Social and ethical determinants of human sexuality: 1. The need to reproduce.

Aims of this study was to review the many and diverse factors conditioning human sexual behavior; starting with the first and still most important: the need to reproduce and to analyse these factors and how they have changed over time in order to better understand the interplay between the major determinants of human sexuality. For this aim the authors made a literature review of relevant scientific papers and books, including religious websites. At the dawn of humanity, sexuality was focused on reproduction; this, however, did not exclude other important meanings in sexual relationships, since non-conceptive copulations have been a constant aspect of human behavior, becoming an almost unique feature of genus homo. In this respect, the characteristics of a female continuously accessible to her male set the stage for a trend towards monogamy and created the substrate for closed families. Anthropologists have justified conceptive sexuality because sexual activity is costly in terms of energy consumption; for this reason, in the early days, restricting sexual activity made sense for the survival of the species. Traditional ethical considerations and ancient norms by the three major monotheistic religions have favored conceptive sexuality, restricting sexual activity to sanctioned unions and insisting that the major scope of sexuality is procreation. In spite of this, among humans sexuality has always had a wider meaning to the point that for millennia, humans have tried to separate its unitive and procreative meanings. Today much has changed since reproduction can be achieved without intercourse, further separating it from sexual activity. In humans sexuality always possessed multiple meanings, first and foremost reproduction and the creation of a bond between a man and one or several women.

Are gay communities dying or just in transition? Results from an international consultation examining possible structural change in gay communities.

This study sought to identify how urban gay communities are undergoing structural change, reasons for that change, and implications for HIV prevention planning. Key informants (N=29) at the AIDS Impact Conference from 17 cities in 14 countries completed surveys and participated in a facilitated structured dialog about if gay communities are changing, and if so, how they are changing. In all cities, the virtual gay community was identified as currently larger than the offline physical community. Most cities identified that while the gay population in their cities appeared stable or growing, the gay community appeared in decline. Measures included greater integration of heterosexuals into historically gay-identified neighborhoods and movement of gay persons into suburbs, decreased number of gay bars/clubs, less attendance at gay events, less volunteerism in gay or HIV/AIDS organizations, and the overall declining visibility of gay communities. Participants attributed structural change to multiple factors including gay neighborhood gentrification, achievement of civil rights, less discrimination, a vibrant virtual community, and changes in drug use. Consistent with social assimilation, gay infrastructure, visibility, and community identification appears to be decreasing across cities. HIV prevention planning, interventions, treatment services, and policies need to be re-conceptualized for MSM in the future. Four recommendations for future HIV prevention and research are detailed.

"The VIHsibilite Project": HIV-positive people in the Quebec press and community responses.

The VIHsibilite Project is a community-based action-research initiative that examines newspaper coverage of HIV/AIDS issues in Quebec from 1988 to 2004. Using standard qualitative research methods, and in consultation with an advisory committee of people directly impacted by HIV/AIDS news coverage, the project discerns trends in reporting on HIV/AIDS and undertakes discursive content analysis of these, aiming to better understand in what normative ways seropositive people are represented in print media, and, ultimately, to reduce the stigma attendant upon HIV infection. Preliminary findings include indications that seropositive women tend to be represented markedly differently from men in the news.

Ethics and social policy in research on the neuroscience of human sexuality.

The potential benefits of neuroscientific research into sexuality are great, but neuroscientists must participate in debates over the social, forensic and therapeutic implications of their findings. If serious research in sexuality is to be supported by the public, researchers must continue to earn society's trust with responsible and thoughtful presentation of their work.

Kenyan Religious Leaders' Views on Same-Sex Sexuality and Gender Nonconformity: Religious Freedom versus Constitutional Rights.

