Sexual self-determination in Cuba: The epistemic decolonial turn

Abstract

The term 'sexual self-determination' has become a keyword for the project of sexual emancipation and the appreciation of sexual diversities in Cuba. Sexual self-determination, as a human right, allows for each individual to define his or her own orientation, condition and gender identity without the stigmatization proposed by psychiatric pathology. At the same time, the principle opens up the possibility for professionals in the fields of health and sciences to deliver care and attention within a new ethical framework. Sex education, as established by the country's feminist movement, is considered to be the means by which this new framework has been shaped in social policy. This article uses the concept of decolonial/border thinking and the epistemic decolonial turn in order to explain current changes being made in Cuban society concerning sexual diversities and identities, and the challenges these pose for global conceptions of health, ethics and human rights.

Missing in action: a scoping review of gender as the overlooked component in decolonial discourses

“…Papers that discussed (de)coloniality and engaged with gender covered a range of global health issues, from specific topic areas to broader concerns about governance and knowledge. Six papers focused on sexual and reproductive health and rights19–24 with a further two papers specifically on maternal health,25 26 while five papers focused on mental health,27–31 three papers discussed health in humanitarian settings,30 32 33 two papers focused on planetary health34 35 and one paper focused on non-communicable diseases 36. Five papers had a focus on pandemics, ranging from prevention37 to transmission38 to response,39–41 and one highlighted the challenges surrounding the production and distribution of vaccines 42.…”

“…Finally, six papers discussed changes to the broader global health architecture, exploring who holds power60 69 70 and who can dictate agendas,20 39 51 while two focused specifically on changing the approach to global health policy 59 71…”

“…Colonialism oversaw the institution of a racialised and gendered colonial hierarchy which “supposed the innate superiority of Christian European white males over every ‘other’ group”;20 37 56 60 68 eleven papers19 20 26 29 34 35 37 39 56 60 68 in our analysis discussed the ramifications of this hierarchisation of society based on the assumed value of individuals. Within this hierarchy, colonised subjects were framed as ‘less than fully rational, closer to nature and thus less than fully human’56 with gender overlayed.…”

“…Through and due to this enactment of a racialised and gendered hierarchy, ‘a series of codes, norms, typographies and ideas concerning sexuality’20 rooted in Eurocentric ideals were introduced and continue to drive gender inequities in health even today. Some papers explored the pathologisation of gender identities and sexual orientations that sit outside of what Lugones describes as the ‘modern/colonial gender system’, driven by a ‘colonial, Eurocentered capitalist construction’ of gender and characterised by ‘biological dimorphism (and) the patriarchal and heterosexual organisation of relations’ 1.…”

“…While the impacts of colonialism and coloniality on global health are well documented, seven papers20 33 35 48 50 66 69 in our study explored how a decolonial gender analysis could improve health outcomes and increase health equity. As Singh et al eloquently implore, we must move ‘beyond the performative dimensions of being gender-sensitive and decolonial, towards understanding what it means to equitably share power… in a meaningful way that challenges traditional methods’ and be explicit in considering how ‘gender intersects with other axes of power’ 33…”