Distributing Condoms and “Hope”: Race, Sex, and Science in Youth Sexual Health Promotion

This book manuscript in preparation is based on my dissertation project of the same name. “Distributing Condoms and ‘Hope'” uses discursive, visual, and ethnographic approaches situated in a critical feminist methodology to understand how ways of knowing about youth sexuality and reproduction influence community health work. I understand the “problem” in this inquiry as the discursive contexts that limit critical ways of knowing about young people’s sexual subjectivities and practices and about the design of policies and programs. Although race, class, gender, and sexuality are understood in the public health literature as important social determinants of health, there is a lack of research that applies a critical, feminist lens to these constructs.

I draw on three years of ethnographic research in “Stockton,” a small, northeastern city with a large Puerto Rican population and high rates of teen pregnancy to illustrate how community health workers take up and transform discourses of race, science, and sexuality as well as how teen parents situate their embodied experiences within these discourses. I combine interviews with key informants, participant observation at coalition meetings and community events, and visual analysis of stories produced by pregnant and parenting young women to argue that the production of authoritative racialized, sexual scientific knowledge both obscures and contributes to health and social inequalities.

In Stockton, youth sexual health promotion is always already about teen pregnancy prevention and teen pregnancy is always already about race, teen parents themselves are generally invisible and silent, race and sexuality are continuously invoked without without ever naming racism or sex, and a selective uptake of scientific discourses affects both knowledge and practice. The politics of youth sexuality and reproduction in the city easily reify what everyone “knows to be true” and enable community health workers to naturalize claims about race, culture, sexual health, and causality. A neoliberal logic allows sexual health promoters to emphasize high teen birth rates, low high school graduation rates, and large numbers of families living in poverty—all consequences of inequality—but privatize responsibility for these inequalities by distributing condoms and hope. Significantly, “Distributing Condoms and ‘Hope'” makes visible the workings of the teen pregnancy prevention industrial complex, my term for framing the web of relationships, policies, money, and professional identities associated with individual and collective actors service providers, community-based organizations, committees, coalitions, research projects, programs, and grants in Stockton. This term is intentionally political and intended to draw attention to the possibilities for social transformation that are foreclosed by a myopic focus on preventing teen pregnancies in the context of a broadly conceived “youth sexual health promotion.”

I follow Sara McClelland and Michelle Fine (2008) in arguing for a “critical sexuality science” that “suspends the ‘givens’ of adolescent sexualities.” This science would not hide inequality in the language of “giving” hope and opportunity, but instead acknowledge the embodiment of “sexual subjectivities situated in larger yearnings for a life of economic, intellectual, and civic possibilities” (p. 67). In “asking more,” a critical sexuality science dares to interrogate that which is always already assumed. It does not merely aim to prevent certain outcomes but instead promotes agentic sexuality for all people. The productive power of a critical sexuality science lies in its potential to fully respond to the complexities of sex in a world marked by power imbalances.

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