Empowerment, Citizenship and Redemption? Economic programmes and policies for female sex workers

28/10/2014

Cheryl Overs

All sides in the complex and frequently fiery debates about female adult sex work acknowledge links between sex work and economic disadvantage, injustice and inequality. My recent work has explored economic programming and policies that affect female adult sex workers in Ethiopia. As in other low income countries a significant percentage of Ethiopian women live in chronic, acute poverty and the links between poverty and sex work are at their least ambiguous – it causes more women to sell sex than there is demand for sexual services which means that the sex industry is a ‘buyers’ market’ from which most women can only find subsistence livelihoods. In very low income countries sex work does not offer women a ladder out of poverty as it can in wealthy and middle income countries. In this context it is crucial to work out what ‘economic empowerment’ of sex workers means, identify the policies and programmes that can achieve it and get them in to place at scale. We also need to know which ones are a waste of time or money.

Basket weave your way out of prostitution

The first time I heard about rehabilitation programmes for sex workers was at an AIDS conference in 1988. I whispered to my friend, ‘What? Basket weave your way out of prostitution?’ He whispered back ‘if it’s that easy, why not get everybody to weave baskets?’. Six years later when I was researching Making Sex Work Safe: a guide for field workers, programme managers and policy makers’ I noticed accounts of sex worker rehabilitation in developing countries coming in alongside the first data from targeted HIV interventions. I included pieces in the book about a programme aiming to help sex workers earn income from other sources in Kenya and about social workers in the Philippines who were disappointed and puzzled because women who had said they desperately wanted another job had abandoned the programmes they’d set up for them.

Since then thousands of HIV projects for sex workers have developed and many sex worker groups have formed, some of which have established and sustained strong economic empowerment projects. In most places, rich and poor, HIV programmes for sex workers include some training or support to help women out of sex work. I have visited several and slowly formed the impression that they are frequently a side event to the public health work operated by an unregistered community based organisation while the funded HIV work is done by a ‘parent’ NGO. I was often told by NGO staff that their rehabilitation or ‘exiting’ programme was a kind of window dressing to help reduce opposition to programmes that might be seen as encouraging immorality because they advise about safe sex and distribute condoms. At the same time some more dynamic initiatives seemed to be emerging from NGOs that had been formed to respond to HIV economic empowerment programmes like that of the Usha Co-operative in Kolkata and VAMP Maharashtra India. Most recently anti-trafficking initiatives have spawned hundreds of projects that aim to rehabilitate exploited or trafficked women. Often called ‘aftercare’, these have burgeoned with the increases in anti-trafficking funds and they are operated by a variety of religious, military, feminist and development organisations such as the International Justice Mission, and Restore International.

Policy on the rehabilitation of sex workers has also developed although not always smoothly. In 2007 UNAIDS recommended rehabilitation as one of three strategies for preventing HIV among sex workers (the others were preventing women and girls becoming sex workers and ensuring that those that were not rehabilitated could access condoms and HIV tests) but replaced this in 2009 after criticism about its reliance on the possibility of relocating significant numbers of women into other occupations or reducing the total number of commercial sexual transactions. Several governments have introduced policy to support women to leave sex work, most notably in India where a Supreme Court decision obligated States to offer rehabilitation services to sex workers.

They tried to make me go to rehab but I said no, no, no

Sex workers activists have been consistently critical of rehabilitation and developed a catalogue of serious human rights abuses associated with it across the world. Several anti-rehabilitation campaigns have called for rehabilitation to be abandoned in favour of rights based approaches to increasing economic options. Because sex work is posited as a valid occupation activists reject both the ideology of ‘rescuing’ women from prostitution and the human rights violations associated with coercive or moralistic programmes. They argue that money would be better spent on increasing sex workers access to justice, education, safe workplaces, finance, housing, health care and other building blocks of fulfilled lives. The sewing machine has been used to symbolise rehabilitation and it has been accompanied with slogans opposing ‘raid and rescue’ such as ‘Save us from Saviours’; ‘Not Your Rescue Project’ and ‘With Rights I can Rescue Myself’. I think everyone’s favourite was created by Cambodian sex workers – ‘Don’t talk to me about sewing machines, talk to me about workers rights’. It encapsulates that position perfectly.

sewing machine logo for Cheryl's blog oct 14

Logo of the Asia Pacific Network of Sex Workers

But although the damage associated with ‘bad rehab’* has been well documented, it can’t be ignored that many sex workers want a livelihood that enables them to absorb economic shocks, access resources and services or to retire or escape from violence, criminality and abuse associated with sex work, which frequently also affects their children. Logically, the poorer the country, and therefore the less profitable the sex industry, the more women will want development agencies to work on giving them this option. This raises the question, what is ‘good rehab’ in a low income country?

I began to answer that question in 1994 in Making Sex Work Safe by distinguishing between moralistic services that aimed to ‘save’ women by setting them up to earn an alternative income and those that aimed to help sex workers by:

  • reducing the discrimination which bars access to economic opportunities
  • developing supplementary income
  •  career development within the sex industry.

I argued that the former were disempowering and the latter empowering – which were fresh and fashionable words in 1994! Since 2011 I have been revisiting this issue, reviewing the relevant literature and conducting field work over several trips to Ethiopia.

The written word

When I looked at the literature to catch up on progress in economic programmes for sex workers I was disappointed to find that few are documented and that there is still no overall map of them and that research and guidance is scarce. I was alarmed that the picture I had painted two decades earlier of two essential approaches seemed to be intact but not much further articulated or evaluated. It appears that most programmes aim for women to abstain from commercial sex completely and a few aim to expand sex workers economic options and power in the way I had previously outlined. The latter seem to be more ethically sound and popular with sex workers and there are signs that they benefit more women than abstinence based programmes which, even where they haven’t violated human rights, don’t appear to deliver the sustainable, new livelihood streams they promise. But I am deliberately using vague words like ‘appears’ and ‘seems’ because there is not enough information to make a call here.

