Since then:. These have all the marks of moral panics: they go beyond simply enforcing the law, and aim instead to rid society of a deeply frightening enemy. Law clearly enables the crackdowns. All the countries in the region criminalize homosexual conduct between men and some between women —except Israel and, at present, Iraq where evidence is rapidly mounting that some militias are targeting non-conforming men and women for torture and murder. Some outsiders mass these laws together as products of Islam, pure and simple. This is not true. Saudi Arabia enforces a particularly strict version.
Egypt, Morocco, Algeria, Jordan, Lebanon, all criminalize homosexual sex under secular laws with fines and prison terms—laws that mostly have colonial origins. Islamists may march for stringency in Morocco, but the law they want enforced is not Islamic in origin. Secular, authoritarian regimes—facing down demands to democratize from leftist movements as well as Islamic dissidents—seem as likely to carry out crackdowns on sexuality as religiously-based ones, if not more so. Reports from Saudi Arabia suggest sporadic, large-scale arrests targeting men who have sex with men, but are insufficient to deduce a pattern.
Iran regularly arrests and tortures men, women, and transgender people under suspicion of same-sex conduct, but there is no real indication that arrests or executions have increased in recent years. A different perspective comes not from looking at the highly publicized cases involving men, but from listening to lesbian and bisexual women.
Law, custom, economy, and family are all implicated as well. This means the crackdowns may connect to fears that norms for gender and sexuality are shifting or breaking down. Women who defy those norms and men who escape them are equally at risk. It is worth remembering that the law under which Egyptian men are tried for same-sex conduct was originally a law targeting women in prostitution.
Culture and politics, daily life and law, are equally at issue, then. They need somewhere to be safe, to find other women, to be able to communicate with them. The major problem is the family and the culture. If you can get knowledge to your family and get them to accept you, you still have to worry about the law and your life, about what happens if the larger community discovers you are a lesbian.
There is no respite: when you think you are safe at home, you could step out on the street and be arrested. In most of the region, civil society is under severe attack. While even highly restrictive countries have allowed selected NGOs limited freedom to operate since the s began, the limits are tightly drawn. Human rights organizations suffer especially from harassment, bureaucratic restrictions, surveillance, and arrests. Governments are quick to use any pretext to discredit them before the broader public—making it doubly risky to take up divisive or difficult issues.
Legal constraints, together with lack of resources, make it hard even for sympathetic NGOs to investigate rights abuses shrouded in stigma or secrecy: many simply cannot collect the information. Internet use has burgeoned in the region. It has also been vital in developing a gay and to some extent lesbian or transgender identity and community. The advantage is that it lets people communicate who would never have dared or had the means before. However, much communication remains anonymous, impersonal, and mistrustful. Since most of the websites used by such communities to meet and socialize are Western gay ones, despite a vigorous blogging community in Iran and Egypt , people articulate their identity and community almost entirely in borrowed terms or bricolage.
Getting wired remains expensive. Dependence on cyberspace accentuates economic divides. Most governments censor the Internet, as they censor other information. Almost anything about sexuality falls under the rubric of pornography. Iran, Saudi Arabia, and other countries try to block most gay sites. These examples affirm that sexual rights like all human rights in the region cannot exist without progress toward democracy: curbing police powers, establishing rule of law, ending censorship, and freeing civil society.
Despite hopeful indications in some countries earlier this decade, that progress is largely blocked. In Egypt, for instance, the government carefully split the democracy movement while the U. Islamist popular movements have not gained power anywhere in the region except Iran. That very fact gives fundamentalism a dissident prestige, and in countries like Egypt and Morocco it threatens to monopolize opposition politics.
Embattled sexual rights activists obviously fear that democratic openings will bring political Islam to power. In some places, particularly Egypt, secular human rights activists have been able to forge expedient alliances with Islamists over core issues such as arbitrary detention and torture. It is not clear whether those alliances—necessary for the moment—have sparked a commitment among Islamist activists to integrating human rights principles with belief. In the long run, it must be remembered that much of modern political Islam has been, paradoxically, a democratizing force within the faith: a popular movement shaking the power of judges and scholars.
There is no intrinsic reason—though there may be strong sociological ones—why a similar populist drive within Islam could not support politically as well as theologically democratic tendencies. Some organizations—in Europe, South Africa, Indonesia—are already sounding out the space for such support. Despite government inaction, awareness of AIDS and informed thinking about sexuality are growing among youth. Several popular Egyptian actors spoke out in against the crackdown on HIV-positive men. The medical profession remains in the sway of 19th century European myths about sexuality.
Programs to train doctors of almost every kind in approaches to sexuality and gender are urgently needed. In a few countries, doctors and lawmakers together have laid out a relatively liberal approach to transgender people: Iran and Egypt have allowed gender reassignment surgeries and change of identity for almost 20 years. Nonetheless, in both countries police arrest and torture transgender people, even with medical papers. Sparse information on sexuality in the region—or related rights violations—goes beyond the borders. What reaches the Western press mostly draws on anecdotes or travelogues.
Misinformation can spread; underground activists in the region have little control over what is said or done on their behalf abroad. In a few places, like Egypt and Morocco, sexual orientation and gender identity issues have begun to enter the agendas of some mainstream human rights movements.
