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Culture is not an excuse for oppressing women

Culture is not an excuse for oppressing women


There are principled and practical reasons for improving women’s rights, says Margot Wallström, Sweden’s foreign minister.

THE light in her eyes had gone out. She sat on her hands, her head bowed, apathetic. We were in a salle d’écoute—a listening room—in a dimly lit hut in a village in eastern Democratic Republic of Congo. I was there as Special Representative of the UN Secretary-General, to prevent conflict-related sexual violence and end impunity for such crimes.

The girl’s father told us she had been walking back from school with a friend. Both were schoolgirls in their early teens, wearing uniforms and carrying books and pencils. A military vehicle stopped alongside them as one of the militiamen called for the girls’ attention. Could they get them a pack of cigarettes? Not daring to refuse, the girls did as they were told. When they returned, the man pointed at one of the girls and said: “You, come with us.”

The militia held her for two days. When she was released, the light in her eyes had gone out. She was bright, the first of her siblings to go to school. The hope of the family, her father said, the hope of the village, perhaps even more than that.

exual violence in conflict is one of the cruellest, most inhumane and vicious acts. It is a war crime. Yet, during my time as UN Special Representative, I often heard people say that sexual violence was inevitable. That it was sad and unspeakable, but an unavoidable consequence of conflict. That it was a lesser crime. That it was part of the culture of war.

Sexual violence in conflict is one of the cruellest, most inhumane and vicious acts.

If sexual violence can be rationalised as inevitable, just imagine the other forms of domination over women that are accepted or seen as unavoidable consequences of culture. Let me be clear: sexual violence is not cultural, it is criminal.

A culture of oppression
But I want to reflect on the word “culture”, and the way that it is used to justify the oppression of women. I believe firmly that culture should never be accepted as an excuse for the oppression of women.

“Culture” is typically defined by sociologists as a set of values, norms and beliefs among a group.  It may refer to the traditional culture in Afghanistan, of football fans in Argentina, or of university students in Sweden. Let me clarify what I mean by the “oppression” of women. I use the term to mean all instances when a woman is restricted because of her gender—whether she is explicitly discriminated against under the law or unfairly treated and looked down upon.

Not all oppression of women around the world can be explained by culture and, of course, not all cultures include the oppression of women. But the instances of it are many and varied: from the woman who is forced to marry against her will in the name of religion to the woman who is expected to put up with sexual harassment at work, because “that is just the way it is.”

The problem exists in all societies. Those who claim it does not exist in the West have been silenced by the MeToo movement, which called out injustices previously excused by a different kind of (workplace) “culture”.

Saying that the oppression of women exists in all societies does not mean it is the same everywhere. The situation is worse in some cultures, and it does no good to pretend otherwise.

Let me be clear: sexual violence is not cultural, it is criminal.

To what extent is this a problem? Should we not respect the fact that some cultures mean a lot to some people, and that cultural differences regarding the roles of men and women should be accepted?

I do not believe we should: particularly when it comes to women’s rights.

First, there is the legal argument. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) is almost universally ratified. The UN Universal Declaration of Human Rights is agreed upon by all countries. Women’s rights are human rights and there is no room for culture in that discussion.

Second, a more principled argument, illustrated by the philosopher John Rawls’s veil of ignorance: what kind of world would you like to be born into if you did not know your position in it beforehand? Or to put it another way, how many men would like to have been born as a woman in this world?

And third, there is the practical argument. Gender equality increases wealth. A recent report by the OECD showed that the rise in female participation in the labour market in the Nordic countries over the past 50 years accounted for a 10–20% increase in GDP. Peace agreements that include women among the signatories are more likely to last.

Women’s rights are human rights and there is no room for culture in that discussion

And finally, a word about democracy. Women are half the world’s population. Is it too much to ask for half the influence?

The actions needed
There is no silver bullet that can instantly eliminate all oppression of women. Nevertheless, I would like to offer a few thoughts, based on conclusions that I have drawn from four decades in politics and foreign affairs.

It is important not to come across as if we are fighting culture (be it religious, secular, ethnic or intellectual). That risks alienating the people we are trying to protect. We should have the deepest respect for the meaning that culture has in people’s lives—including in women’s lives.

We should be careful not to come across as condescending. This does not mean we should be silent in the face of blatant abuse, or not voice support for victims. Although bold statements might be visible and memorable, most of our results come from quiet, determined work.

Four years ago, Sweden was the first country in the world to launch a feminist foreign policy. The notion of feminism is provocative to some people, but to us, feminism means that women and men should have the same rights, duties and opportunities. Or as the aphorism goes, feminism is “the radical notion that women are human beings.”

Our simple model is based on three Rs: rights, representation and resources.

Using these categories in any country where we have an embassy, we assess the practical realities of daily life. Do women and girls have the same rights—the right to education, to work, to marry whom they want, to divorce, to run businesses, to open bank accounts, etc? Are women represented where decisions are made that affect them—in government, parliament, local assemblies, businesses and organisations? Do women’s and girls’ interests receive the same resources—in budgets, in development cooperation?

Although bold statements might be visible and memorable, most of our results come from quiet, determined work.

Wherever we identify inequality, we think of what we can do to remove it. In practice, this means that we have been pushing for the Women, Peace and Security agenda in the UN Security Council, where Sweden is a non-permanent member. We have initiated a network of women peace negotiators who are active all over the world.

We have given a lot of support to women’s sexual and reproductive health and rights and provided funding for midwives in Eastern Africa. And our 108 embassies around the world are relentlessly organising events, creating attention and support for women’s issues.

