Gender role beliefs and adolescent pregnancy in Colombia: findings from the 2015 DHS survey.

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.

Teenage pregnancy in Tambogrande, Peru: causes, consequences and cycles of violence and disadvantage.

Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.

Corpos transmasculinos negros em intersecções estéticas: entrevista com Leonardo Peçanha / Black transmasculine bodies in aesthetic intersections: an interview with Leonardo Peçanha

Resumo Este artigo de opinião consiste em uma entrevista realizada com Leonardo Peçanha, um homem negro trans, ativista no campo dos direitos humanos e dos direitos das pessoas trans e pesquisador do campo da Saúde Coletiva. Na conversa que se segue Leonardo Peçanha, de forma interseccional, reflete sobre o lugar da beleza, modificações corporais e atividade física no processo de transição de gênero de sujeitos homens trans e transmasculinos, como também toca no tema das (im)possibilidades das pessoas trans no campo dos esportes de alto rendimento e nos conta sobre o concurso de beleza Mister Trans Brasil.

Abstract This opinion article consists of an interview with Leonardo Peçanha, a Black trans man, a human rights and trans people rights activist and a researcher in Collective Health. In this interview, he reflects intersectionally on the place of beauty, body changes, and physical activity in the gender transition process of trans and transmasculine men. He discusses the (im)possibilities of trans people in high-performance sports and tells us about the Mister Trans Brazil beauty pageant contest.

"Mãe é só uma!": violência institucional nas experiências de dupla maternidade na atenção à saúde / "You only have one mother!": institutional violence in experiences of double motherhood in healthcare

Resumo Objetivou-se compreender as experiências de dupla maternidade na atenção à saúde durante o pré-natal, parto e puerpério a partir de um método qualitativo, utilizando entrevistas individuais on-line e grupo focal on-line assíncrono com mulheres cisgêneros, a maioria em relacionamentos homoafetivos. Os resultados revelaram a marginalização das vivências parentais dessas mulheres, destacando a violência institucional presente nos serviços de saúde brasileiros, sendo apresentados em dois eixos temáticos: 1) Cisheteronormatividade e seu impacto nas experiências de dupla maternidade e 2) Violência institucional nos serviços de saúde: da curiosidade à LGBTQIA+fobia. Conclui-se que a cisheteronormatividade prejudica a atenção à saúde para essas experiências, especialmente ao invisibilizar a mãe não gestante, destacando a urgência de capacitar profissionais de saúde, repensar e desafiar as normas cisgênero e heterossexuais e promover políticas inclusivas para garantir cuidados equitativos e combater a violência institucional.

Abstract The objective was to understand experiences of double motherhood during antenatal, childbirth and postpartum healthcare, using a qualitative method involving individual online interviews and asynchronous, online focus groups of cisgender women, mostly in same-sex relationships. The results revealed how these women's experiences of parenting were marginalised, highlighting institutional violence in Brazilian healthcare services, which are presented here in two thematic dimensions: 1) Cisheteronormativity and its impact on experiences of double motherhood; and 2) Institutional violence in healthcare services: from curiosity to LGBTQIA+phobia. It was concluded that cisheteronormativity hinders healthcare for these experiences, especially by rendering the non-gestational mother invisible. This underscores the urgent need to train healthcare personnel, rethink and challenge cisgender and heterosexual norms and promote inclusive policies to ensure equitable care and combat institutional violence.

Estigma na percepção de médicas e enfermeiras sobre o pré-natal de homens transexuais / Estigma en la percepción de médicas y enfermeras sobre el control prenatal de hombres transexuales / Stigma in doctors' and nurses' perception regarding prenatal care for transgender men

Resumo Objetivo Analisar o estigma evidenciado nas percepções de médicas e enfermeiras sobre o pré-natal de homens transexuais. Métodos Estudo qualitativo desenvolvido com nove profissionais de saúde (seis enfermeiras e três médicas) atuantes em Unidades de Saúde da Família em um município na Bahia. Foram realizadas entrevistas em profundidade, submetidas à Análise Temática Reflexiva e interpretação baseada na teoria do estigma e do conceito de cisheteronormatividade. Resultados Foram derivados dois temas que explicitaram o estabelecimento de rótulos e estereótipos ao corpo, mente e identidade de gênero do homem trans grávido: (des)preparo profissional e distanciamento das demandas e perspectivas cisheteronormativas para o cuidado pré-natal de homens trans. Elementos do estigma evidenciados: afastamento, rótulos, estereótipo, descrédito e discriminação. Tais elementos (percepções estigmatizantes) se manifestaram dentro da lógica da normalidade e equiparação cisgênero das necessidades de saúde dos homens trans no contexto pré-natal. Conclusão Há estigma na percepção de médicas e enfermeiras sobre o pré-natal de homens trans. A estigmatização pode impactar negativamente a qualidade do pré-natal e da saúde e segurança de homens trans no ciclo gravídico puerperal, antecipando pensamentos, atitudes e práticas que contribuem para a deteriorar a identidade transmasculina na gestação.