Now, unlike in earlier years, there are lawyers to defend people when they are arrested, and voices to speak up in the press. These vital developments were not won through identity politics. Rather, the mainstreaming was won largely by framing the situations of LGBT or otherwise-identified people in terms of the rights violations, and protections, that existing human rights movements understand. Talking about rights rather than identities, and seeking support from mainstream movements vulnerable as they are , is the way those protections are likely to move forward significantly in the foreseeable future.
No country shows much hope of lightening legal penalties through legislative action. In a few countries—Egypt is one—there are limited possibilities for reinterpreting existing legal provisions through strategic litigation. Religious law does not rule in most states, but it affects and inflects secular law and its enforcement. Even offering legal defense in the places where it is possible requires finding and training lawyers willing and able to take the cases.
Reforming medical attitudes means working with conservative professional groups often dominated by the Muslim Brotherhood. Both these tasks need creative approaches, from inside and outside the region. Some activists imagine new paths to political visibility. In a few places, courageous activists have won real social space for LGBT communities. Lebanon, which has a functioning LGBT center that hosts public discussions and cultural events, is the foremost example. There, too, cultivating alliances with other human rights movements has been a key to success.
While rights claims may need to be detached from identity, there is a desperate need for building community. Young people are particularly subject to exploitation and despair. Studying case files from the Egyptian crackdown in reveals a grim figure: most of those arrested and tortured were under Emerging into sexual maturity, they found no community to warn them about social and political dangers, no mentors to protect them from the police. We give women the basic knowledge they are not sick—translating all this information and putting it in one place.
You should fight with the homophobia inside yourself. Even moving from cyberspace to personal contact takes time, and courage. Who would have imagined? Europe, after all, produced the first international legal findings that sexual orientation was protected by the right to privacy. After the Wall fell in , lesbians and gays were among the first to claim political rights, form organizations, campaign to end repressive laws. European institutions stood behind them, supporting legal reform and safeguards for intimate life.
Ten years of international pressure led Romania finally to scrap its Ceausescu-era ban on homosexual sex. Who would have supposed that 20 years later, political leaders would call for beating and jailing LGBT people; that, in ostensibly democratic states, police would stand by while neo-Nazis bashed peaceful marchers? Europe in the 21st century was not meant to be like this.
The pictures are the most memorable evidence of this unexpected Europe: faces bleeding, people running, the air streaked with tear-gas trails. These photographs have burst forth every spring and summer for several years, as LGBT groups try to stage pride marches in Cracow, Chisinau, Moscow. His political allies called for criminalizing anyone who introduced LGBT issues in Polish schools, and for beating any daring marchers with batons.
Russian politicians reminded voters that the sodomy law had been abolished fifteen years before under pressure from the West, and told gays, in effect: We gave you your rights in the bedroom; keep off the streets. Banning the marches became a way of defining who belonged in the public sphere, who could participate in politics at all. The backlash—the threat to freedoms of expression and association—is only one sign of a swelling violence.
Political and religious figures who vilify LGBT people encourage both organized extremists and ordinary haters to move them up the roster of targets. The violence happens in places where LGBT people have little visibility. Bosnian activists speak of death threats. Regular assaults against transgender people by police and private individuals, and gang attacks on gay men, go unpunished. There are less visible inequalities. Countries admitted to the EU have been compelled to adopt anti-discrimination standards, which protect sexual orientation in employment though not, as yet, in other areas of life.
In many places, though, no effective enforcement exists. In countries beyond the new iron curtain—the one separating states with a hope of EU admission from those, like Russia, with none—neither the law nor international standards offer real recourse from discrimination. Recent European Court of Human Rights decisions guarantee transgender people who have undergone surgeries the right to change their legal identities.
These decisions make rights depend on medical intervention, however, and most EU countries require sterilization, among other medical invasions, as a condition of identity change. Some states in the region, like Turkey, have essentially adopted European practices on surgery and identity.
ISBN 13: 9780415948692
In others, like Kyrgyzstan, the medical profession looks on gender identity with incomprehension—and transgender people face violence in family and community with little access to justice. Due to that social distance, violence is seen as an acceptable way of dealing with or reacting to sexual minorities. So we are not at the point of discussing marriage or relationships at all. In many countries, movements that trace their origin to s fascism are reviving in skinhead garb.
The mere possibility of EU entry brought real political liberalization to Turkey. However, many EU states feel its elasticity to absorb new members is at an end. In some apparently straightforward matters, it has exercised little influence: a Maltese activist points out that EU membership has still left his country the only one on the continent where divorce is illegal.
There are many things that Serbia needs to change, and if two more high profile war criminals are extradited, the EU might not be that demanding on sexual rights issues. Groups also face funding challenges. Activists are operating with very little funding, fighting among themselves for the little funding that has been left. We need to invest in people and keep the experienced people in the organization. Many activists in Eastern Europe make cultural change a priority: fighting invisibility and the climate of violence.
For most activists, however, legal and policy change remain critical. Goals they mention include:. Comprehensive anti-discrimination laws, a key element of EU integration, also remain a central goal. Serbia in passed such a law, amid opposition from the Orthodox Church but with the support of rights activists both in the country and in the rest of Europe. However, the passage from paper protections to full implementation also demands close monitoring.
Hopes for such change vary immensely, between the repressive atmosphere of Russia—where neither courts nor lawmakers preserve much independence or have time for LGBT concerns—to the openness of Hungary and the Czech Republic where forms of partnership and other protections have been achieved. The question many activists ask is: given the role European integration has played in legal and political change so far, can European institutions still support LGBT rights effectively?
