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Chemical sexualities: The use of pharmaceutical and cosmetic products by youth in South Sulawesi, Indonesia
Abstract
Although young people in their everyday lives consume a bewildering array of pharmaceutical, dietary and cosmetic products to self-manage their bodies, moods and sexuality, these practices are generally overlooked by sexual and reproductive health programmes. Nevertheless, this self-management can involve significant (sexual) health risks. This article draws from the initial findings of the University of Amsterdam's ChemicalYouth project. Based on interviews with 142 youths, focus group discussions and participant observation in South Sulawesi, Indonesia, we found that young people – in the domain of sexual health – turn to pharmaceuticals and cosmetics to: (1) feel clean and attractive; (2) increase (sexual) stamina; (3) feel good and sexually confident; (4) counter sexual risks; and (5) for a group of transgender youths, to feminize their male bodies. How youth achieve these desires varies depending on their income and the demands of their working lives. Interestingly, the use of pharmaceuticals and cosmetics was less gendered than expected. Sexual health programmes need to widen their definitions of risk, cooperate with harm reduction programmes to provide youth with accurate information, and tailor themselves to the diverse sexual health concerns of their target groups.
Résumé
Si dans leur vie quotidienne, les jeunes consomment une palette étonnante de produits pharmaceutiques, diététiques et cosmétiques pour autogérer leur corps, leurs humeurs et leur sexualité, ces pratiques sont généralement ignorées par les programmes de santé sexuelle et génésique. Néanmoins, cette autogestion peut comporter d'importants risques de santé (sexuelle). L'article s'inspire des conclusions initiales du projet ChemicalYouth de l'Université d'Amsterdam. Nous fondant sur des entretiens avec 142 jeunes, des discussions de groupe et l'observation des participants à Sulawesi-Sud, Indonésie, nous avons découvert que les jeunes, dans le domaine de la santé sexuelle, ont recours aux produits pharmaceutiques et cosmétiques pour : 1) se sentir propres et attirants ; 2) accroître leur endurance (sexuelle) ; 3) être à l'aise et confiants sexuellement ; 4) contrer les risques sexuels ; et 5) pour un groupe de jeunes transsexuels, féminiser leur corps masculin. La manière dont les jeunes réalisent ces désirs varie selon leur revenu et les exigences de leur vie professionnelle. Il est intéressant de noter que l'utilisation de produits pharmaceutiques et cosmétiques est moins différencié selon les sexes qu'escompté. Les programmes de santé sexuelle doivent élargir leurs définitions du risque, coopérer avec les programmes de réduction des risques pour donner des informations exactes aux jeunes et s'ajuster aux diverses préoccupations de santé sexuelle de leurs groupes cibles.
Resumen
Aunque en su diario vivir las personas jóvenes consumen una desconcertante selección de productos farmacéuticos, dietéticos y cosméticos para automanejar su cuerpo, estado de ánimo y sexualidad, los programas de salud sexual y reproductiva generalmente hacen caso omiso de estas prácticas. No obstante, este automanejo puede implicar riesgos significativos para la salud (sexual). Este artículo se basa en los hallazgos iniciales del proyecto ChemicalYouth de la Universidad de Amsterdam. Mediante entrevistas con 142 jóvenes, discusiones en grupos focales y observación participativa en Sulawesi meridional, Indonesia, encontramos que la juventud –en el ámbito de salud sexual– recurre a farmacéuticos y cosméticos para: (1) sentirse limpia y atractiva; (2) aumentar su resistencia (sexual); (3) sentirse bien y con confianza sexual; (4) contrarrestar los riesgos sexuales; y (5) para un grupo de jóvenes transgénero, feminizar su cuerpo masculino. La manera en que la juventud logra estos deseos varía según su ingreso y las exigencias de su vida laboral. Curiosamente, el uso de farmacéuticos y cosméticos era menos influido por género que lo esperado. Los programas de salud sexual deben ampliar su definición de riesgo, cooperar con programas de reducción de daños para proporcionar a la juventud información exacta y adaptarse conforme a las diversas inquietudes de sus grupos objetivos en cuanto a la salud sexual.
... The everyday lives of contemporary youths are awash with drugs to boost pleasure, moods, sexual performance, vitality, appearance and health (Hardon, Idrus, and Hymans 2013). A growing body of sociological and anthropological studies, mostly conducted among student populations in affluent societies, indeed points to the 'pharmaceuticalization' of youths' everyday lives (e.g. ...
... The first involved a 'grand tour' of the breadth of chemicals consumed by youths in their everyday lives, including cosmetics, stamina-enhancing products, contraceptives, and mood-enhancing drugs. The findings of this initial grand tour have been published elsewhere (Hardon, Idrus, and Hymans 2013). ...
... Construction workers mixed energy drinks and potency products; hard-core drug users injected a veritable cocktail into their veins in search of new highs. Students were also found to use Somadril in all kinds of different mixtures, but only on weekends and mainly to enhance sexual pleasure (Hardon, Idrus, and Hymans 2013). ...
The everyday lives of contemporary youths are awash with drugs to boost pleasure, moods, sexual performance, vitality, appearance and health. This paper examines pervasive practices of chemical 'self-maximization' from the perspectives of youths themselves. The research for this paper was conducted among male, female and transgender (male to female, so-called waria) sex workers in Makassar, Indonesia. It presents the authors' ethnographic findings on how these youths experiment with drugs to achieve their desired mental and bodily states: with the painkiller Somadril to feel happy, confident and less reluctant to engage in sex with clients, and contraceptive pills and injectable hormones to feminize their male bodies and to attract customers. Youths are extremely creative in adjusting dosages and mixing substances, with knowledge of the (mostly positive) 'lived effects' of drugs spreading through collective experimentation and word of mouth. The paper outlines how these experimental practices differ from those that have become the gold standard in biomedicine.
