Sexuality - You Must Start With Yourself
||Dr. Nahid Toubia
making a presentation at the launch of ARSRC.
if this paper is not academic enough for some of the
readers. That is by choice, as I believe that sexuality
should not be dealt with from the convenient distance
of intellectual discourse.
Close Your Eyes and Look
Sexuality: a very loaded word. Seemingly, a very personal
matter, yet, in many ways it defines and dictates
much of what goes on in society. Thinking about sexuality
inevitably starts from the subjective before it moves
to the objective, so to understand how and why we
all deal with sexuality we must start with ourselves.
Let us pause and contemplate our
own personal experiences and our thinking and understanding
of our own and other people's sexuality. Yes, close
your eyes, contemplate the following questions and
record your answers with pen and paper.
I hope that through this short journey
of self-scrutiny, I have managed to bring closer home,
a few insights:
We are all sexual beings regardless
of whether we physically display our sexuality or
we stay celibate.
Sexuality, while a hushed and
taboo subject, in fact permeates many aspects of
Sexuality is a social, political
and economic concern around which much of our traditional
and modern societies are structured.
State of the Field of Sexuality
I made an attempt to research the literature on sexuality
in Africa. I admit that my research was very limited
and some readers are likely to be more familiar with
what is in the published literature. Still, I confidently
report to you that not much has been published in
this area. Also the little that is published is not
readily available or accessible. I used the Internet
as my main tool for research and what was listed is
often in specialized libraries and collections. I
will attempt to categorise the types of literature
dealing with sexuality in Africa in the following
Reflections and observations
by anthropologists (mostly Western and mostly men)
on 'their' perceived version of African sexuality.
(Caldwell and Caldwell are a good example).
'Problematic' adolescent sexuality
as the cause of unwanted pregnancy with a focus
on young women.
Sexuality as a "vector"
which transmits diseases, and in particular HIV/AIDS,
with an emphasis on commercial sex workers and polygamous
Sexuality as the contested space
for claiming cultural authenticity in the debates
around polygamy, female genital mutilation, ritual
sexual slavery, virginity taboos, etc.)
Challenges of male sexuality
(in peace and in war) in the field of violence against
Feminist writing demanding recognition
of the need to acknowledge and protect changing
norms of sexuality.
Emerging writing by sexual minorities
(gays, lesbians and transgendered individuals) emboldened
by liberalizing legislation.
Very early and tentative writing
on sexuality as a human rights issue.
What is Required
What is lacking in this list is a body of considered
studies that attempt to understand sexuality within
the context of a variety of social and economic orders
that regulate our many African realities. Some of
The vastly different ways that
girls and women experience sexuality different from
boys and men (the gender dimension) and the extent
that these experience affect their lives (This is
recognized only by feminist writers).
Investigations into the attitudes
towards sexuality of key professionals who shape
and regulate our social environments (teachers/health
care professionals), law enforcement agents ( police,
lawyers and judges) as well as legislators is completely
Understanding of the interaction
between our past heritage shaped by longstanding
values and traditions; the impact of various colonial
cultures, adoption of major religions (Islam and
different versions of Christianity) and the impact
of globalization that reaches us mostly through
the mass media and the internet.
We have not begun to understand
the effect of all these factors on our perception
of sexuality across generations.
HIV/AIDS: A Reality Check
While sexuality is very poorly addressed in academic
and intellectual circles in Africa, reality has forced
us to take action on problems that arise partly from
neglecting to address sexuality as a matter of public
concern and an issue of responsible governance. The
HIV/AIDS epidemic has put sexuality - or more appropriately
the need for low risk sexual behaviour - at the centre
of policy concern.
Let me first affirm that "sexuality"
cannot and should not be equated to sexual behaviour;
be it risky or safe. The latter is a serious consequence
of, yet only partial component of, the former. It
is sad and ironic that as Africans we had to face
the central role of sexuality in our lives as a result
of the spread of a deadly disease that is threatening
to wipe away whole generations and further disable
our ailing economies. The problem is that the need
to fend off HIV/AIDS has now, almost exclusively,
dominated our thinking at the expense of seeing the
need to address issues of sexuality in a broader context.
The Wrong Focus
This 'disease' or 'problem' focused attention to sexuality,
be it as a result of HIV/AIDS, unwanted pregnancies,
death from clandestine abortions, female genital mutilation,
etc., completely misses the point. I believe that
this leads to wasted investment on misguided programs
and interventions in the search for solutions to these
The search for root causes and programmatic
solutions is often carried out by individuals and
institutions that are unfamiliar with the local realities
and are uncomfortable dealing with issues of sexuality.
Sexually-shy non-African research and technical agents
will partner with African individuals and institutions
that promote their goals and views on sexuality and
gender issues in their selection of program interventions
and strategies. This marginalizes those who are able
to deal with sexuality in a more open and realistic
manner. Women groups and sexual minorities have historically
been more able to deal openly with sexuality, and
its close connection to gender definitions and power
relations, as they already suffer from being sexually
The Gender Dimension
Many still fail to acknowledge that 'gender' is a
crucial component in the HIV/AIDS epidemic. While
we may not concur with the view that HIV/AIDS is a
disease of poverty, the fact is that women's economic
vulnerability, their reliance on exchanging their
sexuality for survival (within marriage, with sugar
daddies and as commercial sex workers), is at the
heart of the heterosexual nature of the epidemic in
Africa. Distributing condoms and asking women and
girls to say no to sex will not stop the epidemic
as long as women's economic dependency and their lack
of power to negotiate safe sex remains unaddressed.