Resumen Objetivo Analizar el estigma constatado en las percepciones de médicas y enfermeras sobre el control prenatal de hombres transexuales. Métodos Estudio cualitativo llevado a cabo con nueve profesionales de la salud (seis enfermeras y tres médicas) que trabajan en Unidades de Salud de la familia en un municipio del estado de Bahia. Se realizaron entrevistas en profundidad, que fueron sometidas al análisis temático reflexivo e interpretación con base en la teoría del estigma y del concepto de cisheteronormatividad. Resultados Se derivaron dos temas que explicitaron el establecimiento de rótulos y estereotipos del cuerpo, mente e identidad de género de hombres trans embarazados: (falta de) preparación profesional y distanciamiento de las demandas y perspectivas cisheteronormativas para el cuidado prenatal de hombres trans. Se constataron los siguientes elementos del estigma: distanciamiento, rótulos, estereotipos, descrédito y discriminación. Tales elementos (las percepciones estigmatizantes) se manifestaron dentro de la lógica de la normalidad y equivalencia cisgénero de las necesidades de salud de los hombres trans en el contexto del control prenatal. Conclusión Existe un estigma en la percepción de médicas y enfermeras sobre el control prenatal de hombres trans. La estigmatización puede impactar negativamente en la calidad del control prenatal y de la salud y seguridad de hombres trans durante el embarazo y el puerperio, y puede anticipar pensamientos, actitudes y prácticas que contribuyen al deterioro de la identidad transmasculina en el embarazo.

Abstract Objective To analyze the stigma evidenced in doctors' and nurses' perception regarding prenatal care for transgender men. Methods A qualitative study developed with nine health professionals (six nurses and three doctors) working in Family Health Units in a municipality in Bahia. In-depth interviews were carried out, subjected to reflective thematic analysis and interpretation based on the theory of social stigma and the concept of cisheteronormativity. Results Two topics were derived that explained the establishment of labels and stereotypes on the body, mind and gender identity of pregnant trans men: professional (un)preparedness and distancing from cisheteronormative demands and perspectives for prenatal care for trans men. Elements of stigma observed were distance, labels, stereotype, discredit and discrimination. Such elements (stigmatizing perceptions) manifested themselves within the logic of normality and cisgender equality of trans men's health needs in the prenatal context. Conclusion There is stigma in doctors' and nurses' perception regarding prenatal care for trans men. Stigmatization can negatively impact the quality of prenatal care and trans men's health and safety in the pregnancy and puerperal cycle, anticipating thoughts, attitudes and practices that contribute to the deterioration of transmasculine identity during pregnancy.

Lessons learned from implementing the parenting Program P in Bolivia to prevent family violence.

Parenting programs are an increasingly used strategy to prevent family violence and promote gender equality in the household. Yet, there is limited understanding of the processes and pathways to change through such programs, especially from the Global South. This paper presents key findings of a qualitative evaluation of the parenting 'Program P', which was implemented in El Alto, Bolivia. The study complements and aims to provide additional insights to an experimental evaluation of this program, which found limited impact on the intended objectives, including a reduction in violence against children and women and more gender equitable attitudes among parents. Thirty-six qualitative interviews and 6 focus groups were conducted with men and women that attended Program P, and facilitators of the program. Findings were analyzed thematically and organized around key successes and challenges of the program including motivations and ability to engage with the program, opportunities for supportive group-based processes, addressing hegemonic gender and social norms, and learning and applying skills as a platform to change behaviours. We use these findings to offer implications for more effective design and implementation of gender transformative, parenting programs in Bolivia and globally.

The role of gender and romantic jealousy in intimate partner violence against women, a mixed-methods study in Northern Ecuador.

