Written in May 2010. Reformatted in 2018.
The body, as a physical entity and a cultural construct, is frequently designated as the unit of human value, particularly where gender, sex, and ethnicity are concerned. The idea that some bodies are inherently worth “less” than others directly leads to the spread of HIV infection within the United States, and HIV infection—or worse, AIDS itself—compounds the view that marginalised people are “worth less” than others because of the intense stigma associated with HIV infection.
In particular, non-white people and gender-variant people experience an inordinate amount of culturally sanctioned oppression based on the worth of their bodies that leads to their susceptibility to contract AIDS, and limits their freedom to experience the self-determination which they deserve. This manifests through social marginalisation; limited educational opportunities; cultural erasure; and overt racism, transphobia, homophobia, and sexism. In essence, people in power construct— whether subconsciously or consciously—mythologies to explain social and cultural differences in a way that emphasises their subordination. These mythologies are infused with Judaeo-Christian doctrine, Western sexist and racist practices, and personal prejudices. This form of mythologized oppression prevents people from having the right to themselves. Having the right to oneself, without the encumbrance of unfavourable mythological social constructs, can be a central element in making sure that one is capable to make decisions that positively affect their health.
The construct of gender/sex essentialism creates an insurmountable barrier for transgender people, simply because it is so pervasive in society. Manhood is centred in the penis; womanhood—or, at the very least, not-manhood—is defined by its absence. Sexual essentialism is an ancient philosophy, stemming in part from Judaeo- Christian doctrine, in which the sexual binary is apotheosised through the archetypical biblical myth of Adam and Eve. Eve is the lesser one, the seducer of Adam and the bearer of sin; Adam is greater, and is “fully human,” not merely formed from a rib. Even the salvation of woman from her eternal damnation is predicated on her presumed physical function: she will be saved through childbirth, which is currently not possible for trans women. The barriers of Male and Female are impermeable in this philosophy, and the Bible, as well as other religious works that draw inspiration from its texts, like the Koran and the Book of Mormon. This is somewhat strange, considering the primacy of soul over body within this religious tradition, but even with the concept of the soul, the sexed body reigns supreme.
Sexual essentialism, or the idea that one’s identity is centred in one’s reproductive system, is a barrier which has been placed in front of transgender people in Western culture. Internal perceptions of what “I” represents as a concept are considered irrelevant: genitalia are the determiner of what someone’s gender identity “must” be. Sexual essentialism, particularly as practised by the second-wave feminists Gloria Steinem, Germaine Greer, Janice Raymond, and Mary Daly, has marginalised transgender women in particular; it designates them as “altered men,” never able to share in true womanhood because of their “incorrect” genitalia (Doyle; Serano 167). Conversely, because of their female identity, they are not seen as proper men, either: they exist in an uncomfortable space which is neither male nor female, and unworthy of the respect which is accorded those whose gender identities are commensurate with their genital configuration. There are even queer theorists, far more versed in transgender identity than Steinem, Daly, and Raymond, who cast transgender women in an “other” category, refusing transgender women the right to “true womanhood.” A. Nicki, in the article “Women’s Spaces Are Not Trans Spaces” exemplifies this, claiming that the inclusion of trans women in women’s spaces “oversimplifies the unique gender identities of transsexuals,” placing them in a category which is neither woman, nor man (Scott-Dixon 154). This mentality designates transgender people as “other,” and alienates them from other people who share their gender identity. While Nicki attempts to be friendlier to transgender people than the more vitriolic Daly, Steinem, and Raymond, she contributes to the sexual essentialism that has placed trans people in marginalised social spaces.
When one’s human identity is dismissed in favour of strict rules which define the precise boundaries of manhood and womanhood, people find themselves in a subordinate position in society, unable to experience self-determination with the same ease as those whose identities conform to social expectations of what being “right” is. Others weave their own stories about them, based upon what they are told to know, and those who diverge from the designated “plot” are ostracised for it. They are told that they do not matter: solely the other person’s perceptions, and society’s strictures, have any significance whatsoever. Transgender, genderqueer, and other people who do not fit into the genital-centred sexual binary simply do not, or cannot, exist because society’s Grand Narrative has not written a part for them.
Sexual essentialism is not the only obstacle which transgender people must face in asserting themselves in the face of social oppression. There is also the erroneous notion that transgender people—women in particular—are hypersexual beings with acquisitive sexual appetites that cannot be satiated through normal, “morally correct” means. They are defined by sexual avarice, not the puritanical sexuality which the arbiters of appropriate behaviour define. Some of this is also an element of associating transgender women with their assigned sex, rather than their constitutional femaleness: “men” are sexually greedy; women are receptive and passive, and as trans women are merely “men” in female guise, they must harbour the all-consuming male libido that separates the sexes in traditional sexual cultural mythology. (Caveant lectores et lectrices: I use the word “sexes,” rather than “genders” here, to illustrate the binary-fixated mindset on which people base their notion of transgender women’s sexuality.) These views can hardly be mitigated with the existence of specialist “she-male” and “tranny” pornography that plays on such objectifying stereotypes.
