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Until recently, trans women have been subsumed within the category of men who have sex with men for HIV-related care. Following a 2016 UNAIDS report finding that trans women globally are 49 times more likely to be living with HIV than the general population, health programmes have sought to expand their reach to this key population. Yet, trans women are often treated as passive subjects to be recruited into programming or clinical trials for HIV-related care. This paper uses case studies of two community-based clinics in Thailand to highlight the agency of trans women in creating and implementing unique models for the provision of care that fit their needs and those of their local communities. By tailoring goals to be trans-specific and local, trans women at these clinics help destigmatise HIV-related care. This paper argues for the importance of engaging trans women as community stakeholders in HIV-related care and prevention and identifies suggestions for stakeholder engagement in programme design both in and beyond Thailand by focussing on local conditions. [ABSTRACT FROM AUTHOR]

This ethnographic study conducted among young women aged 18–21 years in Chiang Mai, northern Thailand, explored the parental control mechanisms imposed by Thai middle-class families on the sexuality of their daughters. It addressed the ways in which young women tactically use the social media in order to negotiate the sexual controls they encountered in everyday life. Taking the teenage girls’ point of view, this paper argues that, as active agents, young women achieve a certain level of sexual autonomy and construct their own sexual selves in modern northern Thai society, despite their parents’ attempts to prevent this. The paper highlights the ways in which social media are used by Thai girls in order to achieve such a goal. Research findings should inform the development of future programmes on sexual health promotion, parental skills and sexual communication between Thai parents and their children. [ABSTRACT FROM PUBLISHER]

Each year large numbers of Western men travel to Thailand for sex tourism. Although many will use condoms during their sexual encounters, others will not, potentially exposing themselves to the risk of acquiring sexually transmitted infections, including HIV. Although sex tourism in Thailand has been well documented, the social drivers underpinning voluntary sexual risk-taking through the avoidance of condoms remain poorly understood. Engaging with R.W. Connell’s concept of hegemonic masculinity and drawing on data collected from 1237 online discussion board posts and 14 face-to-face interviews, this study considers the ways in which understandings and performances of masculinities may inform the sexual risk-taking behaviours of Western male sex tourists. It argues that for some of these men, unprotected sex is viewed not as a reckless behaviour but, instead, as a safe and appropriate masculine practice, supported by relationships that are often framed as romantic and within a setting where HIV is still largely considered a homosexual disease. With sex workers often disempowered to request safer sexual practices, and some men’s attitudes towards unprotected sex resistant to external health promotion advice, the paper concludes by considering what this might mean for policy and practice. [ABSTRACT FROM PUBLISHER]

This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks as rites of passage. Discourses on the exposure or concealment of male and female bodies, respectively, witness to the relevance of both the local political-historical context and biomedical hegemony to gendered bodies. The comparisons evince the need to reflect upon the theoretical and ethical implications of studying genital cutting and focusing exclusively on one of the two practices rather than, as this paper claims to be necessary, considering them as inextricably connected. [ABSTRACT FROM AUTHOR]

Abortion decision making by rural villagers in Thailand must be understood within its broader economic, social and ideological context. Abortion laws are highly restrictive in Thailand, yet abortions remain common. This paper examines rural villagers' normative constructions of the act of abortion and the 'socially embedded morality' they bring to discussions about abortion. The paper is based upon seven focus group discussions with women and men and long-term ethnographic fieldwork in rural north-east Thailand. Vignettes based upon real stories of women stimulated detailed discussion in the focus groups of the circumstances under which abortion is acceptable. The paper first discusses the social construction of abortion in Thailand, definitions of abortion as Buddhist sin and ethnomedical categorizations of the foetus. Then it describes the major themes that emerged from focus group discussions and interviews on abortion decision making. The material conditions of women and men's lives, changing constructions of children and motherhood, and gender relations were all found to influence reproductive health decisions. Abortion is described through social idioms that allow villagers to reconcile the practice of abortion with acceptable social norms. [ABSTRACT FROM AUTHOR]

This paper reflects on recent research on Thai discourses of gender and eroticism in order to problematize some of the universalist assumptions that have dominated discussion of the international proliferation of forms of erotic diversity. By mapping the proliferation of Thai gender/sex categories from the 1960s to the 1980s, the paper shows that Thai homoeroticisms are not converging towards Western models and points to the cultural limits of Foucauldian-modelled histories of sexuality. In particular, it demonstrates the inability of Foucauldian history of sexuality, and queer theoretical approaches drawing on Foucault, to account for shifts in Thai discourses in which gender and sexuality do not exist as distinct categories. Only when current feminist theories of gender and queer theories of sexuality are integrated so as to offer a unified account of the eroticization of gender, and the gendering of eroticism, will Western theoretical models be capable of mapping shifts in non-Western patterns of eroticism. [ABSTRACT FROM AUTHOR]

