Authenticating Sexuality: Sexual Ideology and HIV Science in South Africa
Creators: Fiereck, Kirk John
Publisher: name: Columbia University
Year: 2015
Subjects: Ideology
HIV infections--Social aspects
Sexual minorities
Ethnology
Gay and lesbian studies
Gender identity
Sex role

description: This dissertation examines the emergence of queer personhood among black publics and medical cultures in South Africa over the past century. Based on more than two years of fieldwork in South Africa, it contains both a historical and an ethnographic component. The historical research was comprised of archival research and 16 life history interviews exploring how black South Africans reference multiple cultural fields of sexual and gender identities to elaborate composite formations of sexual subjectivity and personhood. In the ethnographic component, I conducted participant-observation and 70 in-depth interviews among various groups, including a number of queer, non-governmental organizations and two global health, HIV-focused clinical sites. In these settings, I examined how social actors, in the context of community settings and global health and community development projects, address sexual and gender nonconformity. 
      Existing scholarship on gender and sexuality in South Africa presumes the existence of only one cultural field of gender and sexual identities in this social field. In contrast, my dissertation argues that multiple cultural fields and sexual ideologies have emerged coevally here. One is a liberal field of sexual subjectivity consisting of globally diffuse concepts of sexual personhood that are historically rooted in a psychiatric style of reasoning, such as homosexual, heterosexual, etc.; the other fields are more localized and are based on ethnic cultural fields of sexual and gender identities. However, they have incorporated aspects of, a globally diffuse psychiatric and anatomical style of reasoning about sexuality. Whereas the `global' liberal sexual ideology dictates a strict alignment of sex and gender, and has done so for some time, the ethnic sexual ideologies I examine, until recently, have not. My work explores the interrelationship of these multiple cultural fields. It follows the enactment of composite sexual subjectivities that are produced when social actors call upon multiple cultural fields of meaning about gender and sexuality. The study demonstrates how race and class mediate the co-emergence of these multiple cultural fields, and how they are entwined with political and economic ideologies and global health knowledge systems. 
      The introductory chapter maps the theoretical and empirical terrain as well as the main questions that are discussed and proposed through the rest of the monograph. The second chapter is a historical analysis of gendered and sexual personhood among black South Africans during the twentieth century. Chapter 3 maps how discourses about cultural authenticity are being used to both contest and constitute LGBTQ sexualities as African. As these cultures and sexual ideologies co-emerge, Chapter 4 examines how they have become entwined with particular political traditions and ideologies during the past century. Chapter 5 explores the ways that biomedicine and public health only reference the a liberal sexual ideology when producing knowledge about black queer bodies and populations in the context of global health HIV interventions. Specifically, I explore the enactment of the MSM and WSW epidemiologic risk categories within HIV science. In Chapter 6, the disjuncture between global health knowledge and everyday experiences of gender and sexuality are highlighted through an ethical case study of the implementation of the HIV intervention known as pre-exposure prophylaxis, or PrEP. The case study concretely demonstrates how the symbolic violence enacted by medical cultures, which only reference the liberal cultural field, conditions structural violence in the form of unjust distribution of health resources among queer groups. 
      The analyses presented in this dissertation suggest new avenues for queer and feminist anthropological inquiry throughout the sub-Saharan African region. In particular, this scholarship contributes to a novel understanding of the political economy of global health and sexuality by exploring how knowledge production and circulation about sexuality within global health contributes to gendered health disparities.