Religion plays an important role in framing the public discourse on sexuality, especially in countries where religion fully permeates social life. We explored the perspectives of Kenyan religious leaders on sexual and gender diversity in their country's specific context. A total of 212 Catholic, Islamic, and Protestant leaders from urban centers and rural townships completed a self-administered questionnaire specifically developed for this study. The leaders' perspectives were predominantly negative. Limited acceptance was conditional on sexual minorities not engaging in same-sex practices or seeing such practices as sinful. A substantial minority (37%) endorsed the use of violence for maintaining social values, especially regarding homosexuality and gender nonconformity. The majority of religious leaders agreed on the difference between civil law and religious doctrine. Human rights principles enshrined in Kenya's Constitution were considered to be applicable to sexual and gender minorities. Decriminalization of same-sex sexuality was seen as against one's religion. Perspectives were less negative if leaders were familiar with lesbian, gay, bisexual, and transgender (LGBT) persons. Interventions that promote intergroup contact could be effective in changing religious leaders' mind-sets and advancing human rights and health for sexual and gender minorities.

Containing uncertainty: sexual values and citizenship.

This essay reflects on one dimension of the challenge of being a queer ethicist. Can we have norms/values without liberal assumptions that might undo the important contributions of queer theory? The reemergence of appeals to "citizenship" in lbgt and queer debates serves as illustrations of this question. Reading Weeks's Invented Moralities: Sexual Values in an Age of Uncertainty(1995), while considering various scholars who have engaged the issue of sexual citizenship since, enables me to illustrate some of the issues that emerge around ethics and queerness at this particular moment. My argument is that attempts to offer constructive ethical engagement in the end often contain challenges rather than successfully address them. Critically examining Weeks's intervention into what he sees as our "loss" of moral authority and ethical concerns to the right wing is helpful for queer ethical conversations that consider available theoretical and philosophical models of claiming citizenship as a way of claiming values in uncertain times. Weeks (1995; 1998), Richardson (2000), Bell and Binnie (2000), and Phelan (2001) provides helpful guides to the struggle with tensions that faces us in lbgt/queer debates of citizenship.

Mapping Queer Bioethics: Space, Place, and Locality.

This article, which introduces the special issue of the Journal of Homosexuality on "Mapping Queer Bioethics," begins by offering an overview of the analytical scope of the issue. Specifically, the first half of this essay raises critical questions central to the concept of a space-related queer bioethics, such as: How do we appreciate and understand the special needs of queer parties given the constraints of location, space, and geography? The second half of this article describes each feature article in the issue, as well as the subsequent special sections on the ethics of reading literal, health-related maps ("Cartographies") and scrutinizing the history of this journal as concerns LGBT health ("Mapping the Journal of Homosexuality").

Hopeless Cases: Queer Chronicities and Gertrude Stein's "Melanctha".

For this contribution to the special issue on "Mapping Queer Bioethics," the author offers a reflection on the nature of the literary, written word as the ethically fraught site of queer bioethics. By invoking the historical tendencies and tropes of the clinical case history alongside a seminal text by Gertrude Stein, the author at once asks if we should liberate a queer bioethics from biomedical discourse via mainstream narrative; or if we should see this strategy as unavoidably housed in narrative forms of storytelling because it echoes the tropes and stakes of the clinical, pathologized case history as regards queer sensibilities.

Queer Pedagogies Out of Place and Time: Redrawing the Boundaries of Youth, Sexual and Gender Difference, and Education.

For this contribution to the "Cartographies" section of the special issue on "Mapping Queer Bioethics," the author focuses on the concept of spatialized time as made material in the location of historical places, in particular as it relates to a reconsideration of approaches to Australian queer/LGBT youth education. Accordingly, the author employs historical maps as illustrative examples of spatialized time, reflecting on the relationships between historical knowledge and queer youth education.

The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings.

The present article maps out understandings about embodied distress among gender-nonconforming youth. Feminist bioethics and queer-inflected clinical perspectives are used to inform thinking about ethical, nonpathologizing health care in the case of gender-related distress. Specific attention is directed at self-harming among gender variant and trans youth. This is contextualized in relation to the role that self-harm plays for some LGBT youth, where it may be seen as a rite of passage or as reasonable and inevitable way of coping. The particular complexities of self-harm among trans youth seeking clinical intervention are examined. Queer bioethics is proposed as potentially facilitating productive uncertainty with regard to the diverse imagined futures of gender variant and trans youth.

