Top or Bottom? Varsity youth talk about gay sexuality in a Stepping Stones Workshop: Implications for sexual health
Abstract
This paper discusses the constructs of sexuality amongst a group of LGBTI university students during a Stepping Stones workshop aimed at exploring their engagement with sexual and reproductive health rights issues as it affects them. These constructs include notions of binary identities of being gay, such as being a ‘top’ versus being a ‘bottom’, that are then applied to sexual practices and behaviour that have serious implications for sexual health and bodily integrity. We discuss the intersections of gender identity, sexuality, sexual health and sexual rights, arguing that such constructs are not only limiting in their demarcations of sexual boundaries in relationships and for intimacy but also that attempts to engage sexual health promotion must take into account the intersecting identities of gender and sexuality that are tied to sexual behaviour.
References
Aninanya, Gifty Apiung, Cornelius Y Debpuur, Timothy Awine, John E Williams, Abraham Hodgson, and Natasha Howard. 2015. "Effects of an Adolescent Sexual and Reproductive Health Intervention on Health Service Usage by Young People in Northern Ghana: A Community-Randomised Trial." PloS one no. 10 (4).
Attride-Stirling, Jennifer. 2001. "Thematic networks: an analytic tool for qualitative research." Qualitative research no. 1 (3):385-405.
Berg, Rigmor C., Peter Weatherburn, Michael W. Ross, and Axel J. Schmidt. 2015. "The relationship of internalised homonegativity to sexual health and well-being among men who have sex with men in 38 European countries." Journal of Gay & Lesbian Mental Health:00-00. doi: 10.1080/19359705.2015.1024375.
Bhattacharjee, Parinita. 2000. "Stepping Stones-a participatory tool to integrate gender into HIV/AIDS work." Development in Practice no. 10 (5):691-694.
Carballo?Diuez, A., A. Ventuneac, J. Bauermeister, G. W.
Dowsett, C. Dolezal, R. H. Remien, I. Balan, and M. Rowe. 2009. "Is bareback a useful construct in primary HIV?prevention? Definitions, identity and research." Culture, Health & Sexuality no. 11 (1):51-65. doi: 10.1080/13691050802419467.
Clarke, Victoria, and Megan Smith. 2014. "Not Hiding, Not Shouting, Just Me: Gay Men Negotiate Their Visual Identities." Journal of Homosexuality no. 62 (1):4-32. doi: 10.1080/00918369.2014.957119.
Cloete, Nico. 2014. "The South African higher education system: performance and policy." Studies in Higher Education no. 39 (8):1355-1368.
Collier, Kate L, Theo GM Sandfort, Vasu Reddy, and Tim Lane. 2015. "This Will Not Enter Me: Painful Anal Intercourse Among Black Men Who Have Sex with Men in South African Townships." Archives of sexual behavior no. 44 (2):317-328.
Cook, Stephanie H, Theo GM Sandfort, Juan A Nel, and Eileen P Rich. 2013. "Exploring the relationship between gender nonconformity and mental health among black South African gay and bisexual men." Archives of sexual behavior no. 42 (3):327-330.
Dunkle, Kristin L, Rachel K Jewkes, Mzikazi Nduna, Jonathan Levin, Nwabisa Jama, Nelisiwe Khuzwayo, Mary P Koss, and Nata Duvvury. 2006. "Perpetration of partner violence and HIV risk behaviour among young men in the rural Eastern Cape, South Africa." Aids no. 20 (16):2107-2114.
Emlet, Charles A., Karen I. Fredriksen-Goldsen, Hun-Jun Kim, and Charles Hoy-Ellis. 2015. "The Relationship Between Sexual Minority Stigma and Sexual Health Risk Behaviors Among HIV-Positive Older Gay and Bisexual Men." Journal of Applied Gerontology. doi: 10.1177/0733464815591210.
Fields, Errol Lamont, Laura M. Bogart, Katherine C. Smith, David J. Malebranche, Jonathan Ellen, and Mark A. Schuster. 2015. ""I Always Felt I Had to Prove My Manhood": Homosexuality, Masculinity, Gender Role Strain, and HIV Risk Among Young Black Men Who Have Sex With Men." American Journal of Public Health no. 105 (1):122-131.