The EU is obviously not the only player. The Council of Europe has taken an active role in condemning hate crimes and promoting free assembly. Russian activists plan regular appeals to the ECHR against decisions denying them the right to demonstrate. The most significant test is coming soon within the EU itself. A new anti-discrimination directive—launched after much hesitation by the European Commission, and after vocal pressure from human rights groups across the Union—would finally extend protections for sexual orientation to a broad range of areas of life, including access to goods and services.
It would extend similar protection to those suffering discrimination due to religion, age, or disability. Both in new member and in non-member states, however, activists also look to alliances with other domestic movements to press forward reforms. Making any sense of the complexity means leaving much of the richness out. One way of organizing the differences from an LGBT perspective is to look at the sodomy laws. In most of South Asia—Bangladesh, India, Pakistan, and Sri Lanka, stretching over to Malaysia and Singapore and some Pacific islands—versions of the same British colonial provision were handed down from code to code.
In India itself, Section gives the police enormous powers to harass and blackmail. But so do other provisions, particularly the Immoral Traffic Prevention Act, which regulates sex work. It is a basis for regular harassment of hijras working-class transgender individuals and other gender-nonconforming communities--as well as many women, whether in commercial sex work or not.
Harassment in schools and silence in curricula are regional concerns. They have only begun reforming policy and practice on sexual orientation and gender identity. In much of East Asia and part of the Pacific , homosexual conduct is not criminalized. Sexual orientation with six other categories was dropped from an anti-discrimination law in South Korea in , at the urging of Protestant churches and business leaders.
China has seen police crackdowns on gay and lesbian bars, baths, and cultural events. Authorities regularly harass or detain AIDS activists. Newspapers carry as little gay-related news as possible As in other regions, legal registration is difficult for many groups to obtain, either due to morals restrictions or the effect of sodomy laws. In many parts of Asia, different forms of fundamentalism are able to set aside differences and cooperate locally where sexual orientation and gender identity are at stake.
As in other regions, nationalism and religious intolerance come together in a conception of cultural authenticity that excludes sexual or gender nonconformity. Asian exceptionalism —the ideology that the continent had different political needs and values, that individual rights protections were at odds with collectivist traditions and an unwanted brake on economic advances—retreated after the economic crises of the late s.
Yet it still materializes as an excuse for state neglect or inaction, particularly in sensitive areas such as sexuality. More concretely, the absence of an Asian regional human rights structure leaves activists without a near-at-hand institutional focus for advocacy, or for networking with mainstream human rights groups. In some cases it did so simply by making conversations about sexuality possible. But now we can discuss the health issues It means the circumstances are being changed slowly but continuously.
The most important doors now ajar, though, are arguably those to funders. After taking the lead in the lead in outreach and prevention efforts, many LGBT groups found grants available for the first time. At the same time, this sparked internecine competitions over identity—over who should be supported for outreach to what communities under what names.
The funding streams also confined many groups to service provision and sapped their energy for advocacy. MSM are much more than just sexual beings. Asian social movements—sexuality and gender-related movements among them—are rich in strategic discussions and disagreements. It is impossible to capture more than a small part of the manifold perspectives posited and directions proposed.
At least one success story has inspired LGBT activists throughout the region. The step from service provision to advocacy is still difficult for groups to manage, given funding constraints. Even after many victories, Nepalese activists admit there is much to be done. Judicial acknowledgement and political influence still do not mean improvements for many of their constituencies. The relationship between legal change and social change is a crucial question for many activists in the region.
Law and policy should never be our priorities even as we recognize the need for them to keep pace with changes we are making on the ground. Even recognizing the importance of removing Section , Indian activists long debated the relative value of litigation as opposed to broad social mobilization against the provision.
Similar divisions occur—or are likely to—in other countries, including those where anti-discrimination protections are a key goal. In India, a compromise has been achieved. If Section goes down in India, its fall will echo through the region. It will raise the question of what comes next. An anti activist points to future priorities:. For instance, eliminating and ensuring that hijras can gain IDs will remove some sources of abuse—but will not affect the criminal-justice machinery regulating and repressing sex work, overwhelmingly the legal pretext for the police impunity and violations hijras face.
Groups across the region warn that the push for stricter anti-trafficking policies generates expanded state power over all sexualities in public and often private spheres. For years, some activists in Asia have criticized the uncritical importation of Western identity constructs as templates for sexuality and gender. Many also question the weight placed on national-level lobbying at the expense of local work. We prefer to work with CBOs [community-based organizations] in rural areas around the country. Most work to date in India that focuses on MSM has been focused on urban spaces.
Groups also look to non-social-movement allies. In Indonesia, LGBT activists, after cautious bridge-building with the Ministry of Religious Affairs, have quietly engaged in dialogues and trainings with young imams, raising issues of sexuality and gender. Lesbian, gay, bisexual, and transgender movements in Latin America have achieved an astonishing record of success in the last 20 years. The Caribbean, a distinctive case, will be dealt with in a separate subsection.
LGBT groups have seized on democratic openings to enter the political and cultural spheres. Despite steady harassment, they have become visible and stayed vocal. The intensity of debate among activists, the degree of networking across the continent, and the diversity of identities and demands they bring to bear, are perhaps greater than anywhere else in the world. The remaining sodomy laws have fallen one by one.
Chile, Ecuador, Mexico, Peru, Uruguay, and Venezuela now have national protections against sexual-orientation-based discrimination—though none for gender identity. In , Uruguay became the first Latin American country to recognize same-sex relationships by law at the national level, although many cities and provinces in the region already offer domestic partnerships.