Male romantic jealousy is a commonly cited driver of intimate partner violence against women. An in-depth, contextualised understanding of the pathways and mechanisms from jealousy to intimate partner violence is, however, needed to inform programmes and interventions. We triangulated data from 48 interviews, eight focus groups and 1216 survey findings from low-income married women and men in northern Ecuador. Male jealousy was associated with controlling behaviours (aOR: 14.47, 95% CI: 9.47, 22.12) and sexual intimate partner violence (aOR: 2.4, 95% CI: 1.12, 5.12). Controlling behaviours were associated with physical and sexual intimate partner violence (aOR: 2.16, 95% CI: 1.21, 3.84). Qualitatively we found that most respondents framed jealousy within a discourse of love, and three triggers of male jealousy leading to intimate partner violence were identified: (1) community gossip, which acted as a mechanism of community control over women's movements and sexuality; (2) women joining the labour force, which was quantitatively associated with intimate partner violence and partially mediated by jealousy; and (3) women's refusal to have sex, which could lead husbands to coerce sex through accusations of infidelity. Gender-transformative interventions at the individual, couple and community level providing models of alternative masculinities and femininities may offer promise in reducing intimate partner violence in Ecuador. Importantly, future economic empowerment interventions should address jealousy to mitigate potential intimate partner violence backlash.

Patologização e criminalização de gênero: a experiência de travestis no cárcere / Gender pathologization and criminalization: The prison experience of transvestites

RESUMO A experiência de ser travesti é atravessada por múltiplas regulações no campo do direito e da medicina. Ambos os conhecimentos se articulam e reafirmam uma determinada concepção normativa de gênero que produz a criminalização e a patologização dessa experiência. Especialmente no caso de travestis presas, tal situação alcança patamares alarmantes. Para ilustrar a articulação entre patologiza-ção e criminalização, utilizam-se levantamento bibliográfico e relato de campo construído por uma das autoras deste ensaio. O objetivo foi demonstrar como essa articulação se dá, a partir do caso concreto de uma travesti submetida à medicalização dentro do cárcere, e como esse procedimento ensejou a sua (re) criminalização. Dessa forma, a patologização e a criminalização constroem um marco epistemológico que traça os limites dentro dos quais gênero e sexualidade se tornam visíveis e passam ao largo de uma compreensão do direito à saúde.

ABSTRACT The experience of being a transvestite is traversed by multiple regulations in the fields of law and medicine. Both fields of knowledge articulate and reaffirm a specific normative conception of gender that leads to the criminalization and pathologization of this experience. This situation reaches alarming levels, especially in the case of imprisoned transvestites. To illustrate the articulation between pathologization and criminalization, we use bibliographic research and the field report constructed by one of the authors of this essay. We aimed to show how this articulation occurs from the concrete case of a female transvestite subjected to medicalization within the prison system and how this procedure led to her (re)criminalization. That way, pathologization, and criminalization build an epistemological framework that sets the limits within which gender and sexuality become visible and bypass an understanding of the right to health.

O olhar da enfermagem no contexto do atendimento à saúde da população LGBTQIA+ / The nursing perspective in the context of health care for the LGBTQIA+ population

RESUMO A população LGBTQIA+, ao buscar assistência à saúde, é constantemente exposta a vulnerabilidades evidenciadas por práticas preconceituosas decorrentes de atendimentos que reproduzem discriminação. Considerando a importância do debate relativo à diversidade sexual e de gênero, e em contraposição ao atendimento baseado em uma cis-heteronormatividade presumida, discriminatória e desconectada das necessidades das pessoas usuárias, este trabalho partiu de inquietações advindas do campo de atuação da enfermagem. Como a enfermeira percebe o corpo sob seus cuidados? Como se relaciona com esse indivíduo no contexto do processo de enfermagem? A enfermeira está preparada para assistir à população LGBTQIA+? Quais as melhores práticas que podem ser adotadas? Essa profissional tem conhecimento sobre os riscos de uma assistência ineficaz para as pessoas LGBTQIA+? Este estudo qualitativo foi desenvolvido mediante questionário semiestruturado aplicado a 17 enfermeiras atuantes no Hospital Maternidade Theresa Sacchi de Moura/Hospital da Mulher, no município de Barra Mansa, interior do Rio de Janeiro. No processo de pesquisa científica, foi adotada a técnica de análise de discurso a partir das falas compiladas que apontaram despreparo em relação às especificidades da comunidade LGBTQIA+, resultando na reprodução de violências e, consequentemente, tornando-se uma barreira ao acesso dos serviços de saúde.

ABSTRACT When seeking health care, the LGBTQIA+ population is constantly exposed to vulnerabilities evidenced by prejudiced practices resulting from assistance that reproduces discrimination. Considering the importance of the debate on sexual and gender diversity, and in opposition to care based on presumed cisheteronormativity, which is discriminatory and disconnected from the needs of the people who use the service, this work was based on concerns arising from the field of nursing. How does the nurse perceive the body under her care? How do they relate to this individual in the context of the nursing process? Are nurses prepared to assist the LGBTQIA+ population? What best practices can be adopted? Are they aware of the risks of ineffective care for LGBTQIA+ people? This qualitative study was carried out using a semi-structured questionnaire applied to 17 nurses working at the Hospital Maternidade Theresa Sacchi de Moura/Hospital da Mulher, in Barra Mansa, countryside of Rio de Janeiro, in the municipality of Barra Mansa, in the interior of Rio de Janeiro. In the process of scientific research, the technique of discourse analysis was adopted based on the statements compiled, which pointed to a lack of preparation in relation to the specificities of the LGBTQIA+ community, resulting in the reproduction of violence and, consequently, becoming a barrier to access to health services.

