down upon and despised. Violence and lack of sexual agency were normalised when doing kudanga. However, young women understood kudanga to often be their best option to obtain economic stability and felt strongly that those who practised kudanga should not be stigmatised. Our research provides further evidence that transactional sex exists on a continuum and highlights the importance of reducing community stigma surrounding transactional sex as a means of decreasing risk of HIV and gender-based violence for young women. To our knowledge, this article is the first to explore kudanga. [ABSTRACT FROM AUTHOR]

The last literature review on swingers was written by Richard J. Jenks in 1998, and for the past 25 years, no review has been published with a focus solely this group. Some individual studies have analysed swinging together with other consensual non-monogamies, while other research has looked at swinging in the context of sexual health. This paper presents early and recent literature on swinging, highlighting some of the directions taken in swinger research, and addressing the challenges of finding a theoretical framework suitable to explain swingers, swinger settings, and swinging. [ABSTRACT FROM AUTHOR]

In this paper, I critically analyse biomedical clinical studies and literature reviews regarding the physiological phenomenon known as female ejaculation to demonstrate a process by which androcentric bias, which positions the male body as the scientific 'standard human', produces what I term as knowledge-driven ignorance. I show how even though knowledge about female ejaculation has expanded, its biomedical ontological status remains vague and controversial. The production of ignorance in this case does not result from active erasure or concealment, but rather from unintentional disregard, and is a by-product of knowledge-creation itself. As such, it is not only the narration of the scientific story that has the power to abject and exclude certain bodies from culture, but also what is untold and unknown. [ABSTRACT FROM AUTHOR]

The one-child policy in China brought about a fast decline in fertility levels and an increasingly skewed sex ratio at birth in China. The deep-seated tradition of son preference has been regarded as the main cause. However, news and recent research have pointed out that having daughters appears more popular among young people in urban areas. The analysis reported in this paper was based on empirical evidence drawn from 47 in-depth interviews. Findings highlighted that regarding the preference of sex at birth, a relatively balanced composition is sought in most cases. Other than the absolute dominance of one son and one daughter together, a preference for having a son remains. Although having two daughters has gained greater popularity among young couples, this turns out to be a compromise to some extent. Daughter preference cannot be regarded as a major trend. In practice, a stronger preference for a certain sex increases the fertility rate as couples attempt to fulfil their preferences, whereas no preference signals the least likelihood to realise fertility intentions. In this sense, the desire to have two children with at least one son may help boost fertility. [ABSTRACT FROM AUTHOR]

Using a qualitative approach, this paper explores the accounts of 30 women who accessed assisted reproductive technology treatment in five fertility hospitals in Ghana. A semi-structured interview guide was used to collect data on women's experiences of the procedure. Findings indicated that most of the women sought ART treatment to save their relationships from collapsing, with pressure and demands from friends and in-laws as key motivating factors. Women complained of emotional imbalance and the high cost of ART treatment. They felt compelled to borrow money from friends, family and banks and, sometimes sold assets to pay for treatment costs. Health consequences such as depression, changes in menstrual flow, weight loss, body pain, breast tenderness, bleeding and disruption to daily activities and sexual life were reported as problems encountered by the women. While study findings are supportive of the inclusion of infertility treatment in the national health insurance scheme, more adequate counselling and education for women undergoing ART treatment is required. [ABSTRACT FROM AUTHOR]

In 2016, Human Rights Watch, an international human rights organisation, published a report on the use of forced anal examinations to identify and prosecute putative 'homosexuals'. The report provided detailed descriptions and first-person accounts of these examinations in several countries in the Middle East and Africa. Drawing on theories of iatrogenesis and queer necropolitics, this paper uses these accounts and other reports of forced anal examinations to explore the role of medical providers in the 'diagnosis' and prosecution of homosexuality. The goal of these medical examinations is explicitly punitive rather than therapeutic, making them quintessential examples of iatrogenic clinical encounters which harm rather than heal. We argue that these examinations naturalise socioculturally derived beliefs about bodies and gender that construct homosexuality as 'readable' on the body through close medical inspection. These acts of inspection and 'diagnosis' reveal broader hegemonic state narratives of heteronormative gender and sexuality, both within countries as well as internationally as different state actors circulate and share these narratives. This article highlights the entanglement of medical and state actors, as well as contextualises the practice of forced anal examination within its colonial roots. Our analysis offers the potential for advocacy and holding medical professions and states accountable. [ABSTRACT FROM AUTHOR]

