The original idea to make sexual rights the subject of this Summit came through discussion with colleagues in Melbourne. The state of Victoria is in the midst of considering a major shift in health policy that will embrace sexual rights as its guiding framework. They’re advances on such ideas have always been enviable. Even so Australia seems an unlikely place to launch sexual rights into public health policy. Obviously a tribe of savvy gay thinkers is behind it. Today, I’d like to retrace the steps that took us here, steps that come from movements in thinking emerging from the discussions we’ve had for several years in the BC Gay Men’s Health Summit.
After years of tracking rising HIV infections among gay men through the Sex Now Survey -- trying but failing to point out the extent of the problem and lack of attention -- we recognized that health determinants out of our control must be playing playing an critical role in sustaining epidemic conditions. We wondered if sexual orientation was an unrecognized key determinant. But we soon learned that we have few data to indicate the role of sexual orientation in population health-- indeed we learned that we have a “profound lack” of population data on gay men. In any case, growing knowledge of social determinants of health suggested there had to be more than sexual orientation behind gay men’s apparent inequities in HIV.
Considering theintersectionality of gay health challenged the categorical thinking that has pervaded the HIV field. One such category is MSM – the way all men having sex with men are considered a common group in public health -- ignoring the agency of “gay men” in self identifying with fellow others. Emerging data from Sex Now 2010, our first national survey of 8,000 men seeking men for sex on the internet, showed that there were substantial social and economic status differences between gay men and men partnered or married with women in the survey. The data suggested that gender status – in the hierarchy of masculinity – was playing a central role in determining health outcomes.
We have to agree with critics of gay health that the cure for inequity lies beyond the scope of health action by itself. We have to change society not gay men to improve gay health. To move upstream from health problems like HIV, bullying and suicide we have to do more than offer more health services. If gay health is so determined by gender status and sexual hierarchy we need social change on a grand scale to bring gay health into being. We need to work on social justice to achieve health ends.
Which brings us to Sexual Rights - the latest addition to the greater discussion of universal human rights that’s been going on for decades.
Here are few highlights of related ideas contributing to the definition of sexual rights on the WHO website.
But once there you begin see the problems immediately, tarnished by the same omissions and limitations as human rights to begin with… and then a flood of other issues – the assumption of ethical participation, the enforcement of the rights of the victimized … where does it end?
When we brought the topic of Sexual Rights to a gay health reading group we’ve recently held at CBRC a few poignant remarks stayed with me. One contributor found the topic depressing because it’s so evident we’ll never get there. Is Canada even a rights based society? someone else asked. Laws exist but nothing changes. Another suggested that there were so many weaknesses with human rights -- what could we really expect from sexual rights? We really have to see ourselves in comparison with elsewhere to recognize our relative “circumstance”. Take the current film “Circumstance” about lesbian love in Iran for example. We may not have morality police in Canada but “vice squads” are not far behind us. We’re reminded of where sexual rights remain with Jamie Hubley’s recent and very public suicide…
We’re in hotly contested territory around human and sexual rights but I wonder if “rights’ are really what we’re after. We do need sexual rights as a way to mentally frame something else – the endstate – the way life will be when sexual rights are taken seriously. Our Australian colleagues suggested that the goal is a society that accepts “equity of sexual expression”. That seems to answer to our Canadian paradox – where we have laws but institutional neglect at the same time. Equity of sexual expression has to be practiced among people because it’s the right thing to do – not just an enforced right.
The function of Sexual Rights is really about how it focuses our thinking about how to achieve the greater goal “equity of sexual expression” Indeed we may even achieve de facto sexual rights in some places if we work on equity of sexual expression in institutions where it matters like schools, and health environments. We’ve already had a paper in this Summit on how equity of sexual expression is being achieved in the Canadian military.
As key thinkers have noted, we can never get away from politics and some of what were going through at the moment is truly oppressive but the fact is that enormous change is upon us
Nonetheless we still have the workplace where so many of us contend with the real politics of life without equity of sexual expression. So we have to live with Derrida’s paradox as we engage sexual rights. Sexual rights may well be a flawed agenda, insufficient for the real state of life on the planet but an indispensible marker of progress all the same.
We’re going to hear many papers in this Summit that will converge with these ideas, contribute more data, and provoke our taken for granted thinking. Welcome again to the Summit.
Gay Health &Human Rights ^Sexual
Sexual orientation alone inadequately explainsgay health disparities