Inventários de Conformidade com as Normas Femininas e Masculinas: estrutura fatorial e análises de invariância

O presente estudo teve como objetivos avaliar a estrutura fatorial e analisar a invariância dos parâmetros dos itens do Inventário de Conformidade com as Normas Femininas e do Inventário de Conformidade com as Normas Masculinas no contexto brasileiro. Participaram 724 mulheres e 555 homens, estudantes universitários. Os participantes responderam aos instrumentos e a um questionário sociodemográfico. Por meio de análises fatoriais confirmatórias, as estruturas originais compostas por fatores correlacionados foram testadas e parcialmente corroboradas. Ademais, foram sugeridas modificações para melhoria da qualidade psicométrica dos instrumentos. Por fim, análises fatoriais multigrupos indicaram a invariância fatorial em relação ao estado civil, orientação sexual, área do curso de graduação e modo de aplicação. Estes resultados apresentam evidências iniciais de validade dos instrumentos no Brasil e sustentam sua utilização em estudos futuros envolvendo a temática de gênero.

El presente estudio tuvo como objetivo evaluar la estructura factorial y la invarianza factorial del Inventario de Conformidad con las Normas Femeninas y el Inventario de Conformidad con las Normas Masculinas en el contexto brasileño. Participaron 724 mujeres y 555 hombres, estudiantes universitarios. Los participantes respondieron los instrumentos y un cuestionario sociodemográfico. A través de análisis factoriales confirmatorios, las estructuras originales compuestas por factores correlacionados fueron probadas y corroboradas parcialmente. Además, se sugirieron modificaciones para mejorar la calidad psicométrica de los instrumentos. Por último, los análisis factoriales multigrupos indicaron la invarianza factorial en relación con el estado civil, la orientación sexual, zona del curso de graduación y método de aplicación. Estos resultados presentan evidencia inicial de la validez de los instrumentos en Brasil y apoyan su uso en estudios futuros que involucren el tema de género.

This study aimed to evaluate the factorial structure and analyze the parameter invariance of the items of the Conformity to Feminine Norms Inventory and the Conformity to Masculine Norms Inventory in the Brazilian context. The participants were 724 female and 555 male college students. Participants answered the instruments and a sociodemographic questionnaire. Through confirmatory factor analyses, the original structures composed of first-order correlated factors were tested and partially corroborated. In addition, modifications were suggested to improve the psychometric quality of the instruments. Finally, multigroup factor analyses indicated the factorial invariance with regard to the marital status, sexual orientation, college course area and application mode. These results present initial evidence of the validity of the instruments in Brazil and support their use in future gender studies.

Atitudes quanto as normas não equitativas de gênero: propriedades psicométricas da versão curta de uma subescala da Gender Equitable Men / Attitudes regarding non-equitable gender standards: psychometric properties of the short version of a Gender Equitable Men subscale / Actitudes acerca de las nomas de género no equitativos: propiedades psicométricas de la versión corta de una subescala de la Gender Equitable Men

O estudo objetivou validar a versão curta de uma subescala da Gender Equitable Men (GEM) em universitários da área da saúde. A escala original possui 24 itens e avalia atitudes quanto às normas de gênero equitativas e não equitativas em relacionamentos íntimos. A partir de uma amostra censitária de 2.295 universitários da área da Saúde do Centro-Oeste brasileiro, foram realizadas análise fatorial exploratória (AFE) por meio de correlações policóricas com rotação direct Varimax e análise fatorial confirmatória (AFC) por meio da técnica de Modelagem por equações Estruturais. Outros 347 estudantes participaram na avaliação da estabilidade teste-reteste. A solução unifatorial com oito itens encontrada na AFE se mostrou satisfatória (χ²20=47,733; p<0,005; CFI=0,988; RMSEA=0,025[0,016-0,034]; SRMR=0,045), assim como na AFC (RMSEA=0,025; CFI=0,988; SRMR=0,033), obtendo-se α de Cronbach geral de 0,99. O modelo final apresentou bom ajuste e houve indícios de estabilidade moderada. A subescala da GEM versão-curta apresentou evidências de validade e fidedignidade, permitindo a avaliação de normas de gênero em adultos escolarizados com número reduzido de itens.(AU)

