Living Up to the Ideal of Respectability : Sexual and Reproductive Health and Rights Implications for Unmarried Migrant Workers, Single Mothers, and Women in Prostitution in Sri Lanka

This thesis aims to gain a deeper understanding of relationships and sexuality of women at risk of social exclusion in Sri Lanka and the risk of violations of their sexual and reproductive health and rights (SRHR) that they might face. Individual qualitative interviews with migrant women workers (n=18) and men (n=18) in the Free Trade Zone (FTZ), women facing single motherhood (n=28) and women formerly involved in prostitution (n=15) were conducted. Conceptual approaches included gender, social navigation and SRHR. The interviews were analyzed using thematic analysis, qualitative content analysis and discourse analysis. Findings revealed that the migrant women workers negotiated norms of respectability in a society that highly stigmatizes FTZ women workers, while the men identified conflicting constructions of masculinity existing in the FTZ. The women facing single motherhood navigated oppressive and stigmatizing social forces, and the women in prostitution constructed themselves as respectable in opposition to their societal disvalue and marginalization. In order to retain an image of sexual innocence, unmarried women are likely to refrain from demanding or demonstrating SRHR knowledge and accessing services. Furthermore, gender power imbalances leave the women vulnerable to sexual persuasion, coercion and violence. Once pregnant, social, legal, and knowledge barriers hinder or delay them in accessing abortion services. Unmarried pregnant women are thus left with the alternatives of adoption, infanticide, and suicide or become stigmatized single mothers with risks of health and social exclusion for mother and child. Extreme marginalization and limited power make women in prostitution vulnerable to unsafe sex, rape and violence. In conclusion, these women are likely to face numerous and serious SRHR hazards. The complexity of gendered social circumstances and the SRHR implications demonstrated in this thesis, add to the SRHR knowledge in Sri Lanka, and should inform politicians and policy makers about the need to improve the situation of all women in Sri Lanka

Living Up to the Ideal of Respectability : Sexual and Reproductive Health and Rights Implications for Unmarried Migrant Workers, Single Mothers, and Women in Prostitution in Sri Lanka

This thesis aims to gain a deeper understanding of relationships and sexuality of women at risk of social exclusion in Sri Lanka and the risk of violations of their sexual and reproductive health and rights (SRHR) that they might face. Individual qualitative interviews with migrant women workers (n=18) and men (n=18) in the Free Trade Zone (FTZ), women facing single motherhood (n=28) and women formerly involved in prostitution (n=15) were conducted. Conceptual approaches included gender, social navigation and SRHR. The interviews were analyzed using thematic analysis, qualitative content analysis and discourse analysis. Findings revealed that the migrant women workers negotiated norms of respectability in a society that highly stigmatizes FTZ women workers, while the men identified conflicting constructions of masculinity existing in the FTZ. The women facing single motherhood navigated oppressive and stigmatizing social forces, and the women in prostitution constructed themselves as respectable in opposition to their societal disvalue and marginalization. In order to retain an image of sexual innocence, unmarried women are likely to refrain from demanding or demonstrating SRHR knowledge and accessing services. Furthermore, gender power imbalances leave the women vulnerable to sexual persuasion, coercion and violence. Once pregnant, social, legal, and knowledge barriers hinder or delay them in accessing abortion services. Unmarried pregnant women are thus left with the alternatives of adoption, infanticide, and suicide or become stigmatized single mothers with risks of health and social exclusion for mother and child. Extreme marginalization and limited power make women in prostitution vulnerable to unsafe sex, rape and violence. In conclusion, these women are likely to face numerous and serious SRHR hazards. The complexity of gendered social circumstances and the SRHR implications demonstrated in this thesis, add to the SRHR knowledge in Sri Lanka, and should inform politicians and policy makers about the need to improve the situation of all women in Sri Lanka

Living Up to the Ideal of Respectability : Sexual and Reproductive Health and Rights Implications for Unmarried Migrant Workers, Single Mothers, and Women in Prostitution in Sri Lanka