AbstractMiscarriages, stillbirths and neonatal deaths have received limited attention in global health programmes and research, even though pregnancy loss is common, traumatic and stigmatised. This paper seeks to illuminate lived experiences of pregnancy loss in southern Malawi, drawing on findings from semi-structured interviews and focus groups with women who have experienced loss, health professionals and community members, and observations of maternity care. Combining thematic and discourse analysis, we show how societal and medical discourses frame women as responsible for (failed) reproduction, and restrict possibilities to speak about, and respond to, loss. Some accounts and (care) practices invisibilise loss and associated suffering. However, invisibilisation may also be intended as support, and underscores rather than denies the social significance of parenthood. Other accounts (e.g. women emphasising faith and acceptance) constitute moral survival strategies to avoid the acquisition of a ‘spoiled identity’. We conclude that societal and medical discourses of loss enact stigmatised, subaltern subject positions for women experiencing pregnancy loss, create social suffering, and amount to a form of structural violence. Programmes and interventions should change these discourses. [ABSTRACT FROM AUTHOR]

Post-apartheid, South Africa has come a long way in making the inclusion of gender and sexuality equality explicit in its Constitution. To make schools more inclusive for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) identifying learners, the Department of Basic Education has developed what it claims are South Africa's first guidelines regarding sexual orientation, gender identity and sex characteristics (SOGIESC). Despite the emphasis on equality in South Africa's post-apartheid policies, which set out to protect the rights of LGBTIQ+ individuals, there has been a backlash from conservative advocacy groups, many with links to the US Christian Right. This paper argues that contrary to the disinformation being propagated by anti-LGBTIQ + groups, it is queer and transgender individuals who experience extreme levels of violence and marginalisation in schools. The empirical research makes explicit the bullying and exclusion that transgender and gender-diverse youth experience in school; however, this evidence is neglected in conservative claims that SOGIESC (SOGIESC) guidelines and Comprehensive Sexuality Education (CSE) endanger other learners. Notably, and in stark contrast to those advocating for measures to make schools safer for LGBTIQ + learners, far-right advocacy groups have no empirical basis to support their claims. [ABSTRACT FROM AUTHOR]

Vaginismus and dyspareunia are common sexual difficulties; they often take a long time to be appropriately diagnosed, and their origins remain unclear. This paper examines the metaphors used by women to describe bodily experiences associated with vaginismus and dyspareunia, and highlights the contribution this form of analysis can make to the study of sexuality and sexual difficulties. A secondary analysis was conducted on primary data from biographic interviews exploring women's experiences of sexual pain and difficulties with sexual intercourse. Metaphor analysis was used to analyse a data subset of 28 interviews translated from German into English. Metaphorical concepts lying at the basis of the metaphors used were identified and grouped into three themes: characterisation of sexual difficulties; split body and 'self'; and sexual agency and objectification. Results are discussed with in the context of literature regarding the function of metaphors and the utility of metaphor analysis for research, and healthcare research and interventions more generally. [ABSTRACT FROM AUTHOR]

This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what's ahead. Participants' health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants' strengths and personal resources. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP), a daily oral pill for HIV prevention demonstrated to be effective for adults, was recently approved by the US Food and Drug Administration for use with young people weighing at least 35 kilograms. Given that young people aged 13-19 years account for a disproportionate share of new US HIV infections, PrEP presents an important opportunity. There has been limited effort, however, to increase PrEP awareness and uptake among young people. While prior work has identified barriers young people face in getting PrEP, effective strategies for overcoming these barriers have not yet been identified. This paper presents results from interviews with 15-19 year old gay and bisexual young men about their knowledge and perceptions of PrEP, and the barriers they perceive. Results suggest that participants were aware of PrEP but confused by the details of insurance coverage and out-of-pocket costs. Participants also felt parents and providers would not be knowledgeable or supportive, and were reluctant to share their own use of PrEP on social media. Suggested next steps include online parent and provider education, systemic health care reform to streamline and simplify access to preventative care and awareness campaigns that meet youth where they are on popular platforms. [ABSTRACT FROM AUTHOR]

Intersex has been a topic of much discussion in courses on sex and gender in the academy. Rather than focusing on what intersex people I are, i this growing body of work has examined the challenges that intersex people face, which include systematic oppression, discrimination and human rights violations (Ghattas [24]; FRA [21]; Carpenter [5]; Crocetti et al. [10]). Intersex activists and advocates have asserted the human rights of intersex people, including the right to freedom from discrimination; the right to protection from torture and other cruel, harmful or degrading treatment; and the right to health (Horowicz [30]; Behrens [2]). Intersex rights movements and a range of international organisations and supranational legal bodies (including the United Nations, the Council of Europe and Yogyakarta Principles + 10) condemn cosmetic medical interventions on intersex minors and the routine termination of intersex foetuses on grounds of medical "abnormality" (Holmes [31]; Crocetti et al. [10]). [Extracted from the article]

