Sexuality & sexual rights in a snapshot of rhm papers

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  • In this presentation I hope to introduce a few RHM papers on the theme of sexuality, sexual rights and sexual health. For those of you who are already familiar with the journal, I hope you’ll enjoy being reminded of some of these great papers. When we were looking through them for papers to include I know Marge was really enjoying being reacquainted with so many great passionate and inspiring papers. Looking back over 41 issues of the journal it is interesting to see how many of the same conversations are still taking place. This is a tribute to the determination of authors, activists, policy makers and health practitioners to keep SRHR on the agenda, and alive in their workplaces but also a testament as to how far we still have to go, how dogged the opposition is and how there is never room for complacency. This is something that Marge’ captures so well in her editorials which are often a combination of rage and optimism!All this presentation can do is to provide a snapshot of RHM’s work on this issue. Hopefully it will encourage everyone to visit the journal online and read and re-read some of these papers most of which are free to download; and to remember to keep up with future issues of the journal.
  • When I started looking through RHM papers to find papers on the theme of sexuality, sexual rights and sexual health, I was overwhelmed by the number and diversity of papers I found. The title of this meeting is the intersection between sexual health and sexual rights and sexuality: it was written on the false assumption that many of the papers I would find in the back catalogue of RHM would look at these aspects of sexual health as discrete topics, reflecting the common dichotomy in writing on this issue between scientific/medical research on the one hand and cultural, politicalor sociological enquiry on the other. In reality hundreds papers in RHM address aspects of sexual health and the cultural, political, social and economic aspects of human sexuality. The articles I found are also rooted in the belief, and demonstrate clearly, that delivery of good sexual health is not something that can be untangled from issues of sexuality, gender, rights, identity, legality, safety, relationships and more. The papers I have selected from our 21 year old back-catalogue represent a rights-based and person-centred approach to questions of health provision, one which addresses the impact of laws, policies, and every day community views and practices on the sexual health of individuals.Many of the papers show the impact on people’s health when their sexual identities or consenting sexual behaviour are ignored, denied, criminalised or severely stigmatised. While much progress has been made at the level of international law and conventions to address this, for many people in many countries and across generations not enough has changed.
  • Correa paper - This paper mapped recent changes in discourse on sexuality and reproduction and identified new conceptual perspectives on gender and sexuality. In Cairo sexual rights didn’t make it into the language, but reproductive rights did which was still considered a victory – just a year later in Beijing – matters of sexuality makes it into the language ‘The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence. Equal relationships between women and men in matters of sexual relations and reproduction, including full respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behaviour and its consequences.’Correa references RosPetchesky who she says ‘identifies a trend in international women’s rights campaigns towards emphasising horrors such as genital mutilation and trafficking in women and children, which propagate an image of women as victims in the arena of sexuality. This discourse, she says, is so powerful that it was not surprising in Beijing that: ‘the spectre of sexualised bodies desiring pleasure remained lurking behind the debates’. Of course all these years on the sexualised bodies desiring pleasure are still lurking…hardly at the forefront of policy making or practice!In their paper, Miller and Roseman look at the fragmentation of rights in global standard setting in contrast to the efforts of the conservative opposition, such as the Holy See and Organisation of Islamic Conference, who take a wholllyholisitic approach to undermining every strand of work on sexual and reproductive rights. These rights have sometimes been broken Work on sexual and reproductive rights is fragmented and individual rights are addressed while others are not (i.e. calls for decriminalisation of same-sex sexual behaviour are not necessarily matched by action to decriminalise some consensual heterosexual sex –for example fornication) even when they fall within the same scope of privacy rights. Meanwhile the conservative opposition e.g. the Holy See , Organisation of Islamic Conference and others have a holistic approach to the ‘dangers of sexual rights’ across the board and present a united front against attempts to progress any rights. This paper contradicts the notion of the ‘inevitable continuous forward progress’ towards full sexual and reproductive rights. Framing rights within a health context has been successful to an extent in giving legitimacy to discussion of sexual orientation and gender, but has limited value – especially when the anti-abortion organisations make concerted bogus claims of morbidity related to abortion etc The Committee on Economic Social and Cultural Rights has avoided an expansive, all-encompassing approach, choosing to avoid the ‘hot button issues’ and therefore fragmenting the rights canon. As reproduction becomes the favoured outcome of heterosexual sex and some homosexual sex is ‘naturalised’ the question the authors ask is – is abortion the new queer?ask whether people in the field are working under the effect of a kind of magical thinking, believing that all advocacy is good advocacy, that battles should be waged everywhere and norms always fought for, no matter how slight their weight, because progress is inevitable.
