International Journal of Sexual Health Itineraries of Sexology in Peru

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International Journal of Sexual Health Itineraries of Sexology in Peru
  This article was downloaded by: []On: 07 January 2013, At: 07:34Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK International Journal of Sexual Health Publication details, including instructions for authors and subscription information: Itineraries of Sexology in Peru Ximena Salazar a  & Carlos F. Cáceres aa  Unit of Health, Sexuality and Human Development, School of Public Health, CayetanoHeredia University, Lima, PeruAccepted author version posted online: 19 Dec 2012. To cite this article:  Ximena Salazar & Carlos F. Cáceres (2012): Itineraries of Sexology in Peru, International Journal of SexualHealth, DOI:10.1080/19317611.2012.751079 To link to this article: Disclaimer:  This is a version of an unedited manuscript that has been accepted for publication. As a serviceto authors and researchers we are providing this version of the accepted manuscript (AM). Copyediting,typesetting, and review of the resulting proof will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect thecontent, and all legal disclaimers that apply to the journal relate to this version also.PLEASE SCROLL DOWN FOR ARTICLEFull terms and conditions of use: article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form toanyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contentswill be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses shouldbe independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims,proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly inconnection with or arising out of the use of this material.  ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 1 Running head: Sexology in Peru Itineraries of Sexology in Peru XIMENA SALAZAR, CARLOS F. CÁCERES   Unit of Health, Sexuality and Human Development, School of Public Health, Cayetano Heredia University, Lima, Peru This research was coordinated by the Latin American Center for Sexuality and Human Rights (CLAM/IMS/UERJ) and the Institut National de la Santé ET de la Recherche Médicale (INSERM - France). Correspondence concerning this article should be addressed to Ximena Salazar, Unit of Health, Sexuality and Human Development, Cayetano Heredia University, Av. Armendariz 445, Lima 18, Peru. Email address: We thank Alain Giami and Jane Russo for their helpful comments to earlier versions of this manuscript.   Abstract At a time of increasing re-medicalization of sexuality in the region, where concerns about its social dimensions and the role of culture and structural contexts become less apparent, an exploration of the role played in recent history by other approaches, such as sexology, is  particularly relevant. This study intended to assess if, and to what extent, the field of sexology was ever established in Peru. With this goal in mind, the study built a dynamic map of    D  o  w  n   l  o  a   d  e   d   b  y   [   1   9   0 .   4   0 .   5   2 .   1   4   6   ]  a   t   0   7  :   3   4   0   7   J  a  n  u  a  r  y   2   0   1   3  ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 2 institutional arrangements, academic and clinical practices in Peru that can be linked to that tradition. Document analysis and interviews conducted with key professionals were employed. The history of sexology in Peru is relatively short. Its emergence appears fragmented in the data collected. Its most formal institutional basis, the Peruvian Society of Sexology, was established in 1986, and remained active for 15 years, when the increasing presence of non-medical  professionals challenged medical leadership and produced a medical diaspora. Sexology in Peru faced a number of obstacles to increase its level of professionalization and institutionalization. Over the past 25 years it has proved impossible to find common ground across several diverging points of view, in order to establish a real disciplinary field. This failure may be explained by the limited renovation in leadership that could reunite perspectives across disciplines that are hierarchically positioned in the world of health professions; the failure to establish clear channels of accreditation as sexologists; and most recently, the global decay of sexology as a reference field, vis-à-vis the emergence of alternative concepts such as sexual health and sexual medicine. A theoretical discussion is needed that can formulate, in the Peruvian context, a discourse and a practice that preserves links with the multidisciplinary dimensions of the sexology tradition and at the same time incorporates the diverging  perspectives of sexual medicine and sexual health and rights.  