Archive for sexuality

6 de Noviembre: La feminización del VIH/SIDA

Posted in Bolivia, HIV/AIDS with tags , , , , , , , , , , on November 6, 2010 by eugeniadealtura

I’d like to apologize to my readers; lately, teaching and research responsibilities have made me unable to update the blog as regularly as I would like.  However, an article published today in La Paz’s La Prensa paper has prompted me to draft this brief post.  The article, entitled, “The La Paz resident with HIV/AIDS is young, male, heterosexual, a worker, and a city dweller,” explores the (growing) phenomenon of HIV/AIDS in the Andean city.  Despite the title of the article, it goes on to explain a trend occurring around the world–the feminization of HIV/AIDS.  Despite the fact that most known HIV/AIDS carriers in Bolivia are male, new cases of the virus are found just as often in women now as in men–particularly among younger generations.

Not surprisingly, local health department official René Barrientos noted that women are likely infected due to the infidelity (and sexual carelessness) of their partners.  “Generally,” states Barrientos, “women who complete domestic tasks are at home and are infected by their partners, since these also pursue sexual liaisons outside the household and then take the infection home.  In absolute numbers, 69 women who work in this area were found positive across the period [of study]…This is alarming because it places the household at risk” (all translations mine).

Barrientos also notes that life expectancy of HIV/AIDS carriers in Bolivia is considerably shorter than that of carriers in other countries, since people often do not know they have the virus.  In July and August of 2010, 38 new cases were discovered in the city of La Paz.  18 of these individuals already had AIDS.

Having spoken with a number of people of different social classes in the cities of La Paz and El Alto about sexual and reproductive health, I am convinced that few people seek testing for sexually transmitted infections (STIs).  In general, the population seems to believe that STIs affect only “dirty,” “promiscuous,” or “sexually deviant” individuals–ie., not them.  Attitudes such as these do not reflect the realities of STI infection and transmission, and typically stem from abstinence-only education and an atmosphere of fear and shame around the discussion of sex.  This article is a good reminder that abstinence-only education, the shaming of sex, the lack of acceptance and availability of condoms, and people’s reluctance to seek STI testing, equal death.

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27 de Agosto: No se necesita receta

Posted in Bolivia, health care, sexuality, United States with tags , , , , , , , , on August 27, 2010 by eugeniadealtura

This week at Womanist Musings, I’ve written a post on the difference in over-the-counter access to drugs and other items in the U.S. versus Latin America, particularly Bolivia. What inspired the posting?  A visit to a U.S. pharmacy where customers can now purchase vibrating sex toys right off the shelf, without visiting a sex toy store or buying online.  Check out the posting here.

15 de Agosto: Noticias

Posted in abortion, Argentina, birth control, Bolivia, Latin America, reproductive rights, women with tags , , , , , , , , , , , , , , on August 15, 2010 by eugeniadealtura

This week, a variety of news bits on Bolivia and reproductive rights around the world.

First, a story of social and political conflict in Bolivia’s Potosí department, where for the past 18 days, strikers have blocked roads and led social protests in the area.  Protestors are attempting to hold the Evo Morales government responsible for a number of projects that, although promised some time ago, have scarcely advanced.  The projects include an the construction of an international airport in the city of Potosí, the establishment of a new cement factory in the region, and government preservation of the historic Cerro Rico–the mountain pictured below whose silver deposits essentially financed the Spanish conquest of Latin America over 500 years ago.

The Andean Information Network (AIN) interprets recent protests in Potosí as evidence that Evo Morales’ traditional bases of support are disappointed with the administration’s failure to keep its promises.  While the Morales government often describes protests as led by the right wing, the AIN notes that, “seventy-eight percent of Potosí voters chose Morales in the 2009 presidential elections, second only to voters in the La Paz department.”  La Paz’s paper La Razón reports today that a variety of officials of the Morales government have been in negotiations with the Potosí protestors, and that some progress has been made on at least one point of contention, the plan to construct an airport.  However, hunger strikes and street blockades have continued, since five other major grievances have not yet been addressed.  Meanwhile, in the city of Potosí, families have been subsisting largely on noodles and rice, since blockades have prevented meat from reaching local markets.

None of the coverage of the Potosí protests that I have encountered thus far has discussed women’s particular participation in the protests or how women and girls are being affected by the conflicts.  In similar mobilizations in Bolivia, however, women have taken an active role.

This photo of the Cerro Rico mountain and Potosí city courtesy of Gerd Breitenbach, a user of Wikimedia Commons.