A case for hope
I do not know what the girl in Congo is doing today, what her life is like and whether the light has returned to her eyes. But for her sake, and for the sake of all other girls and women in the world, I want to call on everyone reading this to join us on this endeavour.

Let us remove the obstacles to gender equality, one at a time. Let us dismantle the structures that subordinate women. Let us do what we can to make the world a little bit fairer, a little bit more gender-equal. Let us show that equal rights for women can be part of any culture in this diverse world.


Margot Wallström is Sweden’s foreign minister. She was the first United Nations Special Representative on Sexual Violence in Conflict from 2010 to 2012. Ms Wallström initiated the country’s “feminist foreign policy,” which makes the promotion of gender equality a top priority for Sweden’s Foreign Ministry and embassies.

Afghan asylum seekers resort to sex work in Athens

Afghan asylum seekers resort to sex work in Athens


In the rundown Pedion Areos Park, older men walk slowly by young asylum seekers before agreeing on a price for sex.

Athens, Greece – Mahmoud looks out over the chaotic mess of rooftops and aerials and towards the neglected park he now calls home. He’s wearing a red hoodie, blue jeans and a black cap. Everything suggests he is a typical 20-year-old, apart perhaps from the jagged scar on his brow. 

“I am ashamed about what I do for money, but I will tell you,” he says.

The Afghan asylum seeker clasps his hands tightly in front of him as he speaks. “I didn’t know anyone when I arrived in Athens,” he begins. “Life was very difficult and it still is. I don’t have a home so I sleep every night in a park nearby.

“I had only two options when I arrived – one was to become a thief or a drug dealer,” Mahmoud explains. “But I am not that kind of person.

“The other option was to stay in the park and have sex with older men, or anyone … that asked for it for five or 10 euros [around $5 and $10] ….”

His only shelter is a cheap tent that he shares with an Iranian asylum seeker. Perched on the concrete roof of a small maintenance building hidden among the trees of Pedion Areos Park, it offers little protection from the cold. A bag of oranges provides breakfast, lunch and dinner.

Mahmoud says the money he makes selling sex only covers the cost of his daily food. He cannot afford to save anything.

He speaks regretfully about his work but sees no way out.

“This is my only source of money now,” he says. “I’ve made a mistake, and now I’m deep in this s***.”

But Mahmoud isn’t alone. Pedion Areos Park has become a hub of illegal male prostitution, sometimes involving refugees as young as 15. 

Greece has strict laws regulating prostitution. Sex workers must register, be aged over 18, legal residents in Greece and work in a licensed brothel. Despite this, illegal street prostitutes, who are often migrants and refugees, are estimated to outnumber licensed prostitutes by 20 to one.

Licensed sex workers have fortnightly sexual health checks and access to free treatment for sexually transmitted diseases. Unlicensed street sex workers, like Mahmoud, do not.

Shopping for sex

While the majority of Athens’ sex workers are female, Pedion Areos has long been a hot spot for male sex work.

The park, although grand and sprawling, has, like its inhabitants, been largely ignored. The large statue of King Constantine I that stands at its entrance has been covered with graffiti. Used condoms and tissues litter the ground.  

Those familiar with the park say that the majority of the sex workers there are Albanian, Bulgarian and Romanian.

Neno, a Bulgarian Roma, arrived in Athens eight years ago and has been a sex worker in the park ever since. He says he doesn’t particularly mind the work, but that it doesn’t pay well.

“A lot of people hate this job, they don’t want to be here,” he says. “For me, it’s OK. I don’t have a problem with it. Just the money isn’t good.”

Neno isn’t homeless. He lives in a small town to the southeast of Athens which is popular with tourists, and takes the bus into the capital each weekday. The bus stops directly outside the park.

At the weekends, he makes a little extra money playing guitar in tavernas along the coast.  

For Neno, being a sex worker is a job like any other. For Mahmoud and the park’s other homeless residents, it is a desperate attempt to survive. They spend their mornings waiting and warming themselves by fires started in steel cans, into which they put anything that will burn, often producing a choking smoke. 

“The Greek guys [clients] don’t come in the day because they think they might get caught,” Mahmoud explains. “They wait until later to come to the park, when they’ll be safer.”

Business begins in the late afternoon as the winter sun starts to set and the few dog-walkers and runners leave the park. Their busiest time is from dusk until midnight, when the majority of those in the park are sex workers or their clients. 

As the light in the park fades, middle-aged men walk slowly past benches on which young men and boys sit, as though perusing shop windows. By now, a different demographic has arrived: unaccompanied minors, refugees who have been orphaned, are travelling alone or have been separated from their family during the journey, and see the park as a place to make money.

“The main issue is that they have no money, either for their daily lives or to pay for a smuggler,” explains Kenneth Hansen, the programme manager at Faros, an NGO that runs a shelter for unaccompanied minors close to the park.

“Some of them have told [us] that they have sex with men in order to do other things, to have money to go and buy a new phone,” he says.

“One boy told us he had sex with two men and got five euros [$5] so he could buy cigarettes … One guy told us he had sex with a man so he could pay to have sex with a woman.”

The clients are always Greek, explains Mahmoud. Most are in their 60s, but some can be as young as 30; others as old as 90. “You see men of all ages [buying sex],” he says. “Some are young men and some look like they might die the next day.”

Some of the sex workers are clearly on familiar terms with the clients, laughing and chatting openly with the ones they recognise. Others, often the younger ones, sit awkwardly, saying little. 

“Usually the men see me in the park, they come closer to me then ask me, ‘Where are you from?'” says Mahmoud. “I’ve learned a bit of Greek so I understand and we speak a bit. Then they sit down next to me and that’s how it starts.”