... In the past few decades, the number of personal care products production and usage has increased significantly (Wang et al. 2021;Garlantézec et al. 2013). Young and sexually active people between the ages of 18 and 30 years around the world are increasingly using pharmaceutical, cosmetic, and other related personal care products for reasons including maintaining sexual drive, sexual outlook, and mood-stabilizing (Hardon et al. 2013). Yet, health science researchers largely ignore the assessment of post-consumption risks and consequences (Hardon et al. 2013;Wang et al. 2021). ...
... Young and sexually active people between the ages of 18 and 30 years around the world are increasingly using pharmaceutical, cosmetic, and other related personal care products for reasons including maintaining sexual drive, sexual outlook, and mood-stabilizing (Hardon et al. 2013). Yet, health science researchers largely ignore the assessment of post-consumption risks and consequences (Hardon et al. 2013;Wang et al. 2021). Given that most of these chemicals easily permeate every facet of our lives, their health impacts remain profound (Bellavia et al. 2019;Dutta et al. 2020;Meeker et al. 2011;Rattan and Flaws 2019;Zota and Shamasunder 2017;Dodge et al. 2015;Li et al. 2019). ...
Background
Endocrine disruptors originate from multiple sources making their health impacts enormously complex. This study systematically synthesizes the sources, exposure, and effects of personal care products on reproductive health.
Main body
The PRISMA and Meta-Analyses frameworks were used to review and present integrated evidence. The literature search was undertaken in PubMed, Google Scholar, and Scopus. All studies that focused on the sources, exposure pathways, and reproductive health impact of endocrine disruptors were included in the final review. Although the review included articles published from 2000 to 2021, most studies were conducted between the years 2010 and 2020. There was great variability in terms of studies conducted in individual countries, of which 34.4% were published in the USA. The review found that endocrine disruptors abound in the environment and their impact on females and males’ reproduction are profound. Phthalates, Bisphenol A, MXC, and Dioxins were widely studied EDCs as determiner of reproductive health. Crucially, the human body concentration of these EDCs varies between people of diverse backgrounds.
Conclusion
While the bodily concentration of these EDCs is higher, it varies greatly among different groups of people. Respective governments and NGOs should provide the needed funding for research on personal care products and EDCs. Moreover, individual and spatial heterogeneity should be considered in the risk assessment of these chemicals.
... This study fits into the perspective of anthropological studies on the use of misoprostol to induce abortion by looking at how the drug can reframe the meaning of abortion for some of its users [18][19][20]. For example, De Zordo [19] shows how, in Brazil, induced abortion was tolerated morally among women who use misoprostol to induce abortion. ...
... For example, De Zordo [19] shows how, in Brazil, induced abortion was tolerated morally among women who use misoprostol to induce abortion. Hardon and colleagues [20] discussed how girls use misoprostol in the Philippines for menstrual regulation (a euphemism for early abortion). Drawing on insights from this body of literature, this paper will discuss how using a pill rather than an invasive procedure could change the meaning of induced abortion from the perspective of women. ...
In Burkina Faso, induced abortion is socially stigmatized, condemned, disapproved and legally restricted to cases of rape, incest, fetal malformation or endangerment to the life of the mother. Many women often resort to unsafe procedures to induce abortion, which puts their health at great risk. Misoprostol, which is officially restricted to the treatment of postpartum hemorrhage or post-abortion care, is also used illegally by women to terminate their pregnancies. Misoprostol represents an addition to the existing abortion methods, such as vacuum aspiration, which health workers have often used to induce abortion clandestinely. Many women also use misoprostol to self-induce abortions, replacing abortifacients such as herbal teas, potions, high doses of antimalarial drugs, or bleach. Despite the changes that occur in abortion access due to the use of misoprostol, little is known about what the drug means to its users and how this meaning can in turn influence the meaning of abortion. The aim of this paper is to describe how the use of misoprostol to terminate pregnancy contributes to changing women’s perception of the meaning of abortion. This paper is based on ethnographic fieldwork conducted between March 2016 and February 2017 in the city of Ouagadougou, Burkina Faso. By examining the relation between the use of misoprostol and the meaning that women give to abortion, this study found that women experience abortion either spontaneously or using emergency contraception with misoprostol. Through the experience of women, this paper claims that the meaning of abortion should be seen as a social construct and fundamentally rooted in individual practices and experiences rather than being subject to dichotomist global discourse.
... Despite the often-present notion of the singularity of the body in expressions like 'depending on our own body' (similar to the relational notion of compatibility in Hardon et al. 2013), it was especially based on privately shared experiences that the logic of experimentation took place. The secrecy of such consumptions, especially regarding female partners, was important to maintain the good reputation. ...
... As this and other studies (e.g. Hardon et al. 2013 have shown, the generational aspect of performance investments play an important role on how possibilities of change and improvement are perceived and managed; while individuals' socioeconomic and educational backgrounds of individuals appear, as well, as conditions for stimulating certain types of investments. Considering these different consumptions and performance investments together, as part of a broader picture of the performing self, was important. ...