  • Despite the articulation of sexual rights in several international documents and national laws, addressing the issue remains a daunting challenge in sub-Sahar.an Africa because current sexual rights declarations derive from the notion that the body, as a physical entity belongs to the individual. The work of the authors in two southeastern Nigerian cultures, the Ngwa-Igbo and the Ubang, shows that there is at least one alternative view of the body, which constructs it as the property of the wider community, rather than that of the individual. The assumption that individuals always hold the ultimate right to their bodies is problematic in this context where a higher premium is put on duty than on privacy, and may constrain the effectiveness of rights-based programmes and interventions in general, and of work around sexual rights in particular. The authors call for an alternative articulation of rights that better speaks to this concept of community ownership of the body.In the second paper the author touches on the same problem and describes: ‘the persistent quandary of whether legal change can actually transform social practices’This paper written following a conference which explored the patriarchal notion that women's bodies and sexuality belong not to themselves, but to their families and society. Despite this view being reflected not only in customary practices, but also sanctioned by the penal and civil codes in all of the countries in the region, there is increasing interest in and acceptance of sexuality as a human rights issue and the conference reaffirmed that sexual autonomy and bodily rights lie at the core of women's human rights, and notions of equality and empowerment cannot be applied to daily life unless sexual and bodily rights are fully realized. 
  • This paper presents a study in 1996 of a guardian programme in primary schools in two districts in Mwanza region, Tanzania, whose aim was to protect adolescent girls against sexual exploitation. Sexual exploitation of school girls by schoolboys, young men in their teens and 20s and teachers was common. The guardian programme appointed women teachers to support young women who were experiencing sexula violence or harassment.. The programme has been well accepted and has already generated considerable public debate and has served to bring the issue into the light. It has also meant that abuse by teachers may have become more difficult than in the past. However, most guardians and other teachers were opposed to any sexual activity among girls, which limited their potential to encourage contraceptive use and prevention of STDs and HIV. In this context, the guardian programme should be only one component of a much broader effort to address the issue of adolescent sexuality. Very significant that the Guardians role was to protect perhaps more than to empower young women themselves in relation to sexual exploitation. Fifteen years later, a paper on adolescent pregnancy in Tanzania finds some of the same conditions still present. With widespread reports of sexual coercion by older men and peers, rape and abuse experienced at an early age. In this paper the authors find that many young women saw this unwanted sex, as the only way in which to meet their basic needs and transactional sex as one of the few sources of income available to them. Despite this being widespread and acknowledged, young women alone were blamed for putting themselves at risk, by both parents and other community members.
  • In contrast to the intended policy for teaching of sex education in primary school in Brazil, the paper finds that it is not being taught as a cross-cutting theme in any of the schools, and that any lessons were mostly dominated by a biomedical discourse focusing primarily on the reproductive organs, fertility, pregnancy, and contraception. Sexual health and relationships and non-heterosexual sex and relationships were being neglected. Sex education was also considered a possible means of correcting or controlling sexual identities and behaviours deemed abnormal or immoral.In the Chilean paper the authors review the recent history of sexuality education in Chile and related legislation, policies and programmes. Despite a growing recognition of individual autonomy and sexual diversity in Chilean society, the Conservative and Catholic influence on policy has led to many steps backwards including the banning of emergency contraception from the public health care system on the basis that it was unconstitutional to distribute it as it was an abortofacient. Conservative opposition forces have fought ‘tooth and nail’ against the integration of sexuality education. All steps forward are hampered by the Government’s expectations of political and religious opposition at every stage and as a result much has been left up to individual schools regarding their own curriculum for sexuality education with parental opt outs etc introduced to try to make an acceptable compromise position. Though all schools are expected to have their own bye laws to prevent discrimination on the grounds of pregnancy, HIV and sexuality, many byelaws are not compliant with national law or are absent entirely so that in fact discrimination is common.  As the authors note, this opposition to sexuality education is predicated on the denial of teenage sexuality. Teenagers are supposed to be celibate or asexual and if they are sexual then that is problematic. 