Yet progress has had an uneven reach. What happens next? That is done, and now our priority is to have sexual orientation included in the anti-discrimination law, which now mentions ethnicity, color, sex—but not this. Then we will move to civil rights and full citizenship. Who is left out? The repeal of sodomy laws has left a range of other provisions that enable police abuse. Such provisions are found in state and local criminal codes, and sometimes in national laws, from Mexico to Argentina. For example, 10 out of 23 provinces in Argentina retain them. Transgender people are constant targets.
In Guatemala, Honduras, and other countries, armed gangs—which many believe include off-duty police—menace, abuse, and shoot transgender people on the streets. Transgender people encounter the health system in charged ways, as perhaps the key point where they meet the state and officialdom: they report discrimination, abuse, lack of access to services, and comprehensive refusal to acknowledge their identities. This is the biggest challenge we face as a movement. Many governments still do not permit any change of legal identity for transgender people—and lacking identity papers that reflect their lived gender, many still cannot work legally, rent rooms, obtain passports, or even drive.
States that do, however, generally make surgery an obligatory condition. Medical care is also an issue for other groups. Workplace discrimination is common. Some of those reports are anecdotal partly because lesbians have little visibility, both within the movement and before the state and society: abuses against them go unrecognized and their needs unmet.
The rights of lesbian, gay, bisexual, and transgender children—including sexual rights, both to autonomy and to protection from abuse—are at risk in all regions. In Latin America, it is conspicuous that, amid region-wide advances in protection, children have been almost completely left out. Speaking about sexual orientation and gender identity in people under that age raises terrible fears. By that time, she already has a long history of marginalization and abuse behind her. Its opposition to state promotion of safer-sex methods, including condoms, has a disproportionate effect on groups particularly vulnerable to HIV and AIDS.
Religion in the region operates on its own terms. Where laws and policies actually are positive, implementation remains uneven. People point to several levels:. Yet activists pointed to positive opportunities, now and in the near future. Sympathetic governments hold power in influential countries in the region. Several activists noted that such neighbors rarely use their weight regionally on LGBT issues.
Overridingly, people cited the potential of the hard-won alliances between LGBT groups and other social forces. I cannot think of a single movement that is very cut off from the rest of civil society. This is the product of the patient, intersectional work of a generation of activists. It is paying off. Regional networks and cooperation among LGBT social movements—especially lesbian and transgender groups—have had a powerful effect.
But a formal federation can lead to monopolizing resources by a few. Lack of funding is a continual problem, as well as the demands of specialized funding sources. We want to work on the issues that matter to us, lesbian and human rights, and we want to get funding for that, explicitly. This also affects political horizons.
The main question, again, is: what next? Others would qualify or question this. Bills with criminal penalties for unequal treatment raise doubts in some quarters about the wisdom of relying on state punitive measures for protection. We [transgender and intersex people] cannot wait for it. Further legal change is needed. Then something happens, a custody case for instance, and we run to the family code and see the horrors that are happening.
Inadequate funds hamper taking up strategic litigation, or simply providing legal help to people who face discrimination. Alliances continue to be crucial. The fundamentalists have clearly said that if the bill did not include LGBT people, it would already have been approved. But the coalition is holding its ground strongly. Regional work is also vital. Emerging evidence from yet unpublished longitudinal data from South Africa shows that women who have experienced intimate partner violence and have greater gender power inequity in relationships are at elevated risk of acquiring HIV.
In both cases, there is a dose response relationship [ 16 ]. In an effort to explain why partner violence and relationship gender power inequity should place women at risk of HIV, research has been conducted with men. This has shown that like their Indian counterparts, South African men who have been physically violent towards partners are more likely to be infected with HIV [ 10 , 15 ].
Some indications of why men who have been violent are more likely to be HIV infected can be seen in analyses that focus on the inter-relationship of gender-based violence perpetration and a range of risky sexual practices. South African research shows an apparent clustering of violent, anti-social and risky sexual practices, suggesting that these are connected. Thus, men who have been violent towards intimate partners are more likely to rape, have large numbers of partners, drink heavily, not use condoms, have sex with prostitutes and engage in transactional sex [ 17 ].
Men who rape are more likely to have had transactional sex, be physically violent to partners, have large numbers of partners, drink heavily and engage in transactional sex [ 18 ]. Men who engage in transactional sex are more likely to be physically violent to partners, have large number of partners, drink heavily and rape [ 19 ]. In essence, men who are violent are more likely to be sexually risky, and vice versa. A key question is: what is the basis and nature of this connection? And what are the implications of these for HIV risk, prevention and care?
This paper seeks to move beyond the epidemiology and the measurement of behaviours and associations and enable us to understand these empirical findings. In so doing, we draw on theoretical resources from the area of critical men's studies, and in particular, the notion of hegemonic masculinity, initially developed and expounded by Raewyn Connell [ 20 , 21 ], and related discussion of femininities. We will describe the theoretical framework, discuss its relevance in terms of findings of South African research on hegemonic masculinity and femininities and their relation to HIV risk, and relate it to broader concerns in HIV prevention and care.
Feminist studies of sex and gender have historically foregrounded the oppression of women. The former approach, which focuses on the genetic or physical to explain gender inequalities, has the major disadvantages of failing to explain diversity among men and among women and of lacking a model of how to make things better. Models that focus on how gender is a learned behaviour make more allowance for diversity and provide conceptual clarity about the forms that inequality take and how inequalities occur.