With an increasing range of products in global and local markets, more options are available for individuals to enhance their image and their (cognitive, social and physical) performance. These ‘performance consumptions’ relate to ideals of well‐being and improvement, and are based on constructed desires, expectations and needs that go beyond the (often blurred) dichotomy of health and illness. Drawing from mixed‐methods research in Maputo, Mozambique, this paper discusses individuals’ use of medicines and other substances – pharmaceuticals, food supplements, traditional herbs, cosmetics and energy drinks – for managing different aspects of their everyday lives. Through an overview of the main consumption practices, we explore the underlying purposes and strategies of users, and the perceived legitimacy and risks involved when using a variety of products accessible through formal and informal exchange channels. From tiredness to sexual and aesthetic management, we show how the body becomes the locus of experimentation and investment to perform in accordance with socially expected roles, individual aspirations and everyday tasks. With insights from individuals’ accounts in Maputo, we aim to add to discussions on pharmaceuticalisation of body management by showing how the emergence of new performance consumptions is articulated with the reconfiguration of more ‘traditional’ consumption practices.
... PrEP is perhaps a queer echo of the birthcontrol pill that enabled women to experiment with new modes of sociality and sexuality in the twentieth century. Emergency contraceptive pills, generic Viagra, cosmetics, and tonics have been exported from the United States and Europe to enable promiscuous chemosocial sexualities in places like Ethiopia, Indonesia, the Philippines, and West Papua (Hardon, Idrus, and Hymans 2013; see also Hardon and the Chemical Youth Collective 2017). ...
... This collection can be read as an intervention in American studies, since the United States has been an important historical experimenting ground for industrial chemistry (across petrochemistry, pharmaceuticals, and agribusiness). Yet the authors in this collection are also doing imaginative labor beyond the confines of national borders-tracing chemical species through global assemblages to describe sprawling lines of relation that are producing both discomforting and liberating modes of chemosociality ; see also Agard-Jones 2013;Hardon, Idrus, and Hymans 2013). ...
... Similar findings were also reported elsewhere [5,[25][26][27][28]. The drives commonly enumerated for using cosmetics include feeling clean and attractive, increasing sexual stamina, feeling good and sexually active, as well as countering sexual risks [28][29][30]. Several studies have found that using cosmetics makes women appear healthier, more attractive, and more feminine [7][8][9]26,30]. ...
... The drives commonly enumerated for using cosmetics include feeling clean and attractive, increasing sexual stamina, feeling good and sexually active, as well as countering sexual risks [28][29][30]. Several studies have found that using cosmetics makes women appear healthier, more attractive, and more feminine [7][8][9]26,30]. Furthermore, cosmetic use may also be linked to success in the work place. ...
Abstract: The trend of cosmetics utilization has increased globally; however, the exact amount of usage is not researched well. Lack of population awareness on proper use of cosmetics, particularly in developing countries, causes a prominent health challenge. Therefore, this study was conducted to assess the cosmetics utilization practices in Jigjiga town, Eastern Ethiopia. A community based cross-sectional study, using a semi-structured questionnaire, was used to assess factors associated with cosmetics use. Of the 559 participants, 93% used at least one type of cosmetics in the two weeks prior to the survey. The most commonly used products were body creams and lotions (68%), shampoos and conditioners (35%), and deodorants and perfumes (29%). Being single, female, and in the age group of 18–20 years increased the odds of cosmetics utilization. However, being in primary school and being self-employed showed a less likely use of cosmetics. Two hundred forty-seven (44%) of the interviewed household members reported that they use traditional herbal cosmetics. A higher likelihood of traditional herbal cosmetics use was observed in the age group of 18–20 years. This study indicated that the community in Jigjiga town use different types of cosmetics. Education, occupation, marital status, age, and gender were all important factors that determined the use of cosmetics in the study area.
Keywords: cosmetics; cosmetic types; Ethiopia; Jigjiga town; traditional herbal cosmetics
... A previous study of vocational school students' drugs and alcohol behaviour patterns found that most students use more than one type of drugs. "Sociality" is found to be one of the key factors that introduce vocational school students to drugs by way of new groups of friends or new social environments [10]. Adolescents often seek social and peer support in entering a new environment [11]. ...
Background
In Thailand, drug use is widely observed, especially among vocational-school students, who are more inclined to use various types of drugs and to experience pride-based violence (violence based on institutional pride, honor, or on seniority status) than any other groups of students. Drug use contexts differ based on sexual orientation and gender identity (e.g., clubs). This study aims to examine the prevalence and correlates of poly-drug use (the use of at least three types of drugs) among vocational-school students, with a focus on sexual orientation and gender identity.
Methods
In this study, 638 vocational school students living in Bangkok metropolitan area participated in a three-year longitudinal survey of four vocational schools. Experiences of violence, sexual behaviours, and poly-drug use were assessed and analyzed using multivariable logistic regression.
Results
About one tenth of all students (11.3%) reported poly-drug use, a fifth among Lesbian, Gay, Bisexual and Transgender (LGBT) students (20.2%) and almost a tenth of heterosexual students (9.8%). In the multivariable logistic model of LGBT students, GPA, pride-based violence, intoxicated sex, and counseling needs were significantly associated with poly-drug use (AOR = 4.62; 95% CI 1.17–18.29, AOR = 6.01; 95% CI 1.31–27.32, AOR = 5.17; 95% CI 1.10–24.28, AOR = 4.64; 95% CI 1.16–18.54, respectively). Likewise, among heterosexual students, GPA and intoxicated sex were significantly associated with poly-drug use (AOR = 2.02; 95% CI 1.09–3.75, AOR = 5.31; 95% CI 2.81–10.04, respectively).
Conclusions
LGBT vocational-school students have significantly higher prevalence of poly-drug use than their heterosexual peers. Correlates include lower GPA, having experienced pride-based violence and intoxicated sex. School-based intervention programs should also address pride-based violence and intoxicated sex in their harm reduction programs.