This thesis aims to gain a deeper understanding of relationships and sexuality of women at risk of social exclusion in Sri Lanka and the risk of violations of their sexual and reproductive health and rights (SRHR) that they might face. Individual qualitative interviews with migrant women workers (n=18) and men (n=18) in the Free Trade Zone (FTZ), women facing single motherhood (n=28) and women formerly involved in prostitution (n=15) were conducted. Conceptual approaches included gender, social navigation and SRHR. The interviews were analyzed using thematic analysis, qualitative content analysis and discourse analysis. Findings revealed that the migrant women workers negotiated norms of respectability in a society that highly stigmatizes FTZ women workers, while the men identified conflicting constructions of masculinity existing in the FTZ. The women facing single motherhood navigated oppressive and stigmatizing social forces, and the women in prostitution constructed themselves as respectable in opposition to their societal disvalue and marginalization. In order to retain an image of sexual innocence, unmarried women are likely to refrain from demanding or demonstrating SRHR knowledge and accessing services. Furthermore, gender power imbalances leave the women vulnerable to sexual persuasion, coercion and violence. Once pregnant, social, legal, and knowledge barriers hinder or delay them in accessing abortion services. Unmarried pregnant women are thus left with the alternatives of adoption, infanticide, and suicide or become stigmatized single mothers with risks of health and social exclusion for mother and child. Extreme marginalization and limited power make women in prostitution vulnerable to unsafe sex, rape and violence. In conclusion, these women are likely to face numerous and serious SRHR hazards. The complexity of gendered social circumstances and the SRHR implications demonstrated in this thesis, add to the SRHR knowledge in Sri Lanka, and should inform politicians and policy makers about the need to improve the situation of all women in Sri Lanka

Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction : Plastic Surgery.

Purpose of the Review: The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). Recent Findings: Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced. The current evidence on outcomes of clitoral reconstruction shows potential benefits. However, there is a risk of postoperative complications and a negative outcome. Experts in the field advocate for a multidisciplinary approach including psychosexual counseling and health education with or without subsequent clitoral reconstructive surgery. Summary: The evolution of reconstructive treatment for women with FGM/C is expanding, however at a slow rate. The scarcity of evidence on clitoral reconstruction halters availability of clinical guidelines and consensus regarding best practice. Clitoral reconstruction should be provided by multidisciplinary referral centers in a research setting with long-term follow-up on outcomes of postoperative morbidity and possible benefits

Feeling like an untapped resource. Experiences of working life among nurses with ADHD and/or autism: An interview study

Background: ADHD and autism are common and increasing neurodevelopmental disorders in the world and also occur among nurses. However, almost nothing is known about nurses with these diagnoses. To promote high-quality care provision and well-being in the nursing workforce, it is important to discover more about these nurses. Therefore, in the present study, we aimed to describe how nurses with ADHD and/or autism experience their working life. Methods: The study was descriptive in design. Nurses were invited via Swedish Facebook groups targeting nurses. Semi-structured individual interviews were conducted with 17 nurses with ADHD and/or autism, online or by telephone. Data were analyzed using qualitative content analysis. Results: One overarching theme and seven subthemes emerged from the analysis. The theme “feeling like an untapped resource” reflected the subthemes: 1) Being passionate about one's job, 2) having strengths and talents to use in working life, 3) a stressful and disturbing work environment inhibits personal strengths, 4) managers show goodwill but lack knowledge and resources, 5) feeling appreciated but socially different among colleagues, 6) using a variety of strategies to facilitate working life and 7) toward an uncertain future. Conclusion: Nurses with ADHD and/or autism experience having abilities and talents that are useful in the nursing profession. However, they feel that the physical and organizational working conditions and lack of managerial support entail challenges that prevent them from making optimal use of their strengths

Respectability and rights : Sexual and reproductive health and rights of Sri Lankan women formerly involved in prostitution

Women in prostitution are often disrespected and subject to health risks. The aim of this study is to explore how women formerly engaged in prostitution in Sri Lanka position themselves in relation to gendered norms of respectability, and to discuss the possible implications for their sexual and reproductive health and rights (SRHR). Semi-structured qualitative interviews were conducted with fifteen women formerly engaged in prostitution. Discourse analysis was used to identify and describe interpretative repertoires and four repertoires were identified: Victimhood, Resistance, Responsibility, and Independence. The first three were drawn upon to construct their identities in line with norms of female respectability, as the women emphasised being victims of unfortunate situations, resisting sexual disrespectability and taking responsibility for their children and others. The last repertoire deviated from the respectability norm as it conveyed a picture of the women as independent, strong and courageous subjects, characteristics more in line with male respectability in Sri Lanka. Despite marginalised and oppressive circumstances, the women drew on interpretative repertoires to enhance access to respect, dignity and resources. However, their vulnerability to violence, SRHR risks and virtual absence of rights leave them with little access to resources that could enable a healthier and better life