Can a woman demand that her husband
who just came back from a business trip wear a condom
or get tested for HIV before he has sex with her?
Can a single mother of small children reveal her HIV
status to her current boyfriend (or sugar daddy) at
the risk of becoming destitute and starving her children?
Can a high school girl insist that her affluent suitor
wear a condom if she is desperate to get him to pay
her school fees?
Issue of Teen Pregnancy
Another example is the issue of teen pregnancy. The
few in-depth inquiries into teenage pregnancy reveal
an array of causes including incest, intimate rape
(by boyfriend, family friend or relative), complete
ignorance of the physiology of reproduction, lack
of contraceptives (including the very safe and practical
morning after pill), expensive and unsafe abortion
services, and the sale of young girls to older men
within or outside marriage.
A third example is Female Genital
Mutilation. For years, programs repeatedly attempted
to 'educate' communities against the health risks
of this primitive and "no longer necessary"
but harmful traditional practice. What they failed
to address is the continuing importance of FGM to
the gendered power relations within sexual unions
and how they service the social order.
The reigning social order of patriarchy
in certain African societies demands the removal of
a woman's sexuality as a component of her reproductive
function. Women in return accepted that social order
and continue to exchange their genitals as a negotiated
settlement for a limited amount of power and control
over their lives.
Addressing Power Balance
This is the underlying reason why FGM is so deeply
protected by women even more than men. Such a strong
social pact will not be undone through preaching an
abstract link to health risks. Experience has proven
that women will not voluntarily abandon FGM unless
the existing power balance within the social order
is set right and women provided alternative means
of negotiating a similar or higher level of power
and control. On its own, even the threat of legislative
sanctions cannot stop the practice; it only forces
Modeling of Male 'Sexualities'
Another issue almost completely avoided by program
designers, policy makers and even legislators is that
of the social and psychological modeling of male sexualities.
I deliberately use the term 'sexualities' even though
we popularly talk only of male and female sexuality.
I believe that thinking of male sexuality as a stereotype
and a singular entity re-enforces dominant and problematic
Let us first acknowledge and applaud
existing models of male sexuality that are non-violent
and which centre their psychological reference to
emotions and fantasies that are positively creative,
respectful and non-harmful to others. Let us pay special
attention to the undervalued men and boys who only
have sex within equitable and consensual relations.
We must thank the mothers and fathers who nurtured
such men and boys and the individuals themselves who
uphold these positive male sexual values, despite
tremendous peer pressure, ridicule and sometimes physical
Unfortunately such men and boys
are still in the minority regardless of whether they
practice homosexual or heterosexual sex, within or
outside marriage, with partners they love or partners
they pay for their services. In short we must seriously
and urgently address the violent, possessive and controlling
model of male sexuality into which most African boys
are shaped. We must also look at the local and imported
contributors to these values.
Economic, legal, educational and
employment policies must aim, as one of their goals,
to break the link between sexuality, social power
and control over resources. Male sexuality must be
defined outside of control, power and wealth and female
sexuality must not be subservient to economic dependency,
absence of autonomous decisions and control. If men
and women are socially, legally and politically equal,
and have equitable access to education, skills and
economic resources, then maybe, sexuality will cease
to be a tool of gender oppression or a vehicle for
the spread of a killer disease.
Role of Donor Community
I turn next to the role of the donor community in
how sexuality was dealt with in Africa in the past
and the way in which the future is being shaped. For
over twenty years the international donor community
had focused their attention on the problem of rising
populations in Africa. Family planning programs and
clinics have been the best-funded health-related service
for the past thirty years. There was no talk about
sex. The fact that sex has to happen for contraception
to be needed or that negotiating the use of contraceptives
was directly related to gender power relations within
sexual unions was completely absent from the formula.
Such basic, everyday associations seemingly did not
enter the consciousness of these donors and the agencies
they chose to contract for hundreds of millions of
dollars. Or, if they were indeed conscious of these
issues, it did not show in the way they designed services
and conducted training.
Even after 20 years of the HIV/AIDS
epidemic and after THE ICPD and Beijing conferences,
there is still serious discomfort and outright neglect
of sexuality and sexual power relations within the
priorities and programs of most donors. The Africa
Regional Sexuality Resource Centre is a welcome exception
to the rule and, hopefully, a first step in donor
and government recognition of the importance of sexuality
to many fields, and in particular the health and human
Sexuality: Safe, Creative,
In conclusion, I hope that I have impressed upon the
reader that sex and sexuality are very serious matters
indeed and if neglected will lead to problems that
will result in the loss of lives and valuables resources.
But sex and sexuality need not be too serious or problematic.
In the age of advanced contraception, heterosexual
intercourse has been liberated from its ominous link
to pregnancy. Our understanding of healthy sexuality
has evolved away from compulsory or forced intercourse
to all forms of safe, creative and pleasurable exchanges
among consenting adults of either sex. It does not
even have to be between two adults but a matter between
the individual and the flight of his or her fantasy.
In a democratic secular system, sex and sexuality
should be protected as a matter of personal ownership
and choice. When we have reached that point, we will
know that we have reached the threshold of holistic
This article is an adaptation
of a paper presented at the official launching ceremony
of the Africa Regional Sexuality Resource Centre on
June 11, 2003 by guest speaker, Dr. Nahid Toubia,
the first woman surgeon of Sudan,
and President, Research Action and Information Network
for Bodily Integrity of Women (RAINBO).