Culture, Health & Sexuality最新文献

Despite growing international criticism of actions and efforts to change sexual orientation and gender identity, such efforts remain prevalent in Malaysia. Using data from a nationwide community-based survey, this study examined the prevalence of these efforts amongst LGBT+ adults and the association between exposure to them and mental health outcomes. Participants (n = 521) completed an online survey assessing exposure to efforts to change their sexual orientation and/or gender identity, internalised LGBT-phobia, negative future expectations, and several mental health variables. Just under sixty-four percent (n = 333) of participants reported having experienced change efforts, with the most common perpetrators being family members, friends and religious organisations or people. Recent (past year) and past exposure to change efforts (over one year ago) were each associated with significantly higher odds of suicidal ideation, non-suicidal self-injury, and suicide attempts. Participants with recent exposure to change efforts also reported elevated internalised LGBT-phobia and negative future expectations compared to those who lacked such experience. A content analysis of participants' open-ended responses documented the perceived impact of change efforts on proximal stressors and mental health and wellbeing. Recommendations are made for national authorities and healthcare bodies to ban efforts to change sexual orientation and gender identity in Malaysia.

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

Female circumcision (genital cutting) in Malaysia is largely understudied at present. This study unpacks the perceptions of Malay-Muslim women with regards to sunat perempuan (female circumcision) in Malaysia. Through stakeholder engagement discussions organised by a civil society organisation, 17 Malay-Muslim women shared their views in relation to the practice with a particular focus on: (1) their awareness and personal experience of it; (2) their opinions and knowledge about the practice; (3) beliefs related to the practice; and (4) the roles of relevant stakeholders in advocacy work related to the practice. The data were analysed thematically and interpreted based on the grammar of legitimation and social norms theory. The findings reveal several themes, involving the perceived benefits of the practice; tradition and conformity to social norms; conflicting emotions related to religion; and implicit pressure and fear of negative sanctions in relation to the practice. The findings shed light on the concerns faced by Malay-Muslim women in their decision-making process in relation to the practice of female circumcision in Malaysia.

Kerala, the Indian state with the highest reported level of social development, faces a challenge with persistent early marriage, particularly among Muslims in Malappuram. This study explores the sociocultural factors influencing this situation, in which child marriage rates among Muslims are significantly higher than those of Hindus and Christians. Employing a qualitative research strategy within a specific Malappuram mahallu, a Muslim-majority village cluster encompassing three villages, we identify a multifaceted interplay of micro and macro forces perpetuating early marriage. Lack of social networks, stemming from limited higher education options and career opportunities, restricts girls' choices and makes them susceptible to parental pressure to marry early. Parents, on the other hand, often view early marriage as an appropriate solution to their anxieties concerning parental responsibility, dowry and family honour. This pressure is amplified by the narrative promoted by religious leaders who portray early marriage as the ideal path. This narrative, in turn, resonates with a subset of young men, particularly temporary Gulf migrants who prefer to marry adolescent girls, thereby perpetuating the cycle. We also argue that, unlike most regions in India, poverty and illiteracy are not the primary drivers of early marriage among Muslims in Malappuram.

The COVID-19 pandemic had a devastating impact on the health and wellbeing of populations around the world, with vulnerable groups, including sex workers, being disproportionately affected. This study explored the effects of COVID-19 lockdown restrictions on the lives of female sex workers in Pattaya, Thailand. In-depth interviews with ten women were used to explore the ways in which they sought to cope during the crisis using Lazarus and Folkman's transactional model of stress and coping. Findings suggest that those who could, tended to seek economic shelter with their parents in rural parts of the country during the pandemic. However, those who could not relocate to be with family were forced to try to eke out a living in other ways, which could be both challenging and dangerous. None reported receiving any financial support from national or local authorities, to whom they were invisible, and this placed tremendous pressure on both them and their families. The authors conclude that the pandemic further highlights the need for the Thai Government to accept the reality of sex work and seek to both legitimise and protect vulnerable women and their labour.

Men who have sex with men represent a significant portion of new HIV diagnoses in China. Guided by the systemic transactional model and interdependence theory, we examined the mediating role of 'we-ness' between dyadic coping and HIV-specific support among Chinese serodiscordant male couples, and how cultural interdependence shapes this we-ness. We employed a mixed-methods design which included a cross-sectional survey of 234 couples and qualitative interviews with 20 couples. Using the actor-partner interdependence mediation model, our quantitative analysis found that (1) both positive and negative dyadic coping had significant actor effects but nonsignificant partner effects on HIV-specific support, and (2) we-ness mediated both dyadic coping strategies and HIV-specific support, with significant actor-actor effects and partner-actor effects. Our qualitative inquiry identified that we-ness is fundamentally shaped by couples' negotiated pattern of interdependence, characterised by selective independence in HIV care alongside interdependence in HIV prevention. Our findings advance theoretical understanding by demonstrating we-ness as a critical mediating mechanism and reveal how couples' negotiated interdependence extends beyond the traditional continuum between dependence and independence. Findings suggest the need for culturally embedded interventions that recognise couples' shared we-ness and strategic negotiation in HIV management.

