About

Naming the unnameable

The term MSM (or men who have sex with men) is a behavioural term originally arising from the context of non-gay-identified men having sex with other men in the West.

In Bangladesh, male sexualities are primarily framed around gender and sexual roles and gender-based identities, not around sexual orientation. Education and class also have a role to play in such framing.

The term “gay” evolved in the West to reflect not only sexual orientation, but also a political orientation involving a process of “coming out” and engaging with other gay identified men. The word “gay” does not mean homosexual.

For many donors, governments and NGOs, the phrase “men who have sex with men” has unfortunately become synonymous with the term “homosexuals” or “bisexuals”.

Male to male sex is not as uncommon as people would like to think. It is not an exclusive category. It involves a broad range of males that include:

• Gender variant males who desire to be penetrated by “real men” and how identify they desire around a performative role and label – i.e. “kothi”. Thus such males seek normative men from the general male population .

• “Real men” who desire to penetrate but have no specific sexual identity, and are comfortable penetrating both females and males who are “not like men”.

• Men in inclusive male populations, such as prisons

• Men/males in gender segregated environments, where sexual access to other males is easier than females

• Hijra identified males, who are biological males but identify as “neither man nor woman”. Sex work is economically driven

• Male sex work which is often economically driven, but can also be based on same sex desire within (but not always) a gender performance framework.

• Gay identified men, who usually seek other gay-identified men as sexual partners.

• In the context of Bangladesh, gay-identified men tend to be from the educated and economically privileged classes, who have regular access to English language websites. In Bangladesh this is a class-based identity.

• There are two primary same-sex identities in Bangladesh: kothi and gay, with the former being the most prevalent.

Male sexual behaviours are not divided into exclusive categories of “heterosexual”, “homosexual” or even “bisexual”.
In terms of HIV/STI risks and vulnerabilities, the ones with the highest risks tend to be those who are penetrated and have significant numbers of different partners.

IN the context of Bangladesh this means kothi-identified males (feminized males), hijras, and male sex workers who sell receptive sex. But male sex workers tend to be primarily kothi-identified.

The masculine partners are less at risk because they penetrate (lower infection risk), and have fewer partners.

Evidence from India and Pakistan has shown that Kothi-identified males tend to have more sexual partners than gay-identified men.

The term “sexual minorities” has become a useful term to be inclusive of all those who express no normative identities, gender performance and consensual sexual behaviours, in situations where the complexity and sexual diversity is difficult to express in simple terms.

Further in Bangladesh, one has to be sensitive to the cultural/religious dynamics of society, and not create levels of tension over the use of certain terms that are loaded with discriminatory meaning. The word gay is such a word (media driven), as is “men who have sex with men”. Hence Bandhu uses the term “male health” primarily except in certain safe settings.

Stigma, discrimination and social exclusion

In Bangladesh, stigma, discrimination and social exclusion is focused on those males/men who do not “fit” the social gender norms and expectations, i.e men/males who express gender variance through performance and/or sexual roles, i.e. those men/males who are sexually receptive partners of “normative gender performing males, where gender normative is around penetration, and not around biological maleness.

This stigma, discrimination and social exclusion is given social sanction by religious norms as well as social and cultural expectations of maleness and manhood.

Such discrimination also has enormous impact on reducing the impact of HIV/STIs in Bangladesh, because it invisibilises same sex behaviours, it refuses to accept treatment needs, and rejects people who are express gender variance as “abnormal” and therefore “bad” and “undeserving”.

If Bangladesh is truly to reduce the potential economic and social burden of HIV, then it must address stigma and discrimination and social exclusion, to ensure that these most highly vulnerable populations must have access to health services, remembering that many of even feminised males, will be married with children (for socio-cultural reasons, and not on desire).
Sexuality and gender is another important arena and different organizations have chosen different methods to address it. At Bandhu, over a decade programme experience amongst Kothis (feminized males) and Hijras, following issues came up more prominent:

• Lack of education: The Kothis [feminized males] have faced extreme harassment at schools/colleges which resulted in increased drop out rates among the feminized boys who later on became kothis or Hijras, arguably the biggest group among sexual minorities. However ‘people who identify as Gay’ exhibit similar/comparable sexual practices yet because of their family’s enhanced social and economic backgrounds and ‘lack of feminization’, did not faced any harassment.

• Livelihood: Again, a large number of Kothis and almost all Hijras are denied equal opportunities to earn their livelihood. This also forces some kothis to leave home as they cease to be ‘productive’ because their feminization brings shame and ‘loss of honors’ to the family. Lack of equal opportunity to earn livelihood forces some of the Kothis and Hijras to become part/full time sex workers. However, ‘self-identified gays’ are rarely denied equal opportunity to earn their livelihood. They face discrimination from colleagues and management if they express their ‘sexuality’ or if colleagues ‘get to know’ about it.

• Discrimination in health seeking systems: Kothis and Hijras are not provided what is due to every citizen of the country. Their perceived gender roles are not respected and approved by government owned medical fraternities who do not provide them essential services, which they would provide to other citizens. Gays do not face similar problems as generally they can afford to buy the services themselves.

• Denial of human rights and justice: Law enforcement agencies/forces treat them as an outcast and ‘lesser’ citizens. The frequent abuses, violence in public places along with extortions, sexual assault and rapes are very common among Kothis and Hijras. Gays however face less of these problems. Their problems are mostly around extortions from Police if they are caught in sexual acts in public or otherwise.

Human Rights

UNAIDS and its co-sponsors have accepted that the only effective way to address HIV, risks and vulnerabilities and ensure social justices through what is term a rights-based approach towards creating an enabling environment, in which marginalised males feel safe to access appropriate services.

What does this mean?

It means that laws that criminalise same-sex behaviour should be repealed. It means that what is deemed normative needs to be expanded to include gender variant males (and of course females as well). It means understanding that human sexuality does not come in a box but is a broad framework of sexual variance and diversity, and not fitting into this heterosexual/homosexual/gay framework. It means understanding the complexity of human sexual desires that have porous boundaries.

The World Health Organisation’s definition of sexual health is:

Sexual health is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, a well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.

Advocacy therefore is around health rights, sexual health rights, and is not so much based on identity politics. To speak of gay rights is to limit such rights to those who are gay-identified. This is not the situation in Bangladesh Hence the need to speak of sexual minorities and health rights.