Once a price has been agreed, they move somewhere more private – but that usually just means going behind a bush a few metres away.

The clients

Costas is 46 and has good job at a logistics company. Most evenings after work, he goes home to his apartment in a suburb of Athens, where he lives alone. But three or four evenings a month he changes his clothes and drives to the park to look for sex.

His routine has been the same for 10 years, he explains.

“It’s easy to find sex here,” he says. “I normally stay for about an hour before I find someone to go with.”

He is familiar with two or three of the sex workers at the park whom he knows by name and sees regularly. Five euros is the going rate, he says, regardless of nationality.

Costas insists that he never has sex with refugees or anyone under the age of 18. That would be “wrong”, he says. But he does acknowledge that he can’t be sure about the age or nationality of those he does have sex with.

Only his closest friends know about his visits to the park, he says.

Yiorgos says he is 52 but he looks much older. He lives an hour away but comes to visit a friend who lives near the park three times a week. They go for coffee and, on his way home, Yiorgos walks through the park, looking for sex workers.

“[The sex workers] are 17, 18, 20, 30, 50, it depends,” he says. “The day before, there was one that was 16, small,” he adds, before looking around nervously. “They should be 18,” he admits. A sex worker in their 20s could have sex five times a night, earning up to 50 euros, he explains.

He doesn’t believe that what he does is wrong. “If I steal, it’s a problem. But I don’t steal. Neither do I fight …. If I fight or steal, yes, the police will come. But if not, they don’t come. What could they tell me? All they can do is ask me why I am sitting here. Is it wrong?” he says. 

Prices vary, explains Tassos Smetopoulos, a volunteer who organises a weekly food donation in the park. “In Pedion Areos, it starts from five euros [$5] and goes to 200 [$213],” he says. 

“Some of [the clients] say to the boys, ‘OK, you can come to my apartment, to have a little party. Some friends of mine will be there too. You can stay the night.’ Something like this can go up to 200 euros [$213]. It depends on what they’re asking and what the boys accept.”

In search of a better life

Shortly after the US-led invasion of Afghanistan, Mahmoud, who was then five, left his native Herat with his family. “My father went first before us and then the rest of our family followed him,” he says.

“Everybody in Afghanistan then who wanted to seek a good life usually went to Iran, so that’s what we chose to do.”

In Iran, his family lived on the margins, unable to find legal work once their temporary residence permit, which they couldn’t afford to renew, had expired. After five years of schooling, Mahmoud started working to support his family.

At 15, he left Iran ahead of his family to search for work opportunities in Turkey.

“I stayed for five years in Turkey working on a construction site, trying to earn some money and to organise my trip to Greece,” he says.

But so far, he hasn’t found the greater opportunities he had hoped for in Europe.

“If I find any way at all, I want to go to Germany because I know some people there. Maybe I could find a good job,” he says. “I would leave as soon as possible if I just found the road and some money to get there.

“I’ve tried many times to go [illegally] to Italy from Patra, hiding under a truck, but it never worked,” he adds.

He says he’s tried the official, legal routes for asylum in Greece, which would enable him to live and work legally in the country.

“I’ve tried to claim asylum but I can’t. It’s very hard. Many times I’ve been to [the asylum office] but I never get a meeting. They always say I have to wait.”

Using a mobile phone borrowed from a friend, Mahmoud speaks to his family in Iran at least twice a week. He gives them updates on his journey but never tells them the truth about his life in Athens.

“I tell them Athens is a good city, with nice people, but really, it’s like someone has injected this city with filth,” he says.

‘It is going on in front of our eyes and no one is doing anything’

Mahmoud says there are no pimps operating in the park and that it is only the asylum seekers’ desperate situation that forces them into sex work. But Hansen believes that not enough is being done to investigate whether anyone is behind it.

“Many [young refugees] are involved in sex for money,” he says. “But whether they do it for survival sex, or just to get an allowance, or if it is more organised, this we don’t entirely know and it’s an area the authorities don’t really want to touch.

“It’s taking place so obviously. You can just go to the park and solicit a 15-year-old … It is going on in front of our eyes and no one is really doing anything.”

In November, Greek police told CNN that “they had not had any reports of unaccompanied minors involved in the sex trade in [Pedion Areos or Victoria Square],” but said they were “aware of the problem and working to address it”.

The office of the Prosecutor for Juveniles, which is responsible for unaccompanied minors in Greece, told Al Jazeera that it had begun an investigation in December into the issue but that the investigation was ongoing. They declined to answer any further questions about it.

Mahmoud says that uniformed police officers sometimes patrol the park, but that evading them has been easy so far. “When the police come, if they come, we just go into the bushes and hide and they don’t know we are there.”

* The names of sex workers and clients have been changed to protect their identity

Source: Al Jazeera News

Here is how excessive porn is bad for you

Here is how excessive porn is bad for you


According to science, consistently watching porn can lead to erectile dysfunction, sorry to be bearer of the bad news.

We all know that this is probably true. This is one news I hoped that I wouldn’t write but the truth is watching porn can adversely affect your sexual health especially for the guy.

And you don’t have to take my word for it. Dr. Andrew Smiler, a masculinity expert believes that men get erectile dysfunction after constantly beating one too many to porn. Your right hand or left hand whichever you prefer totally gets you and this might feel like the best and sometimes even feel better than sex, especially because you’re doing it to a porn, and those are might unrealistic, especially with how unrealistic they can be compared to the actual sex that you’re having.

“The guys I see, most of them are between 13 and 25. The vast majority are, for the most part, the picture of physical health,” he told The Independent, he insinuated that watching porn can lead to limp dick and depressed men according to Zeynep Yenisey, Maxim.