  • It’s All One, is a comprehensive teaching resource published in two volumes and available in five languages currently, with practical lesson ideas aimed at putting gender and human rights at the heart of sexuality education. When I reviewed the resource for RHM in 2010 I stated that ‘The question remains whether the current generation of policymakers around the world will create the time, space and training for educators to prioritise these important issues in schools and in their communities, and to use this exciting new resource.’ The authors of this paper answer a similar question. Using an online survey of It’s All One users and documentation from five case study programmes using the resource in Nigeria, China, Haiti, Guatemala and the United States, they find that there is a shift to an empowerment approach across diverse geographic and programmatic contexts. Indeed the US project evaluated was unusually a polygamous Mormon community, while the projects in Haiti and Guatemala targeted extremely vulnerable youth. The authors describe in detail the five projects chosen for assessment and the role of the It’s All One resource in supporting the sexuality education within those projects. Reporting on the Chinese project the authors report ‘In China, as elsewhere, prevailing gender stereotypes and sexual double standards affect adolescents' sexual attitudes and behaviour. Silence about sexuality and negative attitudes about homosexuality are also still dominant. However, sex education in the country neglects these issues.’ In the Haiti project, the resource helped practitioners to address two areas – the right of young people to know that the medication they had been taking all their lives was HIV treatment, and the complex concept of inalienable rights and where these, to quote ‘ bump into each other’ i.e. right to confidentiality about HIV status v right of people to know the HIV status of their partners in order to properly protect themselves.ResponseThe teaching resource has supported and strengthened programme capacity to address gender and foster young people’s critical thinking skills around their sexuality. The authors also identify something that is a universal challenge in the field of sexuality education, the need for training to strengthen teacher capacity
  • It’s All One, is a comprehensive teaching resource published in two volumes and available in five languages currently, with practical lesson ideas aimed at putting gender and human rights at the heart of sexuality education. When I reviewed the resource for RHM in 2010 I stated that ‘The question remains whether the current generation of policymakers around the world will create the time, space and training for educators to prioritise these important issues in schools and in their communities, and to use this exciting new resource.’ The authors of this paper answer a similar question. Using an online survey of It’s All One users and documentation from five case study programmes using the resource in Nigeria, China, Haiti, Guatemala and the United States, they find that there is a shift to an empowerment approach across diverse geographic and programmatic contexts. Indeed the US project evaluated was unusually a polygamous Mormon community, while the projects in Haiti and Guatemala targeted extremely vulnerable youth. The authors describe in detail the five projects chosen for assessment and the role of the It’s All One resource in supporting the sexuality education within those projects. Reporting on the Chinese project the authors report ‘In China, as elsewhere, prevailing gender stereotypes and sexual double standards affect adolescents' sexual attitudes and behaviour. Silence about sexuality and negative attitudes about homosexuality are also still dominant. However, sex education in the country neglects these issues.’ In the Haiti project, the resource helped practitioners to address two areas – the right of young people to know that the medication they had been taking all their lives was HIV treatment, and the complex concept of inalienable rights and where these, to quote ‘ bump into each other’ i.e. right to confidentiality about HIV status v right of people to know the HIV status of their partners in order to properly protect themselves.ResponseThe teaching resource has supported and strengthened programme capacity to address gender and foster young people’s critical thinking skills around their sexuality. The authors also identify something that is a universal challenge in the field of sexuality education, the need for training to strengthen teacher capacity
  • In January 2009 a law was passed to criminalise the buyer of sex. This article explores the campaigning and political processes leading up to this event including the debates around pornography and sex tourism. Opposition to the bill came from those that wanted to make a distinction between trafficking and prostitution and those who were concerned about the well-being of women who may not have alternative means of support. However the bill was passed, public prostitution has reduced and there is still debate about how to ensure that those women who would have supported themselves through prostitution are able to work in other ways.
