The politics of sex research and constructions of female sexuality: what relevance to sexual health work with young women?

Abstract

By examining the relationship between the cultural construction of female sexuality and the lack of potential for many young heterosexual women to be truly sexually healthy this paper submits that messages for women within HIV prevention programmes can be confused, confining and at times dangerous to women's health and well-being. It is suggested that these messages also reinforce a traditional, biologically determined medical understanding of female sexuality that does not take note of social or culturally based research or commentary on female experience or female desire, but rather confines many women to sexual restrictions, doing little to empower women to prevent sexual risk-taking. The ideological basis of the discussion within this paper is informed by the awareness that applications and understandings of 'sexuality' are diverse and contested within sex research traditions and will influence the choice of research concerns. The 'deterministic' explanation of sexuality that 'sexuality' (the abstract noun referring to the quality of being 'sexual', Williams 1983) is your fate or destiny and that biology causes the patterns of sexual life, is abandoned in this paper in favour of a search for a definition of sexuality which brings together a host of different biological and mental possibilities which are given meaning only in social relations. This allows for a framework for the study of sexuality that relates it to other social phenomena, particularly economic, political and social structures (Foucault 1979); in other words, a study of the 'social construction' of sexuality. This paper suggests that health care professionals need to develop an awareness of the diversities within female sexuality and gain insight into their own values and assumptions about female sexuality if these are not to inhibit effective approaches and interventions in the areas of HIV and sexual health.

PIP: The introduction to this theoretical examination of women's sexuality notes that it is based on the supposition that female sexuality is composed of various and diverse elements rather than conforming to a static, single clinical definition or social standard. From this starting point, the usefulness of current clinical research into sexual activity, prompted by efforts to prevent HIV transmission, is evaluated along with mainstream HIV prevention strategies. The first part of the paper explores the relationships that may or may not exist between clinical, cultural, and social-based sex research and covers such topics as the increased status of venereology in medical research, the lack of nationally representative survey data on sex behavior, the increased susceptibility of young women to sexually transmitted diseases and carcinogens, and prevailing cultural definitions of sexuality in general and female sexuality in particular. The second main part of the paper describes constructions of female sexuality and their relevance to women's sexual health. The effect of stereotypical sexual images and contradictory messages arising from the traditional understanding of female sexuality is shown to legitimize the idea that women are passive, sexually submissive objects (and, thus, unable to dictate behaviors that would protect their sexual health). The final main section of the paper looks at HIV prevention strategies in terms of women's interests and the current realities of gender power imbalance. It is concluded that clinical research is locked into old assumptions about sexuality and is isolated from relevant socially- or culturally-based research. The inequality of women in heterosexual relationships must be acknowledged, women's self-esteem must be bolstered to help women assume sexual decision-making responsibility, and efforts to bolster the sexual health of young women must include men.