Sexuality, Gender, Reproductive Health, HIV/AIDS
Gender reflects the expectations and standards of a society toward females and males, especially in the area of behaviour and expression as characteristics and roles of males and females. Sexuality refers to sexual preference, sexual expression, sexual behaviour, reproduction, love, sexual pleasure, sexual habits and selection of a sex partners. Gender and sexuality are similar in the sense that they are governed by culture and power relationships of a given society.
Hundreds of studies from around the world affirm that gender and sexuality are at the root of challenges regarding HIV transmission and reproductive health (RH). Patriarchal societies generally have double standards of behaviour for men and women regarding sex, often with little flexibility, and are slow to adapt to changing global norms. These societies tend to have more challenges related to RH, unplanned pregnancy and HIV/AIDS than more democratic societies in which there is more gender equality and flexibility.
Thailand is one of many societies facing RH challenges, the most significant of which is unplanned pregnancies, resulting in unsafe abortions as well as HIV/STIs and lack of male involvement in family planning and RH prevention behaviour. This situation reflects the cultural aspects of gender and sexuality in Thai society and serves as a significant obstacle to a healthy and happy sexual life, especially for women.
Studies of sexuality, gender, RH and HIV/AIDS are essential at present and in the future. The purpose of advocating research in this cluster is to build a database that can assist to inform policy and public campaigns which aim to modify the socio-cultural structure and individual behaviour so that it is consistent with modern values and universal sexual health.
2. Past Research
In the past four decades, IPSR has conducted research of three types related to gender and sexuality: (1) Studies of family planning, fertility and maternal and child health; (2) Sex studies, studies of AIDS, sexually transmitted infections (STI), RH and sexual health; and (3) Studies of the roles of men and women in development. More details on these three groups of research are outlined below.
2.1 Family planning, fertility and maternal and child health (MCH): This covers research during 1971 through to 1996 and mostly consisted of evaluation studies of the National Family Planning Programme, studies of factors facilitating and obstructing acceptance of contraception and studies of guidelines in support of MCH. The studies were rooted in Malthusian dogma about the balance between the size of the population and quantity of food. At that time, Thailand still had a high fertility rate. The research questions were also influenced by behavioural theory which included determinants such as socio-economic and demographic factors affecting fertility behaviour, acceptance of contraception and health maintenance of the population.
2.2 Sex studies, studies of AIDS, sexually transmitted infections (STI), RH and sexual health: These studies, more than 80 in total, emerged during the period since 1986 and can be classified as follows:
Group 1: Studies in response to the AIDS epidemic which looked at sex behaviours and attitudes, risk behaviours for HIV and knowledge about prevention of AIDS. These studies were conducted among urban and rural populations, youth, sex workers, factory workers, long-distance truck drivers, motorcycle taxi drivers and foreign migrant labourers. In addition, evaluation studies of AIDS policy and the national AIDS prevention and control response. Also included were studies of sexual networking among at-risk populations that viewed the challenges regarding HIV/AIDS as relating to sex behaviour with a conceptual framework driven by social epidemiology and behavioural science.
Group 2: This group includes research which adopted a new conceptual thinking style regarding population and development. Traditionally, approaches emphasised population control and family planning almost exclusively. Later on however, there was more interest in RH rights, access to services and quality of government RH services. IPSR research on these issues began in 1997 and continues at present. Researchers used a conceptual framework of gender, sexuality and sexual health to examine issues of AIDS and RH problems from a broader perspective, including dimensions of domestic violence, human trafficking and commercial sex. A number of ground-breaking studies were conducted by IPSR including the Creation and Management of Knowledge on Sexuality, Gender and Sexual Health (in accordance with Strategic #1 of the Sexual Health Promotion Plan); The Study of the Status of Sexual Health and Reproductive Health of Female Sex Workers in Thailand; From Planning to Policy: Empirical Basis for Policy Formulation on Sexual Health and HIV/AIDS in the Mekong Sub-region; Thailand and AIDS and Reproductive Health Policy Evolution Regarding Foreign Migrant Labourers; the Project to Increase Access to Reproductive Health Services for Migrant Youth in Bangkok; and in addition research studies to build a foundation of knowledge for sexual health advocacy and long-term studies in RH.
2.3 Roles of men and women in development: In the past 40 years, IPSR has conducted five major studies on women’s health development including: (1) the Mid-term Evaluation of Implementation of Empowerment of Women and Adolescents (2008); (2) Study of Economic Leadership by Rural Women: A Case Study of Kanchanaburi (2002); (3) Responsibility for the Family and Impact of Work on Women’s Health (1998); (4) Study of the Economic Aspects of the Role of Women in the Family (1993); and (5) Changing Roles and Status of Thai Women (1988).
IPSR intends to continue to develop research on gender, sexuality, RH and HIV/AIDS in order to fill knowledge gaps and to provide useful information for quality of life development and sexual health of different groups of the population. Some of the possible research topics that IPSR may pursue in the future include the following:
Studies on the meaning of love, relationships, femininity and masculinity which impact on use or non-use of methods to prevent unwanted pregnancy and STI among youth;
Studies of RH and sexual rights of youth;
Studies to develop indicators of inequality and power relationships between women and men in the context of the family and decision-making about sexuality and RH;
Research into violations of human and sexual rights which impact on the health of vulnerable populations (e.g. alternative sexes, sex workers, drug addicts and foreign migrant labourers).
Research on how to eliminate sexual abuse and domestic violence and promote sexual justice.
Research to support participation of men in promoting sexual health and social welfare of women.
Research into health of women in the context of different identities
Research into sexual health of Thai male service workers working abroad.
Action research in collaboration with all related stakeholders to achieve consensus and understanding about sexual diversity in Thai society with involvement of representatives of the family, parents and the school.