As political conflict rages in Bolivia, Argentina received an embarrassingly poor report card last week on women’s reproductive and sexual rights.  Last Tuesday, Human Rights Watch released a 52-page report chronicling, “the many obstacles women and girls face in getting the reproductive health care services to which they are entitled, such as contraception, voluntary sterilization procedures, and abortion after rape.”  Regular readers will remember that these are also common problems in Bolivia.  Their prevalence in Argentina, however, is even more appalling considering that this country’s socioeconomic indicators tower above those of Bolivia, even after the economic crisis of 2000-2001.

Similar to conditions in Bolivia, the report, entitled, “Illusions of Care: Lack of Accountability for Reproductive Rights in Argentina,” notes the high prevalence of illegal abortion, high rates of maternal mortality due to abortion, and the failure of judges and doctors to authorize and perform those abortions that are legal (ie., in cases of rape). Access to contraceptives is also restricted due to a variety of issues, such as long waits at clinics, the (unauthorized) demand that a husband sign for a woman’s sterilization procedure, and financial costs.  These issues–and other, similar ones around the world–prompted one Guardian blogger to call for a UN agency specifically devoted to women. That’s an idea that’s easy to get behind.

The Human Rights Watch report on Argentina can be downloaded here.

The San Telmo neighborhood of Buenos Aires, Argentina.

Finally, good news from the U.S.A.: the Food and Drug Administration (FDA) in that country approved a new pill to be used to prevent pregnancy after intercourse. The medication, called “Ella,” is considerably more effective than the morning-after pill that is currently on the market, Plan B.  While Ella will prevent pregnancy for up to 5 days following sex, Plan B is only effective for 3 days, and becomes less effective the later it is taken after the event.

This move by the FDA has been interpreted as “evidence of a shift in the influence of political ideology at the FDA,” since its approval moved more quickly than that of Plan B, and, as one activist mentioned, was “‘based on scientific evidence, not politics.'”  This does not mean that the battle has been won, however–anti-abortion activists have been quick to describe Ella as an abortifacent, and some are planning campaigns against the drug.  At the moment, women can obtain Ella with a prescription from their health care provider at any time, so they can keep a supply at home.  Go get yours today!

6 de Agosto: Lo que no sabemos nos dañará

Posted in Bolivia, sexuality with tags , , , , , , , , on August 6, 2010 by eugeniadealtura

This week, UK-based Independent Television News (ITN) reported on Bolivia’s first-ever hosting of the “Miss Transvestite South America” beauty contest.  The contest included male-to-female (MTF) trans contestants from Chile, Bolivia, Ecuador, and other South American nations.  Evidently, organizers had a difficult time raising the necessary funds for the event, which nearly prevented it from moving forward, but the contest was saved when the La Paz city government pitched in.  This video—despite carelessly confusing the concepts “trans” and “gay”—shows colorful snippets of the contest, and in one scene, breathtaking views of La Paz, Bolivia.

It strikes me as rather odd that I have chosen to write about this event, and the themes it raises, since I know little of the reality of being trans in Latin America.  But also, I suppose that it is that fact—that we do know so little about trans life in the region, that there is so little visibility around it—that prompts me to write.  This piece, therefore, is designed to spark reflection and elicit your thoughts broadly on sexual diversity in Latin America, rather than teach you something new.

Bolivia, like most countries in Latin America, is marked by machista attitudes that threaten the lives and health of women in general, and people who do not conform to traditional gender/sexual roles and identities, in particular.  This machismo is visible and palpable.  I feel it walking down the street.  I witness it in the way young couples argue in La Paz parks, the men threateningly leaning in to the women’s personal space.

Machismo is also visible, however, in the very way it makes dissent invisible. In Bolivia—where rates of sexual and domestic violence against women top those of other Latin American countries—I have never seen an openly gay couple walking down the street.  Or in a bar.  Or anywhere else.  I do know of a few bars and cafés in La Paz that specifically cater to gays, and there are certainly some activists working for gay rights in the city, but compared to North America or Europe, gay life remains in the shadows.  Like other kinds of dissenters, gays and lesbians are often considered “funny” or downright “crazy.”  As I noted several weeks ago, typical residents of La Paz describe the local feminist group Mujeres Creando as “extreme,” but when pressed to explain this characterization, simply point to the fact that a few of the group’s members are lesbians.