... Several researchers have argued and empirically shown that cosmetic products help to make women appear more youthful, healthy, feminine, and attractive (Batres, Kramer, DeAngelis, & Russell, 2019;Borau & Bonnefon, 2019a;Cash, Dawson, Davis, Bowen, & Galumbeck, 1989;Etcoff et al., 2011;Hardon, Idrus, & Hymans, 2013;Jones, Russell, & Ward, 2015;Jones & Kramer, 2016;Kellie, Blake, & Brooks, 2020;Russell et al., 2019). Older women seem to strategically use makeup in order to appear younger (Mafra et al., 2020;Russell et al., 2019). ...
Researchers have highlighted numerous sociocultural factors that have been shown to underpin human appearance enhancement practices, including the influence of peers, family, the media, and sexual objectification. Fewer scholars have approached appearance enhancement from an evolutionary perspective or considered how sociocultural factors interact with evolved psychology to produce appearance enhancement behavior. Following others, we argue that evidence from the field of evolutionary psychology can complement existing sociocultural models by yielding unique insight into the historical and cross-cultural ubiquity of competition over aspects of physical appearance to embody what is desired by potential mates. An evolutionary lens can help to make sense of reliable sex and individual differences that impact appearance enhancement, as well as the context-dependent nature of putative adaptations that function to increase physical attractiveness. In the current review, appearance enhancement is described as a self-promotion strategy used to enhance reproductive success by rendering oneself more attractive than rivals to mates, thereby increasing one’s mate value. The varied ways in which humans enhance their appearance are described, as well as the divergent tactics used by women and men to augment their appearance, which correspond to the preferences of opposite-sex mates in a heterosexual context. Evolutionarily relevant individual differences and contextual factors that vary predictably with appearance enhancement behavior are also discussed. The complementarity of sociocultural and evolutionary perspectives is emphasized and recommended avenues for future interdisciplinary research are provided for scholars interested in studying appearance enhancement behavior.
... www.ijsrp.org 2016; Hardon, Idrus, & Hymans, 2013). According to a report by Cosmetics Europe (2017), young people often struggle with self-esteem and social interaction as they transition from teenage hood into adulthood. ...
... Conducted from December 2011 to September 2013, the study began as an open-ended survey of the different chemicals that young people use (see Hardon, Idrus, & Hymans, 2013) which led to a focus on the role drug use plays in their everyday economic lives ( Lasco, 2014). Ethical approval for the research was secured from the College of Social Sciences and Philosophy of the University of the Philippines in Diliman. ...
Background:
A violent 'war on drugs' continues to be waged in the Philippines, even as the use of drugs - particular methamphetamine - continues to rise. Furnishing contextual background to the current situation, this paper explores how long-running law enforcement approaches in the Philippines might be viewed by those in their receiving end by presenting findings of an ethnography among marginalized young men.
Methods:
Semi-structured interviews and focus group discussions were conducted among 20 young men throughout a 12-month period of participant-observation from December 2011 to September 2013.
Findings:
Young people make use of various 'tactics' to keep using drugs and evade law enforcement, even as drug use itself is a tactic in their everyday lives. A sense of hypocrisy and injustice, borne of their own experiences, informs their view of law enforcers, whom they call kalaban (enemy). They feel they are being unfairly targeted, but in their view, this danger is just part of the perils of their everyday lives.
Conclusion:
Young men's resort to various tactics speaks of an agency that is often ignored in public discourses. Their 'lay assessments of risks' and experience-based perceptions of law enforcement raises questions about the efficacy of fear-based anti-drug campaigns. Overall, the study offers an ethnographic argument against the punitive methods being employed by the Philippines, and for measures that reframe the relationship between police and young drug users - from hostility to trust.
... Por medio de una descripción de la sintomatología, las waria se recomiendan mutuamente medicamentos concretos -que pueden ser adquiridos en farmacias sin prescripción médica-y las dosis que consideran suficientes en base a experiencias pasadas (Hardon y Ilmi,8 Los beneficiarios de este programa son estimados a través de la encuesta nacional SUSENAS, que calcula los gastos de los hogares. 2014; Hardon, Ilmi y David, 2013;Nuño, 2016). Esta es una práctica ampliamente extendida en contextos de exclusión sanitaria (Nichter, 2003;Reynolds, Van der Geest y Hardon, 2003). ...
According to the exigencies of national and international institutions, non-governmental and grassroots organizations assisting waria —male-to-female transvestites— in the Indonesian city of Jogjakarta have focused all their programs in the prevention and treatment of HIV. As a result of a recent training program in social management, groups of waria have decided to establish themselves as independent institutions and initiate socio-political processes of revindication and negotiation aimed at obtaining free medical access and care. Throughout analysing the underlying causes that have motivated these practices and their consequences, this paper seeks to discuss and rethink the prevailing priorities constructed in global health —characterized by presenting the battle against HIV and Malaria as a the pressing health priorities in the Global South.
... However, we can also envisage the shaping of collective identities through attitudes towards pharmaceuticals and the ways in which individuals organise their shared experiences in relation to them (Hardon et al. 2013). Drugs serve as catalysts when they become the object around which new socialities appear, be it through non-medical or illicit use, as in the case of cognitive enhancers (also called smart drugs), or through the rejection of a diagnostic label and subsequent treatment, as in the management of extreme shyness with psychotropic drugs. ...
This article proposes a theoretical framework on the role of pharmaceuticals in transforming perspectives and shaping contemporary subjectivities. It outlines the significant role drugs play in three fundamental processes of social transformation in Western societies: medicalisation, molecularisation and biosocialisation. Indeed, drugs can be envisaged as major devices of a pharmaceutical regime, which is more akin to the notion of dispositif, as used by Foucault, than to the sole result of high‐level scheming by powerful economic interests, a notion which informs a significant share of the literature. Medications serve as a key vector of the transformation of perspective (or gaze) that characterises medicalisation, molecularisation and biosocialisation, by shifting our view on health, nature and identity from a categorical to a dimensional framework. Hence, central to this thesis is that the same underlying mechanism is at work. Indeed, in all three processes there is an evolving polarity between two antinomic categories, the positions of which are constantly being redefined by the various uses of drugs. Due to their concreteness, the fluidity of their use and the plasticity of the identities they authorise, drugs colonise all areas of contemporary social experiences, far beyond the medical sphere.