 Dr. Angela Gregory is a Psychosexual therapist had this to say “Men are becoming both physically and psychologically desensitized to normal sexual stimulation and arousal with a sexual partner.”

A lot of times, the false image of pornography can mislead a lot of guys. For example, you can be with the girl of your dreams, someone you’ve always wanted to be with and be unimpressed that she isn’t moaning like Mia Khalifa, so your dick game is low. One big disclaimer here, everyone doesn’t moan like a porn star and you can still have a great time.

Plus, the fact that porn stars usually look much different than everyone else apparently puts many men off too, because it “alters perceptions and expectations of who is attractive,” says Dr. Smiler.  Because of this, some men who watch a lot of porn get used to seeing fake boobs and bleached buttholes, too much of this might lead to my-girlfriend/wife-isn’t-this-sexy syndrome.

To be honest, this doesn’t affect everyone, some people are well aware of the situation and therefore the scenes aren’t taken to heart, they’re still not desensitized, and still horny as usual.

“It’s like an itch they can’t scratch and is always on their minds,” Dr. Gregory says. But this isn’t as bad as being desensitized to normal sex. In fact, it’s not really bad at all.

For some good news, Dr. Gregory says it’s very easy to get back to normal after falling into a porn-induced funk. All you need to do is stop jerking off, and you’ll be good as new!

“If you can stop [masturbating], you can reboot your system to normal arousal,” she says, suggesting refraining from porn and masturbation for 90 days.

Haha, no thanks.

So, that is it, if you feel your jerking off is under check and doesn’t affect your sexual health but if its affecting you, it might just be the time to stop and reset your sexual clock

H/T: The Independent

Maximizing the potential of a new HIV prevention method: PrEP

Maximizing the potential of a new HIV prevention method: PrEP


Pre-exposure prophylaxis (PrEP)most often a combination of tenofovir and emtricitabine taken orally as a daily tabletis extremely effective at preventing HIV infection when taken regularly.

The choice of PrEP is recommended for people who are HIV-negative but at high risk of becoming infected. The people who can benefit most from PrEPincluding gay men and other men who have sex with men, transgender people, sex workers, serodiscordant couples before the partner living with HIV becomes virally suppressed and young women and girls in the areas of sub-Saharan Africa most affected by HIVare located where there are high rates of untreated HIV and inconsistent condom use.

People starting on PrEP must be HIV-negative and undergo repeat HIV testing every three months. The side-effects of taking PrEP are usually mild and short-lived. The risk of developing resistance to PrEP medicines is extremely low, as long as the person is confirmed to be HIV-negative when starting PrEP.

In the past two years, PrEP roll-out has moved quickly. It is estimated that in October 2016 around 100 000 people were using PrEP in more than 30 countries, with the majority of users in the United States of America. The UNAIDS target is for there to be 3 million people on PrEP worldwide by 2020.

There are now active national PrEP programmes in Australia, France, Kenya, Norway, South Africa and the United States. Botswana is pursuing regulatory approval and creating an implementation plan, while Thailand and Zimbabwe are among other countries producing guidelines for PrEP roll-out. In addition, more than 20 projects around the world are exploring the use of PrEP.

However, even where there is an existing national programme, PrEP uptake is unequal and the people who would benefit most do not always gain access. Many activists in the AIDS response continue to criticize this inequality. “PrEP is powerful, it has to reach the disempowered,” said Nel Gordon of the Human Rights Campaign.

PrEP adds to the package of proven prevention options already available. PrEP should be used in conjunction with other prevention methods, such as male and female condoms, voluntary medical male circumcision and antiretroviral therapy for all people living with HIV. When antiretroviral therapy is effective in a person living with HIV, the virus becomes undetectable in the person’s blood and the risk of transmitting the virus to a partner approaches zero. No single HIV prevention method is 100% protective and PrEP does not prevent other sexually transmitted infections or prevent unintended pregnancy. Condoms remain the most widely available and affordable HIV prevention tool and as such should always be promoted along with PrEP.

The benefits of choosing PrEP can be psychological as well as physical and the use of PrEP may counter the anxiety and isolation felt by some people who feel they lack the ability to control their risk of exposure to HIV. PrEP can give people more autonomy about their sexual decision-making, which may also include risk reduction. PrEP may promote improved communication and intimacy with a partner, reduced fear of intimate partner violence, raised self-esteem and greater engagement with all aspects of sexual health.

Offering PrEP can encourage more people at the highest risk of HIV to attend HIV clinics, undergo HIV testing and access either PrEP or treatment depending on the test result. Either way, the outcome is good for the individual and good for HIV prevention.

PrEP gives us one more tool that we can use to better tailor the prevention package to each person’s individual needs, which can change over time. PrEP is not for everyone and is not for ever. Routine PrEP follow-up involves regular review of broader sexual health, including the diagnosis and treatment of sexually transmitted infections and discussion of appropriate combination HIV prevention strategies and contraception, as appropriate.

How Do You Help Girls Make Healthy Reproductive Decisions? Engage The Parents.

How Do You Help Girls Make Healthy Reproductive Decisions? Engage The Parents.


