Hymen ‘repair’: Views from feminists, medical professionals and the women involved in the middle east, North Africa and Europe

In Europe, hymen ‘repair’ is controversial because it is often seen as a concession to immigrant groups that do not respect women’s sexual autonomy. But how is hymen ‘repair’ viewed in societies in which the norm is that women should not have premarital sex? And why do women want hymen ‘repair’? Hymen ‘repair’ is also controversial in Middle Eastern and North African (MENA) countries because it is seen as undermining social mores about women and premarital sex. However, some Islamic leaders have defended the procedure. Women request hymen ‘repairs’ for a variety of reasons. Some have been sexually abused and may desire the surgery to overcome trauma. Some have had consensual sex and may fear sanctions, while others may see the surgery as a covert act of rebellion against the virginity rule. Still others may choose it to please their future husband. Hymen ‘repair’ is extensively discussed in MENA countries and in Europe. Feminists in MENA countries are divided over whether the surgery promotes sexual autonomy while, in the European debate, an important issue is whether the choice itself is an autonomous one that doctors should respect. Inspired by a relational approach to autonomy, I see the women involved as individuals with culturally informed identities and interests who may feel pressure to get the surgery yet are still capable of autonomy. I argue for a policy to stimulate debate in communities about the virginity norm and to make hymen ‘repair’ available to women. However, it should be combined with an attitude of sympathetic distrust, recognising that hymen ‘repair’ harms women’s dignity and authenticity.

Culturally Informed Services in Tribal Communities

Indigenous populations have experienced hundreds of years of historical trauma, systemic racism, and oppression since colonization began in the Americas, Australia, and New Zealand. Settler colonialism has created and continues to perpetuate historical and ongoing trauma and systemic racism in Indigenous populations. Despite considerable diversity and resilience among Indigenous populations globally, there is a clear pattern of significant disparities and disproportionate burden of disease compared to other non-Indigenous populations, including higher rates of poverty, mortality, substance use, mental health and health issues, suicide, and lower life expectancy at birth. Substantial gaps related to access to healthcare and service utilization exist, particularly in low-income Indigenous communities. Implementation and sustainment of White dominant-culture frameworks of care in Indigenous communities perpetuate these systems of oppression. Development and implementation of culturally informed services that address historical trauma and oppression, and systematically integrate concepts of resiliency, empowerment, and self-determination into care, are issues of policy as well as practice in social work. The co-creation and subsequent implementation, monitoring, and sustainment of effective systems of care with Indigenous populations are essential in addressing health disparities and improving outcomes among Indigenous populations globally.

The Christianizing the Home Movement

The ecumenical National Christian Council of China (ncc) was the institutional home to an important religious and social campaign: the Christianizing the Home Movement. This article traces the development of this movement from the ncc’s founding in 1922 until the Second World War disrupted its activity. This home- and family-centered movement was a site of female empowerment, and the expansive topics it addressed show women’s desires to serve and lead in a broad set of arenas. This article shows how the Chinese women who led the Christianizing the Home Movement built and shaped a movement and describes the nationwide network of leaders that carried it out, promoting an ideal of Christian family that was culturally informed and progressive.

‘The wairua first brings you together’: Māori experiences of meaningful connection in neurorehabilitation

Background and Aims: Therapeutic connections enhance patient experience and outcomes after neurological injury or illness. While we have some understanding of the components necessary to optimise therapeutic connections, these have developed from western-centric ideals. This study sought to explore the perspectives of Māori brain injury survivors, and their whānau (wider family and community), to develop more culturally informed understandings of what matters most for Māori in the development and experience of therapeutic connection. Design and Methods: A bicultural approach underpinned by principles of Kaupapa Māori Research was used. Whānau views and experiences were gathered through wānanga (focus groups). These perspectives were analysed drawing on Māori methods of noho puku (self-reflection), whanaungatanga (relational linkage) and kaitiakitanga (guardianship). Findings: Three wānanga were held with 16 people – 5 brain injury survivors and 11 whānau members. The phrase ‘therapeutic connection’ did not resonate; instead, people spoke of meaningful connections. For rehabilitation encounters to be meaningful, three layers of connection were acknowledged. The elemental layer features wairua (spirit) and hononga (connection) which both underpinned and surrounded interactions. The relational layer reflects the importance of whānau identity and collectivism, of being valued, known, and interactively spoken with. Finally, the experiential layer consists of relational aspects important within the experience: relationships of reciprocity that are mana-enhancing and grounded in trust. These layers are interwoven, and together serve as a framework for meaningful connections. Conclusions: Meaningful connections in neurorehabilitation are underpinned by wairua and hononga; are multi-layered; are enabled through interactions with people, practice, process and place; are inclusive of whānau and resonate with Māori worldviews. The primacy of wairua and whānau within an interconnected view of health, challenges individualistic notions inherent in western health models and deepens existing understandings of meaningful connections in neurorehabilitation which can guide future rehabilitation research, teaching and practice.

