A Novel Clinical Service for MSM

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A Novel Clinical Service for MSM
SEXUAL ORIENTATION PREJUDICE Glenn de Swardt
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Sexual identity
Male ___________Intersexed____________
Female Physical sex
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Sexual identity
Straight____________Bisexual__________________
Gay Sexual orientation Male
___________Intersexed____________ Female Physical
sex
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Sexual identity
Masculine____________Transgender_____________Femi
nine Gender identity Straight____________Bisexual
__________________Gay Sexual orientation Male
___________Intersexed____________ Female Physical
sex
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Who are MSM?
Masculine____________Transgender_____________Femi
nine Gender identity Straight____________Bisexual
__________________Gay Sexual orientation Male
___________Intersexed
Physical sex
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Myths, stereotypes
All MSM / WSW / SSP / LGBTIQ people ... ...
were abused as children ... are sexually
interested in children ... are promiscuous ...
are unAfrican, unChristian, unNatural ... are
effeminate (masculine), visibly identifiable ...
'chose' their orientation ... are unfaithful,
cheats - relationships ... are failed
heterosexuals (inferior beings)
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Myths, stereotypes
All MSM / WSW / SSP / LGBTIQ people ... ... are
unable to be effective parents ... have a mental
illness ... need therapy and can be cured ...
are unhappy people ... cross-dress, wear drag ...
want to be the opposite sex ... want to seduce
straight people
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Contextual factors
Homophobia Irrational fear response Level of
insight General avoidance of stimulus Clinically
rare Homoprejudice Irrational anger response No
insight Often seeks out stimulus Clinically
common
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Contextual factors

• Social environment generally hostile in spite of
  Equality Clause in Constitution even government
  challenges LGBT rights equal versus special
  rights
• Expressions of prejudices - verbal taunting to
  rape / murder, no hate crimes recorded in SA
• Prejudice serves to other, compels adherence to
  social norms and reinforces dominant
  hetero-normative social values

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Contextual factors

• Levels of Empowerment Among LGBT People in KZN,
  2006 OUT/UNISA n410
• 78 lesbian/gay, 22 bisexual
• 66 black, 13 Indian, 21 white
• 45 aged 16-24, 53 25-40, 2 40

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Contextual factors

• Experienced victimisation at school
• Verbal abuse/harassment, 42w, 68m
• Physical abuse/assault, 29w, 39m
• Sexual abuse/rape, 19w, 20m
• Negative jokes, 63w, 76m

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Contextual factors

• Victimisation, by whom
• Other learners, 65
• Teachers, 22
• Principles, 9
• Other, 4

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Contextual factors

• Subject of homosexuality raised in classroom
• 57 report topic raised in class
• 73 report that this was negative/hostile

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Contextual factors

• Homoprejudice pervasive institutionalised in SA
  - in schools, SAPS, media, trade unions, health
  system
• Attitudes conveyed by socialisation
• Organised religion - hate speech
• Othering of bisexuals by both straight and gay
  sectors on basis of difference
• Othering of gay identities by
  straight-identifying MSM

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Psychological crisis coming out

• Complex, internal process The Ugly Duckling
• Internalised prejudice
• Sense of awareness of being the other fear,
  dissonance, shame, guilt, conflict
• Denial, anxiety, depression, isolation
• Family crisis, also for parents
• Increased risk of suicidality
• Process should culminate in sense of integration,
  acceptance of self and others but not always
  resolved

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Implications for HIV / AIDS

• Safer-sex messaging is hetero-normative
  consequences?
• Vacuum of data on HIV prevalence in LGBTI
  groupings in South Africa MSM?
• Health services are prejudiced in spite of NSP
  identifying MSM as target group
• Evidence of increased risk-taking behaviours,
  augmented by substance abuse gt crystal, slamming
• Interface between sex / life and death is
  complexed by homoprejudice

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Implications for HIV / AIDS

• Curative / corrective rape of lesbians
• Survivors of male rape not accessed
• MSM / LGBTI groupings often invisible,
  difficult to reach for messaging / services
• Transmission interface between MSM / LGBTI and
  heterosexual population not researched but
  anecdotally evidenced

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A Sex-Positive paradigm

• HIV not caused by sex caused by a virus
• HIV not spread by sex spread via body fluids
• Normalise all sex between consenting adults
  Enjoy the sex you want but manage body fluids
• Educate around body fluids gt don't moralise
  around sexuality

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A Sex-Positive paradigm

• Sensitise health professionals to their own
  prejudices regarding diverse sexual identities
• Make VTC sites more accessible for diverse sexual
  identities, less hetero-normative staff,
  symbols, images
• Respect rights to privacy and confidentiality
  regarding sexuality as well as sexual health
  issues

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Discussion

• What can you do to help eradicate prejudice on
  the grounds of sexual orientation at your school?
• What would you do if you were being bullied on
  the grounds of your perceived sexual orientation?

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Thank you to Centre for HIV/AIDS
Networking