Almost no data is available from any of the HIV projects about outcomes – how many women they caused to leave sex work or what impact that has had on HIV, and which industries and types of programmes (microcredit, training etc) are best. The focus on a narrow scope of alternative occupations is striking. In a margin I scribbled, ‘isn’t it unlikely that there is sufficient market demand for hairdressers to justify training whole groups of sex workers in hairdressing?’ There is even less information about the outcomes of ‘aftercare’ and religious programmes for trafficked persons and/or sex workers and/or victims of exploitation. Much is written about the potential for women to find new livelihoods after various short trainings and small loans but most are anecdotal ‘success stories’, typically about the redemptive transformation of a sex worker into hairdresser, or internal evaluations written by the operators of programmes. We don’t know if sex workers leave the sex industry at all and, if they do, whether they are replaced. We don’t know which sex workers benefit from which kind of program or who qualifies for micro-credit. Nor do we know what impact rehabilitation programmes have on the sex workers who don’t participate – which is important because most programmes can only offer places to a tiny percentage of the total number of candidates.

Methodologies, and the questions of scale and coverage that are usually central to development and public health programming remain unaddressed. No-one has identified how many sex workers would need to earn how much alternative or supplementary income to reduce the overall number of women selling sex or to drive shifts in the number and pattern of commercial sexual transactions/networks sufficient to impact on an HIV epidemic, the incidence of gender based violence, or any other outcome.

This lack of information needed to make the call about what constitutes good or bad ‘rehab’ is alarming because a large amount of money is spent on economic programmes for sex workers, much of which comes from large agencies that would normally require solid evidence before they support specific approaches. Rigorous research here is sorely needed. Why it hasn’t happened already is a mystery.

What is sure is that every day, with all I do, I always have less than I need

Over four years I conducted interviews with adult female sex workers, NGO workers and policy makers in three Ethiopian cities. The work explored the impact of the laws against sex work (minimal because they are not enforced); the incidence of coercion and violence (low compared to other places but still serious enough); mobility (the vast majority of sex workers live and work away from their place of origin); underage prostitution (far too much and few efforts to stem it); trafficking into the sex industry (it happens but is minimal because poverty ensures a steady flow of recruits); police corruption (bribes are not paid) and exploitation (yes, but how much depends on the benchmark of non-exploitative work). Freelancers can work independently but women who depend on third parties often suffer poor conditions and are overcharged for services and accommodation. I also asked lots of questions about the dynamics of income generating projects and visited several. I was trying to sort out ‘window dressing’ from useful projects and work out how to identify, measure and encourage ‘good rehab’.

In the process I ate the Ethiopian staple, injera which has been produced for many years by a self-funding sex worker collective; watched football in a crowded café run by HIV positive sex workers; helped at a 24 hour ‘hole in the wall’ condom kiosk and saw a sex worker catering collective providing lunch at a police training workshop. I also had a wonderful coat made for a great price (but within my benchmark of exploitation!). I heard some bad things too. One NGO told me about funds they had for a ludicrous silk production scheme that might save a handful of ‘fallen women’ years down the track but which, in the meantime, was covering the salaries of a gaggle of project officers with an office and shiny Land Rover. I talked with women who were working very hard to sew goods that they are only permitted to sell at an NGO market that’s mainly patronised by foreigners. They couldn’t work out why they sold so little. Sadly, I was able to figure it out with a glance at the colours and designs.

I was curious about which sex workers did, and didn’t, attend the income generating projects or enrol in trainings or join savings and loans groups. I asked focus groups and individual interviewees “Who joined?” “Who stayed?” “Who dropped out and why?” One woman answered the ‘why’ with a lesson in basic arithmetic:

To support my family and live with any kind of dignity would cost 100 birr [about 3 pounds] per day. I make between 20 and 70 birr from sex work, but only on some days. I can get 20 to 50 [from the income generating project] and sometimes I can make a few birr in another way. What is sure is that every day, with all I do, I always have less than I need.

As those words illustrate, broader economic conditions mean that multiple strategies are needed because every available strategy is weak and highly likely to fail at some stage and welfare safety nets are non-existent or unreliable. It also illustrates the need for daily income and thus why schemes that require a women to invest time and money before she has any return may not be suitable for sex workers.

sewing at the Sisters Project cheryl overs blog oct 14

Sewing at the Sisters Project

Another important motivation to attend the income generating projects emerged from my interviews that surprised even their operators. By enrolling in an income generating programme sex workers can obtain the address and supporting documentation they need to obtain a government identity document. These ID cards are needed to conduct any economic activities, travel or access services in Ethiopia, similarly to ration or voting cards that Indian sex workers have also struggled to obtain. This is especially important for mobile sex workers (as already mentioned, the majority) because the cards are recognised locally not nationally.

I asked everyone I spoke to about women exiting the sex industry as a result of NGO economic empowerment programmes. Most said they didn’t know any young women who had gained a new occupation as a result of the programmes yet but that some were on the way in that they were trained and/or had received a loan. Some said that they had heard of older women who had attended NGO projects or joined traditional local income generating groups (Idars) stopping sex work permanently. Mothers said they can take their children to the income generating projects that produce and sell goods (usually injeras) on a daily basis and provide lunch. Several older women said they benefit from even tiny amounts of money when they cannot earn much from selling sex.

From all this I could see evidence that for Ethiopian sex workers, NGO economic empowerment programmes are a strategy for dealing not only with low income but with discrimination and lack of access to various services, commodities, spaces and to citizenship itself. I argued that the neo liberal ideals that place enterprise as a central element of development are not serving sex workers well and that programmes would almost certainly work better if they were targeted and planned rather than rolled out to a frankly tired formula. But I also suggested that improvement is unlikely without more resources, some evaluation and better accountability.

Revisiting Soloman

After writing and talking about sex work and poverty in Ethiopia over the years I visited in mid-2014. I was wondering if any of my arguments about the potential benefits of sustainable, rights based economic empowerment initiatives for sex workers had fallen on fertile ground.