2016-10-24-1477331162-5700101-mtggirlsactingforcedearlymarriage-thumbAndy BryantExecutive Director, Segal Family Foundation

I hope you’ll dive into this article by Kelsi Hines and Kevalin Aulandez and the work of Organic Health Response described therein. As the father of a young daughter, I find it unimaginable to consider a reality in which she would feel forced to exchange sex for food. As gut-wrenching as that scenario is, the clever responses to change that paradigm on a remote island in Lake Victoria are somehow as inspiring…

Imagine you are an adolescent girl in rural Kenya. Like generations of girls before you, your path, opportunities, and odds in life are largely set at birth. Unlike your male peers of the same age, you are 2.9% more likely to contract HIV between the ages of 15-24. As you grow up you are forced to gamble with these odds in order to fulfill your responsibilities. You are a crucial building block of your family, of your community, and of the future generation of your children. You may need to choose between care-taking for your family and getting an education. You may feel the need to put your health at risk to find food for the table. Planning for the future takes a backseat as you juggle urgent daily decisions that impact your health.

Organic Health Response, a community-based health organization, works to strengthen the capacity and confidence of residents of Mfangano Island, Kenya to protect their health, culture, and unique island ecosystem. Located in the heart of Lake Victoria, roughly 30% of this remote island’s population is HIV positive. The young women and adolescent girls of Mfangano carry, like their global sisters, a disproportionately large burden of HIV/AIDS infection. In a culture where women hold sole responsibility for feeding their families and caring for those ill due to HIV/AIDS, young girls often have no choice but to engage in sexual relationships with local or traveling fishermen in order to procure fish for their families to eat. Living 10 miles off the shores of Kenya’s mainland, the young women of Mfangano Island lack access to comprehensive sex education and quality reproductive health services. Transgenerational relationships, gender-based violence, and systemic gender inequality are additional factors that contribute to making Mfangano’s young women particularly vulnerable to contracting HIV.

As we at Organic Health Response began to design a reproductive health education program to address these issues facing adolescent girls in our community, we took the opportunity to visit a fellow Segal Family Foundationpartner, Moving the Goalposts Kilifi (MTG), to learn about their unique model to empowering girls in coastal Kenya. During our visit, we learned an important lesson: to empower our girls we must start with our elders. Moving the Goalposts Kilifi uses football as an entry point to tackle issues such as a girl’s vulnerability to HIV/AIDS, low retention rates in school of female students, and early and unwanted pregnancies. Through bi-annual football camps girls develop essential leadership skills and participate in peer-led education on sexual and reproductive health, economic empowerment, and career guidance.

We saw the impact on the girls we met during our visit to MTG. MTG’s biggest barrier to successful programming, however, is that girls are often denied permission by their parents to attend football camps focused on reproductive health and sex education. For Moving the Goalposts Kilifi, this is why parental education is a crucial strategy in their organization, one without which they would not be able to meet their programming goals. “Tumanyane,” a Giriama word for “let’s know each other” is a community and parental forum organized by MTG that is used to increase parental and community support for girl’s empowerment. With understanding and support from their parents and elders, adolescent girls are able to make choices that support their own health and livelihood. As the old African proverb goes, “If you educate a boy, you educate an individual. If you educate a girl, you educate a community.”

As for Mfangano Island, Organic Health Response is eager to apply the lessons we learned from MTG and engage our elders to invest in the future of our young women. We look forward to using our community radio station, Ekialo Kiona Youth Radio, to engage with, and host, call-in shows on the importance of reproductive health and women’s empowerment. By empowering elders with the knowledge they need to promote the advancement of their young women, Organic Health Response is working to change the current narrative on Mfangano Island. When young women are given the knowledge they need to protect themselves, and families and communities support them in making healthy reproductive decisions, they are empowered to make sexual choices that allow themselves, their families and their communities to thrive.

National Aids Control Council. Kenya AIDS response progress report 2014: progress towards zero. Published March, 2014. Accessed July 12, 2016.

UNAIDS and the African Union. Empower young women and adolescent girls: fast-tracking the end of the AIDS epidemic in Africa. Published 2015. Accessed July 12, 2016.

Nagata JM, Fiorella KJ, Salmen CR, et al. Around the table: food insecurity, socioeconomic status, and instrumental social support among women living in rural Kenyan island community. Ecology of Food and Nutrition. 2015; 00:1-12. DOI: 10.1080/03670244.2014.995790. Accessed July 12, 2016

Fiorella KJ, Camlin CS, Salmen CR, et al. Transactional fish-for-sex relationships amid declining fish access in Kenya. World Development. 2015; 74: 323-332. Accessed July 12, 2016.

Bellan SE, Fiorella KJ, Melesse DY, Getz WM, Williams BG, Dushoff J. Extra-couple HIV transmission in sub-Saharan Africa: a mathematical modelling study of survey data. Published February 5, 2013. Accessed July 18, 2016.


Sexual Identity and Children

Sexual Identity and Children


Posted by Ian Kerner, Ph.D., LMFT

Are younger people more likely to embrace their sexual identity? That’s the implication of findings from a recent large Gallup survey.

The survey, which asked 120,000 American adults whether they identified as lesbian, gay, bisexual or transgender, found that 6.4% of people aged 18 to 29 said they were LGBT: about three times more than people over age 65.

But do results like these indicate that younger adults are more likely to be LGBT, or are they simply more likely to acknowledge it? It’s probably the latter, say my colleagues.

“These numbers might reflect a generational change in social acceptance for LGBT identities,” said psychotherapist Jean Malpas, director of the Gender and Family Project at the New York-based Ackerman Institute for the Family. “Today’s youth and young adults, at least in some communities, are gradually more comfortable being open about their sexual and gender identities.”

Another potential reason for the increase in self-identified LGBT youth is the influence of a new generation of parents who embody a positive attitude and wouldn’t have it any other way.

“Today’s millennial parents are more than just accepting of their children’s sexual identity. They’re comfortable and embracing of it, too,” said Ron Taffel, psychologist and author of the book “Childhood Unbound.” “They want to actively support and engage their children through communication about all aspects of their lives.”