Facing uneasiness in feminist research: The case of female genital cutting

Genital cutting evokes an uneasiness among feminist scholars. In this chapter I will show how this uneasiness is ignored, denied and silenced, drawing upon a specific feminist debate about female circumcision in Africa. I then turn to several perspectives provided by feminist scholars for understanding affective experiences of discomfort and show how they can help make sense of the debate and, more generally, the difficulties of having debates about controversial practices. I make a case for treating uneasiness as a resource rather than as a hindrance for understanding female genital cutting because it allows space for differences in experience, contradictory emotions and the inevitable messiness of bodily practices that are both harmful and fervently desired

Unmarried women's ways of facing single motherhood in Sri Lanka : a qualitative interview study

Background: In Sri Lanka, motherhood within marriage is highly valued. Sex out of wedlock is socially unacceptable and can create serious public health problems such as illegal abortions, suicide and infanticide, and single motherhood as a result of premarital sex is considered shameful. The way unmarried women facing single motherhood reflect on and make use of their agency in their social environments characterised by limited social and financial support has consequences for the health and well-being of both themselves and their children. The aim of this study was to explore and describe how unmarried women facing single motherhood in Sri Lanka handle their situation. Methods: This qualitative study comprised semi-structured interviews with 28 unmarried pregnant women or single mothers. The data were analysed by qualitative content analysis and the results related to the conceptual framework of social navigation. Results: The women facing single motherhood expressed awareness of having trespassed norms of sexuality through self-blame, victimhood and obedience, and by considering or attempting suicide. They demonstrated willingness to take responsibility for becoming pregnant before marriage by giving the child up for adoption, bringing up the child themselves, claiming a father for their child, refraining from marriage in the future, permanently leave their home environment, and taking up employment. Throughout the interviews, the women expressed fear of shame, and striving for familial and societal acceptance and financial survival. Conclusions: A social environment highly condemning of unmarried motherhood hindered these women from making strategic choices on how to handle their situation. However, to achieve acceptance and survival, the women tactically navigated norms of femininity, strong family dependence, a limited work market, and different sources of support. Limited access to resources restricted the women's sexual and reproductive health and rights, including their ability to make acceptable and healthy choices for themselves and their children

'I want what every other woman has' : reasons for wanting clitoral reconstructive surgery after female genital cutting – a qualitative study from Sweden

Female genital cutting (FGC) involves the removal of women's external genitalia for non-therapeutic reasons. An estimated 38,000 women living in Sweden have undergone some form of the procedure. These women often belong to marginalised minorities of immigrant women from countries where FGC is widespread. Clitoral reconstructive surgery following FGC has recently been introduced in Sweden. This study investigates women's perceptions of FGC and clitoral reconstructive surgery with a particular focus on: (1) reasons for requesting reconstructive surgery, and (2) FGC-affected women's expectations of the surgery. Seventeen women referred for clitoral reconstructive surgery at the Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, participated in the study. Findings revealed five factors motivating women's request for clitoral reconstruction (CR): (1) symbolic restitution - undoing the harm of FGC; (2) repairing the visible stigma of FGC; (3) improving sex and intimacy through physical, aesthetic and symbolic recovery; (4) eliminating physical pain; (5) and CR as a personal project offering hope. These factors were highly interconnected, suggesting that the reasons for seeking surgery were often multiple and complex

Pricking in the African Diaspora : Current Evidence and Recurrent Debates

Purpose of ReviewThe purpose of this review is to assess current evidence and summarise key debates on pricking within the African diaspora.Recent FindingsCurrent evidence reveals divergent views regarding pricking. (Inter)national legislation is unspecific regarding the illegality of pricking, further complicated by the difficulty of detecting pricking due to a lack of visible change in the genitalia. Debates are polarised and pricking is commonly viewed from a 'harm reduction' or 'zero tolerance' approach. This means that pricking can be approved of as a strategy for minimising health risks of female genital cutting (FGC) while still allowing for cultural diversity, or rejected as a violation of girl's human rights and bodily integrity.SummaryPricking is receiving increased attention, yet evidence from a migration context is still scarce. More research regarding the underlying reasons for supporting pricking, its potential harm, and whether it has a role in the eradication process of FGC is needed