My first stop was the Addis Ababa sex worker group Nikat. Since my last visit its economic empowerment project had been funded by the Dutch organisation that I had urged to adopt the idea of developing careers within, without and alongside sex work. The programme is called Stepping Up Stepping Out and the women in it are dedicated to their studies of trades by day and they don’t need to make it a secret that they still sell sex – ‘but not every night and not until late like I used to’ said one women in the programme. The bad news is that the programme is miniscule. At best it reaches tens of women in a place where it needs to reach tens of thousands. Hopefully it is a pilot and a larger donor will pay for rapid and significant scale-up.

I was delighted to hear that the NGO Timret, who had shown me around its centres, had conducted a successful campaign in its 34 centres across the country to obtain ID cards for sex workers in response to my observation that lack of them drove sex workers vulnerability. Hundreds of women became ‘legal people.’ I was even more pleased to hear that Timret found most local authorities to be more co-operative than they had expected. The bad news is that most of those centres will close or be scaled right back due to funding cuts.

The EU Delegation to Ethiopia asked me to advise about how they might be able to support ‘good rehab’ through their work with local authorities. ‘No need for me’ I said, ‘Come to Nikat’. A traditional coffee ceremony and an excursion to talk to women in sex work shanty towns were quickly arranged. The Nikat leadership held forth on issues around poverty and their vision of ‘rights based’ policies and programmes to alleviate it. The women in the shanty town explained that while talk about becoming a shopkeeper or a hairdresser was good for a select few, it isn’t relevant to the thousands of women living in huge slums without sanitation, basic health care, education or child protection. Their points about what ‘economic advancement’ and ‘access to services’ meant were underlined by there being a newborn baby on virtually every bed. They explained that their babies stay there while their mothers service clients and the toddlers play outside amid open drains and live electricity cables. As well as the visible conditions which were shocking enough, the women provided eye popping facts about how much they pay to live in tiny leaking huts and what it takes to earn it. The EU delegation is supporting local government to improve services in slums and I left confident that some excellent information had been shared and that there would be follow-up that explored how to make sure those benefits extend to these slums.

I had yet another pleasant surprise when I visited the office of the President’s Emergency Plan for Aids Relief, (PEPFAR) at the US Embassy in Addis. USAID’s PEPFAR programme is the major donor for HIV services for sex workers in Ethiopia. I asked what its policy is in respect of helping women get out of the sex industry. Those who know about US HIV policy will know that PEPFAR has favoured abstinence and required the organisations it funds agree to oppose prostitution and that this has caused much gnashing of teeth. The Ethiopia PEPFAR director began defensively. He is clearly used to this enquiry coming from people who want or expect US funding to be used to reduce sex work. ‘It is not realistic to try to get all the sex workers in Ethiopia into new jobs. It’s also moralistic and that alienates them. Now our programmes are focussed on helping expand options which includes human rights, access to services and better living conditions and generating income that supplements sex work which allows women to work less or refuse clients that don’t want to use a condom.’ I resisted the impulse to make a wisecrack about how a lot of time and money could have been saved and HIV prevented if USAID had have listened two decades ago. Later I shared this with a colleague who had contributed all those years ago to Making Sex Work Safe. “We can sure rack that up as a belated success” she chuckled.

Conclusion

It’s clear that economic empowerment for sex workers in poor countries matters – it must work if human rights, public health and development goals are to be reached. My work on poverty alleviation and sex work is limited and it asks many questions as well as making some recommendations based on the evidence I gathered. It supports one solid conclusion above all others – that more research is needed to drive better conceptual frameworks and practical guidance to identify what policy and programmes should be scaled up and how. Now I know, I know – all researchers call for more research – but I am confident that if anyone doubts my assertion about lack of reliable data or thoughtful modelling about economic empowerment for adult female sex workers they will find the information abyss of which I have spoken.

*Sex workers made a film about abuses associated with rehabilitation named Bad Rehab

Cheryl Overs is a Senior Research Fellow at The Michael Kirby Institute of Human Rights and Public Health at Monash University Melbourne Australia and is a visiting research fellow at IDS.

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Digital Battlegrounds: the growing struggle to contest LGBT online spaces

15/10/2014

Stephen WoodStephen_Wood200

The meteoric rise in the use of smart phones and the internet over the last ten years, both within the West and in increasing numbers in regions such as South-East Asia and Africa, has brought fresh opportunities by which we can make sense of ourselves as individuals and participate in our communities. There is now recognition amongst politicians and policy actors that these technological advances are shaping public debate in unexpected and interconnected ways.

Nowhere has this transformation been so noticeable and relevant than amongst those sexual minorities building lives in societies whose harsh cultural and legal barriers prevent open expression of non-normative sexualities. For many, lives lived online have become richer, offering resilience and strength in ways impossible on the streets or even within their home.

Opportunities for online growth

The possibilities of social media have facilitated the establishment of discreet and anonymous methods of connecting and meeting up for social support, commercial transactions, sexual and romantic encounters. In places such as China, where family plays an incredibly important part in building and maintaining social capital, there has been a growth in ‘arranged’ marriages between lesbians and gay men organised online that provide opportunities for mutually-assured social acceptance and a freedom to explore identities discreetly, especially in urban settings where kinship networks are policed less. Heavily moderated and secure online spaces on platforms such as Facebook in countries like the Philippines allow for anonymous or open organizing for social and political activism, as well as providing opportunities for HIV prevention outreach work, such as the Adam’s Love campaign in Thailand for men who love men.

As researchers, these virtual spaces provide fresh opportunities for us to engage with and hear from ‘hidden’ populations, providing we remain mindful that any data we might glean could stem from the relatively privileged in society. As my colleague Pauline Oosterhoff writes in her recent paper ‘Research Methods and Visualisation Tools for Online LGBT communities’, there are remarkable possibilities for larger scale quantitative data collection from geographically dispersed and ordinarily inaccessible participants, although not without some concerns about the quality of data and ethical considerations. With the rising expense of conducting research, this also represents a cost-effective mechanism for building research cohorts and disseminating our findings to new audiences.

