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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.

This paper critically examines the role of transnational AIDS networks and resources in the consolidation of one of the earliest identity categories,imeti/i, 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 ofimeti/ito 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.

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.

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 on BBC News, in The Guardian, on Sky News, on Channel 5 News, and in the Metro. As the latter 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.

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.

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.

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.

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.

This paper explores some of the challenges of publishing photographs generated as part of sexuality research. It aims to initiate discussion of these issues to enable sexuality researchers to consider and navigate the use of images in their work. Examples highlighting these difficulties are employed from a photo-method project which examined young people, sexuality and schooling. It is argued that existing child-sex-panics rendered these images risky and intensified their scrutiny by gatekeeping forces. The discussion contributes to a broader conversation within the field of sexualities about the constitution of sexuality research as dirty work. Specifically, the paper investigates how some publishing and editing practices might be conceptualised as constituting techniques that construct sexuality research as dirty work. By not publishing photos which form part of sexuality research, the knowledge it is possible for sexuality researchers to generate and circulate is subsequently curtailed.

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.

The pre-exposure prophylaxis (PrEP) drug Truvada is a new HIV prevention technology that is predominantly promoted as relevant to HIV-negative gay men. This paper explores what PrEP represents for HIV-positive gay men living in Paris, based upon data collected through interviews and ethnographic research. While HIV-positive gay men do not directly consume Truvada through PrEP, they nonetheless hold opinions and understandings of this drug, specifically as it relates to their own sexuality. This paper expands the representations and meanings of this new technology in a different light through the voices of gay men living with HIV in Paris. The main argument of this article is that PrEP as an additional HIV prevention tool blurs the lines between science, technologies and human sexuality.

Across South Africa there is a growing body of work that explores gender dynamics in heterosexual relationships between young people aged 15–24 years. This is mainly influenced by the high prevalence of HIV and the incidence of intimate partner violence in this age group. Most studies to date have been based upon non-disabled young people, with limited focus on young disabled people. In an attempt to address this gap, this paper describes findings from a study conducted with 22 Zulu-speaking young people with visual and physical disabilities in KwaZulu-Natal. Throughout the findings, young disabled participants appeared to downplay their disability with respect to intimate relationships and accentuated the interweaving of complementary and contentious discourses of gender and cultural identity. Taking cognisance of the intersectionality of gender and cultural discourses, the paper extend constructs of disabled sexualities beyond an exclusive gaze on disability in the South African context.

This ethnographic study conducted among young women aged 18-21 years in Chiang Mai, northern Thailand, explored the parental control mechanisms imposed by Thai middle-class families on the sexuality of their daughters. It addressed the ways in which young women tactically use the social media in order to negotiate the sexual controls they encountered in everyday life. Taking the teenage girls' point of view, this paper argues that, as active agents, young women achieve a certain level of sexual autonomy and construct their own sexual selves in modern northern Thai society, despite their parents' attempts to prevent this. The paper highlights the ways in which social media are used by Thai girls in order to achieve such a goal. Research findings should inform the development of future programmes on sexual health promotion, parental skills and sexual communication between Thai parents and their children.

Condom promotion has emerged as a mainstay of targeted HIV prevention interventions in India, with its emphasis on individual behaviour change and personal responsibility. However, such approaches often do not account for marginalised populations' structural vulnerability to HIV, arising from social, economic and political factors in the lived environment. In this paper, I use a critical health communication framework to analyse how structure and agency interact in influencing condom use among long-distance truck drivers in India. Drawing on an abductive discourse analysis of condom-use discourses among truckers and peer educators in two Indian cities, findings reveal that while truckers understand the biomedical logic of condoms as barriers, they also express anxiety about condom breakage and experience structural barriers to condom use. The paper concludes by calling for greater attention to structural vulnerabilities in future HIV prevention efforts with truck drivers.

