title: Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women's Experiences of Sexual Embodiment.
abstract: In Australia and Canada, the sexual health needs of migrant and refugee women have been of increasing concern, because of their underutilization of sexual health services and higher rate of sexual health problems. Previous research on migrant women's sexual health has focused on their higher risk of difficulties, or barriers to service use, rather than their construction or understanding of sexuality and sexual health, which may influence service use and outcomes. Further, few studies of migrant and refugee women pay attention to the overlapping role of culture, gender, class, and ethnicity in women's understanding of sexual health. This qualitative study used an intersectional framework to explore experiences and constructions of sexual embodiment among 169 migrant and refugee women recently resettled in Sydney, Australia and Vancouver, Canada, from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, India, and South America, utilizing a combination of individual interviews and focus groups. Across all of the cultural groups, participants described a discourse of shame, associated with silence and secrecy, as the dominant cultural and religious construction of women's sexual embodiment. This was evident in constructions of menarche and menstruation, the embodied experience that signifies the transformation of a girl into a sexual woman; constructions of sexuality, including sexual knowledge and communication, premarital virginity, sexual pain, desire, and consent; and absence of agency in fertility control and sexual health. Women were not passive in relation to a discourse of sexual shame; a number demonstrated active resistance and negotiation in order to achieve a degree of sexual agency, yet also maintain cultural and religious identity. Identifying migrant and refugee women's experiences and constructions of sexual embodiment are essential for understanding sexual subjectivity, and provision of culturally safe sexual health information in order to improve well-being and facilitate sexual agency.
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia. j.ussher@westernsydney.edu.au.
authors.forename: Jane M
authors.identifier: http://orcid.org/0000-0002-2128-0019
authors.initials: JM
authors.lastname: Ussher
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
authors.forename: Janette
authors.initials: J
authors.lastname: Perz
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Metusela
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Hawkey
authors.affiliation: Centre for the Study of Gender, Social Inequities and Mental Health, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Marina
authors.initials: M
authors.lastname: Morrow
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, 2751, Australia.
authors.forename: Renu
authors.initials: R
authors.lastname: Narchal
authors.affiliation: , Family Planning New South Wales, Sydney, NSW, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Estoesta
mesh_terms: D000293:Adolescent; D000328:Adult; D000351:Africa, Eastern / Q000208:ethnology; D000368:Aged; D001211:Asia, Western / Q000208:ethnology; D001955:British Columbia; D003142:Communication; D003219:Confidentiality; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology; D005260:Female; D017144:Focus Groups; D005783:Gender Identity; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D008393:Marriage / Q000208:ethnology* / Q000523:psychology; D008572:Menarche / Q000208:ethnology / Q000523:psychology; D008598:Menstruation / Q000208:ethnology* / Q000523:psychology; D008875:Middle Aged; D017008:Negotiating; D009517:New South Wales; D011247:Pregnancy; D036301:Qualitative Research; D012036:Refugees / Q000523:psychology; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology; D000074384:Sexual Health / Q000208:ethnology; D019529:Sexuality / Q000208:ethnology* / Q000523:psychology; D012752:Shame; D014171:Transients and Migrants / Q000523:psychology; D016387:Women's Health; D055815:Young Adult
keywords: Intersectionality; Migrant and refugee sexual health; Sexual health; Sexual shame; Women’s sexual embodiment