  • Sexuality & sexual rights in a snapshot of rhm papers

    1. 1. sexuality & sexual rights: in a collection of RHM papers Lisa Hallgarten RHM Online Editor presentation at side meeting of IASSCS conference, Buenos Aires, August 2013
    2. 2. looking back over 41 issues In this presentation I will introduce a handful of papers that provide a snapshot of the scope of RHM papers on: issues of global policy; talking about sexual rights; young people and sexuality education; HIV criminalisation; and different perspectives on criminalisation of sex work We have published on many of the same themes over several years and you can see some progress, but there are some papers addressing the same problems recurring across time and across continents
    3. 3. global policy papers several papers address the outcomes of global policy discussions over several years: ‘From reproductive health to sexual rights achievements and future challenges’ Sonia Corrêa, November 1997 ‘the spectre of sexualised bodies desiring pleasure remained lurking behind the debates’. Sexual and reproductive rights at the United Nations: frustration or fulfilment? Alice M Miller, Mindy J Roseman, November 2011 ...and pleasure as public health in: Pleasure and Prevention: When Good Sex Is Safer Sex Anne Philpott, Wendy Knerr, Vicky Boydell. November 2006
    4. 4. talking about sexual rights Who Owns the Body? Indigenous African Discourses of the Body and Contemporary Sexual Rights Rhetoric Chimaraoke O Izugbara, Chi-Chi Undie. May 2008 Sexual and Bodily Rights as Human Rights in the Middle East and North Africa Liz Ercevik Amado. May 2004 Towards a sexual ethics of rights and responsibilities Ruth DixonMueller, Adrienne Germain, Beth Fredrick, Kate Bourne. May 2009
    5. 5. sexuality, sexual identity I’ll show you mine if you’ll show me yours Gary W. Dowsett. May 1996 Holy Hatred Anissa Hélie. May 2004 ‘By ‘‘closing ranks’’, coalitions of Christians, Muslims and other fundamentalists affect the international agenda.’
    6. 6. criminalisation: the impact on HIV care HIV criminalisation and sex work in Australia (abstract) Elena Jeffreys, Kane Matthews, Alina Thomas. May 2010 Responses to criminal prosecutions for HIV transmission among gay men with HIV in England and Wales Catherine Dodds, Adam Bourne, Matthew Weait. November 2009 Advocating prevention over punishment: the risks of HIV criminalization in Burkina Faso Patrice Sanon, Simon Kaboré, Jennifer Wilen, et al. November 2009 Decriminalising homosexuality in India Geetanjali Misra. November 2009
    7. 7. coercive and transactional sex, gender and class Protecting school girls against sexual exploitation: A guardian programme in Mwanza, Tanzania Zaida Mgalla, Dick Schapink, J. Ties Boerma. November 1998 AND Gendered norms, sexual exploitation and adolescent pregnancy in rural Tanzania (abstract) Jennifer McCleary-Sills, Zayid Douglas, Annagrace Rwehumbiza, et al. May 2013 Unsafe sexual behaviour among schoolgirls in Mozambique: a matter of gender and class Josina Z Machel. May 2001 ‘He gives me clothes, stationery and money for other things, and my parents cannot afford to give me all this when I need it’ Double subordination, double risk: class, gender and sexuality in adolescent women in Argentina Rosa N.Geldstein, Edith A. Pantelides, May 1997
    8. 8. young people and sexuality education Sex education in the eyes of primary school teachers in Novo Hamburgo, Rio Grande do Sul, Brazil Denise Quaresma da Silva, Oscar Ulloa Guerra, Christiane Sperling, May 2013 Teenage sexuality and rights in Chile: from denial to punishment Lidia Casas, Claudia Ahumada, November 2009 The importance of a positive approach to sexuality in sexual health programmes for unmarried adolescents in Bangladesh Miranda van Reeuwijk, Papreen Nahar, May 2013