In terms of trans folks, any awareness of their existence in La Paz is limited to comedic representations of men dressed as women, but never accepted as women.  A popular television character in La Paz consists of a light-skinned man dressed as a cholita, or indigenous woman—adopting and exploiting not only female, but indigenous, identity for laughs.  Female-to-male representations are altogether absent in La Paz, perhaps reflecting the cultural and social distance between women and men in Bolivia (ie., a cisman becoming a woman is a step down on the social scale, and easier to pull off than the reverse).  At one meeting of women activists I attended this year in La Paz, the entire concept of trans identity was discussed as if it consisted exclusively of the MTF experience.

My last point signals a glaring reality in Bolivia: that even those of us who are progressive, who work for women’s rights, and are concerned with the welfare and equality of all people, know way too little about the reality of gays, lesbians, and trans folks.  This is probably also true of other realities, such as that of people living with disabilities.  I am, for one, ashamed of my ignorance; however, that ignorance also sparks me to action.  Today, more than ever, I welcome your comments & questions.

10 de Abril: Pedacitos

Posted in Bolivia, sexuality, violence against women with tags , , , , , , , on April 10, 2010 by eugeniadealtura

This week, some odds and ends from the Bolivian highlands that I hope will spark conversation and debate.

First, yet another Bolivian woman has been killed in Spain. The 34-year-old migrant, known only by the initials M.S.P., was discovered last week in a Marbella hotel room; she had been suffocated to death.  This week, Spanish police found the likely culprit–her one-time boyfriend, a 39-year-old Peruvian man.  As if to chide the dead woman, this article from Madrid’s El País newspaper notes that M.S.P. “had never reported any mistreatment [that she had received], nor solicited assistance from the Municipality of Málaga nor the Andaluz Institute of Women” (all translations mine).

“Cycle of violence” graphic at a local organization working to combat violence against women.

Several weeks ago, in the aftermath of the murder of another Bolivian woman in Spain, I wrote a post on the problem of domestic violence against migrant women and the particular vulnerabilities these women face because of their status as (often illegal) migrants.  Even women living in their countries of birth hesitate to denounce acts of violence.  Sometimes this is due to their (and their children’s) financial dependence upon the perpetrators, or because police do not take the accusations seriously, or for a number of other reasons.  Add to these the social isolation that many migrants suffer and the fear of deportation, and migrant women are even less likely to report (or to be able to report) acts of violence.

Accusations of sexual violence are even more fraught, as women’s behavior and dress are often scrutinized by authorities as supposed “causes” of or “justifications” for male attacks.  In a recent interview, several Bolivian police officials blamed adolescent girls’ drinking for rising rape rates in La Paz’s Max Paredes neighborhood.  This logic ignores the problem of male perpetrators’ sense of entitlement to women’s bodies, drunk or sober.  Even in countries where activists have made significant gains in raising awareness about rape, such as the U.S., many women’s accusations go unheard.  For example, see this case of a Washington, D.C. woman who was refused a rape kit–valuable forensic evidence that could have put her attacker behind bars (thanks to Feministe for reporting on this story).

An educational comic instructing women on how to report acts of violence to authorities.

In lighter–but still somewhat disturbing–news, RadioFMBolivia.Net published an article this week instructing (implicitly only) men to “caress women’s breasts to satisfy your partner more.” Accompanied by a picture of a large-breasted white woman in a seductive pose, the article, written in a woman’s voice, begins as sex advice and ends as soft porn, as the author finally succumbs to memories of an ex-boyfriend’s expert fingers.

Don’t get me wrong–I am all for frank discussions of sexuality in print, on the radio, on T.V., in the classroom, and anywhere and everywhere else.  However, as I have mentioned before, sex is already surrounded by so many unrealistic and negative messages (ie., that most women can achieve orgasm by vaginal penetration alone; that touching yourself during sex means that your partner is inadequate, etc.), that not just any type of press coverage will do.

This article, for example, gives explicit advice to men on what to do and what not to do in playing with a woman’s breasts: “It is not just about putting your hands on the breasts and moving them quickly and clumsily…  Handling a woman’s breasts requires a certain art, it demands patience.”  But whose breasts are we talking about, here?  Any woman’s?  Every woman’s?  “Sex advice” like that provided by this article actually discourages the one thing required for “good” sex–open and honest communication.  Some women may want their partners to handle their breasts “quickly and clumsily.”  Others may prefer a more delicate touch.  Still others may get no sexual stimulation from having their breasts touched.  But this isn’t something that men (or women who sleep with women) can find out from reading this article.  If you want to know how to turn your partner on, you have to talk to her.