Such analysis also can suggest gender equity interventions. The focus on the social construction of gender has in the past quarter of a century generated a sophisticated literature on the gender identities of men and women, masculinities and femininities. This has permitted the conceptual inclusion of men within the ambit of gender studies, an initiative strongly associated with the theoretical work of Raewyn Connell [ 20 , 21 ]. Connell [ 20 , 21 ] describes the existence of multiple configurations of masculinity that are hierarchically organized and structured along lines of gendered domination of men over women, of powerful men over less powerful men, of adult men over younger men.
She identifies one masculine position that is dominant and refers to this as "hegemonic masculinity". It is this position that is generally associated with the subordination and oppression of women. The concept of hegemony, drawn from Antonio Gramsci's work, refers to the exercise of power by creating consent through the establishment of accepted ideas or values. The concept is generally used descriptively to identify that form of masculinity that legitimates the subordination of women. It is in this sense that the framework enables an analysis of gender power while also allowing for the existence of divergent forms of male expression that may, for example, challenge the unquestioned right of men to this power.
There have been several interpretations of hegemonic masculinity by Connell herself [ 22 ] and others. Some focus on the fluidity and contested nature of the concept, while others stress the organizing, structured and structuring nature of hegemony. In this latter sense, hegemonic masculinity represents the dominant cultural model of idealized manhood. It is a frame used by individual men to judge their "success" as men.
In a highly gender-inequitable country like South Africa, hegemonic masculinity mobilizes and legitimates the subordination and control of women by men. Conceived in this way, hegemonic masculinity is a necessary and integral element of patriarchy, the social organization that allocates, distributes and secures the power of men over women.
Hegemonic masculinity is characterized by a set of practices that both expresses men's power within the social system and serves to bolster this power. In essence, the practices flow from the hegemonic ideal. Implicit in the idea of "hegemony" is recognition that social ascendancy of this ideal of masculinity is not achieved through brute force, although violence may be used by men to bolster this ideal, but through a complex web of processes that extend into the organization of private life and cultural arrangements [ 21 ].
Thus, tenets of culture and religion and, for example, the operation of the legal system, may work to preserve the ascendancy of a particular cultural ideal of manhood. Connell [ 21 ] argues that there is no equivalent notion of "hegemonic femininity" because there is more diversity in feminine ideals, although women are globally subordinated to men.
She describes a form, or forms, of "emphasized femininity" that is characterized by compliance with women's subordination and an orientation towards accommodating the interests and desires of men. In other words, women "agree" with the unequal structuring of relations, do not challenge these relations, and ultimately collude in the unequal distribution of gender power with men. Other forms of femininity are shaped around strategies of resistance, and some combine compliance, resistance and cooperation [ 21 ]. Just as hegemonic masculinity is given power as a "cultural norm", forms of femininity that either in whole or in part emphasize compliance with this are expressed as cultural ideals of femininity, and are usually in some way socially rewarded.
Women who adopt femininities based on resistance, or indeed engage in acts of resistance, can be marginalized and stigmatized. Patriarchal societies are heteronormative, that is, they require men and women to demonstrate their gender by actively participating in heterosex or affirming heterosexual desire [ 23 ]. While there are societally different ways in which this might be done, transgressions of heteronormativity are punished, and in South Africa, often violently so.
The gang rape of African lesbian women and other instances of homophobic violence are particularly horrifying examples of this [ 24 , 25 ]. Having said this, it is important to note that gender identities change over time and that under particular circumstances, may change rapidly, for example, when legal or material contexts change dramatically. In South Africa, there is evidence that gender identities are indeed changing, although for our purposes, the persistence of gender violence remains a worrying continuity that shapes and binds forms of femininity and masculinity.
While hegemonic masculinity, and emphasized femininity, encompass practices that extend far beyond the arena of domestic, sexual and otherwise intimate relations with women and men , it is the expression of these practices in these domains that is particularly pertinent to consideration of the intersections of gender power inequity and intimate partner violence and HIV risk.
A lens of gender identity provides a frame through which we can begin to understand why men and women behave in the way that they do. It provides a way of reflecting on the emotional and material context within which sexual behaviours are enacted, in particular, the broader struggles, aspirations, desires and needs that motivate men and women's behaviour. It follows that only when we understand this, will we be able to change sexual behaviours and thereby reduce the risk of HIV infection. The gender order in South Africa under colonialism and apartheid was strongly racialized [ 26 ].
Two major features are relevant here.
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The first is that racial integration occurred to a very limited extent and this ensured that black African and white South Africans lived largely separate lives, connecting in the work place under conditions of inequality whites dominating professional and business positions, and black Africans overwhelmingly limited to positions as labourers or subsistence farmers. This arrangement allowed for quite distinct racialized gender arrangements to persist, with perhaps the most notable feature being the retention of traditional forms of male-dominated authority for example, chiefs.
The second important feature was the emergence of distinctive gendered ideals for black and white men and women. The material inequalities and associated spatial demography with black Africans prohibited for a long period from living in cities unless in the service of white-owned industry, and therefore confined to increasingly impoverished rural areas , which are a feature of South African life to this day, impacted on constructions of masculinity and femininity. Offering a broad brush stroke description of gender topography always runs risks, but for our purposes, we will venture some generalizations.