A video abstract of this article can be found at: https://www.youtube.com/watch?v=djIBY7DHKW4&feature=youtu.be
... 35 Likewise, painkillers have been used in Indonesia to enhance libido, and hormonal therapies have been documented as being repurposed by individuals self-identifying as men who seek to feminise their bodies. 36 Research in this vein reveals the complex social lives of 'enhancements' that exceed anticipatory imaginaries of their uses and actions, and that also enrich medical humanities and social scientific understandings of the relationships between biomedicine and wider society. 37 A concern with gender-as well as ethnicity and other somatic markers of identity-connects with themes of embodiment more generally. ...
For some time now, bioethicists have paid close attention to issues associated with 'enhancement'; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with 'normal' function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with-and further develop-existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to-and be benefitted by-research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
... On the other hand, the energy drink KukuBima was consumed widely, especially by physical labourers. But although the highly advertised energy drink contains ginseng and images of male virility are omnipresent in its promotion, it was found that most of the informants had a more mundane purpose in mind: to get through their long working days (Hardon, Idrus, and Hymans 2013) as the energy drink is seen to generate kuat kerja (energy to work). While KukuBima was not seen to directly enhance libido, it nevertheless aided sexual relations by helping manual labourers to feel less capek (tired) or loyo (weak), and by helping them to wake up with energy. ...
This paper examines changing sexualities and gender relations as they are reflected in the use of sexual enhancement products by young women and men in the eastern Indonesian city of Makassar. To examine the relationships between the use of these products and socially sanctioned gender roles, their 'gender scripts' were studied - the assumptions embedded in the products' design and advertising. What kinds of femininity and masculinity are expressed through their use? It was found that the most popular products - 'magic tissues' that promise to prolong erections and a 'neotraditional' vaginal wash that promises to cleanse, perfume, and tighten vaginas - espouse the dual purpose of promoting sexual pleasure and hygiene. While it was found that the images in advertising to reflect changing gender relations in the field site, this research also points to enduring gender scripts in Indonesian culture: men should be virile, women should be clean and attractive.
... In the initial phase of this project, our research team sought to survey the many chemicals that young people use in their everyday lives, as well as what these chemicals 'do' for them (cf. Hardon, Idrus, & Hymans, 2013). ...
Background
Amid growing concerns about methamphetamine use in Southeast Asia, one important lesson from the field is that the drug serves various ‘functions’ for its users. The current study explores the functions of methamphetamine (locally known as shabu) in the economic and social lives of a community of underclass young men in a Philippine port.
Methods
Semi-structured interviews and focus group discussions were conducted with 20 young men (aged 18-25), most of whom worked as street vendors. Participant observation was carried out for 12 months.
Findings
Methamphetamine use led these young men to experience various desirable effects: increased strength and confidence, disinhibition, insomnia, and an overall improvement of mood that facilitates performance at work and social bonding in their peer group. Methamphetamine, in short, is seen as a ‘performance enhancer’ (pampagilas). While young people were aware of the legal, economic, and physiologic risks of using methamphetamine, these risks were outweighed by the perceived benefits in the context of an informal economy where opportunities are limited.
Conclusion
Drug policies and programs in the Philippines must acknowledge the economic and social role of methamphetamine in the daily lives of young men. This group need skills training and opportunities to move out of an informal economy that generates the demand for drugs to enhance performance – necessary in an arena where performance means survival.
... Fieldwork in South Sulawesi took place in two phases. The first involved a "grand tour" of all kinds of chemicals consumed by young people, including cosmetics, energy drinks, contraceptives and mood-enhancing drugs, the results of which have been published elsewhere (Hardon et al., 2013). The second phase of the project involved focused ethnographies of chemical practices that appeared central in the everyday lives of specific subgroups of young people. ...
The use of psychoactive prescription drugs (PPDs) by young people is part of a broader worldwide trend towards the consumption of pharmaceuticals to improve social, emotional, and sexual performance. Few studies have examined how young people use PPDs in developing countries, where off-label use is likely to be greater due to weaker market controls. This study presents our findings on PPD use among sex workers in Makassar, Indonesia. We focus on one potent painkiller, Somadril, which is freely available over the counter in pharmacies. The sex workers we studied used most of their earnings to purchase Somadril pills, which they used to feel more confident and to make their work more palatable. This paper also traces the history of the active component in Somadril, carisoprodol. This was developed in the United States, where it was soon used recreationally. We found that knowledge of its effects seeped from health professionals into youth networks, where it was spread by word of mouth. The flow of information on carisoprodol's harmful effects, however, was less evident.
This research focusses on low mood as a generic category in everyday social interactions, outside the clinical realm and among non-patients. We examine if and how a clinical depression label and treatment are employed when low mood occurs in everyday life, which enables us to analyze the extent and content of medicalization and brings to the fore the interactional mechanisms and cultural concerns that potentially drive medicalization. The analysis is based on 316 observations of everyday life in the Netherlands. We observed and recorded interactions in which low mood was spontaneously expressed.
http://doi.org/10.1016/j.socscimed.2017.04.025
The chapter focuses on the global spread of psychopharmaceuticals, discussing how in 1990s psychopharmaceuticals were cast as heralding a new era of treating mental ills. Yet this hope, or hype, started to wane in the 2000s, and even large pharmaceutical companies are now withdrawing from this segment. Doubt about psychopharmaceuticals has even gained ground in the more recent policies of the World Health Organisation, which has moved from advocating drugs as the best first-line treatment to a greater emphasis on non-pharmacological therapies.The “public lives” of drugs that are captured by WHO treatment gap calculations are shown to be cut off from the “private lives” of psychopharmaceuticals in the prescriptions of nonspecialists in the private market. Drugs are circulating far more widely than is known, and the influence of manufacturers onto prescription patterns is far stronger than is assumed.