The double-edged sword

This connectivity, that brings global communities closer together and feeds perceptions of users as private, individual consumers going about their business away from prying eyes, masks very real dangers. The backlash is already with us. Human rights advocate Scott Long has written extensively about the state targeting of sexual minorities communities in Egypt over the last couple of years, with police targeting LGBT people as a result of online postings that even tangentially aid in their identification. Popular gay male smartphone app Grindr (which presents profiles ordered by GPS distance between users and is thereby incredibly popular for organizing hook-ups) has the potential to identify the physical location of users and could have its functionality distorted into a tool for facilitating violence, entrapment or blackmail for unwary users. The illusory freedom of online life sometimes leaves people feeling invincible and unable to gauge the potential dangers.

As researchers and activists, we must recognize that we stand at a crucial crossroads in the maturity of the internet. In the public eye, the fiercely empowering nature of online activity still holds sway, with acres of media coverage of how democratic accountability was ignited in the ‘social media revolution’ of the Arab Spring or domestically during the recent Scottish Independence debate. These dramatic images of societies coming together in online dialogue are much more visible than the more abstract concerns about big data, cyber security, state surveillance and silencing of dissent. But their impact is devastating. In the last month alone, Scott Long has compellingly exposed the Egyptian government tendering out for tech companies able to provide tools for monitoring online traffic in incredibly intrusive ways, including for evidence of “terminology and vocabulary that are contrary to law and public morality or beyond the scope of custom and community ties”. The successful tender came from a sister company of a Californian-based US internet security firm, raising probing questions about the conflicted relationship Western states are playing in ongoing global debates around LGBT equality, as arrests, detention and abuse across Egypt of LGBT people increases dramatically.

Online activism represents a new front for citizen participation, mobilization and (in)visibility. As a relatively new area of research, there is a real need for evidence to elucidate whether or not it facilitates the emergence of voices from those parts of sexual minority communities that are usually rendered invisible, or whether we are exposed to a vocal activist base drawn from the technologically literate, relatively privileged classes in society pursuing campaigns that at times run counter to the needs and priorities of poorer LGBT people. These campaigns in turn run the risk of being unquestioned and mirrored into global policy spaces by the rapidly expanding class of well-intentioned international LGBT activist ‘clickdavists’, whose efforts could exacerbate accusations of Western cultural imperialism.

The potential for online spaces to foster strong communities and civic participation amongst those facing discrimination as a consequence of their sexual identities remains great, yet are being contested aggressively by opponents. Even amongst sexual minorities themselves, the dynamics of social media use are reshaping communities and civil society in under-examined ways that are potentially troubling and warrant further research. With activists and academics pressured on a daily basis to put their energies into the viscerally immediate ‘ground war’ of embattled LGBT communities, we ignore the online ‘air war’ at our peril.

Stephen Wood is a Research Officer on the Sexuality and Development Programme within the Participation, Power and Social Change research team at IDS. He can be found on Twitter as: StephenWood_UK

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The paradoxical role of families in women and girls health in slums

09/07/2014

Pauline OosterhoffPauline profile

One of the things that strikes one most clearly in working in the slums in Kenya is that, as in many developing countries, the state is barely present in most people’s lives. For the women my colleague Emily Kahega Igonya and I encountered in Nairobi’s slums last week, the government was inactive while they were sold by their sisters or brothers-in-law, tricked into unpaid work with false promises of education, and kicked out of their parental homes as orphans.

Yet Kenya’s recent constitutional reforms are based on the idea that devolution, handing off central government responsibilities to municipalities, can solve people’s problems by bringing government closer to their lives. This seems doubtful, given that for most of the women in slums we talked to, it is family and friends, not the state, that provides them with support. It made us wonder how and to what extent state policies can interfere in dysfunctional families, when it is the family that provides for the services that dysfunctional states fail to provide.

The impact of the new Kenyan constitution on health outcomes

According to the new Kenyan constitution introduced in May 2010, all Kenyans have the right to the highest attainable standard of health. To realise access to health, the constitutional reforms prescribe “devolution”, a transfer of responsibility from the national government to the counties. Devolution should bring the government closer to the people.

Last week Emily and I examined the effects of Kenya’s constitutional reforms on access to HIV and AIDS services for women and girls in Nairobi slums. We worked with HIV-positive women, all young mothers, on digital storytelling to inform policy makers of the effects of these national policies on their health. All women described betrayal in their families –often by other women- that exposed them to HIV, violence, and destitution. Yet it is their sense of family –even if it is just their own children – that allows them to survive in the absence of a functioning state.

When Larissa, a widow with two children, completed primary school in a village, her mother was no longer able to pay for her school fees. She called her elder sister in Nairobi, who offered to pay for her education. Upon arrival in Nairobi, however, her sister told her that she would only pay for school fees if Larissa agreed to marry her husband as his second wife. When she refused, her sister’s husband presented Larissa with a widower with two children who would marry her and pay her school fees if she were to take care of him and his children. She ran away and met a man with a job in a restaurant who paid her school fees and married her. Shortly after the delivery of her second child, he fell ill with AIDS. He encouraged her to seek treatment from international donors but he denied that he was HIV positive to her until the very end. She has now been inherited by his younger brother. He takes good care of her, and she is pregnant with his child. Who is failing women like her?

The implementation of the devolution of health services began last year, with the election of governors and county principals, but it has barely affected these women. For sex workers -some of whom have been involved in sex work since their early teens – the effect on their health has been clearly negative. Municipalities interpret and enforce laws on sex work more harshly than the central authorities did, chasing women off the streets and detaining them. Police detention makes it harder for them to take their AIDS medicines. Sex workers reported having to stop their medication completely, or change to herbal medication. In their perception, devolution means that “law enforcement can now use their cars freely to extort more bribes from us later at night.”