In the 21 years since the 1994 Cairo International Conference on Population and Development, those working in the fields of health and sexuality have seen changing ‘men and masculinities’ as central to struggles to improve the health of women and men (Cornwall, Edstrom, and Greig 2011; Peacock and Barker 2014). Efforts to respond to men’s violence and HIV, in particular, have focused on understanding the links between masculinities and men’s health-related behaviour, and increasingly on engaging men and boys as a pathway to transforming masculinities (Jewkes, Flood, and Lang 2015; Mane and Aggleton 2001; Peacock and Barker 2014). Perhaps as a consequence of these efforts, the phrase ‘We need to work with men and boys’ has become something of a mantra dominating health and sexuality programmes. In the past few years, there have been a number of reviews of interventions that have sought to work specifically with men and boys to promote health-enhancing behaviours. These reviews have highlighted the important role that interventions engaging men and boys can have in reducing men’s use of violence against women (Dworkin, Treves-Kagan, and Lippman 2013; Jewkes, Flood, and Lang 2015), increasing access to HIV-testing (Hensen et al. 2014), reducing HIV-risk behaviours (Barker, Ricardo, and Nascimento 2007; Dworkin, Treves-Kagan, and Lippman 2013) and, more widely, enabling men to become more engaged in supporting partners and children (Levtov et al. 2015). However, these reviews also highlight that working with men and boys does not always translate to changes in their behaviour, that changing attitudes about gender does not always lead to behaviours that support gender equality and that intervention effectiveness is dependent on the approaches used and the process and context of implementation (Barker, Ricardo, and Nascimento 2007; Dworkin, Treves-Kagan, and Lippman 2013; Jewkes, Flood, and Lang 2015). Given the growth in the number of programmes and interventions working with men and boys globally, research exploring the processes involved, the challenges, problems, limitations and politics of this kind of work is surprisingly limited. The ways in which women are and could be involved in this work, so as to support and not hinder efforts at changing masculinities, has also received limited attention. It was against this backdrop that this special issue of Culture, Health & Sexuality was conceptualised. A call for papers led to 55 abstracts being submitted for consideration; reflecting on these submissions provides us with an insight into some of the wider contemporary dynamics of the field of masculinities and how this special issue could contribute, potentially stimulating new conversations, reflections and debates. First, the geographical spread of research on this topic was highly skewed towards Africa and in particular, South Africa. In total, 21 abstracts were received based on research conducted in South Africa, and a further 19 were about Africa more widely. Beyond that, 5 abstracts were submitted drawing on work undertaken in Australia, 5 more from Asia, 2 from Europe, and 1 each from Canada, Mexico and the Caribbean. What does this suggest to us? First, it would be correct to acknowledge that this partly reflects existing networks and communities of research, which are reflected in our specific geographic locations as editors in South Africa and Australia, and that English is the primary language of the journal. Second, those writing on a country are not necessarily based there (although this was only the case in the minority of submissions). However the geographical focus of submissions does reflect something wider about the global production of knowledge on masculinities at this moment in the field of health and sexuality. It highlights that much of the recent research on masculinities has emerged in the context of the immediate needs and challenges faced in the global South, particularly those associated with violence and HIV (Shefer et al. this issue). In the early years of the HIV epidemic, the global response focused on communities’ urgent, practical needs and on advocacy and activism for structural and political change (Mbali 2013). Practitioners responding to the epidemic were often informed by debates in relation to Women in Development and then Gender and Development, but less space was allocated to reflection on how gender transformation efforts could contribute to this work (Jewkes et al. this issue). However, over the last 20 years, the often hard lessons of the epidemic have seen HIV researchers and practitioners in southern Africa shift their gaze towards gendered power, masculinities and men’s violence against women. Across the Atlantic, frustration at prevailing discourses about gender equality and the limited attention paid to the struggles of young Brazilian men gave rise to the highly influential work of Program H and subsequently the work of Promundo. In a very important sense, therefore, the global South has been central to the production of knowledge in the field of masculinities, even if the process has often been mediated by the agenda of academic and development partners in the global North (Epstein and Morrell 2012). Collectively, the papers of this special issue significantly upscale existing dialogue around the processes of engaging men and boys in gender transformative work. In the rest of this overview, we highlight a number of key themes we see emerging through the papers.

There are a number of persuasive arguments as to why sexual pleasure should be included in sexual health work with young people, including the suggestion that this would provide young people with accounts of gender and sexuality that are more critical and holistic than those presented in the popular media, pornography and current sex education curricula. This paper considers the possibilities for engaging young men in critical group work about sexual pleasure in research and education contexts, drawing on a mixed-methods study of young people’s understandings and experiences of ‘good sex’. The paper provides a reflexive account of one focus group conducted with a group of heterosexual young men and two youth educators. It explores some of the challenges to building relationships with young men and creating ‘safe spaces’ in which to engage in critical sexuality education in socially unequal contexts. In this case study, adult-led discussion elicits rebellious, ‘hyper-masculine’ performances that close down opportunities for critical or reflective discussion. Although there are some opportunities for critical work that move beyond limited public health or school-based sex education agendas, there is also space for collusion and the reinforcement of oppressive social norms. The paper concludes by imagining possibilities for future research and practice.

Recent public debates about sexuality in India and Vietnam have brought the rights of lesbian, gay, bisexual and transgender people sharply into focus. Drawing on legal documents, secondary sources and ethnographic fieldwork conducted in the urban centres of Delhi and Hanoi, this article shows how the efforts of civil society organisations dedicated to the fight for lesbian, gay, bisexual and transgender rights have had different consequences in these two Asian contexts. The paper considers how these organisations navigated government regulations about their formation and activities, as well as the funding priorities of national and international agencies. The HIV epidemic has had devastating consequences for gay men and other men who have sex with men, and has been highly stigmatising. As a sad irony, the epidemic has provided at the same time a strategic entry point for organisations to struggle for lesbian, gay, bisexual and transgender recognition. This paper examines how the fight for lesbian, gay, bisexual and transgender recognition has been doubly framed through health-based and rights-based approaches and how the struggle for recognition has positioned lesbian, gay, bisexual and transgender people in India and Vietnam differently.