The HIV epidemic is strongly gendered. Women and girls are more likely to contract HIV for biological and social reasons in Sub-Saharan Africa and men living with HIV are more likely to be lost to follow-up and die on antiretroviral therapy (ART) than women. Care work is also gendered, with women shouldering the burden of HIV care-related work. This paper considers the potential of male delivered community health work to improve men's HIV-related health outcomes and shift gendered norms related to care work. It describes the experiences and perspectives of eight HIV community health workers and their clients from the Cape Town area, and reviews current evidence on male-focused HIV and sexual and reproductive health services, gender transformation and men and care. Findings suggest that meaningfully involving more men in HIV care work may be a way to shift damaging hegemonic masculine norms related to care and health, and that South Africa's roll-out of National Health Insurance could be an opportunity to do so. Barriers to engaging men in this feminised profession are also explored. [ABSTRACT FROM AUTHOR]

Many papers have been written on the process of coming out by individuals with predominantly same-sex sexual orientation but few of these papers have explored the concept of how people negotiate the idea of coming out in prison. We conducted in-depth interviews with 13 prisoners and one ex-prisoner in New South Wales, Australia, who self-identified as gay, homosexual or bisexual men. Data was collected and analysed using an inductive or grounded theory framework since very little was known on the sexual behaviours and identities of Australian prisoners prior to the study and elsewhere. We examined and discussed the lived experiences of prisoners whose disclosure stories were seen to fall under four thematic categories: 'coming out', 'forced out', 'going back in' and 'staying out of the closet' on entering prison. Respondents were required continuously and contextually to manage their sexual identities and disclosure to different audiences while incarcerated. Findings suggest that the prison environment and its attendant heteronormative values and hyper-masculine culture, apply significant pressure on gay and bisexual men on how to manage their sexual identities and disclose their sexuality in prison. [ABSTRACT FROM AUTHOR]

Colonialist views of Indigenous bodies and sexualities continue to affect Indigenous peoples worldwide. For Indigenous Australians, this burden has resulted in repression and oppression of power, sex and desire. Focusing on the sexual intimacies of Indigenous Australian women, this paper provides an account of the dominant Australian historical discourses, finding that Indigenous women were viewed as exotic, erotic, something to be desired, yet simultaneously something to be feared. Our sexualities were described as savage, promiscuous and primitive and we were often viewed as prostitutes with our voices and views constrained by patriarchal and imperial regimes of power. But within this context, Indigenous women fought back through both individual and collective acts of agency. This paper demonstrates how Indigenous Australian women's agency not as a new phenomenon but rather as a position that disrupts the popular discourses of exploitation and victimhood that have been persistently perpetrated against Indigenous women. [ABSTRACT FROM AUTHOR]

Young women are increasingly engaging with digital sexual media, yet discussion of female desire remains absent or is vilified. This paper examines young women's online sexual expression, as seen through the eyes of both young men and young women. Based on small friendship group interviews conducted with 106 12-16-year-old young women and men in Aotearoa New Zealand, I analysed perceptions of young women's sexual expression. Framed through patriarchal ideals and underpinned by competitive masculinity, young women's sexuality and opportunities for sexual expression were policed and regulated. Young women were expected to be passive yet digitally heterosexy, but not slutty. Perceptions of young women's sexual expression continue to be framed within silencing and absent pleasure discourses, which ultimately compromises both young men and women's development of sexual subjectivities. [ABSTRACT FROM AUTHOR]

This paper develops the concept of 'abortion exile' to understand the situation of women who are forced to travel for abortion services because the procedure is outlawed, stigmatized, unaffordable or otherwise inaccessible in their place of residence. A number of legislative, economic, and moral mechanisms conspire to deny women abortion rights at home such that they must journey within and across national borders in pursuit of needed abortion care. While anthropologists have examined the movement of women and men in search of fertility care that is unavailable at home, attention to the situation of women forced to relocate to terminate an untenable pregnancy is surprisingly scarce. Taking Mexico's fractured abortion landscape as an ethnographic starting place, this paper examines the experiences of women made to venture to the capital for legal abortion services because the procedure is criminalised and difficult to access elsewhere in the country. The concept of 'abortion exile' can helpfully explain the forced movement, political status and subjective experiences of women in different world regions where abortion rights are limited, absent, or under threat, and for whom reproductive citizenship remains elusive. [ABSTRACT FROM AUTHOR]

