Ernesto Vasquez del Aguila

Globalization, Structural Violence, and LGBT Health: A Cross-Cultural Perspective

It is a daunting task to provide even a partial analysis of the health of lesbians, gays, bisexuals, and transsexuals (LGBTs) from a global perspective owing to the cross-cultural and regional variation in the social construction and expression of sexuality as well as the still incomplete scholarly literature on the topic. This chapter, however, argues that it is precisely such a global vantage point that is required to apprehend the contemporary context of health and illness among LGBT populations. Although LGBT health is shaped by local cultural meanings and practices, it is also inherently embedded in large-scale processes and the position of local LGBT populations within the global system. In the era of a highly mobile, hybrid, and fundamentally interconnected world in which material and symbolic cultures are linked across vast distances, the meanings of LGBT sexuality and their consequences for health in specific locales cannot be understood if nations are viewed in isolation (Altman, 1989). Indeed, the nature of global interconnectedness requires us to engage LGBT health as a fundamentally transnational phenomenon involving the interplay of meanings, practices, and vulnerabilities that extend beyond the purely local. For example, the acquired immune deficiency syndrome (AIDS) epidemic among gay-identified men in the United States and Europe may be intimately related to the meanings and practices that drive risky practices in Papua New Guinea, Uganda, or Bolivia.

‘God forgives the sin but not the scandal’: Coming out in a transnational context – between sexual freedom and cultural isolation

Migration opens new possibilities for sexual freedom for gay and bisexually active men. However, ‘coming out’ carries real and potentially negative implications for immigrant men. Based on ethnographic research over more than four years in New York, this article examines the multiple strategies that Peruvian immigrants perform to fulfil their dreams of sexual freedom, while avoiding rejection and isolation from their relatives and compatriots. It shows different ‘forms’ of coming out or not coming out. Gay men and their families act out their scripts of ‘knowing’, ‘not knowing’ and ‘pretending not to know’, and play by the ‘rules of the game’.

The sexuality of migration: border crossing and Mexican immigrant men

This is a posthumous publication of Lionel Cantú’s ethnographic research on the sexuality of migration. Respectfully compiled and edited by colleagues Naples and Vidal-Ortiz, this book constitutes an invaluable source in the study of fields such as sexuality, migration, masculinities, queer theory, Latino cultures and ethnographic methods. Instead of asking how migration impacts on sexuality, Cantú sees sexuality as a dimension that shapes and organises all migration. He proposes a ‘queer political economy of migration’, a theoretical framework by which sexual identities are shaped by relations of power as are race, class and gender. Cantú approaches sexuality from a ‘queer materialist perspective’ that questions essentialist and reductivist analysis on Latino sexualities. He sees sexuality as a dimension of power that shapes and organises processes of migration and modes of incorporation into the host society. Cantú uses a multimethod approach: ethnography, key informant interviews in the USA, interviews with Mexican men who have sex with men in Guadalajara and oral history interviews with gay men who migrated to the USA. Through more than three years of ethnographic research in Mexico and in the USA, Cantú shows how these men’s experience of migration differs from their heterosexual counterparts. The author’s own subjectivities and social identities intersect with the narratives of migrant men in a compelling exercise of reflexivity, not as a narcissistic enterprise but as a tool for inquiry. As with Hearn, he integrates the personal, the political and the theoretical roles of the activist academic. Cantú is both an ‘insider’ and an ‘outsider’: a Chicano, a queer scholar, a privileged USA citizen and a ‘tourist’ in the country of his ancestors. Cantú examines the social locations from which lesbian, gay, bisexual and transgender migrants face social regulations and exercise resistance, the role of the state in classifying individuals, the ‘border patrol’ as a filter of ‘normality’ against undesirable identities. The author includes an historical analysis of USA and Mexican policies on migration and sexuality. Using a Foucauldian approach, Cantú shows a continuum of institutional discrimination of homosexual people from criminalisation, being considered an ‘immoral’, the category of ‘sexual deviance’, to migration policies that prevent people with HIV from entering to the USA. Cantú shows the heteronormative nature of immigration laws that regulate and discipline sexuality and legitimise discrimination of non-citizens. Cantú sees citizenship as a legal identity constructed by the state to distinguish between ‘native’ and ‘foreign’ in a continuum of stratified relations and legal statuses shaped by dimensions of class, race, gender, ethnicity and sexuality. Cantú shows the role that lesbian, gay, bisexual and transgender organisations played in Mexico and in the USA in fighting for visibility and rights of lesbian, gay, bisexual and transgender migrants. In the case of organisations based in the USA, they help migrants to deal with constrains and unfairness caused by repressive immigration legislation,