The study aimed to validate the short version of a subscale of the Gender Equitable Men (GEM) Scale with healthcare university students. The original scale has 24 items and assesses equitable and inequitable gender norm attitudes in intimate relationships. With a sample of 2,249 students in the health area of a university in the central west of Brazil, exploratory factor analysis (EFA) was performed using polychoric correlations with direct Varimax rotation and confirmatory factor analysis (CFA) using the Structural equation modeling technique. Another 347 students participated in the test-retest stability assessment. The single-factor solution with eight items was satisfactory in the EFA (χ²20=47.733; p<.005; CFI = .988; RMSEA=.025[.016-.034]; SRMR=.045), and in the CFA (RMSEA=.025; CFI = .988; SRMR=.033), obtaining a general Cronbach's α of .99. The final model presented a good fit and there were signs of moderate stability. The GEM short-version subscale presented evidence of validity and reliability, which allows the assessment of gender norms in university educated adults with a reduced number of items.(AU)

El estudio tuvo como objetivo validar la versión corta de una subescala de la Gender Equitable Men (GEM) en estudiantes universitarios del área de la salud. La escala original de 24 ítems evalúa las actitudes hacia las normas de género equitativas y no equitativas en las relaciones íntimas. A partir de una muestra censal de 2.295 estudiantes universitarios del área de la salud de la región Centro-Oeste brasileño, se realizó un análisis factorial exploratorio (AFE) mediante correlaciones policóricas con rotación Varimax directa y un análisis factorial confirmatorio (AFC) mediante la técnica de Modelo por ecuaciones Estructurales. Otros 347 estudiantes participaron en la evaluación de la estabilidad test-retest. La solución de un factor con ocho ítems encontrados en el AFE resultó satisfactoria (χ²20=47.733; p<0.005; CFI=0.988; RMSEA=0.025 [0.016-0.034]; SRMR=0.045), así como en el AFC (RMSEA=0,025; CFI=0,988; SRMR=0,033), obteniendo un α de Cronbach general de 0,99. El modelo final presentó un buen ajuste y hubo signos de estabilidad moderada. La subescala GEM de versión corta presentó evidencia de validez y confiabilidad, lo que permitió la evaluación de las normas de género en adultos escolarizados con un número reducido de ítems.(AU)

Personal beliefs and social norms regarding the sexual exploitation of girls in age-disparate transactional sexual relationships in Brazil: a mixed-methods study.

BACKGROUND: In the global debate around transactional sex little attention has concentrated on Brazil, despite ranking fourth globally in absolute number of girls married or co-habiting by the age of 15 years, and evidence showing that these unions often begin as age-disparate transactional sex (ADTS). This article contributes to filling this gap by exploring the personal beliefs and social norms related to ADTS in urban (favela) communities of Rio de Janeiro, Brazil between adult men (> 18 years) and girls and adolescents (G/A) (< 18 years) with a minimum 5-year age disparity. The primary objective of this study was to identify the social norms that promote and prevent ADTS, and the dynamics between individual beliefs and social norms, to provide contextualized recommendations to prevent ADTS in this setting. METHODS: An exploratory, sequential, mixed-methods design was used, starting with a qualitative phase that included semi-structured, in-depth interviews and focus groups, and a subsequent quantitative phase comprising of a community survey. The items for the quantitative questionnaires were developed based on the qualitative results. RESULTS: Mixed methods results indicate that in these communities ADTS is normalised and not considered exploitative. We identified three themes related to the reasons ADTS occurs: girls' responsibility, male desires and benefits of ADTS. Men's role in ADTS was largely minimised because of a general acceptance of a notion of masculinity characterised by hypersexuality and lack of impulse control. Individual beliefs, however, did not tend to align with these social norms. CONCLUSIONS: In this study, personal beliefs and social norms often did not align, suggesting that initiatives working to change personal or attitudes regarding ADTS may not lead to meaningful change in ADTS behaviours, and social norms interventions may be more effective. Our findings reinforce the need to develop programs tailored to local understandings of ADTS, targeting not only girls but also a wide range of actors. Interventions could also consider the structural factors acting in local and global contexts that promote or prevent ADTS.