Fisher, Celia B., and Brian Mustanski. 2014. "Reducing Health Disparities and Enhancing the Responsible Conduct of Research Involving LGBT Youth." Hastings Center Report no. 44 (s4):S28-S31. doi: 10.1002/hast.367.
Gil, Sharon. 2007. "A narrative exploration of gay men's sexual practices as a dialectical dialogue." Sexual and Relationship Therapy no. 22 (1):63-75.
Grundy-Bowers, Matthew, Sally Hardy, and Eamonn McKeown. 2015. "Barebacking and sexual position." Sexualities no. 18 (1-2):176-194.
Halkitis, Perry N, Leo Wilton, and Jack Drescher. 2005. "Introduction: why barebacking?".
Halkitis, Perry N, Leo Wilton, and Paul Galatowitsch. 2005. "What's in a term? How gay and bisexual men understand barebacking." Journal of Gay & Lesbian Psychotherapy no. 9 (3-4):35-48.
Halkitis, Perry N., Daniel Siconolfi, Megan Fumerton, and Kristin Barlup. 2008. "Facilitators of Barebacking among Emergent Adult Gay and Bisexual Men: Implications for HIV Prevention." Journal of LGBT health research no. 4 (1):11-26. doi: 10.1080/15574090802412580.
Harrison, A, J Smit, T Exner, S Hoffman, and J Mantell. 2015. "The Mpondombili Project: gender inequalities and young peoples sexual health in rural South Africa." Sexual Health Exchange (3-4):4.
Herbst, Jeffrey H, Thomas M Painter, Hank L Tomlinson, ME Alvarez, Centers for disease control, and prevention. 2014. "Evidence-based HIV/STD prevention intervention for black men who have sex with men." Strategies for Reducing Health DisparitiesSelected CDC-Sponsored Interventions, United States, 2014 no. 63 (1):21.
Hoppe, Trevor. 2011. "Circuits of power, circuits of pleasure: Sexual scripting in gay mens bottom narratives." Sexualities no. 14 (2):193-217.
Huebner, David M, Rae Jean Proescholdbell, and Carol J Nemeroff. 2006. "Do gay and bisexual men share researchers' definitions of barebacking?" Journal of Psychology & Human Sexuality no. 18 (1):67-77.
Irvine, Janice M. 2003. "Introduction to Sexual Scripts: Origins, Influences and Changes." Qualitative Sociology no. 26 (4):489-490. doi: 10.1023/B:QUAS.0000005263.56276.9c.
Jewkes, R., M. Nduna, J. Levin, N. Jama, K. Dunkle, N. Khuzwayo, M. Koss, A. Puren, K. Wood, and N. Duvvury. 2006. "A cluster randomized-controlled trial to determine the effectiveness of Stepping Stones in preventing HIV infections and promoting safer sexual behaviour amongst youth in the rural Eastern Cape, South Africa: trial design, methods and baseline findings. Tropical Medicine & International Health no. 11 (1):3-16. doi: 10.1111/j.1365-3156.2005.01530.x.
Jewkes, Rachel, Andrea Cornwall, and Petra Rr-Rouendaal. 1998. Stepping Stones: a training manual for sexual and reproductive health communication and relationship skills: CERSA, Medical Research Council.
Johns, Michelle Marie, Emily Pingel, Anna Eisenberg, Matthew Leslie Santana, and JosBauermeister. 2012. "Butch tops and femme bottoms? Sexual positioning, sexual decision making, and gender roles among young gay men." American journal of men's health no. 6 (6):505-518.
Kippax, Susan, and Gary Smith. 2001. "Anal intercourse and power in sex between men." Sexualities no. 4 (4):413-434.
Knight, R. E., J. A. Shoveller, A. M. Carson, and J. G. Contreras-Whitney. 2014. "Examining clinicians experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice." Health Education Research no. 29 (4):662-670. doi: 10.1093/her/cyt116.