This paper offers a review of the ways in which the Thai print media presents images of transgendered and/or homosexual identities or what may be termed 'gendered/transgendered sexualities'. The author argues that the varied, and at times contradictory, images of gendered sexualities used by the print media can be understood as discursive devices in broader social debates within Thai society. The paper reviews three cases recently covered by the Thai print media: the emergence of lesbian/gay youth cultures (tom-dee, gay); the Rajaphat College ban on transgendered/gay students; and sex crime cases in which the defendant is labelled as 'Tuy' or a type of homosexual male. These three cases offered particular representations of gendered sexualities that can only properly be understood within the social-political context of modern day Thailand. In particular, they operate as a kind of Thai 'Orientalism', or cultural critique, which contrasts sharply with the ironic silence of the media towards high profile individuals who are well known to be transgender/homosexual. [ABSTRACT FROM AUTHOR]

Young Thai men who have sex with men continue to have high HIV prevalence and incidence in spite of much investment in community-based prevention approaches. To make HIV services more appropriate for same-sex attracted young men in Thailand, it needs to be considered how target groups view themselves and manage their identities. This paper derives from a qualitative study of 25 same-sex attracted rural young Thai men. It identifies five tactics men employed to manage the discrepancy between their preferences and parental/societal expectations regarding gender and sexuality, and discusses how the young men viewed themselves in the wider context of Thai society, including whether they felt part of a separate gay community. Participants usually did not adopt a gay social identity and were reluctant to join in gay community activities beyond dating. Hence, they would likely experience barriers in accessing gay community-based HIV services. HIV services targeting young same-sex attracted Thai men need to be diversified if they are to be more inclusive, appropriate and effective. [ABSTRACT FROM AUTHOR]

Twenty-five same-sex-attracted rural young Thai men were interviewed three times to investigate how their sexual subjectivity changed over an 18-month period after they completed high school and moved into a new life-phase. Many young men grew up with strong gender-based understandings of homosexuality, in which a masculine (top) partner is seen as complementing a feminine (bottom) partner. The discursive division between the masculine and feminine domains became increasingly blurred in the actual practice of dating, forcing the young men to develop new understandings of homosexuality and same-sex relations. The shift from a rural to urban environment, the use of the Internet and the experience of falling in love played important roles in this experimentation with new, increasingly masculine presentations of the self, also influenced by a modern urban masculine aesthetic. The paper concludes that the encounter between ‘traditional’ gender-based homosexuality and new ideas, in which masculine object-choice is important in defining sexual identity leads to a variety of fluid ideas and expressions. This process created confusion among some, and opportunities for exploration of new ways of defining sexual subjectivities among others. [ABSTRACT FROM AUTHOR]

Violence in the physical (offline) world is a well-documented health and social issue among young people worldwide. In Southeast Asia, online harassment (defined as intentional behaviours to harm others through the Internet or through mobile devices) is less well documented. In this paper, we describe and critically discuss the mixed-methods data collection approach we used to build a contextualised understanding of offline violence and online harassment among 15- to 24-year-old students and out-of-school youth in Central Thailand. We mapped linkages between offline violence and online harassment, and with their possible correlates including gender, sexuality, and mobile media or Internet use. Data collection methods included in-depth interviews, focus group discussions and a custom-built, self-administered computerised survey. Using mixed methods enabled us to collect holistic qualitative/quantitative data from both students and out-of-school youth. In our discussion, we focus on gender, sexuality, class and ethnicity issues in recruiting out-of-school youth; definition and measurement issues; technical issues in using a computerised survey; ethical issues surrounding data collection from minors as well as privacy and confidentiality concerns in collecting data in both in-school and out-of-school settings; and the general implications of using mixed methods. [ABSTRACT FROM AUTHOR]

This paper aims to contribute to understanding of emergent gender/sexual identities in Thailand. Thailand has become a popular destination for sex change operations by providing the medical technology for a complete transformation, with relatively few procedures and satisfactory results at a reasonable price. Data were gathered from 24 transsexual male-to-female sex workers working in Pattaya and Patpong, well-known sex-tourism hot spots in Thailand. Findings suggest the emergence of new understandings of gender/sexual identity. Sex-tourism/sex work significantly illuminates the process through which gender is contested and re-imagined. The coming together of cultures in Thailand's sex industry, coupled with advances in medical technology, has resulted in the emergence of new concepts of gender. [ABSTRACT FROM AUTHOR]