This article explores the personal beliefs and social norms related to the exchange of sexual favours or relationships for material favours, gifts and/or support in some form, between adult men (> 18 years) and girls and adolescents (< 18 years) with a minimum 5-year age difference. We used interviews, focus groups and questionnaires to understand the factors that promote and prevent these sexual relationships between men and girls. Motivators for these relationships were often related to girls' responsibilities, male desires and the benefits of these relationships. Men's responsibility for their participation in these relationships with girls were often minimised due to a general acceptance of men as overly sexual and lacking impulse control. In this study, personal beliefs and social norms were often not aligned, suggesting that interventions focused on changing personal beliefs or attitudes about these sexual relationships may not be enough to change social norms. The findings highlight the need to develop solutions that consider a wider range of actors, instead of interventions focused only on girls. The study findings also support the need to further investigate how communities and shared expectations can influence sexual relationships in exchange for goods between adult men and girls and adolescents.

Adolescent Dating Violence: Results of a Mixed Study in Quito, Ecuador.

Dating violence is a public health problem affecting people worldwide. This study evaluated the occurrence of different types of adolescent dating violence using a mixed analysis of each data source. The present study addresses the following research questions: does the occurrence of the types of violence analyzed in the quantitative phase match with the narratives obtained in the qualitative phase? and does the additional information obtained in the qualitative phase improve the understanding of the analyzed phenomenon?In the quantitative phase, 410 participants (aged 13 to 19 years) answered a questionnaire based on the Modified Conflict Tactics Scale, while in the qualitative phase, 26 participated in two focus groups. Data were collected from May to June 2019. Written informed consent was obtained from the parents or legal guardians of those who had agreed to participate. The present research was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Ecuador. The results were divided on: prevalence of dating violence based on age groups and gender, management and resolution of dating conflicts, victimization and perpetration of intimate partner violence, factors favoring intimate partner violence and acceptance of abuse. The results were analyzed via triangulation and indicated that adolescents were involved in the perpetration and victimization of psychological as well as mild and severe physical violence. An analysis of the contributing factors revealed a strong tendency toward the acceptance of the traditional gender model. Challenging these models is crucial to deconstruct hierarchical models, develop conflict resolution skills, and promptly identify abusive behaviors that affect emotional development. The combination of different methodological approaches improved the understanding of the phenomenon studied.

Orden de género: un reto histórico y actual para la enfermería / Gender order: a historical and current challenge for nursing / Ordem de gênero: um desafio histórico e atual para enfermagem

OBJETIVO: Identificar la presencia del orden de género a lo largo de la historia de la enfermería a través de factores y eventos que podrían haber repercutido en la identidad de la enfermería moderna. METODOLOGÍA: Trabajo de reflexión basado en una revisión panorámica de documentos originales indizados (que contaran con evaluación con pares y publicados a partir de 2017). RESULTADOS: Desde la antigüedad el menosprecio, la opresión y la subordinación de la mujer a favor del hombre han influenciado el desarrollo profesional de la enfermería. Se destacan tres elementos. Primero, que las actividades como los cuidados de la vida y la salud (propias de enfermería) han sido consideradas inherentemente femeninas, y por tanto, carentes de algún trasfondo científico. Segundo, que la opresión y lucha de poder por parte del gremio médico ha coartado la libertad en la toma de decisiones profesionales. Finalmente, se reflexiona cómo la religión (principalmente el Cristianismo) pudo haber idealizado en el imaginario colectivo una conducta obediente, servil, pasiva y humilde de parte del personal de enfermería. CONCLUSIONES: Probablemente la identidad de la enfermería moderna resulta de una compleja combinación de elementos donde un común denominador es el orden de género. Es necesario cambiar construcciones sociales nocivas (como los estereotipos), construir relaciones profesionales más justas y asumir las responsabilidades que implica el liderazgo e independencia profesional. Un papel protagónico lo puede adoptar el personal de enfermería que ejerce como docente en instituciones de educación superior, elemento clave para transmitir el orden de género.

AIM: To identify the presence of gender order throughout the history of nursing through factors and events that could have affected the identity of modern nursing. METHODS: Reflection work based on a panoramic review of indexed original papers (found in databases, peer-reviewed, and published after 2017). RESULTS: Since ancient times, underestimation, oppression, and subordination of women in favor of men have influenced the professional development of nursing. Three elements stand out. First, activities such aslife-and healthcare (very specific to nursing) have been considered inherently feminine and, therefore, lacking any scientific background. Second, the oppression and struggle for power by the medical profession have restricted freedom in professional decision-making. Finally, we reflect on how religion (mainly Christianity) could have idealized in the collective imagination the obedient, servile, passive, and humble behavior of the nurse.CONCLUSIONS: The identity of modern nursing probably results from acomplex combination of elements where a common denominator is gender order. It is necessary to change harmful social constructions (such as stereotypes), build fairer professional relationships, and assume the responsibilities that leadership and professional independence imply. Nurses who work in higher education institutions may adopt a leading role since they are key elements in transmitting the gender order