Sex work, the family and state support

For sex workers, other sex workers and community-based organizations are the main form of support after their own family failed. Rose, a young mother, was taken in by older sex workers when she was orphaned at the age of 15 and rejected by her family. She has worked as a sex worker ever since. Sarah’s mother decided that her job was done after her daughter finished primary school. Sarah decided to go to Nairobi to live with her aunt, who could not pay for all her expenses. She had to look for money herself, and at the age of fourteen she found herself on the streets as a sex worker. When her aunt guessed how she made her money, she threw her out, leaving her at the mercy of different men who took her in until they were bored or she became pregnant. Linda finished high school and went to college, hoping to become a secretary. She came to Nairobi to look for work and live with her uncle. He had no money to pay for her. The only people who were willing to help her find a job and a home were bargirls who moonlighted as sex workers.

Women we spoke with –no matter how poor- had done their best to avoid the state health services for years. As Lucy, a young widowed mother of two, explains, “there is no confidentiality, the lines are long and the hours are short, and everyone can see you.” Instead, they obtain AIDS medicines through internationally funded and managed services like MSF and CDC. Kenyan community-based organizations, like HAKI and COTANET, help women to organise themselves and establish their own peer support systems. But for housing, food and other essentials, it is their own family they rely on first. And when that system fails- without any safety net offered by the state, charities or INGO’s – women are exposed to many risks, including HIV. Policies that aim to support the right to health of women and girls in slums need to recognize the central roles of families in responding to governmental irresponsibility.

All names in this article are fictional to protect the identity of the women.

Pauline Oosterhoff is a Research Fellow for the Participation, Power and Social Change (PPSC) team at IDS. She can be found on Twitter as: @PPJOosterhoff

Previous blog posts by Pauline Oosterhoff:


What is sexual liberation? And is it safe?

26/06/2014

Anne Philpott

We often forget that safer sex can feel good. Putting on a condom could be like squeezing into your favourite sexy boots or latex dress, ready for action. Telling your lover what you want and your desire to be safe could be foreplay. Sexual health campaigns could focus on the positives of good safe sex. Sex education could include creative masturbation techniques. After all, what’s safer than a good wank?

‘Pleasure is arguably, if not definitively, the single most powerful motivating factor for sexual behaviour.’ – World Association for Sexual Health, 2008

While it’s important to discuss distorting images of sex, consent, and abuse, society’s focus only on saying ‘no’ leaves little room to highlight how we can learn to say yes to good, safe sex. Sex that fulfils us, makes us happy, satisfies us and bonds us to others. Recognising that we can create new types of safe, pleasurable sex, in which multi-faceted desires are recognised, should give us confidence that other forms of liberation are possible.

However today models of development focus on saving victims of violence or negative consequences of sexual risk. Whilst models of sexual liberation emphasize narrow goals of individual pleasure, focusing on lithe, heterosexual, monogamous bodies galloping towards orgasm. The politics of broader sexual liberation or a broader definition of sexual health are rarely discussed.

We need a new model of safer sex promotion
Sexual pleasure remains a highly significant, if not primary, motivating factor for sexual behaviour. There is strong evidence that the pursuit of pleasure is one of the primary reasons people have sex, and that fear of disease is not a strong motivator for safer sex. In ignoring pleasure, the development community is ignoring one of its most potent tools in stopping the spread of disease. It is also stopping the broader discussion of sexuality rights, including the recognition of individual agency, especially when it comes to those most affected by HIV. Female pleasure taboo obviously plays a huge role in female genital mutilation (FGM) practices however this is rarely discussed in terms of pleasure promotion to ensure communities accept that young women have as much right to feel pleasure as young men. Instead campaigns tend to focus on ending a terrible human rights abuse, and rarely mention how women can still feel pleasure post FGM or that the key motivator for carrying out female genital cutting (FGC) is societal fear of women’s pleasure.

Safer sex campaigns have focused almost exclusively on fear-based messages to promote safer sex, to the extent that the pursuit of sexual pleasure is seen either as destructive or even as a major contributor to the spread of HIV. Pleasure can also be about power, and men and women are expected to behave in certain ways to fit in with societal expectations. In many cultures wanting sex makes you ‘too easy’ or ‘a slag’, if you are a woman. In many cultures being too lubricated is a sign of being promiscuous, resulting in a preference for dry sex, whereas for men experience is respected. Women are also burdened with needing to appear always passive or ignorant. We risk violence, death or ostracism if we ‘enjoy sex too much’ or are not virgins when we are meant to be.

So how do we transform ourselves, creating more meaningful, good, safer sex lives? Sexual liberation is not only about more sex for some people, or more orgasms, but should prioritise pleasure, consent, and respect for a wide range of sexualities, (dis)abilities and body types.

Explicit safer sex campaigns that eroticise good, safe sex have been shown to make people feel good and be safer (pdf) with their lovers. Studies comparing American and Dutch young people (pdf) showed that the Dutch sex education, which focused on mutually enjoyable, responsible sex, leads to lower rates of unwanted pregnancy and sexually transmitted diseases.

talk dirty postcard

One of the postcards from the Pleasure Project

We at The Pleasure Project work to try and ensure that there are examples of erotic materials that are safe and that sexual health and training materials include discussions of pleasure. To this end, we wrote The Global Mapping of Pleasure to collect together examples of community groups, sex bloggers, porn film makers who are doing just that.

We profiled the Sensuousness Action Research Project (pdf) in West Bengal in India: they train gay male masseurs and clients in safe, sensual, satisfying pleasure techniques, aiming to provide economic security and life stability for the sex workers. Another project, St James Infirmary, in San Francisco, is a sex worker health service where workers are asked about what they enjoy at work in order to expand discussions of good safe sex.

We also profiled erotic safer-sex tea towels for gay men in Australia, dildo-making contests for marriage counselling nuns in Mozambique, and ‘seduction’ training modules for couples in Nigeria. Many groups work to enhance the sexual repertoire of heterosexual monogamous relationships, encouraging a less traditional view of the kind of sex you have with your marriage or long term partner. One slogan read: ‘Many positions with one, not one position with many’.