Research, including this survey, also suggests that young women may be more likely than men to identify as bisexual.

“The pattern across surveys is that men are more likely to identify as gay, whereas women are more likely to identify as bisexual,” explained social psychologist Justin Lehmiller. “We don’t know exactly why this is, but many psychologists believe it results from women’s sexuality being somewhat more ‘flexible’ or ‘fluid’ and men’s sexuality being somewhat more ‘fixed.’ “

Many other young people are eschewing traditional descriptors for sexuality and gender completely.

“There’s been a lot of work done on how LGBT youth is more and more frequently rejecting labels altogether, blurring the lines between sexual orientation and gender, creating new labels and identifying as gender-queer, gender-fluid or pansexual, to name a few,” said sex therapist Margie Nichols. “The very term ‘LGBT’ is too confining now, which is why I prefer the term Gender and Sexual Diversity, or GSD.”

That term could also include the 1% of people who identify as asexual, which means they aren’t sexually attracted to anyone.

“While we’re creating space for a variety of sexual identities, we also need to create space for non-sexual identities,” said college sex educator Emily Nagoski.

Indeed, many of the experts I spoke to expressed frustration that Gallup and other surveys limit the options from which a respondent can choose.

“The terms lesbian, gay and bisexual just don’t capture all sexual minority identities,” Lehmiller said.

Nichols agrees. “These studies are missing a tremendous opportunity by not including an ‘other’ category. It’s a shame, because the ‘other’ category is the wave of the future.”

Separate from sexual identity is gender identity. While not addressed in the Gallup survey, experts say, this distinction is increasingly important, particularly for today’s youth.

“Gender nonconforming expression and identity are different from sexual orientation,” Malpas explained.

“Sexual orientation is about who you are attracted to and who you fall in love with. Gender expression and identity refer to the gender you feel comfortable expressing and identifying with, which might or might not be aligned with the biological sex you were assigned at birth.”

As transgender and gender-nonconforming children and teens become more visible, both in communities and in the media, parents are less likely to dismiss them.

“Only a decade ago, a parent would have probably answered ‘stop saying silly things’ to a 6-year-old son who insisted on being a girl,” Malpas added. “Today, the same parent will stop and think about the transgender children they’ve seen on TV or in magazines and may more readily inquire with professionals and other parents.”

More than just stop and think, they’ll also hopefully want to talk. Says Taffel, who specializes in breaking through to teens, “Open communication is a primary value for today’s parents, much more so than setting limits and rules, and the spirit of open communication trumps the content of any conversation.”

While it’s important not to confuse gender and sexual identity, parents can take a similar approach in discussing them with their kids.

“Of course, you should reassure the child of your love, but you’ll also want to find ways to expose your child to others like him or her so the child doesn’t feel different or alone,” Nichols suggested. “Allow yourself to experience mixed or negative feelings if you have them, and consider joining a support group. You’ve also got to be prepared to be your child’s advocate with schools, neighbors and community activities.”

I find the survey results very encouraging, as they indicate not just a shift of differences in human sexuality toward the mainstream but also suggest that the future is promising for people who don’t fit into “the norm.”

“We’re evolving, culturally, beyond the need to impose rules on who’s allowed to do what with their genitals and their hearts,” Nagoski said. “This new generation of young people understands that love is love, that people are people and that the freedom to experience joy and mutually consensual pleasure is a birthright.”

C.D.C. Investigating 14 New Reports of Zika Transmission Through Sex

C.D.C. Investigating 14 New Reports of Zika Transmission Through Sex


Health authorities in the United States said they were investigating 14 new reports of the Zika virus possibly being transmitted by sex, including to pregnant women. If confirmed, the unexpectedly high number would have major implications for controlling the virus, which is usually spread by mosquito bites.

Scientists had believed sexual transmission of Zika to be extremely rare. Only a few cases have ever been documented. But if all the women in the cases the Centers for Disease Control and Prevention is examining test positive for the virus — as two women already have, and four others have done in preliminary lab tests — officials believe there is no way other than sex that they could have contracted it.

The specter of so many cases — all in the continental United States — brings fresh complexity to the medical mystery of Zika. The virus is suspected to cause birth defects and a rare condition of temporaryparalysis.

Will climate change cause more complex effects on sexual and reproductive health?

Will climate change cause more complex effects on sexual and reproductive health?


 Published: February 4, 2016

The Zika viral epidemic represents a perfect storm of climate change, disease, sexuality and reproductive health. In 2009, I was deeply interested in the effects of climate change worldwide. I work for a regional organisation and I was studying trends which I thought would impact women’s health and rights.

Disasters – both natural and climate change induced were one of these trends. Three key events stood out in my memory; the 2004 Indian Ocean tsunami, the 2008 Cyclone Nargis in Myanmar and the 2010 Pakistan floods. These incidents affected the partners we work with on the ground, and many had rushed in to deliver aid. A number of partners talked about the need of access to comprehensive sexual and reproductive health services, occurrences of sexual violence, and of course the need for camps to be set up in a manner that suited the needs and realities of women. One of the activists in my circle told me that after the tsunami, women who had tubal ligation in Tamil Nadu, had fought for and won the right to reverse tubal ligation, because they had lost their children in the tsunami. I was often on the lookout for such interesting angles to sexual and reproductive issues during the times of disaster.

In 2009, I read an Oxfam briefing paper which posited that the greatest impact of climate change will be on people’s health. This seemed to reiterate all the experiences I had with partners. This paper also talked about a particular health challenge – the increase in water-borne, insect-borne, vector-borne diseases due to increases in temperature and rain, and the inability of health and municipal services to be able to plan and manage these changes.