Kruss, Glenda, Angelique Wildschut, Dean Janse Van Rensburg, Mariette Visser, Genevieve Haupt, and Joan Roodt. 2014. "Learnerships and apprenticeships: Key mechanisms for skills development and capability building in South Africa." Human Science Research Council, obtained from http://www. hsrc. ac. za/en/research-data/ktree-doc/13717.
Lick, David J, and Kerri L Johnson. 2015. "Intersecting Race and Gender Cues are Associated with Perceptions of Gay Mens Preferred Sexual Roles." Archives of sexual behavior:1-11.
Masvawure, Tsitsi B., Theo G. M. Sandfort, Vasu Reddy, Kate L. Collier, and Tim Lane. 2015. "They think that gays have money: gender identity and transactional sex among Black men who have sex with men in four South African townships." Culture, Health & Sexuality no. 17 (7):891-905. doi: 10.1080/13691058.2015.1007168.
Matebeni, Zethu, and Thabo Msibi. 2015. "Vocabularies of the non-normative." Agenda no. 29 (1):3-9.
McGill, Craig M, and Joshua Collins. 2014a. "The Experience of Bottoming: Considerations for Identity and Learning."
McGill, Craig M, and Joshua C Collins. 2014b. "Bottom Identity: Matters of Learning and Development." SFERC 2014:8.
McGill, Craig M., and Joshua C. Collins. 2015. "Creating Fugitive Knowledge Through Disorienting Dilemmas: The Issue of Bottom Identity Development." New Horizons in Adult Education & Human Resource Development no. 27 (1):29-40.
Meyer, Ilan H. 2003. "Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence." Psychological Bulletin no. 129 (5):674-697. doi: 10.1037/0033-2909.129.5.674.
Mitchell, Kimberly J, Michele L Ybarra, Josephine D Korchmaros, and Joseph G Kosciw. 2014. "Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations." Health education research no. 29 (1):147-157.
Moskowitz, David A, and Trevor A Hart. 2011. "The influence of physical body traits and masculinity on anal sex roles in gay and bisexual men." Archives of Sexual Behavior no. 40 (4):835-841.
Moskowitz, David A, Gerulf Rieger, and Michael E Roloff. 2008. "Tops, bottoms and versatiles." Sexual and Relationship Therapy no. 23 (3):191-202.
Msibi, Thabo. 2013. "Queering transformation in higher education." Perspectives in Education no. 31 (2):65-73.
Mustanski, Brian, Daniel T Ryan, and Robert Garofalo. 2014. "Associations of sexually transmitted infections with condom problems among young men who have sex with men." Sexually transmitted diseases no. 41 (7):427.
Nel, Juan. 2009. "Same-sex sexuality and health: Psychosocial scientific research in South Africa." From social silence to social science: Same-sex sexuality, HIV & AIDS and gender in South Africa:137-142.
Pachankis, John E, Mark L Hatzenbuehler, Ford Hickson, Peter Weatherburn, Rigmor C Berg, Ulrich Marcus, and Axel J Schmidt. 2015. "Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey." AIDS no. 29 (10):1239-1246.
Paine, Katie, Graham Hart, Michelle Jawo, Saihou Ceesay, Mariama Jallow, Linda Morison, Gijs Walraven, Keith McAdam, and Matthew Shaw. 2002. "Before we were sleeping, now we are awake: Preliminary evaluation of the Stepping Stones sexual health programme in The Gambia." African Journal of AIDS Research no. 1 (1):39-50.
Rabie, Francois, and Elmien Lesch. 2009. "I am like a woman: constructions of sexuality among gay men in a low-income South African community." Culture, Health & Sexuality no. 11 (7):717-729. doi: 10.1080/13691050902890344.
Sakaluk, John K., Leah M. Todd, Robin Milhausen, Nathan J. Lachowsky, and Sexuality Undergraduate Research Group in. 2013. "Dominant Heterosexual Sexual Scripts in Emerging Adulthood: Conceptualization and Measurement." The Journal of Sex Research no. 51 (5):516-531. doi: 10.1080/00224499.2012.745473.