Avoid negativity – focus on desire and pleasure
All our case studies avoid sex negativity, promoting safer sex with a focus on desire and pleasure, at the same time working to reduce the shame people feel in pleasure. Most of the community groups in the mapping recognise that a focus on pleasure and safety means liberation from traditional perceptions of their sexuality and lives.

Dorothy Aken’Ova, founder of the Nigerian International Centre for Reproductive Health and Sexual Rights says:

‘People thought we were wasting time talking about sex and pleasure, when maternal mortality is so high … But I was convinced that if this delicate, taboo thing – sexual pleasure – could be negotiated by women, then almost anything can be negotiated (…and that idea gave me multiple orgasms!)’

Safer sex is promoted best through positive incentives and building communities of practise, learning from people who constantly negotiate safer sex, like sex workers, with people who are seen as the experts, like sex educators.

By opening up aspirations for safe pleasure in a wider range of relationships, or for people not traditionally expected to experience pleasure – women and people with disabilities, for example – we can unearth a much wider range of political freedoms.

Getting in touch with what we want from our sex lives might unearth much broader visions of liberation, the kind that moves beyond the individual to recognise collective visions of change.

Anne Philpott is the founder of The Pleasure Project, established in 2004 to challenge the public health approach to sexual health by highlighting the importance of pleasure and good safe sex through advocacy, training, research and general being the ‘guerrilla girls of HiV prevention’.The Pleasure  Project has a long standing partnership with the IDS Sexuality and Development programme that spans joint work on academic papers, some funding and providing joint long term advisory functions. Both the Global Mapping project and training resources were made possible with IDS funding 

This is an amended version of an article that first appeared on Open Democracy.

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Signposting fresh entry points into international sexual rights advocacy

03/02/2014

Stephen_Wood200Stephen Wood

For those that know me well, the beginning of a new year is usually heralded with an explosion of life-planning energy that leaves others dizzy, a spring in my step and a renewed sense of direction. This year is no different, yet as we endure continual assaults upon global sexual and gender rights, I  have tried harder to build clarity as to where I might put my research efforts during 2014.

Accepting the limits of the AIDS and Human Rights approaches

I reported last month in my report from a Berlin meeting examining the emerging challenges for LGBTI NGOs and donors operating in the Global South, that traditionally-funded routes for engagement such as HIV/AIDS prevention work and human rights advocacy continue to be structured in short-termist ways which mitigate against community investment and capacity building. These spaces remain crucial whilst the majority of LGBTI funding continues to be made available via these mechanisms,  but with the future of these modest resources under threat, new entry points for research and advocacy must be identified that can potentially create tangible improvements in the lives of those with non-normative sexualities.

In their synthesis report, “Sexuality and the Law: Case studies from Cambodia, Egypt, Nepal an South Africa” published this week, my IDS colleague Dr Linda Waldman and Monash University’s Cheryl Overs speak to this need to move into unfamiliar spaces and conversations about sexuality. Their conclusions encourage researchers, activists and donors to:

“Elevate the profile of sexuality across all sectors of international development. This involves developing a multi-pronged approach that encourages donors, their partners in governments, and civil society actors to acknowledge and identify the scope for addressing a range of sexuality issues. These include building recognition of the relevance of sexuality in relation to human rights, development, public health, governance, law and policy, and establishing greater awareness in all sectors within international development and in bilateral and multilateral agencies and sectors.”

However, as those of us who have attempted it can attest, moving into unfamiliar political terrain contains it’s own set of challenges. Communicating your policy aspirations into language that makes sense to audiences uninterested in sexuality requires real nuance and evidence of common investment in the drivers underpinning the efforts of those working within these arenas.

Intersectionality – engaging the unusual suspects

Whilst intersectional analyses of multiple forms of discrimination have been popular for the last quarter century, I’ve noticed a discernible upturn in interest in the political alliances made possible by sexual rights advocates building common cause alongside feminist activists, those fighting for disability rights, anti-racists, sex workers and progressive faith organisations. For those of us working on the IDS Sexuality and Development Programme, we have been actively facilitating these connections through our Sida-funded Gender, Power and Sexuality Programme, particularly around work on

The wider question is HOW we can make these alliances sticky and effective?The right-wing has been adept in engaging with certain elements of the feminist movement to curtail the autonomy of sex workers – those of us supporting progressive movements need to learn how to do the same. Breaking artificial divisions amongst the sexual rights movement, such as blindly using LGBT as a term when issues cut across the sexual spectrum and are conceived more fluidly elsewhere in the world, remains a good starting point.

Poverty alleviation as a founding principle of sexuality and development work

The DFID-funded programme of research examining sexuality and poverty that I manage is moving into a new phase, with our final policy audits and synthesis published this month. A series of new case studies commissioned with partners for this year will examine how individuals marginalised from poverty alleviation policies as a consequence of their sexual and gender identities are building up innovative strategies to create sustainable livelihoods from the grassroots.

As I touched upon in my Berlin report, there is a widespread appetite to examine this area further amongst LGBT activists and donor organisations. With austerity measures still high on the political agenda, broadening the debate around sexual rights to encompass arguments that LGBT exclusion results in ineffective poverty alleviation strategies (and consequently representing bad value for money) can also speak to the priorities of centre-right governments who would not ordinarily view these otherwise as useful interventions.

The reality for many of our partners is that their communities obtaining a measure of financial independence is just as important to them as it is to their heterosexual neighbours, much more than sexier media-friendly issues like same-sex marriage. In my view, it remains the foundation upon which all development interventions around sexuality should be built.

How social media is shaping sexual minority communities 

Over the last year or so I have been fascinated (some might argue obsessed) with the possibilities of Twitter and other social media platforms in reaching fresh audiences, engaging in participatory, bottom-up debate and gathering confidential research data from populations such as trans communities that might be otherwise difficult to access in the Global South. It has fundamentally transformed my own connections, understanding and dialogue with the communities we aim to partner with.

