Wednesday, October 5, 2011

Basics of homosexuality - key definitions (From the Desk of Universal Health)


Sexuality: Sexuality is a combination of following six components:
         Biological sex – physical and genetic sex (That is, born with which genitalia?)
         Sexual orientation – Sexually attracted whom (male, female or both)
         Sexual behavior – Sexual act with whom (male, female or both)
         Sexual identity – Self identity of the sexual orientation
         Gender identity – psychological sense of being male or female
            (That is whether considers oneself as man or woman?)
         Gender expression – adherence to the cultural expectations for feminine or masculine behavior
Sexual orientation: One’s erotic, romantic, and affectional attraction to people of the same sex, to the opposite sex, or to both sexes.

Heterosexuality: Erotic, romantic, and affectional attraction to people of opposite sex.
Bisexuality: Erotic, romantic, and affectional attraction to people of both sexes.
Homosexuality: Erotic, romantic, and affectional attraction to people of the same sex.
Similarly, Sexual behavior and identity can be divided into heterosexual, bisexual and homosexual.
A person with same sex behaviour will feature the following attributes:
1) Homosexual or Bisexual orientation
2) Homosexual identity is sometimes not identified by the person himself. In that case it is known as label but not an identity
3) Sexual behaviour varies from heterosexual, bisexual to homosexual (a person with homosexual orientation may have heterosexual behaviour)
4) A person who is born with normal male genitalia may think himself as a woman, so the orientation of the person becomes heterosexual. (He likes to have sex with the male partner like a female).

Some important definitions:
Eunuchs: A castrated male. It is not used any more because it is considered to be a derogatory term.

MSM: Men demonstrating sexual behaviour between each other irrespective of their sexual orientations. (A man can have sex with another man with heterosexual/bisexual/homosexual orientation)

Gays and Bisexuals: MSM may hail from upper, middle and low socio-economic strata. MSM with homosexual and bisexual identity and belonging to upper and middle classes are known as Gay and Bisexual respectively. A Gay can not be always a MSM and vice versa.

Kothis: Similarly MSM with homosexual identity and belonging to lower socio-economic class is known as Kothis. Kothis call their partners as Panthis if they only penetrate them during sexual act and Double Decker/Do Paratha if they penetrate and get penetrated by the kothis during sexual act. Both these terms Panthis and Double Decker are not identities but labels given by the Kothis to their sexual partners.

Few more important aspects on Kothis:
A Kothi is a man with feminine features with homosexual orientation. But the Kothis may demonstrate heterosexual behaviour as well. A number of kothis in India are married and even have children. All kothis do not have anal sex.

Kothis/Gays show varying degree of homosexual orientation like
  • A combination of homo and heterosexual orientation making the person bisexual who may demonstrate bisexual behaviour as well (sex with both male and female partner)
  • Homosexual orientation without homosexual behaviour
  • Homosexual orientation with gender identity as a man
  • Homosexual orientation with gender identity as a man but dislikes some of features of the male body

When gender identity of a male person becomes a female the sexual orientation becomes heterosexual. To satisfy the desire of becoming a female the person adopts a number of techniques like: Dress like the females (Cross dressing), development of breasts, undergoes castration operation (removal of male genitalia) and emasculation (removal of both male genitalia and penis) Sometimes the desire is so strong that he likes to undergo sex change operation to have a female body.

Persons who transgress societal gender norms are known as Transgender. Transgender have variant range of gender identity starting from gender dysphoria (dissatisfaction with one’s own gender identity) to extreme condition of transsexualism where the person strongly believe that he is a female ‘entrapped in a male body’. Female-to-male transsexuals are sometimes referred to as "FTMs" or "transsexual men," and male-to-female transsexuals as "MTFs" or "transsexual women." Transsexualism is a neurodevelopment condition in the hypothalamus of human brain which is considered to be normal in present days though Gender Identity Disorder (GID) if affecting the day to day activities of life is considered to be a psychiatric condition. GID may be childhood or adult onset.

Hijras are basically biological males but transsexuals with the Kothi identity. Feminine MSM is also having Kothi identity. Incidentally the word Kothi comes from Hijra community.

Intersex is the term used to describe persons who carry both male and female genitalia (mostly non functioning) due to developmental anomalies (such condition occurs in one out of one lac new borns). They should not be confused with the Hijras because a Hijra is a normal biological male only. Hermaphrodite is an obsolete term for Intersex.