Particularly relevant to the HIV risk of transgender people is the problem of binary-centred sex education. Sex education, unless it is highly progressive, is predicated on a binary sex model: there is “women’s health,” and there is “men’s health.” When I surveyed the health materials offered at my health provider’s clinic, I saw no guides that presumed the existence of transgender, intersex, and other people whose bodily configuration might not be “typical.” A “women’s” health guide—that is, one which solely focused on the experiences of non-transgender women—would not be sufficient for a trans woman, but a “men’s” one would be insulting to her identity. The gender-variant body is erased from consciousness; it is not sufficiently relevant for health guides to consider it as something which needs to be protected. Because some people whose gender identities, expressions, or sexual configurations are not represented, it is far more difficult for such people to find accurate, culturally sensitive, and appropriate information that can allow them to lower their HIV risk. It is also alienating, perpetuating the notion that those who do not adhere strictly to the Holy Gender Binary cannot exist and do not deserve the benefits of good health.
The entrenched idea of the sexual binary is an unassailable truth for many, and far be it from them to acknowledge the existence of those who either experience asynchrony between their minds and their genitalia, or those who spurn traditional male/female dichotomies for a combination thereof, or something else entirely.
Gender is not the only category through which people’s identities are decontextualised in favour of cultural mythologies: ethnic categories, and the very category of person living with AIDS, are also subject to counterproductive mythological views that deny them the right to self-determination.
The construction of the body of colour in American popular knowledge has its roots in racist social oppression, with the idea that the non-white body is not intrinsically human. In the case of the African American body, it is a human-like automaton, fit to be sold and traded like any number of common animals, to serve the purposes of people designated as “more worthy.” The expression of self-determination from the Black community is emblematic of “stepping out of one’s place.” (Pilgrim, “Nat”) Even though the popular view of African Americans has shifted throughout American history, the very idea that Black people are inherently less valuable than White people still persists, through institutionalised and cultural racism. The Native American body is treated somewhat differently: Native Americans are “taking up space” which “rightfully” belongs to White settlers and their descendants, and they are viewed as mere interlopers who should be removed from “White space.” The perception of Latinos is rather similar with the idea that they are taking up space that belongs to others, although for them, it is the nebulous category of “real Americans,” rather than Whites as an ethnic class. They are also viewed as invaders who swarm the land of the White man, rather than equal participants in American society. Asians have been treated in a fashion akin to Latin Americans, associated with the “theft” of jobs and “taking over” the American landscape, although in much smaller numbers than Latin Americans.
In traditional American cultural mythology, Native Americans, Blacks, Asians, and Latinos exist to be subdued, re-educated, enslaved, or converted by the “heroic” White man, as an expression of his mandated Christian duty, using the language of “missions,”“Manifest Destiny,”or“our peculiar institution.”The idea of people of colour as invasive sinners is further magnified with the stereotypes about non-White people and their apparent insatiable sexual appetites (Pilgrim, “Jezebel”). For instance, Black men and women are portrayed as aggressively sexual, Asian women are portrayed as sexually available and exotic, and Hispanic men are associated with the sexist, hypersexual concept of “machismo,” regardless of their cultural origin or personal beliefs regarding women. Aggressive sexuality, particularly in women, is seen as a moral failing in the puritanical American mind, and ethnic stereotyping leads to the idea that non-White people court AIDS for themselves through “immoral” sexual practices, while ignoring that unprotected sex can exist within any population, not solely those designated as “sinful.”
Culturally sanctioned oppression towards people of colour has led to a fatalistic attitude towards physical suffering (Díaz), which I argue is a consequence of ideas which promulgate the notion that people of colour are “undeserving” of satisfying, healthy lives. When one is taught from birth that one is inferior, and is undeserving of the opportunities afforded those who belong to more privileged classes of people, there is little incentive to have the same attitude towards one’s existence as someone whose existence is celebrated and recognised within the broader cultural narrative. To extend the analogy of the narrative, people who possess White privilege are the protagonists, and people of colour are antagonists, or marginal supporting characters.
Things become still more complicated where transgender people of colour are concerned: their bodies are deemed less worthy both because of their ethnicity and their separation from culturally imposed gender and sexual norms. They are poor personages in gender- and ethnicity-based mythology, simply because they flout its strictures in myriad ways. Often, the mythologies that exist prevent them (or others) from viewing themselves as full members of their identified genders: trans women become “gay,” and trans men are “upgraded butches,” or other categories that do not affirm the genuineness of their gender identities. They are ersatz identities, mere shadows of their cisgender or gender-conforming brethren and sisters.