    9. 9. young people and sexuality education: the good news Integrating gender and rights into sexuality education: field reports on using It's All One Deborah Rogow, Nicole Haberland, Angel Del Valle, et al. May 2013 Programmes using the resource included: • School-based HIV and sexuality education (Nigeria, China, USA) • School-based gender and puberty education for pre-adolescents (Pakistan, USA) • Design of national curriculum framework (Uganda, Turkmenistan) • National curriculum assessment (multiple countries in East and Southern Africa) • Education in large-scale/national community youth groups (Mexico, Nicaragua, Colombia, Guatemala) • Community-based programmes for highly vulnerable youth (street children in Indonesia, internally-migrating Tibetans in China, HIV-positive youth in Haiti, Muslim orphans in Burma, runaways and juvenile offenders from a fundamentalist polygamous community in the USA) • Research (intervention study for internally displaced women in Haiti; randomized trial among adolescents in Bangladesh).
    10. 10. young people and sexuality education: more good news or old news The Sexuality Education Initiative: a programme involving teenagers, schools, parents and sexual health services in Los Angeles, CA, USA Magaly Marques, Nicole Ressa, May 2013
    11. 11. different perspectives on sex work A glimpse into 30 years of struggle against prostitution by the women's liberation movement in Norway Agnete Strøm. November 2009 Criminalization, legalization or decriminalization of sex work: what female sex workers say in San Francisco, USA Alexandra Lutnick, Deborah Cohan, November 2009 ‘They say that they are just so sick of all of the exams and hoops that they have to jump through, and paperwork that they have to fill out, and that it is very laborious. And I don't have to do any of that.
    12. 12. ....not forgetting RHM 12 sex, sexuality and sexual health • • • • • • • • • • • • • • • • • • • • • • • • • • Sex, sexuality and sexual health, Sexuality: Not just a reproductive health matter Nandini Oomman Sexuality today: Research and practice Juliet Richters Bewitched, betwixt, between Michael Lim Tan Protecting school girls against sexual exploitation: A guardian programme in Mwanza, Tanzania Zaida Mgalla, Dick Schapink, J. Ties Boerma HIV positive women, reproduction and sexuality in São Paulo, Brazil Naila Santos, Elvira Ventura-Filipe, Vera Paiva Couple communication and sexual satisfaction among withdrawal users in Pakistan Megan Douthwaite, Peter Miller, Munawar Sultana, Minhaj Haque Like a video: The sexualisation of childbirth in Bolivia Barbara Bradby Withholding of sex and forced sex: Dimensions of violence against Zimbabwean women Charlotte Watts, Erica Keogh, Mavis Ndlovu, Rudo Kwaramba Exploring the context of women's sexuality in Eastern Turkey Pinar Ilkkaracan, Women for Women's Human Rights Talking about sex Radhika Chandiramani Differential perspectives of men and women in Mumbai, India on sexual relations and negotiations within marriage Annie George Masculine identity and the meanings of sexuality: A review of research in Mexico Ivonne Szasz Virginity in Mexico: The role of competing discourses of sexuality in personal experience
    13. 13. RHM online RHM website with news, featured papers, author information, submission guidelines, call for papers, key topics, information on all the different language editions http://www.rhmjournal.org.uk/ RHM-Elsevier website where you can access every edition of the journal and search by author, and key words http://www.rhm-elsevier.com/ RHM blog with comment on and analysis of topical SRHR issues, guest blogs, author blogs and more http://rhmatters.wordpress.com/ @rhmjournal on TWITTER

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