Articles like this one reinforce the idea that sex is something that you are either “good at” or you are not; that there are a set of objective skills that you can pick up and that will work just as well on one partner as on another, and that if you have to ask your partner what she wants, you are somehow inadequate.  I’m not saying this article is totally useless–the soft porn aspect may turn your crank.  But let’s keep porn, porn, and toss out the “one-size-fits-all” sex advice.

Finally, this week Bolivians voted in local (departmental and municipal) elections.  The Andean Information Network has done a superb job summing up the results, so I will not attempt to replicate that here.

As always, I welcome your comments and questions.

3 de Abril: Mejor que un huevito de chocolate

Posted in Bolivia, HPV vaccine with tags , , , , , , , , , , , on April 3, 2010 by eugeniadealtura

This week, the La Paz daily, La Razón, reported on an upcoming campaign to vaccinate 30,000 Bolivian girls between the ages of 9-13 against the Human Papillomavirus (HPV), one of the leading causes of cervical cancer.  The campaign, which will vaccinate girls in five cities and one rural community in Bolivia between April 6-10, is being carried out by the Centro de Información, Educación, y Servicios en Salud Sexual y Reproductiva (CIES) in cooperation with the Ministry of Health.  The vaccinations will be provided without cost, and will be distributed at schools and in public health centers in the areas of highest cervical cancer incidence in the country–El Alto, Oruro, Potosí, Trinidad, Sucre, and in rural areas outside of the city of Sucre.  According to Wilma Pérez, the author of the article, “Bolivia has one of the highest rates of mortality due to uterine cancer in the world,” with “five women dying daily from the disease.”  The World Health Organization reports that cervical cancer is the leading cancer affecting women in Bolivia.

A graffiti penned by El Alto youth at a CIES health and community center, reading, “Let’s prevent STIs.”

According to EhealthMD, poverty and failing to get regular pap test screenings are among the leading risk factors for cervical cancer.  Since women who suffer from cervical cancer generally show few symptoms until the disease is quite advanced, a yearly pap test–which detects changes in the cells of the cervix that can be related to cervical cancer–is the best way to catch the disease early on.  Women who are poor generally know less about the causes of cervical cancer and the importance of yearly screenings, have less access to sexual and reproductive health services, and are frequently malnourished–a condition which also increases the risk of cervical cancer.   Since Bolivia is the poorest country in Latin America apart from Haiti, it is not surprising that it also displays one of the highest rates of death from uterine cancer in the world–according to the WHO study cited above, only 28% of women in Bolivia report ever having had a pap exam.

“Youth Program, ‘You…Decide,’ CIES.”

Although I am as yet unable to provide concrete statistical data on these themes, my own research seems to support the conclusions of the articles cited above.  Since beginning research in Bolivia, I have examined thousands of gynecological and obstetrical records from prominent La Paz and El Alto hospitals stretching from the mid-1950s to 2009.  Anecdotally, I can attest to the fact that the majority of women seen at these facilities across these years report never having had a pap test.  A smaller majority report having had perhaps one or two pap tests across their entire reproductive lives, rather than the yearly test that is recommended.  The number of patients that report to hospitals with advanced cervical cancer seems astounding; many of these women die during their hospital stays.

Another fact that I have noticed in these records, which you can interpret how you like, is this: those women who report having had more than three pap smears in their lives are also more likely to report having used some method of birth control (including the rhythm method), and are more likely to report having had an abortion.

It seems very unlikely that any one of these factors–birth control use, pap tests, or abortions–causes in any direct way any of the other two factors.  Instead, it seems to me that each one of these factors corresponds to a degree of control that women are exercising over their own sexual and reproductive lives.  Women who get yearly pap tests or who use birth control to limit or to space their births are, through these actions, declaring a sense of autonomy over their bodies, sex lives, and reproductive choices.  And women who have abortions, I would argue, are also exercising this autonomy.  Although few women actually want to experience an unwanted pregnancy or to have an abortion, many women who do choose abortion–particularly young women–report that the experience made them more mature, responsible adults, since for many, it was the first time they were forced to make a truly autonomous decision about their lives.  So, perhaps it should not surprise us that women who have had abortions in Bolivia also get pap tests and use birth control.  The conditions of these women’s lives have allowed them access to information and services in sexual and reproductive health, which have given them the tools to exercise control over their own bodies–something that many Bolivian women lack.