OBJETIVO: Identificar a presença da ordem de gênero ao longo da histórica da enfermagem por meio de fatores e eventos que podem ter afetado a identidade da enfermagem moderna. METODOLOGIA:Trabalho de reflexão a partir de uma revisão panorâmica de fatos históricos em documentos originais indexados. RESULTADOS: Desde a antiguidade, a subestimação, opressão e subordinação das mulheres em favor dos homens influenciaram o desenvolvimento profissional da enfermagem. Três elementos se destacam. Em primeiro lugar, que atividades como os cuidados de vida e saúde (muitoespecíficos da enfermagem) têm sido consideradas inerentemente femininas e, portanto, carentes de embasamento científico. Segundo, que a opressão e a luta pelo poder da classe médica restringiram a liberdade de decisão profissional. Por fim, refletimos sobre como a religião (principalmente o cristianismo) poderia ter idealizado no imaginário coletivo o comportamento obediente, servil, passivo e humilde do enfermeiro. CONCLUSÕES:A identidade da enfermagem moderna provavelmente resulta de uma complexa combinação de elementos onde um denominador comum é a ordem de gênero. É preciso mudar construções sociais nocivas (como os estereótipos), construir relações profissionais mais justas e assumir as responsabilidades que a liderança e a independência profissionalimplicam. Um protagonismo pode ser assumido pelos enfermeiros que atuam em instituições de ensino superior, pois são elementos-chave na transmissão da ordem de gênero

Psicanálise e normatividade / Psichoanalysis and normativity / Psicoanálisis y normatividad

O artigo discute a responsabilidade dos psicanalistas na produção e disseminação de normas de gênero e de normas subjetivas, definindo um bom funcionamento psíquico. Aponta o quanto prescrevemos, sem perceber, o modo como os sujeitos devem ser ou viver as suas vidas. Nomeia algumas normas que podem estar presentes no exercício da psicanálise e de suas correntes teóricas, normas pouco visíveis e, por isso mesmo, menos nomeadas.

The article discusses the responsibility of psychoanalysts in the production and dissemination of gender norms and subjective norms, which define a good psychic functioning. It points out how much we prescribe, without realizing it, how the subjects should be or live their lives. It seeks to name some norms that may be present in the exercise of psychoanalysis and its theoretical currents, norms that are barely visible and, therefore, less named.

El artículo discute la responsabilidad de los psicoanalistas en la producción y difusión de normas de género y de normas subjetivas, que definen un buen funcionamiento psíquico. También señala cuánto prescribimos, sin darnos cuenta, cómo los sujetos deben ser o vivir sus vidas. El nombra algunas normas que pueden estar presentes en el ejercicio del psicoanálisis y sus corrientes teóricas, normas poco visibles y, por ello, menos nombradas.

Zika virus public health crisis and the perpetuation of gender inequality in Brazil.

BACKGROUND: In 2015-2017, the Americas experienced a highly consequential epidemics for pregnancy and childbearing. Mainly transmitted by the mosquito Aedes aegypti, but also through sexual intercourse, the Zika virus poses the risk of congenital Zika syndrome to fetus, which includes microcephaly and other child development complications. When a public health crisis taps directly into reproductive health, typically a feminine realm, responses to the emergency may exacerbate deeply-rooted gender norms. This paper investigates the role of gender in two relational contexts: (a) the government-led response to the pandemic in terms of communication campaigns aimed at preventing Zika infections; and (b) an individual level of response to the emergency, concerning women's negotiation with their sexual partners with regard to the prevention of Zika as well as pregnancies. METHODS: We conducted content analysis of 94 unique pieces from public health communication campaigns produced by governmental agencies with the goal of promoting Zika awareness. Print and online materials were collected from May 2016 to August 2017, and included TV ads, Internet Pop-ups, and pamphlets. We also analyzed transcripts from 16 focus groups conducted with reproductive-aged women (18-40) in Belo Horizonte and Recife, two large cities differently affected by the Zika outbreak. Women answered open-ended questions connected to the epidemic, in areas such as personal knowledge and experiences with the Zika virus, experiences of their friends and acquaintances, their primary information sources, their perceptions of public health efforts toward containing the outbreak, as well as women's contraceptive use. RESULTS: Campaign pieces handling pregnancy and microcephaly were largely gendered. Pieces targeted women, placing on their shoulders the responsibility for protecting a potential fetus from the disease. Importantly, campaigns neglected addressing male's participation on Zika prevention and contraceptive management, while failing to take into account Brazil's large proportion of unplanned pregnancies. Women were placed in a double bind by being expected to prevent both pregnancy and Zika, in a context where gendered power imbalances often translate in women having little power/means for condom negotiation/avoiding unprotected sexual intercourse. CONCLUSION: Government and individual responses to the epidemics reinforced gender roles, situating pregnant women as responsible for averting mosquito bites and microcephaly. Further, prevention campaigns largely excluded men. Since low-socioeconomic status women possessed fewer resources to preclude infection, we also found that beyond the gender divide, this subgroup faced more pronounced Zika prevention challenges as they found it harder to negotiate condom use with their sexual partners and often could not access other types of contraceptives resulting in unplanned pregnancies.