This paper aims to contribute to understanding of emergent gender/sexual identities in Thailand. Thailand has become a popular destination for sex change operations by providing the medical technology for a complete transformation, with relatively few procedures and satisfactory results at a reasonable price. Data were gathered from 24 transsexual male-to-female sex workers working in Pattaya and Patpong, well-known sex-tourism hot spots in Thailand. Findings suggest the emergence of new understandings of gender/sexual identity. Sex-tourism/sex work significantly illuminates the process through which gender is contested and re-imagined. The coming together of cultures in Thailand's sex industry, coupled with advances in medical technology, has resulted in the emergence of new concepts of gender. [ABSTRACT FROM AUTHOR]

This paper examines the culturally shaped meanings of AIDS and perceptions of accidental occupational exposure to HIV among a group of twenty nurses in Bangkok, Thailand. The findings are based on data collected as a part of a larger mixed-methods study that examined how perceptions of risk behaviours (including sexual promiscuity) shape health workers' perceptions of patients living with HIV/AIDS. Nurses' narratives revealed that despite acknowledgement of the low probability of occupational exposure to HIV, the fear of HIV infection remained and was largely driven by the enormity of the anticipated social (rather than the health) consequences of being HIV-positive. The perceived certainty of social ostracism was reinforced by participants' observations of the social rejection experienced by people living with HIV/AIDS both within and outside clinical settings. For female nurses, the dominant social perception that women living with HIV/AIDS were violators of gender norms, and thus 'guilty' victims, was an issue central to their self-identities. Ways of improving care for people living with HIV in the light of the nurses concerns and future research are discussed. [ABSTRACT FROM AUTHOR]

This paper explores why Japanese men engage in potentially risky commercial sexual behaviours while on holiday in Thailand. Semi‐structured, in‐depth interviews were conducted with 30 heterosexual male Japanese tourists, aged 19–36, who paid for sex with Thai women. Study participants were recruited at guesthouses in Bangkok. Analysis revealed eight main factors that encourage participation in commercial sex: a sense of freedom and anonymity during “time–out” spent travelling in a foreign country; a sense that there are permissive norms governing commercial sex in Thailand; the perceived sexual desirability of Thai women, a sense of economic and racial superiority relative to Thai women; a sense of loneliness or feeling in need of companionship; peer influence; the widespread availability of inexpensive sexual services in Thailand; and sexual desire or need. Findings indicate that Japanese male sexual conduct reflects individual drives while on holiday, in the context of interactions among Japanese peers, shaped by Thailand's socio‐cultural environment. Résumé Cet article explore les raisons qui conduisent les hommes japonais à avoir des comportements sexuels potentiellement à risque lorsqu’ils sont en vacances en Thaïlande. Des entretiens approfondis semi‐structurés ont été menés avec 30 touristes japonais de sexe masculin et hétérosexuels, âgés de 19 à 36 ans, qui payaient des thaïlandaises pour avoir des rapports sexuels avec elles. Les participants de l’étude avaient été recrutés dans des pensions hôtelières à Bangkok. L’analyse a révélé huit facteurs prépondérants d’incitation au recours au sexe commercial : un sentiment de liberté et d’anonymat pendant le temps libre passé à voyager dans un pays étranger ; un sentiment que le sexe commercial en Thaïlande est géré par des normes permissives ; les perceptions de la désirabilité sexuelle des femmes thaïlandaises, un sentiment de supériorité économique et raciale par rapport à ces dernières ; un sentiment de solitude ou un besoin de compagnie ; l’influence des pairs ; l’importante disponibilité du commerce sexuel bon marché en Thaïlande ; les désirs et les besoins sexuels. Les résultats indiquent que les comportements sexuels des hommes japonais reflètent des pulsions individuelles survenant pendant les vacances, dans un contexte d’interactions entre pairs, conditionné par l’environnement socio‐culturel thaïlandais. Resumen En este documento analizamos por qué hay hombres japoneses que adoptan conductas arriesgadas de comercio sexual cuando se van de vacaciones a Tailandia. Se llevaron a cabo entrevistas exhaustivas y semiestructuradas con 30 turistas japoneses heterosexuales y masculinos, con edades entre 19 y 36 años que pagaron por tener relaciones sexuales con mujeres tailandesas. Los participantes para este estudio se captaron en paradores de Bangkok. Los análisis revelaron que los factores principales para que los participantes pagaran por tener relaciones sexuales eran ocho: la sensación de libertad y anonimato durante las vacaciones en un país extranjero; la sensación de que en Tailandia las normas de comercio sexual son más permisivas; la atracción sexual percibida hacia las mujeres tailandesas; el sentido de superioridad económica y racial con relación a las mujeres tailandesas; la sensación de soledad o necesidad de compañía; influencia de coetáneos; la amplia disponibilidad de servicios sexuales baratos en Tailandia; y el deseo o la necesidad sexuales. Los resultados indican que la conducta sexual de los hombres japoneses se mueve por impulsos individuales cuando están de vacaciones en el ámbito de interacciones entre compañeros japoneses, determinado por el ambiente sociocultural de Tailandia. [ABSTRACT FROM AUTHOR]