Disparities in adolescent sexual and reproductive health (SRH) outcomes in rural areas of the USA persist as a concern in achieving health equity for youth. A growing body of literature recognises that improving adolescents' health necessitates systems thinking to address the culture and environment in which adolescents live. This paper uses systems thinking to identify leverage points to improve adolescent SRH in rural Latino communities in California. We conducted focus group discussions with 22 young people and interviewed 10 adult stakeholders to centre the perspectives of youth and youth-serving professionals. Transcripts were coded and analysed using systems thinking. Five themes were developed: (1) community and cultural norms can be a source of both support and stigma for youth; (2) families are key to supporting health education and services; (3) rural schools provide a central hub for programme delivery; (4) community-based organisations can work to serve rural youth, but limited resources and transport are challenges; and (5) youth face considerable barriers accessing SRH services in their communities. Using systems thinking to identify leverage points and gaps in interactions between system components influencing youth can aid in the development of more holistic and culturally responsive approaches for rural youth SRH.

Black women's sexuality has historically been constrained by stereotypes and a discourse focused on risks rather than pleasure. Early Black women rappers initiated vital conversations about sexual pleasure, with contemporary Black women rappers continuing to challenge norms and define Black women's sexualities. Grounded in Hip-Hop Feminism and Sexual Script Theory, this study explores how Black women interpret and find meaning in sexual pleasure-focused lyrics in Black women's rap music and how these interpretations shape their sexual self-concepts and navigation of systemic oppression. Through semi-structured interviews with 20 Black women aged 20-42 years who frequently listen to Black women rappers, thematic and discourse analysis identified three key themes: (a) prioritising sexual pleasure as a means of self-empowerment; (b) practising assertiveness as a means to achieving sexual pleasure; and (c) celebrating the body as an act of sexual pleasure. Black women rappers' unapologetic discussion of sexual pleasure empowers Black women to reclaim sexuality on their own terms, independent of dominant societal narratives. This study extends existing literature on Hip-Hop Feminism by demonstrating the transformative potential of culturally relevant media in fostering sex-positive attitudes and advocates for incorporating these messages into sexual health education for Black women.

University students in Myanmar experience a high prevalence of sexual and reproductive health (SRH) problems including unintended pregnancies and sexually transmitted infections. These are compounded by pervasive cultural taboos surrounding sex and sexuality. Sexual and reproductive health literacy is crucial to addressing these problems. Four focus group discussions with 33 university students revealed how cultural taboos act as barriers across five SRH literacy subdomains: accessing, comprehending, criticising and applying SRH information, and communicating with healthcare providers. Students primarily relied on online health information rather than face-to-face discussions. Many students considered SRH information to be 'dirty' and experienced feelings of shame, guilt and fear of being blamed or disrespected while seeking healthcare. They therefore hesitated to visit healthcare providers and sought SRH services only in urgent medical situations. Additionally, all SRH literacy subdomains were influenced by cultural taboos surrounding sex: societal denial towards youth premarital sex, and the perception of sexual matters as embarrassing and inappropriate. Advocacy is needed to promote positive societal attitudes towards sexual matters and youth premarital sex, signalling the value of culturally tailored digital SRH literacy interventions using vernacular language. Healthcare providers should offer non-judgemental youth-centred services to promote SRH literacy among students.

Violence remains a persistent challenge in South African schools, prompting investigations into underlying risk factors and mitigation strategies. However, an under-explored aspect of this violence is the potential link between the consumption of Internet porn via cellphones among girls and boys, and girls' risks to sexual violence inside the classroom. To address this gap, we used focus group discussions with 14-17-year-old South African girls to examine their experiences of porn access via cellphones and their accounts of sexual violence at school. The study illuminates the nuanced ways in which the girls experience risks and express agency. First, the girls illustrate a link between sexual harassment and boys accessing porn on their cellphones during class. Second, the findings show how girls negotiate their sexual agency and safety through contesting sexual violence. Third, there are conflicting views about porn: while some girls admitted liking and viewing porn, others objected to it as harmful and degrading. Finally, this study offers crucial insights into strategies to create safer school environments and gender equality by drawing attention to the intersections between cellphone porn consumption, sexuality, and girls' negotiations of sexual agency amidst sexual risk in the classroom.