Focusing on gender, race and colonialism, this paper foregrounds the voices of Indigenous young people, their histories of oppression, their legacies of resistance and the continuing strengths rooted in Indigenous peoples, their cultures and their communities. Exploring the relationship between gender and colonialism, the paper speaks to the lived realities of young people from Indigenous communities across Canada. Over 85 young people participated in six different Indigenous community workshops to create artistic pieces that explored the connections between HIV, individual risk and structural inequalities. In the course of the research, Indigenous young people, and young Indigenous women in particular, talked about how gender intersects with race and colonisation to create experiences that are, at times, especially difficult for them. In this paper, young people discuss the ways in which colonialism has demeaned women's roles and degraded women's sexuality, and how continuing cultural erasure and assimilationist policies impact on their lives and on their bodies.

This paper draws on 24 in-depth interviews and 2 focus-group discussions conducted since 2012 with Hong Kong heterosexual men who buy sex in order to examine men's level of physical and emotional engagement with sex workers under two dominant sexual scripts in contemporary Hong Kong. Torn between companionate sexuality, with its companionate model of relationships, and recreational sexuality, with its promiscuous model of sexual pleasure, Hong Kong male clients seek to satisfy their sexual and affective needs through commercial sexual relationships. The term (meaning 'chicken worm', connoting a 'McSex' form of masculinity) refers to those men who seek impersonal sexual release with as many women as they wish, while the term (meaning 'sunken boat' and connoting a 'Titanic' form of masculinity) refers to those men who seek an intense level of emotional intimacy with sex workers. Between these two contrasting types, the majority of respondents fall into a form of 'bounded' masculinity characteristic of men who emphasise control and balance by seeking emotionally responsive women in a time-bound romance. By comparing clients' variations in the level of physical and emotional engagement with sex workers, this paper seeks to understand individual differences in client types and offers a new understanding of Chinese male sexuality and relationship formation, and the corresponding health risks (e.g., sexual, emotional) associated with each type.

This paper explores the relationship between sex worker activism and HIV-related discourse in Bangladesh, relating recent developments in activism to the influence of feminist thought. Following their eviction in 1991 from brothels from red light areas, Bangladeshi sex workers started a social movement, at just about the same time that programmes started to work with sex workers to reduce the transmission of HIV. This paper argues that both sex worker activism and HIV-prevention initiatives find impetus in feminist pro-sex-work perspectives, which place emphasis on individual and collective agency. However, by participating in these programmes, sex workers failed to contest the imagery of themselves as 'vectors' of HIV. In this way, they were unwittingly complicit in reproducing their identity as 'polluting others'. Moreover, by focusing on individual behaviour and the agency of sex workers, HIV programmes ignored the fact that the 'choices' made by sex workers are influenced by a wide range of structural and discursive factors, including gender norms and notions of bodily purity, which in turn have implications for the construction of HIV-related risk.

This paper examines the way in which erotic-affective exchanges in interracial relationships have been analysed in Latin America. It considers how race, gender and class operate within a market of values such that erotic, affective and economic status are shaped by racial, gender and class hierarchies. In this paper I analyse historical and social arrangements that embody the region's political economy of race and sex. Such a perspective allows me to address the simultaneous co-existence of socio-racial exclusion and inclusion and the repressive and productive effects of power, attraction and anxiety as aspects of lived experiences in relation to sexuality. From there, I outline an analytical framework that references an erotic or pleasure-based market in which capital and other resources are exchanged from a structural perspective stressing relationship alliances. I conclude by identifying the scope and limits of such an approach.

Women who experience intimate partner violence often rely on informal support to mitigate intimate partner violence's health effects. Yet there is little known about who gives the support and how it is provided. This paper explores from whom and how low-income women experiencing domestic violence in urban India seek informal support. In South Asia, women's reliance on kin for support is culturally valued, yet the urban social context makes it more likely that they will access such support from non-kin when they experience intimate partner violence. The paper draws on observations and interviews with 10 families collected over 14 months of in-depth ethnographic research in one Delhi slum community. Using a case study approach to explore women's responses to violence longitudinally, it was possible to track how women drew on support. Results show that even as women sought emotional support and direct intervention from their neighbours to deal with their domestic violence, they restricted these relationships, faced stigma, and emphasised the need to protect their families. Understanding the informal, but deeply ambivalent, systems of social support that women engage to deal with intimate partner violence is a first step toward strengthening such networks, a key recommendation to stem the health impacts of domestic violence.

While recent LGBT rights demonstrations and discussions about same-sex marriage have thrust the issue of homosexuality into the spotlight, it was not long ago that the issue of homosexuality was notable by its absence in Vietnam. Drawing on semi-structured interviews with young gay, lesbian and bisexual people in Vietnam's capital city Hanoi, this paper considers the increasing visibility of homosexuality through the theoretical lens of recognition, and illustrates the heterosexist misrecognition that LGBT young people have been subjected to in legislation, the media, their families, and through the education system. Drawing on the narratives of LGBT young people, the paper highlights the potentially negative impact such misrecognition may have on psychological and social wellbeing.