The paper examines the context of women's risk for HIV by assessing men's and women's sexual behaviour, attitudes towards sex work, and perception of risk for HIV in the city of Chiang Mai, Thailand. The findings are based on data collected in the mid‐1990s, at the height of the epidemic. A range of significant issues were highlighted by the men and women who participated in this study. First, some men continued to have unsafe sex with sex workers. Second, fear of HIV motivated men to seek out friends and acquaintances instead of sex workers for sexual encounters because they were considered ‘safe’ from infection. Third, women in this study were largely unaware of this expansion of the sexual network beyond the sex work itself. Lastly, women's sexuality was largely unrecognized in public health responses, or by the male and female participants, leaving them at risk for HIV. Résumé Dans cet article, l'auteur explore le contexte dans lequel la femme risque d'attraper le virus du Sida dans la ville de Chiang Mai en Thaïlande. Il examine le comportement sexuel des hommes et des femmes, leur attitude vis‐à‐vis des métiers du sexe et la perception du risque d'attraper le VIH. Ses conclusions sont tirées des données recueillies au milieu des années 90, au plus fort de l'épidémie. Les hommes et les femmes qui participèrent à cette recherche soulignèrent un certain nombre de thèmes importants. Tout d'abord, certains hommes continuaient à avoir des rapports sexuels non protégés avec des professionnelles du sexe. Deuxièmement, au lieu d'avoir recours aux professionnelles du sexe, les hommes, étant donné leur crainte du Sida, étaient conduits à chercher des partenaires sexuels parmi leurs amies et connaissances car ces personnes étaient censées ne présenter aucun danger par rapport à l'éventuelle transmission du virus. Troisièmement, les femmes qui participèrent à cette recherche ignoraient en grande partie cette extension du réseau sexuel au delà du milieu professionnel du sexe proprement dit. Enfin, la sexualité des femmes était en grande partie méconnue de ceux chargés de promouvoir la politique de santé publique; les participants hommes et femmes n'en tenaient pas compte non plus, ce qui mettait les femmes en danger d'attraper le VIH. Resumen En este artículo examino en qué contexto las mujeres corren el riesgo de contraer VIH valorando la conducta sexual de hombres y mujeres, las actitudes hacia el trabajo sexual y la percepción de riesgo de HIV en la ciudad tailandesa de Chiang Mai. Los resultados se basan en datos recopilados durante mediados de los noventa cuando la epidemia estaba en su punto más álgido. Los hombres y mujeres que participaron en este estudio destacaron una serie de cuestiones importantes. En primer lugar, algunos hombres seguían teniendo sexo arriesgado con las trabajadoras sexuales. En segundo lugar, el miedo a contraer VIH motivaba a los hombres a buscar amigas y conocidas en lugar de trabajadoras sexuales para sus encuentros amorosos porque pensaban que así estaban seguros de no infectarse. En tercer lugar, las mujeres de este estudio desconocían en gran medida la expansión de la red sexual más allá del trabajo sexual. Por último, la sexualidad de las mujeres en general no era reconocida en las respuestas de salud pública o por los participantes masculinos y femeninos, con lo que corrían el riesgo de contraer VIH. [ABSTRACT FROM AUTHOR]

Concern about the sexual and reproductive health of young people has been mounting recently in Thailand. Unequal gender relations have a considerable influence on the lives of young people, especially young women, yet few studies have explored the ways in which they have impacted on provision of sexual health care. Drawing upon data from a qualitative study in Northern Thailand, this paper explores the views and experiences of young people in seeking health care, highlighting the kinds of gender double standards and power imbalances that may pose obstacles to their use of sexual and reproductive health services. Findings reveal the vulnerability of sexually active young women in seeking support and care from partners, parents, and service providers. Those who experience adverse outcomes of sexual activity, such as unwanted pregnancy or infection, report facing indifference, victim blaming, or the threat of abandonment by their partners. Because of their fear of disclosure to their parents and communities, of their sexual activity, they opt for clandestine and unsafe abortion and seek the counsel of peers and drugstores rather than parents and providers. At the service provider level, young women report facing threatening and judgemental attitudes, indifferent counselling, and possible violation of confidentiality. This is in marked contrast to the treatment of young men, who generally meet with a more sympathetic and accepting response. [ABSTRACT FROM AUTHOR]