We do so even as we acknowledge that the changes unleashed by national political developments especially the assumption of power by the African National Congress in and global economic forces have effected significant alterations to the stark picture that we paint here. Until , white men and women had the vote, had ready access to economic power or, at least, stable employment, and to forms of social and public status [ 26 ].
This influenced the ideals to which both white men and women aspired. White men were heavily invested in material achievement, public position and embodiment that found particular expression in sporting achievement. White women, on the other hand, were less vested in professional autonomy, even though they benefitted from free schooling in well-resourced institutions. Their identities were primarily built around children and the home.
For black African men and women, the material challenges of life were dominant. Men were generally employed in menial, poorly paid positions, and many found only seasonal, insecure ways of securing a livelihood or spent much of their time without any form of paid work [ 26 ]. This has made it difficult for the majority of black African men to vest their masculinity in material or professional achievement, and has increased the likelihood of finding masculine affirmation in homosocial sometimes criminal settings and in their relations with black women.
Black African women, generally without the means to be economically independent, have often been dependent on black African men and this, together with cultural practices of respect, has promoted obedience and passivity as hallmarks of African femininity. With South Africa's history of colonialism and apartheid, all gender identities are in some ways marked by violence. We return to this theme shortly. Historical perspectives on sex in South Africa reveal two competing discourses on sexuality. In one, rooted in Christianity, sex is located in marriage for procreation.
The other reflects traditional black African ideas that sex is a normal and healthy and an essential feature of life for all ages, and something about which there should be openness and communication [ 26 ]. This latter discourse normalizes sex play in childhood and presents sexual exploration as a natural activity, including during adolescence. Historically, pre-marital penetrative sex was prohibited, but it is now the norm and, indeed, half of all black women have had a child by the age of 21, mostly outside marriage [ 27 ].
Within the frame of sexual openness, African women are constructed as sexual beings and sex is seen not just as normal in relationships, but as essential for their success [ 27 , 28 ]. Furthermore, in the domain of healing, sex is seen as a process of cleaning, and is commonly advised by traditional healers and nurses for a range of maladies [ 29 ]. For our purposes, it is important to make some statements specifically about gender in South Africa since , when the country formally entered a period of transition, dismantling apartheid's edifice and constructing a new legal and policy framework for a non-racial democracy.
This period has seen greater public diversity and fluidity in gender identities. The most obvious indication of this is the emergence of a public gay movement in the wake of the constitutional protection afforded to sexual orientation in the Bill of Rights in the Constitution in , although the gay movement per se long preceded this [ 30 ]. For women, there has been a conspicuous emergence, primarily in urban settings, of "modern girl" femininities, associated with the exercise of independence, the use of specific fashion commodities and "explicit eroticism" [ 31 ].
This is an ideal of womanhood that is chiefly the domain of those women with access to at least some material resources. Whether these girls and young women seek political emancipation, or economic or sexual independence, the emergence of this phenomenon has drawn attention to the question of feminine agency. Despite this diversity, there are clear patterns of power and dominance. While there is not one, single, dominant masculine form that serves as a model for all men, it is empirically clear that various racialized forms of masculinity are dominant.
It is these masculinities that prescribe particular ways of being a man and legitimate gender-inequitable practices. One example of a black African hegemonic masculinity is found in the Zulu concept of isoka , an idealized heterosexual, virile man, who is desired by women, and whose prodigious sexual successes are the envy of other men [ 32 ].
Ethnographic research in the Eastern Cape province has shown that a key element of successful African manhood is heterosexual success and this is proved by being able to "win" desirable women, keep them and thus prevent them from being seduced by others , and show evidence of being a man in control of others [ 33 ]. While the power of men is by no means established through the use of force, indeed the cultural foundations of patriarchy and processes through which it is maintained are broad and deep, and the use of violence, within limits and in particular contexts, is viewed by many, but not all, men as legitimate in pursuit of their goals [ 34 ].
This applies both in the public for example, men resolving differences between one another using physical violence [ 35 ] and private domains where domestic violence, including femicide, is common. South African masculinities all valorize the martial attributes of physical strength, courage, toughness and an acceptance of hierarchical authority, but most of all, they demand that men are able to exercise control over women and other men [ 36 ].
Within relationships with women, the expectations of establishing control provide space for the use of physical and sexual violence against women, in efforts both to achieve this and to demonstrate it. While men are not expected to injure women, and acts of extreme cruelty often incur familial and community wrath [ 34 ], the use of moderate violence by men and in other circumstances, by women is tolerated and generally is not viewed as evidence of weakness or lack of self-control. With sex viewed as a need, particularly of men, but within context, also of women, wooing women with gifts, or exchanging money or other services for sex are seen as largely culturally acceptable practices [ 19 ].
Historically, sexual relationships between individuals were part of subsumed socially negotiated relationships between families, with marriages formalized through payment by men of lobola , the bridewealth. Nowadays, marriage occurs relatively late in adult life at a mean age of 28 years for women [ 27 ] , if at all, and sex mostly happens outside marriage, and "serious" intent is demonstrated by gift giving. In this cultural milieu, it is easy for men to assume some form of patriarchal ownership over women and to establish or demonstrate this with physical violence.
In this way, hegemonic masculinity inextricably links having multiple sexual partners with the subordination of women to male control, if necessary with the use of violence. Other practices which flow from hegemonic masculinity involve sexual and other forms of risk taking. These include driving cars fast and dangerously, and heavy alcohol consumption; indeed, social norms around alcohol drinking are such that South Africa has the highest level of consumption per drinker of any country in the world [ 26 , 37 ].