The recent opening of Indonesia to global markets have led to an increment of flows of images closely connected to corporal appearance and the availability and popularization of different technologies to modify the body. These changes have impacted significantly on waria (male-to-female transvestites), who have redefined their bodies as “market commodities” to accomplish illusions of freedom and redefine their position within the society. In a context where waria are strongly discriminated (socially, economically and religiously), silicone injections and female hormones have become noteworthy `life-enabling´ practices used to subsist on the margins and get over gender and religious discrimination. This chapter proposes an exploration of how waria consume these practices in a changing and competitive society and how they have transformed waria's subjectivity.
Betel quid chewing is associated with various oral cancers and other health concerns, including reproductive health issues. Nevertheless, the practice is widespread in Myanmar, especially among men. This qualitative study elucidates the gendered aspects of betel quid chewing by examining how it links with masculine ideology among male betel quid chewers in Mandalay, Myanmar. Data were collected through in-depth interviews, focus-group discussions, key-informant interviews and participant observation. The thematic content analysis was guided by Connell's concept of hegemonic masculinity and Butler's notion of gender performativity. The findings indicated that young Mandalay men were drawn to betel quid chewing by the value they gave to satisfying their curiosity, power competition, risk-taking and a display of manliness. Thus, the practice of betel quid chewing, as defined by our participants, was perceived as manly, trendy, stylish and sexually attractive. For adult men, betel quid chewing was a social lubricant that assisted them in talking with clients and co-workers, thus enhancing their economic opportunities with other men. It also helped working-class men to work harder. Betel quid chewing harm-reduction programmes therefore need to be mindful of masculinity issues as well as the economic aspects of betel quid chewing.
In this chapter, we update and extend our previous analysis of drug use among youth and emerging adults (aged 18-25) in North America (Quintero and Nichter 2011) and reiterate a call for ethnographies of pharmakon: substances that straddle the medicine-drug continuum used as resources in the everyday self-management of bodies, minds, moods, and identity in what some researchers have come to refer to as the regulation of chemical selves .We update some trends previously covered in our 2011 chapter and draw attention to emerging trends in tobacco, cannabis, and prescription psychoactive drug (PPD) use. We also draw attention to displays of alcohol and drug consumption in digital spaces and the extent to which it renders substance use normative. Focusing attention on consumption posts and displays in social media further provides us an opportunity to examine gender dimensions of drug use and identity management not covered in our original chapter. In addition to highlighting evolving trends in substance use, we suggest issues demanding future anthropological research. In our conclusion, we specifically address the need for research on substance use among youth for recreational and self-medication purposes in the time of COVID-19.
The everyday lives of contemporary youths are awash with drugs to boost pleasure, moods, sexual performance, vitality, appearance and health. This paper examines pervasive practices of chemical 'self-maximization' from the perspectives of youths themselves. The research for this paper was conducted among male, female and transgender (male to female, so-called waria) sex workers in Makassar, Indonesia. It presents the authors' ethnographic findings on how these youths experiment with drugs to achieve their desired mental and bodily states: with the painkiller Somadril to feel happy, confident and less reluctant to engage in sex with clients, and contraceptive pills and injectable hormones to feminize their male bodies and to attract customers. Youths are extremely creative in adjusting dosages and mixing substances, with knowledge of the (mostly positive) 'lived effects' of drugs spreading through collective experimentation and word of mouth. The paper outlines how these experimental practices differ from those that have become the gold standard in biomedicine.
Against a background of significant social change
experienced by Spanish women from the 1960s onwards, new
gender identities and conflicts have emerged. These factors have
barely been taken into account in the research work done in
Spain. This article looks into the conversations of young people
concerning their relationship with risky sexual behaviour,
recreational drug use and sexual identity. Drawing from a
qualitative study of discussion groups and semi-structured
interviews with young recreational drug users, the article
suggests that there are at least two models of femininity among
the recreational drug consumers that have taken part in this
study. First there is a traditional romantic model whereby young
women associated risky sexual behaviour with being in love or
trusting in the partner. Here the young woman does not link her
sexual behaviour to the effects of using recreational drugs but,
rather, to the characteristics of her emotional relationship.
Second, there is a model of new values and gender roles that are
closer to those traditionally associated to males, where the young
women use recreational drugs as a form of empowerment to take
on new situations concerning their sexuality. The article analyses
the perceptions of risk among the different identity groups,
along with the negotiations to begin sexual relations and the use
of the condom in these groups of recreational drug users. Issues
for policy and practice are also briefly considered.
Microbicides are most usually conceptualised within a disease prevention framework and studies usually define acceptability in terms of product characteristics, willingness to use and risk reduction. This starting point has led to assumptions about microbicides which, rather than being challenged by empirical studies, have tended to foreclose the data and subsequent conceptual models. Few studies take an emic ('insider') perspective or attempt to understand how microbicides fit into the broader context of women's and men's everyday lives. As part of the integrated social science component of the MDP301 Phase III microbicide trial, in-depth interviews were conducted with female trial participants in South Africa, Zambia, Tanzania and Uganda. Women's experiences of the gel challenge several assumptions that have commonly been reiterated about microbicides. Our analysis suggests that current definitions and conceptual frameworks do not adequately account for the range of meanings that women attribute to gel. Even within the context of a clinical trial, it is possible to obtain a richer, ethnographic and cross-cultural concept of acceptability based on women's practice and emic interpretations. We now need to move beyond limited notions of acceptability and consider how microbicides fit into a more holistic picture of women's and men's sexuality and sexual health.