This paper reports on an ethnographic study of gender and sexuality as factors within contemporary Thai factory women's subjectivities. Competing discourses of what it means to be a woman in contemporary Thai society make women's self-presentations fluid and incoherent. Data from participant-observation and open-ended interviews suggest that the fluidity and inconsistency of women's self-presentations reflect both their negative experiences and oppression within the Thai patriarchal system, and women's strength and resistance to the normative discourses that oppress them. By naming or reinterpreting experiences and desires in their own terms, Thai factory women can redraw elements of their own lives. [ABSTRACT FROM AUTHOR]

By examining competing discourses about women who are maechii (... or 'lay nuns') in Buddhist Thai society, this paper demonstrates that, although maechii vow to be celibate, social constructions of their role are grounded in sexuality. The discourses examined are those of the Buddhist canon and Sangha (Order of Monkhood), the Thai Maechii Institute, the mass media, and the government. The analysis is supplemented with field observations and interviews with monks, maechii, and lay persons. Findings suggest that maechii comprise an ambiguous category linguistically, Buddhistically, and in terms of their sexuality. Case studies of the founders of nunneries conducted in ChiangMai indicate that maechii leaders have been resisting the prevalent views that most maechii are social misfits, yet also are capable of undermining monks' celibacy and, by extension, the larger social order. The analysis contributes to the understanding of the interconnectedness of gender and sexuality in contemporary Thai society. [ABSTRACT FROM AUTHOR]

The family, household and community have often been identified as having a crucial role to play in HIV and AIDS-related care in developing countries. Yet few studies have sought to examine the limits to the support that such institutions can provide. This paper describes findings from a study of the care and support offered to people living with HIV and AIDS in Chiang Mai province, an area of Thailand severely affected by the epidemic. Following an initial Rapid Assessment Process (RAP), data was collected from in-depth household and individual interviews, focus group discussions and participant observation in two village communities. A number of recurrent themes emerge from the data: local beliefs and practices as factors mediating family and community responses; the impact of recent economic and social change on the social organisation of family and village life (including the role of formal village leaders and the growth of sex work); the complex interface between traditional and modern systems of care and support; differences between rich and poor in access to, and use of, health services; and the unequal burden of responsibility shouldered by women as care givers. The implications of these findings for the future provision of health care and support in this part of Thailand are discussed. [ABSTRACT FROM AUTHOR]

Although seroprevalence studies have shown that Thai male sex workers are at heightened risk of HIV infection, no sustained preventive strategies have so far targeted homosexually active men in Thailand. In this paper, we bring together data from qualitative research carried out in Pattaya (McCamish and Sittitrai 1995, 1997) and Bangkok (Storer 1999a, 1999b), with data generated during a bar-based intervention in Bangkok (Carl, unpublished report), to develop a taxonomy of sites in which the recruitment of male commercial sex can occur. We also examine the sexual networks of Thai male sex workers and their clients in order to demonstrate the overlap of commercial and non-commercial male-male sex sites, and the intersection of male commercial sex with heterosexual sex. Previous interventions directed towards Thai male sex workers been non-continuous; largely restricted to high-profile tourist areas, have not acknowledged the importance of recreational sex; and have not built up a capacity for ongoing intervention. With a change of focus, interventions directed towards sex workers could reduce the risks of HIV infection among both organized and freelance sex workers as well as their commercial and male and female casual sex partners. First, however, there needs to be a commitment to well planned and long range interventions directed by and at male sex workers. [ABSTRACT FROM AUTHOR]

In one county of Southwest China bordering Myanmar, large numbers of minority Dai women leave to work in southern Thailand. Many are married and they leave behind husbands and children, sending remittances and returning home intermittently. These women commonly establish relations with Chinese/Malaysian men in their worksites – massage parlours in the tourist sites near the Malaysian border. These men become second husbands just as the Dai women become second wives. This paper examines the complicated set of HIV risks and assumptions that emerge from the circular Dai exodus to Thailand and the manner in which transnational employment networks impact on domestic and sexual relationships for women and their non-migrant husbands back home. [ABSTRACT FROM PUBLISHER]