Sandfort, Theo G. M., Rita M. Melendez, and Rafael M. Diaz. 2007. "Gender Nonconformity, Homophobia, and Mental Distress in Latino Gay and Bisexual Men." The Journal of Sex Research no. 44 (2):181-189. doi: 10.1080/00224490701263819.
Santhya, K. G., and Shireen J. Jejeebhoy. 2015. "Sexual and reproductive health and rights of adolescent girls: Evidence from low- and middle-income countries." Global Public Health no. 10 (2):189-221. doi: 10.1080/17441692.2014.986169.
Schalet, AmyT, JohnS Santelli, StephenT Russell, CarolynT Halpern, SarahA Miller, SarahS Pickering, ShoshanaK Goldberg, and JenniferM Hoenig. 2014. "Invited Commentary: Broadening the Evidence for Adolescent Sexual and Reproductive Health and Education in the United States." Journal of Youth and Adolescence no. 43 (10):1595-1610. doi: 10.1007/s10964-014-0178-8.
Schilt, Kristen, and Laurel Westbrook. 2009. "Doing Gender, Doing Heteronormativity Gender Normals, Transgender People, and the Social Maintenance of Heterosexuality." Gender & Society no. 23 (4):440-464.
Shaw, Jonathan, and John Sweeney. 2015. "P190 We dont need no sex education: do young people value the knowledge they gain from school and sexual health services?" Sexually Transmitted Infections no. 91 (Suppl 1):A79-A79.
Shaw, Matthew, and Michelle Jawo. 2000. "Gambian experiences with Stepping Stones: 1996-99." PLA Notes no. 37:73-78.
Tat, Susana A., Jeanne M. Marrazzo, and Susan M. Graham. 2015. "Women Who Have Sex with Women Living in Low- and Middle-Income Countries: A Systematic Review of Sexual Health and Risk Behaviors." LGBT Health no. 2 (2):91-104. doi: 10.1089/lgbt.2014.0124.
Waldman, Linda, and Marion Stevens. 2015. Sexual and Reproductive Health Rights and Information and Communications Technologies: A Policy Review and Case Study from South Africa. IDS.
Weber-Gilmore, Genevieve, Sage Rose, and Rebecca Rubinstein. 2011. "The impact of internalized homophobia on outness for lesbian, gay, and bisexual individuals." The Professional Counselor: Research and Practice no. 1 (3):163-175.
Wegesin, Domonick J, and Heino FL Meyer-Bahlburg. 2000. "Top/bottom self-label, anal sex practices, HIV risk and gender role identity in gay men in New York City." Journal of Psychology & Human Sexuality no. 12 (3):43-62.
Welbourn, Alice. 1995. "Stepping stones. A package for facilitators to help you run workshops within communities on HIV/AIDS communication and relationship skills."
Wood, Katharine, and Rachel Jewkes. 1997. "Violence, rape, and sexual coercion: Ever yday love in a South African township." Gender & Development no. 5 (2):41-46.
Yep, Gust A, Karen E Lovaas, and Alex V Pagonis. 2002. "The Case of Riding Bareback Sexual Practices and the Paradoxes of Identity in the Era of AIDS." Journal of Homosexuality no. 42 (4):1-14.
Copyright (c) 2017 Peace Kiguwa
This work is licensed under a Creative Commons Attribution 4.0 International License.
This journal is an open access journal, and the authors and journal should be properly acknowledged, when works are cited.
Authors, copyright holders, may use the publishers version for teaching purposes, in books, theses, dissertations, conferences and conference papers.
A copy of the authors' publishers version may also be hosted on the following websites:
- Non-commercial personal homepage or blog.
- Institutional webpage.
- Authors Institutional Repository.
The following notice should accompany such a posting on the website: This is an electronic version of an article published in SAJHE, Volume XXX, number XXX, pages XXX “XXX", DOI. Authors should also supply a hyperlink to the original paper or indicate where the original paper (http://www.journals.ac.za/index.php/SAJHE) may be found.
Authors publishers version, affiliated with the Stellenbosch University will be automatically deposited in the University Institutional Repository SUNScholar.
Articles as a whole, may not be re-published with another journal.
The following license applies:
Attribution CC BY-NC-ND 4.0