Between 2005 and 2006, we investigated vaginal practices in Yogyakarta, Indonesia; Tete, Mozambique; KwaZulu-Natal, South Africa; and Bangkok and Chonburi, Thailand. We sought to understand women's practices, their motivations for use and the role vaginal practices play in women's health, sexuality and sense of wellbeing. The study was carried out among adult women and men who were identified as using, having knowledge or being involved in trade in products. Further contacts were made using snowball sampling. Across the sites, individual interviews were conducted with 229 people and 265 others participated in focus group discussions. We found that women in all four countries have a variety of reasons for carrying out vaginal practices whose aim is to not simply 'dry' the vagina but rather decrease moisture that may have other associated meanings, and that they are exclusively "intravaginal" in operation. Practices, products and frequency vary. Motivations generally relate to personal hygiene, genital health or sexuality. Hygiene practices involve external washing and intravaginal cleansing or douching and ingestion of substances. Health practices include intravaginal cleansing, traditional cutting, insertion of herbal preparations, and application of substances to soothe irritated vaginal tissue. Practices related to sexuality can involve any of these practices with specific products that warm, dry, and/or tighten the vagina to increase pleasure for the man and sometimes for the woman. Hygiene and health are expressions of femininity connected to sexuality even if not always explicitly expressed as such. We found their effects may have unexpected and even undesired consequences. This study demonstrates that women in the four countries actively use a variety of practices to achieve a desired vaginal state. The results provide the basis for a classification framework that can be used for future study of this complex topic.
Since the 1994 International Conference on Population and Development, the need for sexuality education for youth has been articulated, and numerous activities in Indonesia, especially Java, have been directed at young people. However, many parents, teachers and religious leaders have considered it essential that such education should suppress youth sexuality. This article reflects upon current discourses on youth sexuality in Java as against the actual sexual behaviour of young people. Using examples from popular magazines and educational publications, and focus group discussions with young men and women in Surabaya, East Java, we argue that the dominant prohibitive discourse in Java denounces youth sexuality as unhealthy, reinforced through intimidation about the dangers of sex. In contrast, a discourse of competence and citizenship would more adequately reflect the actual sexual behaviour of youth, and raises new challenges for sexuality education. Information should be available to youth concerning different sexualities, respecting the spectrum of diversity. Popular youth media have an especially important role to play in this. The means to stay healthy and be responsible--contraceptives and condoms--should be available at sites where youth feel comfortable about accessing them. Meanwhile, young Indonesians are engaging in different forms of sexual relationships and finding their own sources of information, independent of government, religion and international organisations.
Since the ICPD in 1994, the Government of Indonesia has struggled with the challenge of providing sexual and reproductive health education to adolescents. Following an attempt at a family-centred approach, a pilot project was carried out in Central and East Java to train peer educators, coordinated by the National Family Planning Coordinating Board (BKKBN). A total of 80 peer educators (male/female teams) carried out small-group information sessions in ten different districts. Over 1,300 adolescents attended in all. Forty peer counsellors in 20 teams then carried out five outreach sessions each in their communities, attended by nearly 4,000 adults and adolescents. Educators chosen were older in age, knowledge level, authority and communication skills than adolescents, but were well accepted as mentors. Adolescents wanted to know how to deal with sexual relationships and feelings, unwanted pregnancy and STDs. With 42 million Indonesian adolescents needing information, the government cannot produce enough manuals to satisfy demand. New strategies are required to put information in the public domain, e.g. via the media. The approach described in this paper would probably be beyond the staffing and resource capacity of most districts in Indonesia. Nonetheless, it shows that there was great enthusiasm across a variety of communities for efforts to educate young people on protecting their reproductive health.
This paper is a review of studies on the acceptability of the hormonal contraceptive methods used most extensively in family planning programmes worldwide: the pill, injectables and implants. It aims to elucidate women's views and experiences with these methods, and how they use them. Studies show that women dislike taking a pill every day and fear the effects of hormonal methods on their health. Given the high discontinuation rates found for the oral pill and three-month injectables, there appears to be a demand for further development of new and existing methods, so that they need not be taken daily and will cause minimal menstrual disturbances, such as once-a-month injectables and pills, and early abortifacients. To better understand users' views of hormonal contraceptives, more studies are needed that focus on women and their changing needs for fertility regulation, shedding light on their preferences, experiences and practices.
Introduction: the body as representation and being-in-the-world Thomas J. Csordas Part I. Paradigms and Polemics: 1. Bodies and anti-bodies: flesh and fetish in contemporary social theory Terence Turner 2. Society's body: emotion and the 'somatization' of social theory M. L. Lyon and J. M. Barbalet Part II. Form, Appearance and Movement: 3. The political economy of injury and compassion: amputees on the Thai-Cambodia border Lindsay French 4. Nurturing and negligence: working on others' bodies in Fiji Anne E. Becker 5. The silenced body - the expressive Leib: on the dialectic of mind and life in Chinese cathartic healing Thomas Ots Part III. Self, Sensibility, and Emotion: 6. Embodied metaphors: nerves as lived experience Setha M. Low 7. Bodily transactions of the passions: El Calor among Salvadoran women refugees Janis H. Jenkins and Martha Valiente 8. The embodiment of symbols and the acculturation of the anthropologist Carol Laderman Part IV. Pain and Meaning: 9. Chronic pain and the tension between the body as subject and object Jean Jackson 10. The individual in terror E. Valentine Daniel 11. Rape trauma: contexts of meaning Cathy Winkler 12. Words from the Holy People: a case study in cultural phenomenology Thomas J. Csordas.