La patologización de la homosexualidad en los manuales diagnósticos y clasificaciones psiquiátricas / The pathologization of homosexuality in diagnostic manuals and psychiatric classifications

Investigaremos la relación entre el diagnóstico en la atención de la Salud Mental y la clasificación de la homosexualidad como enfermedad o trastorno mental con el fin de analizar que en lo que a las sexualidades no hegemónicas respecta, el diagnóstico no supone ser únicamente un conocimiento acabado del fenómeno que pretende investigar, sino que funciona como un procedimiento performativo que produce el mismo fenómeno que busca delimitar. Para ello, consideraremos los "Principios para la protección de los enfermos mentales" adoptados por la Asamblea General de las Naciones Unidas el 17/12/1991, así como los sistemas internacionalmente vigentes de Clasificación en Salud Mental. Nuestra hipótesis de trabajo descansa también en las ideas sobre la performatividad desarrolladas por Judith Butler (AU)

We will analyze the relationship between diagnosis in Mental Health Care and the classification of homosexuality as a mental illness. We will reflect that as far as non-hegemonic sexualities are concerned, the diagnosis does not suppose to be a complete knowledge of the phenomenon that it seeks to investigate, but rather works as a performative procedure that produces the same phenomenon that it seeks to know and delimit. We will take into account the "Principles for the protection of the mentally ill" adopted by the United Nations General Assembly in its resolution 46/119 (12/17/1991) and the existing systems of classification in Mental Health. Our working hypothesis rests on the ideas of performativity developed by Judith Butler (AU)

Investigarem la relació entre el diagnòstic en l'atenció de la Salut Mental i la classificació de l'homosexualitat com a malaltia o trastorn mental amb la finalitat d'analitzar que pel que respecta a les sexualitats no hegemòniques , el diagnòstic no suposa ser únicament un coneixement acabat del fenomen que pretén investigar, sinó que funciona com un procediment performatiu que produeix el mateix fenomen que busca delimitar. Per a això, considerarem els "Principis per a la protecció dels malalts mentals" adoptats per l'Assemblea General de les Nacions Unides el 17/12/1991, així com els sistemes internacionalment vigents de Classificació en Salut Mental. La nostra hipòtesi de treball descansa també en les idees sobre la performativitat desenvolupades per Judith Butler (AU)

Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities.

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.

[Being a family today - ethics for assisted reproductive techniques]. / Faire famille aujourd'hui : une éthique de l'Assistance médicale à la procréation.

Currently in France, all the children born as a result of an assisted reproduction procedure, represent 2.5% of all births. Although this proportion is not high, it is not to be neglected, particularly with regard to the sociological issues raised by assisted reproduction technologies (ART) - i.e. removing anonymity of gamete donation, post mortem insemination, ART access to single women and gay couples, surrogacy - to name four of the most prominent debates. What is new with ART is that a new therapeutic target of medicine is being developed, in other words procreation. Now it is no longer necessary for a man and a woman to resort to sex to have a child. This is a profound questioning of the representation of what appeared to be intangible, with some sort of divine aura. How, in this context, developing an ethics for ART? From a fethnographic field survey, we show here how this ethos of ART develops and how, therefore, we consider the multiple ways of being a family today.

Taking up the cudgels against gay rights? Trends and trajectories in African Christian theologies on homosexuality.

Against the background of the HIV epidemic and the intense public controversy on homosexuality in African societies, this article investigates the discourses of academic African Christian theologians on homosexuality. Distinguishing some major strands in African theology, that is, inculturation, liberation, women's and reconstruction theology, the article examines how the central concepts of culture, liberation, justice, and human rights function in these discourses. On the basis of a qualitative analysis of a large number of publications, the article shows that stances of African theologians are varying from silence and rejection to acceptance. Although many African theologians have taken up the cudgels against gay rights, some "dissident voices" break the taboo and develop more inclusive concepts of African identity and African Christianity.

Sexually transmitted diseases: reflections on metaphors and ethics.

Sexually transmitted diseases (STDs) are probably the most tabooed diseases we know. The taboos and the related stigmata shape patients reality and influence significantly health care policies, medical research, and actual problems in medical ethics. To better understand these complex influences of ancient but still powerful taboos, related metaphors associated with illness and disease are analyzed according to their historical development and actual impact on society. It becomes obvious that research and health care policies cannot be satisfyingly successful in helping people affected by STDs as long as they do not take the mechanisms of taboos and associated metaphors into account.