Differences between Hijra and Kothi (though there are overlapping between the two groups):


HIJRA
KOTHI
Gender identity is female
Gender identity is mostly male
Mostly Transsexuals
Rarely transsexuals
Often cross dress
Rarely cross dress
Generally heterosexual orientation
Generally homosexual, sometimes bisexual orientation
Sexual behaviour may rarely be heterosexual with female partners
Sexual behaviour may sometimes be heterosexual with female partners
Tendency to breast development, castration common
Not common
Develops separated community with ‘guru’ system
Stay with partner or alone. Rarely form a group though networking among the kothis is very strong
Sometimes penetrates male partner
Rarely penetrates male partner
Commercial sex work common
Commercial sex work is not that common
Thigh sex common
Thigh sex not common

 


In South India Hijras are known as Aravani. Ali is a derogatory term of Hijra. Some common terms related to Hijras:

Ackwa Kothi: Hijra with intact genitalia. They are also known as pre operative male to female transsexual (MTFT).
Nirvana kothi: Castrated Hijra. They are also known as post operative male to female transsexual.
Non operative Transexxual: Some Hijras do not like to go through castration operation.

Castration is sometimes done by unqualified doctors leading to urethral stricture and urinary retention. This procedure is also carried out by the elder member of the hijra community known as "Dai-Mai".

Some important steps of Sex Reassignment Surgery/SRS:
  • Creation of new vagina
  • Application of female hormone
  • Development of artificial breasts from abdominal muscle
  • Silicon prosthesis for breast development
  • Laser surgery for vocal cord
  • Electrolysis/laser treatment to remove hair

Lesbian: A lesbian is a woman whose primary sexual and romantic attractions are to other women. She may have sex with women currently or may have had sex with women in the past. A smaller number of lesbians may never have had sex with another woman for a whole host of reasons (age, societal pressures, lack of opportunity, fear of discrimination), but nonetheless realize that their sexual attraction is mainly to other women. Some lesbians have sex with men and some don't. It is important to note that some women who have sex with other women, sometimes exclusively, may not call themselves lesbians.
Homophobia: It is the irrational hatred and fear of lesbian and gay people that is produced by institutionalized biases in a society or culture.
Heterosexism: the assumption that only heterosexuality is normal and other sexualities are abnormal and immoral.

Coutsey: Humsafar Trust and Dr V. Chakrapani

Human Sexual Behavior & its effect on Reproductive Health

Sugata M

Sexual activity is one of the most crucial psychophysical activities in the lives of humans. It leads to pleasure and satisfaction which is critical for a fruitful and meaningful living. At the same time the sexual act remains as the most critical expression of the human sexual behavior and is also positioned as the central theme of the reproductive health.

Outcomes of sexual activity: Other than psychosomatic recreation sexual activity may have the following outcomes under various contexts affecting the reproductive health: 1) Pregnancy/Conception, 2) Infection and 3) Injury

Pregnancy: Sexual activity between heterosexual couple during a particular period of time (ovulatory phase of menstrual cycle) results in pregnancy provided both the couple is physically competent to procreate. Pregnancy may be wanted, unwanted as per the objective of the mating couple. Pregnancy is a normal physiological phenomenon but it definitely puts the women under certain degree of risks (like abortion related problems, pregnancy associated or induced health problems, post partum hemorrhage, complications in puerperium, complications of teenage, repeated and late pregnancies, implications on the newborns including Mother To Child Transmission/MTCT of HIV) 

Infection: There are plenty of evidences globally that unprotected penetrative (rarely non penetrative) sexual acts are responsible for genital tract infection (genital tract means sexual and reproductive organs), anal tract infection, oro-pharyngeal infection, body infection (scabies, lice infestation) and other infections (hepatitis, enteric fever etc). The most talked about sexually transmitted infection in today’s world is HIV/AIDS. All the STIs have their epidemiological pattern, pathogenesis and treatment measures. But there is a uniform understanding (based on scientific evidences) throughout the world that protected sex can prevent 90-95% of STIs. Modification of the sexual behavior is unanimously accepted globally as the most critical strategy to ensure safe sex practice among vulnerable as well as general community to control STI/HIV.

Injury: Violent sexual act damages the sex organs (mostly the recipient partners). Rape, molestation, sexual harassment, sexual aberrations (sadism, masochism), some accepted social norms (sodomy, alcoholism, drugs) are common features, which ultimately push the passive partners into the risks of sex organs’ injuries including psychological trauma. 

Behaviors in the form of non penetrative non touching sexual practices (like masturbation, exhibitionism, voyeurism, fetishism etc) also exist in the human society, which have different psycho-social implications and reflect a different dimension of human reproductive health.

So it is evident that the reproductive health is strongly influenced by the sexual behavior which is actually a critical psycho-physical human expression of a number of complex emotions driven by religious/spiritual beliefs, economic condition, cultural background, gender issues, educational status, legal implications and societal norms.

What is sexual behavior
Sexual behavior is a unique combination of knowledge, attitude and practice of sexual activity guided by one’s sexuality and a number of important environmental factors.

Reversing adverse outcome of sexual behaviour through modification of sexual behaviour is very challenging.

Inviting comments.