This paper examines the beliefs and practices that constitute gender among Gypsy-Traveller women and then attempts to discern the consequences that flow from these. It analyses gender ideology and expectations among women and the shared investment in the moral identity attached to being a good Gypsy-Traveller wife. The paper argues that 'Gypsy-Traveller woman' cannot be understood as an identity that stands apart from gender and racial oppression. It is within this context that the tension between change and permanence in gender relations is played out. It argues that the maintenance of cultural taboos embodied and symbolised in the surveillance of womens' bodies is an important issue that problematises the construction of Gypsy-Traveller women. It posits that the appeal to morality may represent as much an avoidance of anxiety as a defence of marked gendered divisions within Gypsy-Traveller society. The paper suggests that the demands of cultural survival play a significant role in framing the degree to which women are willing or able to challenge the status quo.

This paper explores the tensions between the (equal) parental right claims in adopting countries and the global inequalities in class, race and geographical location that shape transnational adoption. It uses the story told by a Belgian couple who disguised their lesbian relationship from the authorities involved to explore the narratives of child, family and nation that undergird transnational adoption. The paper discusses the potential and limits of the creation of non-traditional families for producing greater equity and significant reinterpretations of kinship and the family script. Moreover, taking into account different layers of both oppression and privilege, it discusses the ethical implications of the (queer) liberal ideologies of parental rights and Western moral superiority that prevail in transnational adoption. It argues for a shift away from the desire to create non-biological and/or non-heterosexual forms of private nuclear kinship through transnational adoption to a more profound and critical re-thinking of the (transnational) care of children, with space and acceptance for profoundly different constellations of care.

This paper examines young people's perceived vulnerability to sexually transmitted infections (STIs) and their efforts to create a sense of personal safety within an environment in which risks may be high and where STIs are highly stigmatised. The paper reports on findings from research involving both Indigenous and non-Indigenous 16- to 25-year-olds from remote, rural and regional Australia, including communities in the Northern Territory, Western Australia and South Australia. The study used qualitative methods, including body mapping and scenario based interviewing, to explore how young people made decisions about potential sexual partners and how STIs were understood within the context of young people's everyday social worlds. The paper has important implications for the design and implementation of sexual-health education programmes by documenting the stigmatisation of young people with STIs and the protective mechanisms peer groups employ to create perceptions of personal safety.

This paper contextualises counselling within a broader historical formation that links disclosure to healing and deploys confessional technologies to incite disclosure and awareness of the mysterious substance of the self. Foucault's argument that sexuality was the privileged arena for using confessional technologies to ‘produce’ the truth of the self is particularly relevant in light of the diffusion of counselling practices in Africa in the wake of the HIV epidemic, particularly with their emphasis on inciting appropriate sexual behaviour. Examination of the historical assemblage of counselling practices shows how they articulate what the self is, the nature of truth and a politics of language. This paper focuses on the genealogy of four key assumptions that express this confessional reason. These are that: (1) people can be ‘empowered’ to have control on their own lives by working on themselves, (2) secrets untold become pathogens, (3) the ability to heal requires that one first overcome personal illness, (4) the experience of sharing secrets is cathartic and healing. The genealogy intertwines four strands: that of the Unconscious as revealed by Freud and his followers, attempts to treat shell-shocked veterans of World War I, group psychotherapy and participatory research after World War II.El presente artículo contextualiza el asesoramiento dentro de una formación histórica más amplia, que vincula la transparencia con la sanación, utilizando tecnologías confesionales que alientan la transparencia y la conciencia en torno a la misteriosa sustancia del sí mismo. Es particularmente pertinente el argumento de Foucault acerca de que la sexualidad es el espacio privilegiado para el uso de tecnologías confesionales que "producen" la verdad del sí mismo, especialmente a la luz de la difusión de prácticas de asesoramiento en África tras la epidemia del vih y considerando la importancia que las mismas atribuyen al hecho de fomentar un comportamiento sexual apropiado. Un análisis del andamiaje histórico de las prácticas de asesoramiento demuestra cómo articulan lo que es el sí mismo, la naturaleza de la verdad y las políticas del lenguaje. Este artículo se centra en la genealogía de cuatro suposiciones clave que expresan esta razón confesional: (1) al hacer un trabajo personal, las personas pueden ser "empoderadas" para asumir el control de sus propias vidas; (2) los secretos no revelados se convierten en patógenos; (3) la posibilidad de sanar implica primero recuperarse de enfermedades personales; y (4) la experiencia de compartir secretos es catártica y sanadora. Esta genealogía entrelaza cuatro ejes: el de la Inconsciencia trabajada por Freud y sus seguidores; los intentos de tratar a exsoldados aturdidos por el combate de la I Guerra Mundial; la psicoterapia grupal; y la investigación participativa posterior a la II Guerra Mundial.Cet article contextualise le counselling dans une formation historique plus large établissant une correspondance entre le dévoilement et la guérison, et décrit les « technologies confessionnelles » qui incitent au dévoilement et à la prise de conscience de la substance mystérieuse qu’est le soi. L’argument de Foucault selon lequel la sexualité serait l’arène privilégiée pour l’utilisation des technologies confessionnelles pour « produire » la vérité sur le soi est particulièrement pertinent à la lumière de la diffusion des pratiques de counselling en Afrique dans le sillage de l’épidémie de VIH, notamment parce qu’elles mettent particulièrement l’accent sur l’incitation aux comportements sexuels appropriés. L’examen de l’assemblage historique des pratiques de counselling montre comment elles articulent ce qu’est le soi, la nature de la vérité et une politique du langage. Cet article se concentre sur la généalogie de quatre hypothèses clé qui expriment cette raison confessionnelle. Selon ces hypothèses (1) les individus peuvent acquérir une autonomisation (empowerment) pour contrôler leur propre vie en travaillant sur eux-mêmes, (2) le secrets non révélés deviennent des agents pathogènes, (3) la capacité de guérir exige que l’on dépasse d’abord la maladie personnelle et (4) le partage des secrets est cathartique et permet de guérir. La généalogie de ces hypothèses entremêle quatre aspects distincts : l’inconscient, tel que révélé par Freud et ses disciples; les tentatives de traitement des vétérans commotionnés de la 1ère guerre mondiale; la psychologie de groupe et la recherche participative après la 2ème guerre mondiale.