Gender is one of the most important social determinants of health. First, McLean and colleagues draw upon a gender transformative, theory-based intervention in Rwanda to explore how couples might examine and challenge their norms and assumptions around gender (McLean, Heise, and Stern [25]). 2 This article is part of a special issue on Transformative Approaches to Gender Justice in Sexual and Reproductive Health, led and sponsored by the University of California Global Health Institute, Center of Expertise on Women?s Health, Gender, and Empowerment. [Extracted from the article]

This paper explores the relationship between changes in individual beliefs and behaviours, couple relationship dynamics and gender norms – and how interventions can influence these. It draws on longitudinal qualitative research with heterosexual couples who participated in the Indashyikirwa programme in Rwanda. The couples followed a curriculum designed to improve relationship skills and reduce the gender-inequitable beliefs, behaviours and norms that underpin intimate partner violence. Qualitative findings show that the programme resulted in moderate, but significant, positive 'shifts' in individual beliefs and behaviours, couple relationship dynamics and levels of inequality - increasing men's engagement in domestic duties, women's participation in household decision making, and women's access to economic resources. They also suggest which parts of the couples' curriculum were most effective in catalysing these changes. However, the data also show that these 'shifts' occurred without fully transforming deeply-entrenched beliefs and norms around gender roles and male authority over economic resources. The paper suggests that the persistence of these beliefs and norms constrained the extent of changes among couples – and could potentially constrain their longevity and act as an obstacle to longer-term, larger-scale changes in gender inequalities and violence. [ABSTRACT FROM AUTHOR]

The early months of the SARS-CoV2 pandemic exacerbated health disparities for vulnerable populations, including transgender (trans) communities, creating unique challenges for navigating sex and dating. This paper aims to expand upon the current literature regarding transmasculine populations by capturing their lived experiences during this critical time. We interviewed 20 assigned female sex at birth (AFAB) adults of the transmasculine spectrum - men, nonbinary, and transmasculine individuals - about their social and sexual experiences in the USA in May and June 2020. Transcripts were analysed using an inductive thematic approach. We found that sex drive decreased and uncertainty about health risks increased. Some participants found alternate ways to date and hook-up that reduced their COVID-19 risk, such as engaging in online sex (e.g. sexting, dating apps). Others expressed discomfort using virtual platforms for both personal/work and sexual lives, along with nuanced feelings around being objectified, compared to pornography, and fetishised as trans bodies. COVID-related shutdowns of queer spaces also amplified pre-existing concerns about interpersonal safety and rejection. When seeking new partners, participants sought behavioural characteristics that instilled trust. Future public health communications can take advantage of safety and sexual health strategies already present in trans communities to bolster wellbeing in trans lives. [ABSTRACT FROM AUTHOR]

Adolescence and young adulthood are important periods of transition and therefore for action and intervention to ensure future sexual and reproductive health (SRH). Caregiver-adolescent communication about sex and sexuality is a protective factor for SRH, but there are often barriers to this. Adults’ perspectives are limited within the literature but important as they should lead this process. This paper uses exploratory qualitative data from indepth interviews with 40 purposively sampled community stakeholders and key informants to explore their insights into the perceived, experienced or expected challenges adults’ experience when having these conversations within a high HIV prevalence, South African context. Findings suggest that respondents recognised the value of communication and were generally willing to try it. However, they identified barriers such as fear, discomfort and limited knowledge and perceived capacity to do so. They show that in high prevalence contexts adults grapple with their own personal risks, behaviours and fears that may affect their ability to have these conversations. This demonstrates the need to equip caregivers with the confidence and ability to communicate about sex and HIV, alongside managing their own complex risks and situations to overcome barriers. It is also necessary to shift the negative framing of adolescents and sex. [ABSTRACT FROM AUTHOR]

Child marriage is associated with adverse health and social outcomes for women and girls. Among pastoralists in Kenya, child marriage is believed to be higher compared to the national average. This paper explores how social norms and contextual factors sustain child marriage in communities living in conflict-affected North Eastern Kenya. In-depth interviews were carried out with nomadic and semi-nomadic women and men of reproductive age in Wajir and Mandera counties. Participants were purposively sampled across a range of age groups and community types. Interviews were analysed thematically and guided by a social norms approach. We found changes in the way young couples meet and evidence for negative perceptions of child marriage due to its impact on the girls' reproductive health and gender inequality. Despite this, child marriage was common amongst nomadic and semi-nomadic women. Two overarching themes explained child marriage practices: 1) gender norms, and 2) desire for large family size. Our findings complement the global literature, while contributing perspectives of pastoralist groups. Contextual factors of poverty, traditional pastoral lifestyles and limited formal education opportunities for girls, supported large family norms and gender norms that encouraged and sustained child marriage. [ABSTRACT FROM AUTHOR]