In Malaysia, we have seen year-on-year drastic increases of dengue, and it helped me connect this issue with the larger, little explored connection with climate change. Even in my country, health personnel often attribute it to different things such as; newer, pesticide-resistant mosquitoes and lack of civic consciousness of citizens. However, this was an interesting angle, and of course I could also pick up on the regional stories of dengue and Chikungunya in the Philippines, Indonesia and India.

Naturally, when the first stories of Zika surfaced, these three connections came foremost to my mind.

The first stories revealed that the virus was first reported in May in Brazil, there was an increase in the births of babies with microcephaly – around 3700 to 4000 between October and now. Many were aghast because this spike of babies with microcephaly puts stress on health services, families and communities – and even on educational services. Since the Zika virus manifests itself in indiscernible ways, women may not know that they have contracted the virus, if pregnant – until they deliver. A week ago, I was sitting on a panel in an international conference – when the astonishing news broke that the solution El Salvador presented was that women must avoid pregnancy till 2018 due to the potentially dangerous Zika virus.

Just yesterday, the first case of the sexual transmission of Zika has been recorded in Texas. But in 2013 itself, the possibility of sexual transmission of Zika had been published in medical journals by looking at the case study of an infected person in Tahiti. Some attribute the fast spread of Zika due to dual transmission modes.

It is equally interesting to consider that the largest outbreak is occurring in a region, which has highly restrictive abortion laws and access to contraceptives including condoms is limited due to socio-religious norms.

Many years ago, I wrote a proposal which posited this hypothesis: an undue burden will be placed on women who live in countries which face climate change and have fundamentalist policies (influenced by religion, and do not recognise sexual and reproductive rights) because they will be denied access to essential services. This viral epidemic is one such example.

A comprehensive approach is needed to combat diseases such as these.


One, access to dual-protection methods (pregnancy prevention and safe sex) is essential.

Two, access to comprehensive maternal health services: ante-natal scans to enable early detection, access to pregnancy termination (as a choice), and safe delivery and neo-natal care (as a choice).

Three, understanding that as time goes by, climate change will only cause more complex effects on sexual and reproductive health, and in order to cater for this we need policy, programme and paradigm change, which enables individuals and couples to be able to make decisions about their bodies and lives.

In the longer run, in order to create more resilient societies, which can cope with the multifarious effects of climate change, it would be essential to recognise the rights and agency of individuals and couples. We must further ensure that community systems are built with this perspective in mind. To stop this now, we have to start this now.

Latest Studies Show Testosterone Therapy Safe, Beneficial

Latest Studies Show Testosterone Therapy Safe, Beneficial


It is normal for testosterone to decline as a man ages, about 1% per year once a man has reached middle age. Most men never notice the drop. But some middle-aged and older men feel symptoms when their level has reached a certain point. Symptoms include a decline in sex drive, a lack of energy, moodiness, erectile dysfunction, an inability to lose weight, and in extreme cases loss of muscle and bone mass. Some clinicians call this age-related hypogonadism. Others deny that the condition even exists. Practitioners in the first camp had been prescribing testosterone replacement therapy (TRT).Lots of their patients said it has rejuvenated them, restoring their energy, giving them a more positive attitude, and returning their sex drive to them.


Two previous studies have shown an increase in cardiovascular events associated with TRT. The fear was that an increase in testosterone would ramp up red blood cell production, leading to atherosclerosis or blood clots, the fear being one may get lodged in an artery. It could cause a heart attack or stroke if this occurs in a blood vessel leading to the heart or the brain. But now ever more comprehensive studies are showing just the opposite that TRT is safe and in many cases beneficial.

Researchers at Brigham and Women’s Hospital in Boston just finished up a three year study on TRT, led by Shalender Bhasin, MD. Bhasin’s team found no increased risk of blood clots among older men with low to borderline low testosterone. A large, observational study soon to be published in the European Heart Journal actually showed a decreased risk of heart attack and stroke in conjunction with TRT. In March of this year, the FDA placed warning labels on TRT products about the risks. Now the agency is urging pharmaceutical companies to chip in on a comprehensive study to determine what if any risks exist. For those men experiencing the symptoms associated with low testosterone, it is advised that you speak to a doctor or an urologist, perhaps even an endocrinologist. There may be several conditions which have these exact same symptoms. So it is important to have a licensed doctor determine the cause.

What’s in your pad or tampon?

What’s in your pad or tampon?


About 70% of all American women use tampons. On average, a woman will use between 11,000 and 16,000tampons in her lifetime.

In fact, tampon-like devices have been used since ancient Rome, where women fashioned devices out of wool to absorb menstrual flow. Rolls of grass were used in parts of Africa, and Hawaiian women used ferns.

But what is actually in a modern-day tampon and pads?

Generally, tampons are blends of cotton and rayon, along with synthetic fibers, but each manufacturer’s products are different and considered proprietary.

Consumer groups in the United States have been wanting to know more since the 1980s. A growing environmental movement and awareness about toxic shock syndrome prompted women to ask what was in these products because manufacturers weren’t required to fully disclose what goes into a tampon or pad. That’s because they are regulated and approved as medical devices by the Food and Drug Administration and full disclosure is not required.

Democratic Rep. Carolyn Maloney of New York has introduced legislation nine times since 1997 that would require manufacturers to be more transparent and disclose the complete makeup of tampons, pads, and other feminine hygiene products. She wants companies to clearly label not only the fabrics used, but also any contaminants, fragrances, colorants, dyes and preservatives. Her bill directs the National Institutes of Health to look at the health effects of these products, because, she says, there is little research in this area.

But her bill has failed to move beyond the floor, every time.