Ideas of 'responsible sexuality' are located at the centre of counselling in current antiretroviral treatment (ART) programmes. This paper analyses counselling practices in three HIV/AIDS clinics in Uganda on the basis of participant observation of counselling sessions and interviews with counsellors. The paper illustrates how counsellors concentrate on giving general behavioural instructions, while clients tend to demonstrate their compliance to these 'rules' rather than sharing their more intimate thoughts. This is especially the case in the contested terrain of sexual and reproductive behaviour. To explore this phenomenon, the paper analyses a number of dynamics characterising HIV counselling in Uganda, including the pressures of the global bio-political project to 'save lives' with ART, the counsellors' working conditions in resource-constrained clinics, the professional authority of counsellors and the clients' challenges to following the rules.

The paper examines maternal health-seeking behaviour among the Sabiny people of Eastern Uganda in relation to health policy ideals. It is based on a study of maternal health conducted between 2011 and 2012. Data were collected using in-depth interviews with mothers, focus group discussions with mothers and fathers and key informant interviews. The paper addresses what factors influence choice of place of delivery among the Sabiny. Findings reveal that the majority of Sabiny women opt for homebirths, with around one quarter delivering at health facilities. Some women would prefer to deliver at a health facility but do not manage to do so. Sabiny cultural beliefs and practices are a key factor influencing choice of place of birth. Comprehension of and accommodation to Sabiny concerns in available maternal health services is limited, highlighting the need to develop cultural competence among health workers and methods of accommodating (health-promoting) local practices. This should be accompanied by improved patient care and a narrowing of the gap between health workers and Sabiny communities by promoting outreach and community-based health interventions. The paper highlights how the implementation of policy might be tailored to specific local contexts.

The paper describes findings from an ethnographic study exploring understandings of love and intimacy amongst young heterosexual middle-class Indians of Gujarati origin in the UK and India. A two-site comparative study was used to enable an understanding of how social and economic contexts shape cultural constructions of intimate relationships and sexuality. Focusing on attitudes to 'love at first sight', this paper shows that, for Indian participants, love based on physical attraction denotes a lesser kind of love. A relationship based on 'physical love' is not expected to last, since it has been formed without regard to family and status concerns. Even couples who meet outside of the arranged marriage system demonstrate the quality of their love by not having sex with one another before marriage. In the UK, however, participants view love as properly spontaneous. Love at first sight is considered desirable and demonstrates how the relationship must be based on love only, without any concern for (for example) material gain. This spontaneous love entails both physical attraction and emotional connection - an early transition to sex, usually before marriage, was seen as both desirable and inevitable.

This paper focuses on young people's construction of lesbian, gay, bisexual and queer (LGBQ) identities in contemporary Australia. Through the perspectives of young people, it seeks to position their understanding of LGBQ identities alongside current theoretical and empirical debates about the individual and social significance attached to these identity frames. In this qualitative study, 28 young people (aged 18 to 26 years) shared their stories of identifying as LGBQ through online, face-to-face or telephone interviews. The findings highlight how varying elements of LGBQ identities continue to have currency within this group and how young people adopt and refer to these terms interchangeably and in tandem. This is balanced alongside an awareness of both the limitations of lesbian, gay, bisexual and queer identity categories and of the homophobic discourses informing these subject positions. The paper concludes by arguing that health and social care professionals have a integral role to play in supporting LGBQ youth through a process of co-authorship - to work in partnership to construct more enabling self-stories that transcend restrictive identity frames.