The construction of the AIDS body in American culture has some similarities to the representations of gender-variant and non-White bodies: they are seen as defective, and less worthy than the bodies of those who remain within sexual boundaries, or happen to be White.
There is also a somewhat religious flavour to the prejudices formed about those living with AIDS: similarly to the social perceptions of leprosy in antiquity, Kaposi’s Sarcoma lesions are the visual indicators of sexual depravity, inviting those who see them to ostracise the hapless person with AIDS. This is particularly apparent in early fictional portrayals of AIDS, such as Jonathan Demme’s 1993 film Philadelphia. In the film, Tom Hanks’s character displays increasingly prominent lesions, there to signal to the audience that Hanks is a sinner in the hands of an angry God who condemns homosexuality, and the AIDS that serves as his divine retribution.
The construct of the AIDS body as symbol of moral failure is compounded when people of colour and gender-variant people are visibly living with the syndrome: their bodies are marked, in numerous ways, as being worth less than those of HIV- negative, gender-normative, White people. It is not only that these people suffer from an illness fraught with socio-religious stereotypes; they also differ from social norms that would grant them automatic morality. Is not the Black man, or the Latina woman, or the transgender woman considered more sexual and less morally constrained than the Christian, heterosexual, cisgender, White male? AIDS in and of itself is associated with sexual depravity, and being non-White, or gender-variant, compounds the hypersexualisation of those who experience these forms of cultural oppression.
The forms of discrimination experienced by those whose bodies are marked as inferior share certain characteristics: they are corporeally centred, and they deprive those labelled with such stereotypes of the self-determination and personal identity which would empower them to seek prophylactic or follow-up treatment for HIV/AIDS infection. These people are subject to a brand of medical Calvinism: they are not the elect (that is, straight White cisgender men), so AIDS in these communities is viewed as a moral failing, caused by the “sinful” activities of injection drug use and unprotected sex. Both people of colour and transgender people, and especially those who belong to both social categories, are associated with wanton promiscuity, whether individual people are sexually promiscuous or not. Additionally, HIV-positive, non-White, and gender-variant people necessarily exist outside the Platonic ideal of “good American” (that is, White, heterosexual, cisgender, healthy, Christian, financially well-off men of English, Scottish, or German descent), which excludes them from the Grand Cultural Narrative that accords them near-automatic respect and culturally sanctioned self-determination. All of these people are indelibly “marked” by something, whether it is the colour of their skin, the ethnicity of their parents, their gender identity, their genitalia, or the virus coursing through their veins. As “marked” people, they are granted second- (or third-, or fourth-, ad infinitum) class status within American society, and lack the automatic entitlement to the recognition of their selfhood which they deserve.
The privileging of the body over more salient personal characteristics has had demonstrable ill-effects on the health of those who are stigmatised for their “inappropriate” or “disposable” bodies. People are less likely to seek assistance when they are told constantly through social stereotypes and overt racism, homophobia, and transphobia that they are less important to society, and so they put themselves in situations that would increase their level of HIV risk, simply because they believe they are not “worth” protecting themselves against HIV and AIDS, or they feel that they have been abandoned by society. When one is cast as a “sinner,” or a bit player in the cosmic White-male-led narrative, how does one conceptualise one’s needs within this restrictive philosophy?
The denial of selfhood to various groups causes them to put themselves in a position that deprives them of the self-determination required to take more active steps in their efforts to prevent the spread of HIV within their communities. When entire groups of people are considered irrelevant or disposable, the idea that they deserve the education and care needed to prevent their infection does not register in the same fashion that it would for those who have the privilege of being represented throughout mainstream culture. If they cannot matter as people to the rest of society, what right have they to pursue HIV-prevention methods?
The solution is clearly to foster social and cultural inclusion at all levels in order to reduce the risk of HIV transmission amongst those who are marginalised by current approaches to HIV prevention. This does not solely mean creating a health education system that includes groups not traditionally recognised, but instilling the importance of universal self-determination into the collective American consciousness. Education, governmental policies, and simple social interactions must reflect this, so that future generations of traditionally marginalised people will not find themselves consigned to the edges of social acceptance.
Ignoring people’s selfhood is not merely hurtful and divisive: it is deadly. People are not mere characters in a grand, sweeping narrative: human experience too large and too complex to be reduced to facile fictionalized representations. In order to reduce the risk of HIV amongst marginalized populations, it is necessary to discard these fables and adopt a school of thought that embraces the intrinsic value of everyone, regardless of sex, gender, gender identity, ethnicity, race, or any other ascribed status. The myths that deprive people of their agency are akin to the “boot stamping on a human face forever” of George Orwell’s Nineteen Eighty-Four. It is imperative to abandon these myths to ensure that this humanity-destroying, soul- crushing world will not exist for those who exist outside the traditional American narrative. We ignore the agency of individual human beings at our peril.