IntroductionEmerging Drug Use Trends in Socio-Cultural ContextConclusion
ReferencesFurther Reading
Hyperpigmentation disorders and skin lightening treatments have a significant impact on the dermatologic, physiologic, psychologic, economic, social, and cultural aspects of life. Skin lightening compounds, such as hydroquinone and topical corticosteroids, are often used to treat hyperpigmentation disorders, such as melasma, or lighten skin for cosmetic purposes. Despite their established effectiveness, a multitude of dermatologic and systemic complications have been associated with these agents. Regulatory agencies have also recognized the adverse effects of skin lighteners and many countries around the world now forbid the production and sale of these compounds, although this prohibition has not significantly curtailed distribution. Dermatologists and users of cosmetic products should be aware of the various components in bleaching compounds, their potential adverse effects, and alternative options for skin lightening.
Cytotec, the commercial name for misoprostol, which is a synthetic analogue of prostaglandin E1, was approved for use in Brazil in 1986 to treat gastric and duodenal ulcers. The drug can and has also been used to induce abortion, which has created controversy in a country in which induced abortion is illegal. A study of the drug was undertaken in 1992 that included analyses of the drug's sales profile, of information published by the media, and of its use from women's and gynecologists' points of view, the latter examined using qualitative methodologies. The analysis of Cytotec's sales volume showed quick growth from its introduction until the first half of 1991, when its use was restricted by the Ministry of Health. For women, Cytotec's main advantages have been that it is relatively inexpensive, convenient to use, and can be used in private. Data obtained from gynecologists show that Cytotec's addition to the obstetric therapeutic arsenal was welcome and also confirmed the drug's influence in reducing the complications of illegal abortions shown in other studies.
DKT Indonesia, a social marketing enterprise, undertook research among young people in Indonesia to develop a strategy to heighten understanding of safer sex and increase the availability and use of condoms among sexually active youth. The centerpiece of this campaign was the launch in 2003 of Fiesta condoms, with a range of flavours, colours, shapes and pricing aimed to appeal to young people. Working with key commercial and NGO partners, distribution has focused on places where young people often congregate and shop. The campaign relies heavily on the media, including TV commercials, radio talk shows, print media and mobile text messaging. DKT has also partnered with MTV, the Staying Alive campaign and other NGO and private sector partners to educate young people on a range of reproductive and sexual health issues. Based on retail audits and focus group discussions, the Fiesta brand has been a success. In three years, it has gained a 10% share of the condom market and helped to increase overall condom sales by 22%. Young people identify Fiesta as "their" brand and have started to use Fiesta condoms in significant numbers.
For developmental as well as epidemiological reasons, young people need youth-friendly models of primary care. Over the past two decades, much has been written about barriers faced by young people in accessing health care. Worldwide, initiatives are emerging that attempt to remove these barriers and help reach young people with the health services they need. In this paper, we present key models of youth-friendly health provision and review the evidence for the effect of such models on young people's health. Unfortunately, little evidence is available, since many of these initiatives have not been appropriately assessed. Appropriate controlled assessments of the effect of youth-friendly health-service models on young people's health outcomes should be the focus of future research agendas. Enough is known to recommend that a priority for the future is to ensure that each country, state, and locality has a policy and support to encourage provision of innovative and well assessed youth-friendly services.
Methamphetamine (MA) has become the leading drug of abuse in northern Thailand over the past several years, particularly among youth. The current qualitative study examines factors associated with initiation of MA use.
Between March 2002 and January 2003, 48 in-depth interviews with young MA users were conducted in advance of a randomized, MA harm reduction, peer outreach intervention trial. The interviews were conducted in the city of Chiang Mai and the surrounding district. Data were inductively analyzed using the constant comparative method common to grounded theory methods. Atlas-ti was used for data management.
Participants were 57% male and had a median age of 20 years (range 15-31 years). A culture of MA ubiquity characterized participants' initiation stories. Drug ubiquity encompassed three elements: the extent of MA use within peer networks; the availability of MA; and exposure to MA before initiation. All participants were introduced to MA by people close to them, most often by their friends. Internal reasons for trying MA were curiosity, a way to lose weight or to enhance hard work, and a way to "forget life's problems." With the prevalence of MA use among participants' peers, initiation seemed inevitable.
Initiation was characterized as ubiquitous in terms of peer networks' use and availability. Because of the prevalent norm of MA use, these data indicate that interventions targeting social networks and young Thais before MA initiation are needed.
Topical vaginal microbicides are being developed to reduce HIV infection in women for whom correct and consistent condom use is impossible or undesirable. Although microbicides have been heralded as a "women-initiated" method that requires no action of the male partner, gender norms for sexual relationships and sexual practices could impede acceptability and use. To facilitate development of microbicides and look ahead to their eventual introduction, it is necessary to understand couples' sexual dynamics, including power and pleasure. This article presents data from a study of microbicide acceptability ancillary to a microbicide clinical trial in Malawi and Zimbabwe. Female trial participants, male partners, health care professionals and community stakeholders were interviewed about norms for sexual decision-making, sexual pleasure, and associated intravaginal practices that ensure this pleasure. Even though acceptability of microbicides was found to be high, sexual intercourse is accompanied by issues of power and gender norms that place women, particularly those in stable union, at a disadvantage for enactment of risk reduction strategies. Although woman-initiated use is an important goal in development of microbicides, the need for men's cooperation or agreement must be addressed in strategies for future product introduction.
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