This paper recounts and reflects on conversations about love and sexuality conducted with young people in Kumasi and Endwa, Ghana. It examines the settings of these conversations - in a kinship-based household, secondary schools and Pentecostal churches - and explores young people's reticence to talk about such matters in the light of intergenerational respect. Analysing young people's strategies of silence and provocative speech, the paper shows that, paradoxically, schools and churches provide institutionalised spaces for young people's subversive outspokenness that contrasts with the ethical codex of decency as the expression of hierarchical relations.

This paper examines the interpretative nature of psychiatry in relation to gender, sexuality and race within the particular time and place of one urban, Canadian, clinical psychiatric setting. We bring women's psychiatric inpatient charts and a critical feminist perspective into dialogue in an effort to focus on gender, sexuality and race in psychiatric narratives on women's madness. The research used a qualitative, retrospective research design to examine the psychiatric narrative as a technique of power as it operates on women. This paper focuses on the overarching theme of 'medicalisation', identified from the analysis of women's psychiatric inpatient charts, including two subthemes: (1) language and composition and (2) decontextualisation. Our analysis suggests that psychiatric chart documentation practices that reproduce gendered, sexualised, and racialised biases and assumptions and decontextualise the social and structural context of women's experiences of madness serve to create the paradox of women's visibility/erasure in psychiatric charts. The paper concludes with an exploration of the significance of women's authorship legitimacy in psychiatric chart documentation.

Donor conception challenges conventional kinship idioms: the involvement of a gamete donor culturally raises questions about parentage and also the meaning of genetic heritage. Although there is now a growing body of literature exploring how people resorting to donor conception negotiate kinship and connectedness, this predominantly focuses on heterosexual couples. Little is yet known about how lesbian couples navigate these processes. This paper builds on a qualitative interview study comprising 25 lesbian couples in England and Wales with experiences of pursuing donor conception in the context of their couple relationship to explore how these couples negotiate the contribution of the donor. It explores how couples negotiate meanings of parenthood, genetic origins and the bodily process of conception. The paper argues that lesbian couples negotiate parental identities, biogenetic relationships and also the meaning of conception by disassembling and reassembling the meaning of kinship, parenthood, creation, origin and originator. Findings suggest that lesbian couples weave together old and new understandings of relatedness in complex patterns and that this enables them to assert authority as parents. © 2012 Copyright Crown Copyright.

In the East Province of Cameroon, respectable womanhood has long been intrinsically related to ethics of production and reproduction: women attain social standing through productive work in the fields and through the reproduction of children - preferably within a marital setting. Yet, in the face of current alternative ‘horizons of honour’ such as schooling, employment or relationships with rich urban men, women's intentions with regard to marriage and motherhood acquire different meanings. On their pathways to urban forms of honour, formal engagements and childbearing are often postponed, while premarital sexual encounters proliferate. This paper explores the meanings of pregnancy within the context of these fragile relationships and women's urban aspirations; fertility will be shown to be a ‘bet’ that may either disrupt or stabilize urban affairs and ambitions. As such, pregnancies can be strategically anticipated and deliberately disclosed or unexpectedly encountered and secretly disrupted. This paper sheds light on women's strategies of concealment and disclosure of pregnancies and shows that these practices are often inspired by a notion of the ‘right timing’ of particular reproductive conjunctures - a notion that is of increasing relevance in current frames of female honour in Cameroon.

Drawing upon a one-year-long ethnography of boys' constructions of their gender and sexual identities in one South African high school, this paper seeks to empirically explore and theorise how 58 grade 10 and grade 11 working-class boys create and seek out spaces among their male peers from which to cultivate their masculinities through heterosexual discourses, including being 'at risk' of getting AIDS. In this study, boys' daily struggles of trying to straddle the divide between hypersexual versus homosexual/effeminate versions of masculinity both subverted and reinforced hegemonic gender/sexual relations in the school context. Being caught up in this restrictive grip of heteronormativity meant that there were few spaces in male peer culture to resist hegemonic masculinity. The 'responsible male/controlled' position is indicative of one such space in which boys attempted to resist forms of hyper-sexuality. While this position cannot really be viewed as progressive, it nevertheless allowed boys to re-position themselves as moral agents through an assertion of control over their sexuality. Given the presence of these identity struggles, this paper, in general, suggests that interventions with boys need to cautiously explore these tensions/contradictions in identity making as opportunities to cultivate more gender sensitive and less violent discourses on masculinity.

This paper examines the construction of a homoerotic social scene among Mexican migrants in California. It analyses the discourses of migrant men in the cities of San Diego and Fresno who identify themselves as heterosexual and have not had sexual experiences with men and those of members of civil society organisations doing HIV prevention work with migrant men, to show how an identity-based model of sexuality used by the HIV prevention organisations is counter to the strategic, non-identity-based model constructed by migrant men. With this incongruence as its starting point, the paper offers a critique both of the epistemological factors underlying the category of 'men who have sex with men' and the logic running through HIV prevention discourses that adhere to the Foucauldian notion of the deployment of sexuality, which demands both truth and coherence in subjects' sexuality.