Derision is cast on those who "fail" in navigating these risks without losing control or showing weakness, whether shown by their lives being destroyed by alcoholism or by becoming infected with HIV. Thus, blame is framed in terms of individual weakness, rather than being placed on the overarching gender order that provided the context within which these practices were and are encouraged [ 38 , 39 ]. In this way, hegemonic masculinity can be seen as a cultural ideal that links risky sexual practices and the use of violence and other controlling behaviours against women, particularly women partners.
It is masculine-gendered identities, and the processes through which they are constructed, enacted and reproduced, that explain the clustering of violence and risky sexual practices seen in the epidemiological studies discussed above. Viewed through this lens, these practices are seen as having meaning that extends well beyond the motives and rewards of the individual act. With young black African women in the forefront of the HIV epidemic in South Africa, it is appropriate that we apply ourselves in the same way to young black African femininities.
Our understanding of women's sexuality can be considerably advanced by reflecting in a similar manner on gender identity and the entailed meaning of practices. Emerging, yet unpublished research by the authors, based on extended qualitative interviews and participant observation over 10 months with women from the Eastern Cape, shows that the dominant idea of successful young womanhood is one where success is proven through being desirable to men. This is clearly complicit with hegemonic masculinity as it is framed in a way that encourages resonance, rather than discordance, with those ideas.
With worth of women assessed by men, women who wish to be "successful" are under massive pressure to conform to the dominant social order, including accepting the control by men. But there are other powerful forces at play. In a resource-poor setting, flirting and meeting with boyfriends provides hours of affordable entertainment.
Organizing around Sexual Orientation and Gender Identity Worldwide | HRW
Thus, women have fun, compete and measure their desirability through flirting and encouraging proposals from men, while remembering that this is ultimately "proven" through having a boyfriend. Given the threat of being single to social status and self-esteem, and the risk of boredom, many women prefer to have more than one boyfriend referred to as "walking on two legs" lest they split with one of them. The terms in Sotho and isiXhosa of nyatsi and khwapheni refer to secret concurrent partners, which is culturally accepted for women, as well as men, providing relationships are conducted in a manner respectful of the main partner, i.
With sex viewed as "natural", women's sexual desire is acknowledged, as is an expectation that sex should be pleasurable, preferably "flesh-to-flesh" sex and thus with no condom use [ 41 ].
While there has been a suggestion in literature on sexuality that it is a male requirement, authors have also found that women often oppose condom use because of concerns about their sexual pleasure, as well as a lingering suspicion that their chances of keeping their partners in the competitive world of multiple concurrency, are greater with flesh-to-flesh sex [ 41 ]. The emphasis on the heterosexual prerogative of men in a context of great gender inequalities has often led to treating women as sexually passive, simply waiting for men to propose and then acquiescing [ 42 ].
In some contrast to this, having multiple partners is on one level an expression of resistance to dependence on, and even control by, one man; yet the cultural acceptability of the practice allows women to do so without perceiving themselves as engaging in resistance to the gender order as a whole. While the dominant ideal of femininity is fundamentally subordinate, women do not all experience controlling behaviour by their male partners to the same extent.
Archetypically controlling boyfriends, however, expect to know where their partners are at all times, stop them seeing other men, expect to find them at home when they call, and to have them willing to free themselves from whatever they are engaged in and be ready for sex on demand [ 33 ]. It is hardly surprising that women with violent and controlling partners have been shown both to have more frequent sex and to use condoms less often [ 8 , 43 - 45 ].
Women are expected to avoid behaving in a way that threatens men's sense of control, failing which they are expected to endure and accept their physical punishment [ 33 ]. For African women, excusing male behaviour is an integral part of dominant femininity and essential for keeping the right man. In a practical sense that entails tolerance of violence if he is violent , tolerance of his other partners or when this fails, direction of aggression against them, rather than him , and ensuring that sex with the right man is "the best" i.
This is supported by cultural wisdom, such as the saying that "beating is a sign of love". This dominant form of femininity thus requires women to be strong, and able to accept and cope with the stresses life brings, including those caused by women's subordinate position in their relationships. Acquiescent femininity and hegemonic masculinity are both cultural ideals and are upheld by a system of sanctions and rewards.
Women who do not comply, or express resistance, suffer marginalization and stigmatization. For example, divorce is an ultimate act of non-compliance, and for women in African culture, is strongly stigmatized and happens infrequently. The position of these women was recently described by one older Xhosa woman politician, when she said, "In our language [isiXhosa] we have iintombi unmarried girls and iintombazana married women.
We have no word for women who divorce, we do not know where to put them. This is not to say that there is no social space in South Africa for gender difference. There are many men from across the social spectrum who adopt masculinities that incorporate counter hegemonic practices, such as engagement in childcare and caring for sick and disabled relatives, or support for gender equality and opposition to against violence against women [ 48 , 49 ].
There are also many women who are single mothers and economically independent of men [ 27 ]. But equally, it is important to read these behaviours through a historical and cultural lens. In South Africa, the gendered division of labour has constantly evolved and shifted. Women historically have engaged in domestic work and caring [ 50 ]. They have adopted gender positions as "wives" in single-sex institutional settings [ 51 - 53 ], and women have run households that are economically independent of men [ 54 ].
The long historical trajectory shows the dynamism and fluidity of gender relations, but it does not show that these women and men resist the fundamental gender order that subordinates women to men [ 48 ]. It is possible to occupy apparently dissident gender positions without mounting an outright challenge to the gender order or supporting an alternative, gender-equitable vision of society.