Yet talking to my gay peers, I can sense how the ‘Grindr’ generation’s experiences of gay social media in Europe and North America are radically reshaping our sense of community and identity. How is this translating into the experience of sexual minorities in those regions such as South East Asia, which have also seen a rapid increase in the use of mobile technology?  Do these shifts have implications for the way these individuals experience community, conduct their activism, mediate their sexual relationships or even facilitate their economic empowerment? How can the opportunities of this technology be harnessed for progressive ends?

For me, these are some of the really exciting questions and spaces I’m keen to throw myself into in the coming months. I suspect I may have just written my own professional research manifesto for the rest of this year…

Stephen Wood is a Research Officer on the Sexuality and Development Programme within the Participation, Power and Social Change research team at IDS. He can be found on Twitter as: StephenWood_UK

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What are the emerging funding challenges for international LGBTI activists and their donors?

17/12/2013

Stephen WoodStephen_Wood200

We are living through a difficult period in the funding and resourcing of LGBTI groups in the Global South. At a time when public appetite for action has arguably never been higher, budgets are increasingly under threat or actively being cut.  I recently returned from a meeting in Berlin organised by the Federal Ministry for Economic Cooperation and Development and the Lesbian and Gay Federation in Germany, which sought to strategise around potential ways to square this circle.

The funding environment within international development is shifting fundamentally and may look very different in ten to fifteen years. Spanish aid funding is being cut drastically, with the impact already filtering through to many Latin American LGBT groups who depend upon it to resource their defence against mobilised evangelical political attack.  Donors are increasingly pulling out of South Africa as it is no longer perceived as a poor country, yet unlike some other thematic aid areas, disappearing LGBTIQ funding is not been replaced by local sources.  This is at a time when gender and sexual violence is at a record high in the country and LGBT protections within the Constitution are under sustained political attack.

What was really promising about Berlin was that there were a lot of the right people in the building: European and US Government officials, senior figures from donor and philanthropic organisations, European and North American LGBT campaign organisations and southern LGBTIQ activists who took the opportunity to make everybody grapple with some of the practical and political dilemmas they face when negotiating with the funding mechanisms available to them.

How funding mechanisms can be improved

Even with available funding, priorities need re-examination. The Global Gaze 2010 report from Funders For LGBTQ Issues shows that whilst there has been a modest increase in international funding for LGBTIQ groups, it isn’t reaching trans groups, who receive a paltry 4.6% of the available funds compared to nearly 84% for LGBTI programming, which (whilst not always) often still remains mainly gay male programming with lip-service inclusion of other groups.

The complexity of grant proposal systems are especially difficult to negotiate by the nascent trans movements that are still growing in maturity and there was a real push from trans activists in the meeting for low-threshold funding from donors, to take a calculated gamble to help seed young organisations. I was particularly struck to see that the vast majority of the miniscule trans support originated from North America, with a noticeable lack of commitment from European donors. I suspect some analysis of why this is the case would be fascinating.

Similarly, there was anecdotal evidence from some speakers that funding proposals submitted that focus exclusively on lesbian themes tend to not get funded, also underscored by the Global Gaze report, which reported a scant 2% of funding going to support lesbian programming. Yet when they packaged the same proposals as LGBT, they were more likely to be successful.

Similarly to HIV/AIDS programming, any funding for those groups conducting strategic litigation is generally de-coupled from any complimentary empowerment work that organisations seek to undertake to back up their campaigns. These same legal cases are expensive and take several years to see through, yet donor funding continues to be short-termist. Even when successful, groups find it a struggle to convince donors to continue funding beyond the headline ‘victory’ to monitor the realities of implementation attempts. Paradoxically, in many cases it is at this point that sustained funding is most necessary.

Fresh thinking and challenging orthodoxies

Throughout the meeting, I sensed a commitment from all sides to make the most of this space to tackle these sticking points and to step outside of orthodoxies in thinking.  From several, there was an appetite to invest real energy in nurturing new sources of global leadership from regions such as Latin America which could transform debates around equality with discriminatory states in ways that avoided accusations of renewed Western imperialism. It came across in debates about southern states being creative in the establishment of community-determined endowments for activism that could survive independently of aid support – adaptation instead of continued financial dependency.

Whilst less glamorous, the meeting also wrestled with the difficulties in measuring and mapping the amount of aid funding made available for LGBTIQ issues by Governments and donors and how this data might help multiple donors operating in the same country-context communicate more effectively, make more informed funding decisions and support partner LGBT organisations to develop their longer-term campaign strategies. It is a double-edged sword however, as whilst that transparency could mobilise the public in support of aid budgets under threat, the data would provide a very discernable target for opponents of equality to coalesce around.

Bringing research to the table

On behalf of IDS and our partner organisations, I presented some of the principal findings generated within the Sexuality theme of the Institute’s DFID-funded Accountable Grant, examining the disconnect between sexual minorities and poverty alleviation policies. The findings are outlined in case studies from India, the Philippines and South Africa. The ability of this project to allow organisations to identify a priority issue relevant to their contexts and use the research process and collaboration with IDS to help increase their own evidence base appeared to strike a chord with the audience. Many southern activists identified capacity-building in research methods as essential moving forward. There was support for developing a more robust research agenda for donors based on the needs of LGBTIQ stakeholder groups, as well as an appetite to explore the poverty angle further as a way of conducting different conversations and expanding entry points for interventions.

One example of this was using poverty alleviation as a method of conducting dialogue with faith-based NGOs. In fact, there have already been some interesting developments in this area, with the ARCUS Foundation reporting that their fascinating Global Religions programme has begun supporting pro-LGBT Christian and Muslim faith leaders in Africa and Middle East, amongst other regions. It is an area I’d be keen for the IDS Sexuality and Development Programme to explore further.