This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks as rites of passage. Discourses on the exposure or concealment of male and female bodies, respectively, witness to the relevance of both the local political-historical context and biomedical hegemony to gendered bodies. The comparisons evince the need to reflect upon the theoretical and ethical implications of studying genital cutting and focusing exclusively on one of the two practices rather than, as this paper claims to be necessary, considering them as inextricably connected.

This paper investigates web users, their sexual behaviours and self-representations as observed on a sex and dating site. The website concerned is a massive social network for sexual self-display and encourages members to find real-life partners for sex – whether this be casual sex affairs between singles, swinging couples or extra-marital affairs between ‘aba’ (attached but available) individuals and their lovers. The paper analyses the imaging strategies of Chinese and non-Chinese web users in reference to the playful adoption of commonplace notions of sexiness as ‘cybertypes’. The aim is to reflect on these online behaviours as changing sexual culture while also debating the use of libidinal online personalities as a cognitive apparatus within sex research. The paper thus explores sexual identity within social networks as auto-ethnography and the dual identities and boundary-crossing agencies of web-based researchers and their subjects.

This paper argues that young Vietnamese men's beliefs around women's changing sexual identities and habits generate some anxiety around their own heterosexual abilities, while contributing to growing doubts around 'traditional' masculine advantage within sexual relations. It explores this notion in regard to eight Vietnamese men aged 18-30 years, interviewed over 13 months of fieldwork in Hanoi, Vietnam. The paper suggests that young men are increasingly ambivalent about notions of 'gendered morality' in general and the significance of female virginity in particular, because of popular ideas around women's changing sexual behaviours since the economic liberalisation of Vietnam in the late 1980s. However, while such ambivalence might at first suggest a shift toward improved gender and sexual equality, findings reveal that some young urban Vietnamese men construct and reinforce explicitly 'masculinist' gender ideologies by watching heterosexual pornography in groups with male friends or by visiting female sex workers for the purpose of watching their friends have sex. In a time of rapid change around discourses on women, some young men seek to build a stable community and relationships with each other by controlling the terms and practice by which women's bodies are used and consumed.

Pre-abortion counselling has a role in promoting safe sex practices and in preventing repeated unplanned pregnancies and repeated abortions among abortion-seeking women. Such counselling is essential in Vietnam, especially given the common use of abortion. Arguably, in Ho Chi Minh City, Vietnam, the delivery of pre-abortion counselling is more urgent for young women, who have historically been ignored by State reproductive health initiatives and are increasingly exposed to transmission of sexually transmitted infections (STIs), unplanned pregnancies and abortion. This paper charts urban Vietnamese service providers' discourses in pre-abortion counselling specific for reducing risks of additional unwanted pregnancies, repeat abortion and STI/HIV transmission among young Vietnamese women. Thirteen providers working in counselling delivery, management and programme-planning at the Reproductive Health Care Centre of Ho Chi Minh City participated in this study. Through qualitative interviews, this paper elicits a range of provider attitudes, considerations and approaches in pre-abortion counselling and presents these discourses using participant anecdotes. Demonstrated among participant responses were five key pre-abortion counselling phases for promoting effective family planning among young women. Topics covered in these counselling phases included abortion complications, post-abortion fertility return, contraception, behaviour change and STI/HIV prevention and sexual and reproductive health basics (SRH). The service provider discourses gleaned from this study are foundational for further research and development of best practice guidelines in pre-abortion counselling.

This paper takes as starting point research conducted in Durban, South Africa to unravel the complexities of care ethics in the context of humanitarian aid. It investigates how the gendering of care shapes humanitarian aid in the context of the HIV/AIDS epidemics in Africa constructing an image of “virile” and “violent” African masculinity. Humanitarian organizations construct imagined relations of caring invoking notions of a shared humanity as informing the imperative to facilitate change. This paper draws on varied examples of research and NGO activity to illustrate how these relations of care are gendered. Humanitarian interventions which invoke universalizing conceptions of need could instead draw on feminist care ethics that seeks to balance rights, justice and care in ways that attend to the webs of relationships through which specific lived realities are shaped. Essentialising, feminized discourses on care result in a skewed analysis of international crises that invariably invoke women (and children) as victims in need of care and, at best, ignore the lived experiences of men, and at worst, cast men as virile and violent vectors of disease and social disorder.

Although South Africa's total fertility rate is one of the lowest in sub-Saharan Africa, high rates of early childbearing remain a concern. Most teenage pregnancies occur among poor black and coloured South Africans. The majority of these pregnancies are said to be unwanted and unplanned and the teenager's relationships, unstable. Becoming a mother during one's teenage years is perceived to be socially, economically and physically deleterious for the teenager and her baby. This paper presents ethnographic data collected over a five-year period in the South African township of Nyanga East in the Western Cape. It draws attention to the circumstances that surround teenage pregnancy and discusses reactions to teenage pregnancies in this community. Findings highlight that despite the negative perception of teenage pregnancy within the township, particular social and cultural circumstances provided fertile ground for its occurrence. Furthermore, the paper argues that in this particular community the management of a teenage pregnancy played a functional and critical role in maintaining and reproducing social norms and ideals regarding intergenerational relationships, which ultimately ensured that the rates of early childbearing remained high.