A final note: it seems sort of ironic to me that the HPV vaccination campaign has been timed so close to Easter, a holiday that is widely celebrated in the largely Catholic country of Bolivia.  The HPV vaccine has drawn criticism from right-wing and religious elements in other countries due to the belief that girls who are vaccinated–like girls who have access to birth control–will have sex earlier than girls who are not (or do not).  Instead, opponents of the vaccine believe that young people should not be taught about sex, have access to birth control, or be protected from HPV, and that this will simply prevent adolescents from having sex.  This profoundly sex-negative message–which was institutionalized in the U.S. through abstinence-only education in many schools during the Bush years–has proven to only increase rates of adolescent pregnancy and STI infection.  Fortunately, right-wing forces have not derailed the HPV vaccination campaign in Bolivia.  So, during the week following Easter, 30,000 Bolivian girls will receive something much more valuable, though perhaps less tasty, than chocolate eggs.

8 de Marzo: Blog por el Día Internacional de la Mujer

Posted in Bolivia, International Women's Day with tags , , , , , , , , , , on March 8, 2010 by eugeniadealtura

Today is International Women’s Day (IWD), and women and their allies around the world are celebrating in a variety of ways.  On the blogosphere, Gender Across Borders, a feminist blog with an international focus, is hosting “Blog for International Women’s Day.” (Click here for a full list of participating blogs.)  This year’s theme for IWD is “Equal rights, equal opportunity: Progress for all,” and participants in Blog for IWD are being asked to write about what this phrase means to us.

To me, the phrase “equal rights, equal opportunity” immediately conjures up a number of important goals in gender equity that, in most countries, have yet to be met: gender parity in government and in other arenas of decision-making and power; equal pay for equal work, and dozens of others.  These goals are immensely important and, fortunately, many individuals and organizations around the world are working to realize them.  However, this is not what I want to write about.  After years of speaking with Bolivian women about their daily struggles with gender inequality, I’d like to address a different aspect of “equal rights,” one that likely underlies the majority of concrete inequalities in women’s experience: different ideas about and attitudes toward men and women.

If you were to come to Bolivia and ask any random woman on the street what the situation is like for women in the country, I would bet money that she would tell you that there is a lot of machismo in Bolivia.  Many men would probably concur.  And yet, I doubt you would find many individuals who would assert that there is a lot of sexismo in Bolivia.

To most Bolivians, it seems, machismo refers to those idiosyncratic, slightly annoying, but mostly harmless attitudes displayed by men who feel they are superior to women.  Although to your average western feminist, and probably to a lot of western men, the above definition sounds a lot like the stuff that sexism is made of, in Bolivia, these attitudes have become so normal and so normalized, that calling Bolivian men machista is something that even many men are willing to do.

Sexism, on the other hand, has another, slightly scarier, ring, and few are willing to pronounce the word.  Sexism, unlike machismo, is a word that carries political weight, that makes local women feel they are “complaining” about something, and that implies a call to action.  Sexism—a term used in Bolivia to refer to those more concrete gender inequities I mentioned at the top of the post, when it is used at all—is not really normalized, as machismo is, but neither is it recognized by society at large.

It’s time to wake up: machismo is sexismoUnequal ideas about appropriate male and female behavior, about who men and women are—psychologically or biologically, and about what men and women deserve, are what justify, legitimize, and normalize unequal rights and unequal opportunities for men and women. So, this is what “equal rights, equal opportunity: progress for all” means to me—it means recognizing that ideas about sexual difference are constructed, not natural, and it means exposing the lies that these ideas represent.

Below are a number of visions of what “equal rights, equal opportunity” might look like in Bolivia.  These visions are based upon the unequal ideas about and attitudes toward women and men that I have witnessed in La Paz and El Alto since 1999.

She can have multiple sexual partners, as he can, and not be considered a slut while he is considered a stud.  They can both just be considered sexually active human beings.

He can wash dishes, clean clothes, and help take care of his children without being considered a “sissy” by his male friends.

She can buy condoms and be prepared for sex, and not be considered “easy.”

She can run for political office without being considered laughable, nor facing violence or threats.

He and his female partner can chose to not have children without his virility being questioned.

She can have male friends and acquaintances without being accused of sexual infidelity by her male partner.

She can choose abortion without being considered a murderer, a bad mother, or a “cold woman.”

She can have sex with women, without being sexually exoticized nor labeled as politically extreme.

She can be considered just as capable as a man when driving or working in construction.

She can go out at night and drink with friends, and not be considered guilty or “asking for it” if she is raped.

She can go out at night, or in the morning, or at any time of day–and NOT be raped.

Thank you to the Bolivian women who have shared their experiences with me, and to all of the women around the world who make me wake up every day still believing that change is possible. ( The above photograph was provided by a guest photographer.)