Whilst the meeting provided space for a diverse set of actors to step outside of their institutional roles and recognise their common aspirations for social justice for LGBTI communities, it also gave us space to highlight where our priorities differed. As one of the NGO participants summarised “We want to spend more. They want to spend better”.  Ensuring the practical outputs that resulting from this meeting address both of these essential drivers will be crucial to building credibility and good faith on both sides that delivers for LGBTIQ communities on what remains heavily-contested political terrain.

Stephen Wood is a Research Officer on the Sexuality and Development Programme within the Participation, Power and Social Change research team at IDS. He can be found on Twitter as: StephenWood_UK

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“AIDS has a women’s face”, or does it? Beyond the Gender and HIV Dyad

02/12/2013

Elizabeth MillsElizabethM125

This post was  published on the IDS Knowledge, Technology and Society blog on 29th November. 

With World AIDS Day being celebrated on 1st December, and as we move into 16 days of activism against gender-based violence, I am prompted again, to reflect on some of the important links between gender-based violence and HIV, and also some of the problematic assumptions that perpetuate uncritical thinking on the gender-HIV dyad.

A Discomfort with Development Categories
Meet Zama, a 33-year old South African woman and an old friend of mine; she has been an AIDS activist and professional HIV treatment literacy practitioner in South Africa since the height of AIDS denial in the early 2000s.  Zama lives in Khayelitsha, which means ‘new home’ in isiXhosa. Its name is rather cynical, given that in this area homes are rarely ever permanently sunk into the earth. Space matters here when the only source of water is a leaky tap, whose muddy veins run down unlit side alleys where women risk rape when they leave their homes at night, or when all adults and children risk electrocution (from illegal wires that wind through the sand) when walking to the single toilet that also serves their 500 – 1000 closest neighbours. Khayelitsha is also the space where women have stood with men, in conjunction with the Treatment Action Campaign and Médecins Sans Frontières, to call on the state to provide essential AIDS medicines; it is the place where these medicines were first made available through the MSF trial in 2001.

Like almost 33% of Khayelitsha’s residents, Zama is also HIV-positive; and like almost two million South Africans, she is on ARVs. She explains,

‘It’s like when the skies fight, when the clouds are angry and dark. They crash into each other and lightning flies across the sky. You never know where the lightning is going to hit. That’s what it’s like with HIV.’ (Zama, 2011).

In this conversation, Zama told me how she had initially found it difficult to negotiate safe sex, or sex at all, when she was a young woman. Zama had been wary of narrating this ‘illness history’ because it colluded with the ‘development category’ of the poor, black HIV-positive woman who was unable to actively navigate her own life. In fact, she eschewed labels like ‘HIV-positive woman’ and considered herself to have substantial personal power to negotiate her current sexual, socio-economic and political relationships.

Looking beyond Victimhood: Between Agency and Structure
While the presence of gender inequality, and its brutal manifestation as sexual violence in girls’ and women’s lives, is a strong feature of my work, I – like Zama – have been confronted by the explanatory limitations of epidemiological assertions that stipulated a correlation between gender inequality and higher rates of HIV infection among women compared to men. I do not dispute this correlation; my research has been informed by the multiple and intersecting inequalities that seemed to drive HIV, in epidemiological terms, into women’s lives and bodies. This was most striking when, in 2008, young women in South Africa were almost four times as likely to be HIV-positive compared to young men of the same age (20 – 24) (Johnson et al., 2013, Dorrington et al., 2006).  Overall prevalence in this age group has subsequently declined, but the characteristics of prevalence according to sex remained the same: young women are still more likely to be HIV-positive than men (UNAIDS, 2012).

Studies link these statistics to sexual violence. Articles with titles like ‘AIDS has a woman’s face‘ or ‘Troubling the angels‘ proliferated in research that explored this correlation.  Other research suggested that sexual violence and its relationship to HIV occurs against an inflected backdrop of pervasive and entangled inequalities in South Africa, where gender, sexuality, race and class powerfully intersect to reinforce poor Black women’s vulnerability (Dworkin et al., 2012, Jewkes and Morrell, 2012).

Although these studies give texture to the correlation between gender inequality and high rates of HIV incidence among women compared to men, they may also (unwittingly) support a paradigm that has fuelled development interventions to ‘empower’ women by foregrounding women’s relative lack of power compared to men. Ascribing HIV transmission, in epidemiological terms, to entrenched gender inequality does not, in itself, engage with the complex pathways that women navigate between desire and risk in their sexual relationships, and in extremely difficult socio-economic contexts.  In this respect, my research shows that women are subtly, and sometimes with great difficulty, negotiating their intimate relationships with men by forming separate households and by working and establishing their financial independence. This was not a straightforward matter of asserting agency or submitting to intersecting structures of inequality.

The Biopolitics of Violence: Bringing a Global Network of Actors into View
In my research on gender and HIV, and now as I convene the Sexuality, Poverty and Law Programme at the Institute of Development Studies, I suggest that we – researchers, policy makers, activists – need to be careful about situating vulnerability in individual bodies and relationships. I propose that we nuance our analyses to look at how people’s bodies and lives are located in a far more complex network of actors. I suggest, then, that the gender-HIV dyad is problematic not only because it positions women as passive victims of men who are, conversely, held to be active perpetrators (or even more unhelpfully, ‘vectors of transmission’). More fundamentally, it is problematic because these discourses direct our attention towards individuals or ‘cultures of inequality’ and away from the biopolitics of violence in which national, regional and global actors are implicated.

While we certainly need to address the manifestation of inequality in people’s lives, the bolts of lightening, we also need to explore the context – the skies that fight – in which women’s lives are located. This includes a recognition: of the subtle ways that women hold agency, albeit fraught and contested; that men are a part of the solution in working towards equality; and that national, regional and global actors need to be held to account for the ways they intimately affect our lives, from a distance, at the most molecular level.

Elizabeth Mills is a Research Fellow in the IDS Knowledge, Technology and Science research team. She works on health, citizenship and HIV/AIDS. 

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