En Nombre del estado. Servidores públicos en una microrred de salud en la costa rural del Peru

This ethnographic study, carried out among public health providers in a rural community in Peru, shows the complexities of a healthcare system under conditions of poverty, inequality and social exclusion. Reyes gives voice to a population that is not well studied and challenges common assumptions about the work of public health providers. She draws upon the notion of culture as praxis to illustrate the ambivalent and dilemmatic nature of social relations between health providers, patients and their broader community. These interactions are framed by power relations and moral values that clash due to cultural gaps and structural inequalities present in Peruvian society. Reyes conceives the role of the public health provider based on democratic values rather than a mere administrative role, which questions traditional definitons of public servants, particularly public health providers, in places such as Latin America. The main actors are analysed taking into account the contexts where interactions with patients occur. Through the narratives of health providers, the book shows the life of men and women in rural communities, their values, beliefs, and the social and economic conditions that shape their decisions and behaviours towards healthcare. The rural communities are not static places, but instead are presented as part of a set of fluid interactions with urban areas, and are in a constant state of change due to internal migration. Global notions of health and care also travel between the cities and rural communities that enrich the individuals’ understandings of health and illness. These rural villages can constitute real traps for those with stigmatised health conditions, such as sexually transmitted infections (STIs), as ‘everybody knows’ about everybody’s health conditions. Gossip and rumors about someone’s health circulate in the communities, which constitute powerful barriers to accessing care for the most vulnerable populations. Reyes illustrates conflicts between so-called folk medicine and medical knowledge and between what is considered ‘modern’ and ‘traditional’. The work environments of these public health practitioners are also places of tension and hierarchical relations between those who are permanent workers, and benefit from full-time and secure employment, and those who are contract workers, under temporary and precarious conditions. There are also power dynamics between medical doctors, nurses and the other healthcare professionals throughout the hierarchy in the public health centres. Public health practitioners are constantly ‘learning while doing’ in the field. Their training in health issues is not enough to face the everyday challenges they experience. Patients bring not only health problems, but

Book Review: Body and Soul: Notes of an Apprentice Boxer: Loïc Wacquant Oxford: Oxford University Press, 2004, hardcover

multiple modernities. When attention is turned from the former organizational powerhouses of religion toward the vital role of spirituality and a diversity of forms of religion in the daily lives of people, additional dimensions of the desecularization process become evident. But this requires sociologists of religion to move beyond the comfort zones of organizational analyses. For example, a mixed-method study of the role of religion and spirituality in fertility decisions makes clear that they play a role and that by disaggregating data, finer relationships between religion, spirituality and fertility can be discovered, patterns which reflect the results of qualitative approaches. The volume ranges over a variety of countries, thus not falling into the trap of seeing the world through American, European or English lenses. In doing so it demonstrates the value of comparative research across and within societies, religions and spiritualities. For example, the multiplicity of ways societies deal with religious diversity, the public–private boundaries, and the religion–state relationship are explored. In the chapters of this volume religion and spirituality are shown to be critical factors in understanding many different social contexts. Finally, there is a very helpful set of chapters on the implications of taking religion seriously for social science research methodology and, conversely, the implications of taking seriously the changing nature of religion and spirituality for the ways these aspects of life are measured. For example, the explanatory power of self-assigned religious affiliation is demonstrated and, by extension, the utility of other forms of self-assigned positioning on various dimensions of religion and spirituality. Much past work has been severely limited by using categories suitable to one religious group as normative rather than being open to the diversity of religion and spirituality both within and between groups. Measures of religiosity that have been developed for work among Christian groups are not helpful in studies of Muslims or Buddhists, to say nothing of the rising numbers of pagans, wiccans and groups referred to as New Religious movements. A quick perusal of the relevant journals will show that this lesson is far from learned. This volume opens the opportunity to re-think and explore the diversity that characterizes the field. It challenges us all to take the problem of measurement as an opportunity to be creative and to attend afresh to what people are saying and doing, rather than being blinded by what we or religious leaders think they do or should do. Many of the scholars represented are young; all are fresh and current in their approaches to issues. Their work is well worth reading.