Compliance with the dominant acquiescent femininity is rewarded, not just by men, but by other women. Women with desirable partners are admired by their peers, and respected in families and communities. Just as hegemonically masculine men seek amenable female partners so that their relationships can be relatively harmonious, rather than characterized by strong resistance, successful women desire hegemonic men [ 55 ]. Viewed as "real men", their displays of hegemonic masculinity are interpreted by many women as sexually and socially desirable, and research by the authors, and others, shows that men who practice more gender-equitable masculinities are often marginalized by women.
It is important for this argument not to be read in a way that is either culturally deterministic or victim blaming. We argue that in pursuit of hegemonic masculinity, as well as the dominant emphasised femininity, men and women are following ideals that have deep cultural roots and thus, models of behaviour that may be hard for individuals to critique and exercise real choices around. Indeed, we invoke a notion of choice for women with considerable caution, given the huge constraints on the power of young, impoverished women in a patriarchal society that has a marked age hierarchy.
Nonetheless, there is considerable diversity in the actual practices of men, choices of partners by women, and degrees of complicity, cooperation and resistance. There are women from across the social spectrum who resist gender inequality, and there is a proud history of women's movements in South Africa and of role models of women who have asserted considerable power of different forms within communities [ 56 , 57 ]. When interpreting women's decision making around partners and responses to male violence and controlling practices, it is apparent that women differ in the degree to which they accept and excuse these.
While in some cases, this is a product of social and financial circumstances that leave no options, the visibility of this in the dating relationships of girls who are supported financially in their families reveals that the picture is more complex. Women who experience more marked gender inequity in relationships and violence are placed at risk of HIV because they lack control of the circumstances of sex during particularly risky encounters, but their exposure to such gender inequity and violence is often related to complicity with an ideal of hegemonic masculinity.
When women are acquiescent and accept male control and violence, their behaviour is considered as a trade off made from an expectation of social or financial reward. The degree to which women feel able to risk loss or non-acquisition of these rewards differs according to other dimensions of their material and emotional vulnerability.
Thus, the poorest and most marginalized women, and those who have been rendered vulnerable in other ways, such as by abuse in childhood, may be least able to take the risk of displaying signs of non-conformity and resistance and of bucking the patriarchal trend of passively subordinating themselves to men. Thus far, we have argued that sexual practices are rooted in and flow from although not always in a consistent and linear way gender identities, and therefore we need to address our attention to changing the bigger picture, rather than the individual behaviours.
In real terms, this means focusing attention on building more gender-equitable and caring masculinities, and less acquiescent femininities. In so doing, interventions are needed at policy, service and community levels, as well as individual levels [ 58 ].
This needs to include, for example, investment in education, change to the national legal and policy framework related to gender equity, policy support for women's economic empowerment and property and inheritance rights, and strengthening the school curriculum and institutional environment so that it can promote gender equity and protect girl learners from violence and harassment in schools. Both policy changes and service strengthening are needed to effectively enforce legislation that protects women and girls from gender-based violence and enables effective care and legal redress and protection for survivors.
There is a need for initiatives at all levels to promote men's involvement in the care economy, including in South Africa, promoting the involvement of men as fathers, both financially and socially, in the lives of their children. Interventions at an individual level and those that address community norms around gender and HIV have been developed in many settings. Some of these are gender sensitive, in that they recognise the specific needs and realities of men based on the social construction of gender roles.
The better ones are "gender transformative" in that they seek to transform gender roles and promote more gender equity and thus address themselves to changing how men come to view themselves, and thus behave, as men [ 59 ].
Introduction: Gender and Politics: A Gendered World, a Gendered Discipline
Examples are interventions that have focused on changing harmful gender norms away from attitudes and behaviours that negatively impact on women's health and HIV risk through initiatives such as the Better Life Options for Boys that was implemented across 11 Indian states in schools with more than boys [ 60 ]. There are also examples of major national mass media initiatives, such as the Sexto Sentido campaign in Nicaragua, the Brothers for Life campaign in South Africa that seeks to change societal norms around masculinity, and the White Ribbon campaigns initiated in Canada that have focused on raising awareness about and changing norms on gender-based violence in many countries.
Sexto Sentido has been very extensively evaluated and shown to be effective in building gender-equitable attitudes, communication about HIV and condom use [ 61 ]. Other examples include the Program H group education intervention and social marketing campaign, developed in Brazil, that focused on improving sexual health and reducing HIV risk through changing gender norms and reducing violence.
Its evaluation showed impact on gender attitudes and the prevalence of self-reported sexually transmitted infections [ 62 ]. Evaluation suggests that gender-transformative interventions are more effective than those that merely acknowledge or mention gender norms and roles. The small, but emerging, body of literature on evaluations of HIV prevention behavioural interventions in sub-Saharan Africa has shown these to be generally unsuccessful, especially when using biological markers of sexual risk [ 63 , 64 ].
An exception is Stepping Stones. This intervention, first developed by Alice Welbourn for Uganda and now used in more than 40 countries, seeks to be gender transformative. Stepping Stones involves a participatory approach that includes critical reflection to encourage safer sexual practices through building more gender-equitable relationships. Evaluation of its effectiveness in a randomized controlled trial showed that it was successful in achieving a reduction both in a biological indicator HSV-2 infections in men and women and in perpetration of intimate partner violence over two years of follow up [ 65 ].