Keywords : Sexology, sexual health, sexual medicine, field, institutionalization Introduction Over the past two centuries, western views about sex have experienced significant reconfiguration, with the emergence of a biomedical discourse (‘human sexuality’) as a central    D  o  w  n   l  o  a   d  e   d   b  y   [   1   9   0 .   4   0 .   5   2 .   1   4   6   ]  a   t   0   7  :   3   4   0   7   J  a  n  u  a  r  y   2   0   1   3  ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 3 element (Foucault 1976, Weeks 1985). This discourse became instrumental in regulating sexuality in rapidly changing social contexts, defined by modernity and the industrial revolution, where reason was believed to dethrone faith as the main force of civilization. The moral discourse on sex, however, never disappeared (Hawkes & Scott, 2005); it rather coexisted with the new biomedical stance on sexual normality and pathology, assumed to be based on nature, the body and brain, and their functioning. As many have pointed out, however, the moral discourse fed into the latter, often transforming ‘sin’ into ‘sexual deviance’ (Foucault 1976). As characterized by Weeks (1985), several sources of knowledge have participated in the dynamic formulation of modern sexuality sciences, including early psychopathology,  psychoanalysis, colonial anthropology, Kinsey’s large population surveys, Masters and Johnson’s physiological research, clinical sexology, and critical gender and sexuality studies. Of those, approaches involving a clinical component include, of course, psychopathology (in the late XIX century), psychoanalysis (in the early XX Century), and modern third wave of sexology (starting in the mid 1960's, and more recently evolving into ‘sexual medicine’) (Ariès, Béjin, 1985). As Weeks (1985) points out, sexology de-stigmatized sexual concerns, was sensitive to social context and spoke in favor of sexual wellbeing, although its approach was still positivistic and prescriptive. Contrastingly, present-day sexual medicine  and andrology , clearly driven by  pharmacological developments, are focused on normative sexual performance (Giami 2004), while sexual health , a new non-clinical field, placed in the realm of public health, struggles to  become institutionalized globally as distinct from reproductive health (Cáceres, Cueto & Palomino 2008).    D  o  w  n   l  o  a   d  e   d   b  y   [   1   9   0 .   4   0 .   5   2 .   1   4   6   ]  a   t   0   7  :   3   4   0   7   J  a  n  u  a  r  y   2   0   1   3  ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 4 Given the role of principles and clinical practices of biomedicine in defining social, and even legal contexts, as well as in delimiting health, with legal consequences, any serious concern about sexual justice, sexual health and rights should understand the role played by the  biomedical discourse on sexuality. In a region such as Latin America, which subscribed Western  biomedical discourse as the hegemonic scientific discourse about health (Giami and Russo 2008), it implies looking at the presence, consistency and characteristics of discourses, practices and institutions linked to the sexology tradition. Additionally, understanding the local histories of sexology may help better assess the modes and strength of implantation of sexual medicine and the role the latter may play in the future vis-à-vis the discourse of sexual and reproductive health and rights in our countries. In this context, our research questions focused on exploring whether a field of sexology was ever constituted in Peru; if so, on understanding its srcins, the meanings attached to it, and the path it has followed to date. For this endeavor, we used Bourdieu’s concept of ‘field’ (Bourdieu & Wacquant 1992) 1 , i.e. a network, or a configuration of objective relations between positions. Methods A qualitative approach was carried, based on the following procedures: a) Systematic Document Search and Identification 1  According to Bourdieu “ field”   is defined   as  an  area   of socialization and   sociability   which  is  related,   voluntarily or involuntarily  with agents that are organized   into different interests : education, health, arts, disciplines, and institutions. These centers  of interest define   specific areas   of interest which arise from   different    positions. Bourdieu, P. Razones prácticas. Sobre la teoría de la acción, Barcelona, Anagrama, 1997    D  o  w  n   l  o  a   d  e   d   b  y   [   1   9   0 .   4   0 .   5   2 .   1   4   6   ]  a   t   0   7  :   3   4   0   7   J  a  n  u  a  r  y   2   0   1   3
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