A Scoping Review of the Experiences of Violence and Abuse Among Sexual and Gender Minority Migrants Across the Migration Trajectory

Violence against sexual and gender minority (SGM) individuals has continued to proliferate globally. Yet, less is known about victimization among subgroups of SGM individuals, especially SGM immigrants, refugees, and asylum seekers. There has been a steady increase in this vulnerable group of migrants over the years, and emerging evidence has pointed to their heightened risk of victimization. We conducted a scoping review of the peer-reviewed literature that examined violence, abuse, and mental health among SGM individuals who migrate internationally. One hundred ninety-nine articles were identified by searching five scholarly databases and hand searching. Twenty-six articles met inclusion criteria. We first used the migration framework, which outlines the distinct phases of the migration trajectory (predeparture, travel, interception, destination, and return), to categorize findings and then identified four overarching themes to capture SGM migrants’ experiences at each phase: severe and prolonged violence and abuse related to sexual orientation or gender identity (predeparture); continued victimization and high-risk for sexual violence (travel); detainment- and deportation-related violence and abuse (interception and return); and new manifestations of violence and abuse while living with past trauma (destination). Violence and abuse began in childhood and continued in the host country, where they faced discrimination while managing posttraumatic stress disorder and depression. Findings indicate that SGM migrants are extremely vulnerable to victimization. There is an immediate need for policies to protect SGM individuals worldwide and for affirmative, culturally informed practices to help SGM migrants manage trauma and the structural barriers impeding recovery.

Negotiating Authenticity in Technological Environments

Essentialists understand authenticity as an inherent quality of a person, object, artifact, or place, whereas constructionists consider authenticity as a social creation without any pre-given essence, factuality, or reality. In this paper, we move beyond the essentialist-constructionist dichotomy. Rather than focusing on the question whether authenticity can be found or needs to be constructed, we hook into the idea that authenticity is an interactive, culturally informed process of negotiation. In addition to essentialist and constructionist approaches, we discuss a third, less well-known approach that cannot be reduced to any of the two forms. This approach celebrates the authenticity of inauthenticity by amplifying the made. We argue that the value of (in)authenticity lies not in choosing for one of these approaches, but in the degree to which the process of negotiating authenticity enables a critical formation of selves and societies. Authenticity is often invoked as a method of social control or a mark of power relations: once something is defined as authentic, it is no longer questioned. Emerging technologies—especially data-driven technologies—have the capacity to conceal these power relations, propel a shift in power, and dominate authentication processes. This raises the question how processes of authentication can contribute to a critical formation of selves and societies, against the backdrop of emerging technologies. We argue in favor of an interactionist approach of authenticity and discuss the importance of creating space in authentication processes that are increasingly influenced by technology as an invisible actor.

“You Do It Through the Grapevine”: A Bourdieusian Analysis of Under-Age Access to Tobacco Among Adolescents From Seven European Cities

Despite efforts to reduce adolescent smoking via minimum age-of-sale legislation, many young people continue to access tobacco through a mix of social and commercial sources. Little is known about the roles of habitus, capital, and social topographies in shaping under-age access to tobacco. This article draws on Bourdieu’s theory of practice and data generated from 56 focus groups with 14- to 19-year-olds across seven European cities to answer the question “via what sources and by what means do adolescents obtain tobacco?” We find that adolescents use a range of personal capitals (social, cultural, and economic) to access tobacco, with the specific constitution and deployment of these capitals varying according to the regularities of different fields. Since adolescents access tobacco via culturally embedded practices, attempts to curtail this access are more likely to be effective if they are multi-pronged, culturally informed, and attuned to the lived experiences of adolescent smokers.

Educating nursing students for cultural competence in emergencies: a randomized controlled trial

Background Racial and ethnic minorities suffer significantly more than others in the wake of disasters. Despite the growing recognition of the importance of culturally competent health services, systematic cultural competence training in the medical education system is still scarce, especially in the field of emergency. The current study aimed to examine the effectiveness of an online culturally informed intervention for increasing cultural competence in emergencies among nursing students. Methods A randomized controlled trial was used to test the intervention effectiveness in increasing nursing students’ cultural competence in four domains: attitudes, knowledge, skills, and encounters. The study included 72 undergraduate nursing students recruited from two academic institutes. Participants were randomized (1:1 ratio) to an intervention (n = 34) and control group (n = 38). The study adheres to the Consolidated Standards of Reporting Trials (CONSORT). Data analysis was based on multivariate analysis of variance with repeated measures, followed by post hoc analyses with Bonferroni correction for multiple comparisons. Results Results showed that the intervention was effective in increasing the participants’ culturally competent knowledge. The effect of the intervention on the skills domain approached significance. No group differences were identified in the attitudes and the encounters domains. Conclusions An online culturally informed intervention, incorporated in the curriculum, was effective in enhancing the cognitive aspect of cultural competence (especially at the basic knowledge and understanding levels), but not other domains. Our results encourage the development of future intervention programs that are based on a deep understanding of local values, needs, and preferences.