 Demands for more transparency

Last month, members of the consumer group Women’s Voices for the Earth dressed up as boxes of tampons and pads and protested in front of Procter & Gamble’s corporate headquarters. They held up signs that said, “My uterus loves accurate labels.”

According to market research group Euroshare, P&G is the largest manufacturers of feminine products, with 44% of the United States market share. Women’s Voices for the Earth wants manufacturers such as P&G to fully disclose what goes into tampons, sanitary pads and wipes.

“Our concerns of the care products … was out of the lack of ingredient disclosure,” said Alexandra Scranton, director of science and research for Women’s Voices for the Earth. The group has been leading a two-year campaign it calls “Detox the Box.

When the group tested P&G’s Always pads, it found the sanitary napkins emitted chemicals, like styrene, chloroethane and chloroform. The World Health Organization classifies styrene as a carcinogen. And the EPA says short-term exposure to high concentrations of chloromethane can have neurological effects. The Centers for Disease Control and Prevention says high levels of exposure to chloroethane can result in lack of muscle coordination and unconsciousness.

However, all the levels are accpetable under federal regulations. In a statement, Women’s Voices for the Earth said, “While the levels of the toxic chemicals emitted by Always pads were relatively low, their presence warrants health concerns for women.”

Tonia Elrod, a P&G spokeswoman, said the company hasn’t seen the complete study, but pointed out that these are naturally occurring chemicals found in the ambient air, and that the study did not measure the composition in their product.

Tucker Helmes, executive director of the Center for Baby and Adult Hygiene Products, an industry trade group, said there should be no concern about these chemicals. “There is more styrene in strawberries than there is in the air sample they measured in this study,” said Helmes.

The U.S. Food and Drug Administration, which regulates the industry, reviews all designs and materials. In May, the organization addressed concerns, responding to Internet allegations, which alleged that tampons are contaminated by asbestos and dioxin, which can lead to toxic shock syndrome.

The agency said, “The available scientific evidence does not support these rumors.”

 Manufacturers release more information

 In the past few weeks, both P&G, maker of Always pads and Tampax tampons, and Kimberly-Clark, maker of Kotex tampons and pads, have published additional information on their websites.

But microbiologist Philip Tierno of the New York University School of Medicine said that’s not enough. “Even if they list some ingredients, they may not be listing all of them.”

Tierno was one of the scientists who helped discover the link between toxic shock syndrome and tampons in the 1980s. He connected TSS to the synthetic materials that were used in superabsorbent tampons at the time.

The FDA says those synthetic products are no longer used in tampons sold in the United States.

“Those fibers amplified the bacteria staph, if a toxigenic strain was present,” Tierno said. About 20% of people naturally have the bacteria staph. At the height of the TSS scare in 1980, there were 890 cases reported to the CDC.

According to voluntary reports to the CDC, the number of TSS cases since 1998 has varied between 138 to as low as 65 in 2012.

But Tierno said there are still products using viscose rayon, which he called “the best of the four bad ingredients.”

 ‘A lot of dioxin’

 Rayon is a synthetic made from sawdust and a byproduct of it is dioxin, which the EPA says is likely carcinogenic. The FDA says that trace amounts of dioxin are not of concern for human health and that rayon tampons don’t have higher incidences of TSS.

“Sure, one tampon is trace,” said Tierno, “but consider the menstrual lifetime of a woman. They use approximately 12,000 tampons in a lifetime. That means 12,000 exposures of dioxin … five, six, seven times a day. That’s a lot of dioxin absorbed directly through the vagina. It goes directly into the blood.”

“Vaginal tissue isn’t like other skin. It’s covered in mucous membranes, it’s very permeable. It’s a direct route to your reproductive organs. We need to be really careful of these products,” said Scranton, of Women’s Voices for the Earth.

Bob Brand, spokesperson for Kimberly-Clark, said “Kimberly-Clark’s U by Kotex tampons are manufactured by a process that is both chlorine and dioxin-free. However, since dioxins can be found in the environment, Kimberly-Clark regularly tests for dioxins to ensure the safety of our products.” P&G said it also used a similar process.

And while companies are required to track their dioxin levels, neither company would offer to make those measurements public when asked.

 ‘Our products are safe’

 “Our member companies take into consideration lifetime use of these products, the materials they are made from, and the body areas they contact as part of their rigorous safety assessments,” said Helmes of the industry trade group.

But what may be of greater concern, said both Tierno and Scranton, are ingredients like “superabsorbent foam,” found in pads, or “fragrance” that doesn’t list any other details.

“We want to know what ‘flexfoam’ is made of. Is it rayon or cotton or both? What are the ‘fiber finishes’?” asked Scranton.

“Every single product contained in a tampon has to be researched. We already know the fibers contain dozens (of chemicals), polyester contains hundreds of chemicals. It’s not just a fiber you put in the vaginal vault,” said Tierno.

And the concern is not just for TSS, they say, but for adverse and allergic reactions. The FDA does catalog such complaints. Since 2014, there have been 270 claims made about tampons, and 12 claims about pads.

The complaints allege everything from TSS to the products breaking apart to allergic reactions.

Elrod of Proctor & Gamble stated plainly, “Our products are safe. That’s the foundation of everything that we do. We’re working with university scientists, FDA. Women can use our products safely.”

Brand of Kimberly-Clark said “Nothing is of greater concern to Kimberly-Clark than the quality of our products and the well-being of the consumers who use them. “

The FDA says women should choose a tampon with the minimum absorbency they need, and should consult their doctors.

The FDA requires manufacturers to provide labeling on packaging about the signs of TSS, and how to minimize risk.

By Nadia Kounang, CNN