Adolescent boys and girls learning, reproducing, and resisting gender norms in Colombia and Uganda: a qualitative comparative study.

There is growing interest in studying inequitable gender norms and their impact on health and wellbeing, particularly among adolescents. Studies have shown that discriminatory gender norms limit girls' access to power within their families and communities, reduce their educational and economic opportunities, and alter their own aspiration and ambitions for their lives. This comparative qualitative study sought to understand how gender norms manifest themselves in the lives of adolescents in two distinct settings: Uganda and Colombia. A total of 133 young people aged 13-21 years from Colombia and 109 from Uganda participated in either focus group discussions or individual semi-structured interviews in May 2017. Results reveal similarities and differences in how norms are learned, reinforced and resisted and how intersecting social factors affect the ability of adolescents to facilitate norm change. A key similarity was the primacy of parents and peers in the transmission and reinforcement of gender norms. However, setting-specific material and structural factors shaped the manifestation of power and policing of gender norms as well as the ability of young people to contest them. Lessons are identified for the future design of effective gender transformative interventions with adolescents.

Risk and Refuge: Adolescent Boys' Experiences of Violence in "Post-Conflict" Colombia.

Increasingly, researchers and practitioners are examining connections between public and private cycles of violence. In complex emergency settings, these cycles of violence often intersect with conflicting norms and values as societies work toward sustainable peace. Gender norms, particularly norms of masculinity, are not often highlighted in transdisciplinary violence studies. Furthermore, few studies on either subject capture the perspectives and experiences of adolescent boys. This study seeks to explore adolescent boys' (13-17 years) experiences with violence at home and in the community in "post-conflict" Colombia. Thematic qualitative analysis of 20 interview transcripts from 14 Colombian boys in Cundinamarca (n = 5) and Córdoba (n = 9) revealed themes of conflict avoidance, hegemonic masculinity, and opportunities for change in the form of positive coping habits. Further research into social and emotional coping behaviors and linkages to perpetuating violence between adolescence and adulthood is needed.

Gender norms and sexual behaviours among Indigenous youth of the Comarca Ngäbe-Buglé, Panama.

The Comarca Ngäbe-Buglé, an administratively autonomous Indigenous region in western Panama, is home to a significant population rural Indigenous people of Ngäbe and Buglé ethnicity. HIV prevalence in the Comarca is two times higher than the national average, and the great majority of cases are concentrated in young men. Yet, there is little data regarding socio-cultural and sexual behaviour factors that may drive this high prevalence. Understanding such factors would enable the development of relevant prevention interventions. We conducted a qualitative study between January and March 2018, consisting of 20 semi-structured interviews with male and female young people aged 14-19 years, complemented with ethnographic observations of one month's duration each in two communities within the Comarca, to identify potential factors that could increase risk of HIV and other sexually transmitted infections (STIs). We suggest that interventions to prevent HIV and other STIs should focus on increasing open communication between sex partners, especially with respect to condom use, as well as facilitating people-driven change in gender norms that are harmful to both young women and young men.

Community perceptions of transactional sex with children and adolescent girls, a qualitative study in favelas of Rio de Janeiro.

The sexual exploitation of children and adolescents is a frequently underestimated health problem which includes transactional sex (TS), or the practice of sexual activity based on an expected return of benefits, favours and/or support in some form. This qualitative study focuses on age-disparate transactional sex (ATS) in urban favela communities of Rio de Janeiro between adult men (over 18) and girls and adolescents (G/A) (under 18), involving a minimum 5-year age disparity. We have employed social norms theory as a framework to identify the prevailing social norms contributing to or protecting children and adolescents from these relationships. Data collection utilised semi-structured interviews (n = 30) and ten focus groups with a total of 130 men/boys and women/girls selected through purposive sampling and varying in age from 15 to 65. Overall the findings identify factors, especially the essentialisation of gender, which promote the acceptability of ATS. When ATS surpassed the acceptability threshold, social norms discouraged direct interference. Concluding remarks point to possible strategies for reducing the occurrence of ATS. These must include girls, boys, women and men with community involvement in the deconstruction of social norms involving gender, age and economic consumption.