HIV prevention discourses concern lives, the protection of bodily rights and people's active involvement in the policies and programmes that affect them. HIV prevention discourses also create lives, relying upon the deployment of normative sexual identities at the same time as they invite complex and fluid youth identities to embody the norms of prevention. This paper examines a particular HIV prevention text that is available to teachers in the Western Cape province of South Africa to support the implementation of the national Life Orientation programme. Rather than considering this text as a neutral 'scaffold' upon which teachers and students add cultural meanings, it is important to interrogate the ways in which texts rely upon and reiterate particular discursive constructions of the youth sexual subject. This paper argues that the text deploys a particular discursive framework in order to construct a 'normal' (and hetero) sexuality that validates, rather than questions, social constructions of masculine privilege within heterosexuality. This is achieved through the deployment of a scientific expertise of sexuality; the mobilisation of a valued hetero/homosexual binary to create a 'safe' heterosexuality; the normalisation of bourgeois sexuality through the ideology of marriage; and the naturalisation of heterosexual masculine and feminine identities.

Engaging men in work towards gender equality is a critical aspect of gender and development. However, there are few documented grassroots-level approaches to undertaking such work. This paper argues that context specific stresses on local constructions of masculinity, such as unemployment, poverty and high HIV prevalence, may provide useful entry points for work with men towards gender equality. While these stresses may act to undermine men's ability to 'achieve' the requirements of traditional constructions of masculinity, particularly the role of men as providers, they simultaneously create spaces for change. In this research, land-use provided a basis from which to engage with a group of older men (45-75 years) around a range of issues, including HIV and AIDS and health. Increases in levels of communication around HIV, household resources and health are used as indicative of the men's moves towards gender-equal behaviour. The paper argues that this was achieved by supporting positive aspects of traditional masculine identities, particularly the role of men as breadwinners, in a social and economic context where these roles are threatened or placed under pressure, while simultaneously working around 'sensitive' issues.

Sex-selective abortion is the major direct cause of the severe imbalance in the sex ratio at birth - contributing to the phenomenon of over 100 million 'missing' females worldwide and 40 million in China alone. Internationally as well as in China, moral condemnation and legal prohibition constitute the mainstream and official position on sex-selective abortion. This paper characterises the dominant Chinese approach to the issue as state-centred and coercion-oriented. Drawing upon case study material, the paper discusses eight major problems arising from coercive state intervention in sex-selective abortion: neglect of reproductive liberty and reproductive rights; the hidden dangers of state power; inconsistency with existing abortion policies; practical ineffectiveness; underestimating the costs and resistance involved; simplifying and misrepresenting the key issues; the lack of sufficient public discussion; and ignoring the moral and political principles established by traditional Chinese thought. To avoid a solution that is worse than the problem itself, alternative social programmes that are focused on women, community-oriented and voluntary in nature need to be developed.

Group sex has consistently been identified as one of a group of risk behaviours among gay men associated with HIV seroconversion. This paper presents a detailed description of how gender, and specifically masculinity, operates as an aspect of the discourse of gay men's group sex. The findings presented in this paper are one part of a multi-aspected discourse analysis through which we are aiming to develop an account of the discourse of gay men's group sex as it was produced in a series of qualitative interviews conducted with gay men who participate in group sex. The interviews were conducted as part of the Three or More Study (TOMS), a larger project that involved a substantial quantitative component. The overarching intent of the discourse analysis is to provide as comprehensive a mapping as possible of this discursive terrain to facilitate the targeted development of HIV and sexual health educational initiatives. The discourse of gay men's group sex reproduces some key formations of masculinity within discourses of gender, which present specific challenges for HIV prevention education. These challenges are outlined at the conclusion of this paper.

Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population.

Over the course of the past three decades, there has been a significant increase of research on the social and cultural dimensions of sexuality. This paper reviews three major phases in the development of this work. In the first phase, work focusing on the social construction of sexual experience developed an important critique of the biomedical and sexological approaches that had dominated the field over much of the twentieth century. In the second phase, increasingly detailed studies of sexual life were developed which highlighted the cross-cultural diversity of sexual cultures, sexual identities and sexual communities. In the most recent phase, there has been a growing recognition of the complex relationship between culture and power, and increasing attention to the political and economic dimensions of sexuality. In spite of the significant conceptual and methodological advances that have taken place over time, however, it is also possible to identify a number of important questions that have not yet been adequately addressed and that may have been precluded by some of the perspectives that have come to dominate the field. The paper ends by focusing on the silences and invisibilities that continue to characterize this field of research and the challenges that must still be confronted in seeking to expand our understanding of these issues.