Acción directa de la víctima

Medical anthropology is often described as an applied discipline (Inhorn and Wentzell 2012); however, this research study intends on going beyond applied anthropology, and engaging in praxis. An anthropological approach is crucial for the advancement of social policies, education, and health in Costa Rica through a more in-depth assessment of the current situation, and future needs. Anthropological praxis strives to be an all-inclusive and ‘bridging’ discipline (Rylko-Bauer, Singer, and Van Willigen 2006), which is not just the integration of practice and theory, but a

higher level of ethic and civic consciousness (Kozaitis 1997). Kozaitis defines anthropological praxis as “intellectually mediated, ethically sound and socially responsible work” (Kozaitis 1997:13). This definition seems extremely appropriate for public health as well, as all public health interventions should be guided by intellectually sound evidence, solid ethical principles, and with the aim of carrying out work for the well-being of society.

This piece of research was concerned with understanding local perceptions of sex, sexuality, and gender, and attempting to include these views in public policy and public health interventions. There is a clear imbalance of power exerted by public health authorities; communities and societies that are often neglected and not taken into consideration in the planning and implementation of public health interventions. Indigenous populations are not the exception. With this research project, I aimed to obtain valuable information regarding the implementation and viability of the sexual education program, and informing results to the Ministry of Education. Outcomes from this research have provided useful and relevant data to better adapt or adjust existing programs to minority populations and to create inclusiveness and well-being for the entire population.

I conducted the analysis of the data collected under two main theoretical approaches: queer theory, and critical theory – specifically critical pedagogy. The term queer theory may bring to mind initial impressions related to the LGBTQ movement, however, this social movement was only the starting point of this theoretical approach. Queer theory, as Cameron and Kulick (2003) frame it, is a theoretical discourse that uses critical approaches on heteronormativity. Queer theory then emerges as an appropriate framework to analytically examine “those processes that produce sexed bodies, sexed relations and – importantly – sexual desires” (Cameron and Kulick 2003, 149).

Judith Butler developed queer theory using a performativity theory lens, shifting attention on the meanings that underlie behaviors and performances; it challenges the idea that how people behave is a true expression of their identity, instead proposing that “identity is not the origin but the effect of practices of signification” (Cameron and Kulick 2003, 150). Queer theory can help redefine what we consider ‘normal’ and helps challenge traditional understandings not only by questioning gender categories and binaries, but also by deconstructing the meaning of sexuality, identity, and the language we use to refer to them (Meyer 2010).

A great amount of the philosophical groundwork out of which queer theory was developed was conceptualized by Michel Foucault (Lyons and Lyons 2011). Foucault proposed that the current discourse that surrounds sex is the result of “modern ideologies of sexual liberation” and these modern ideologies are often framed around religious discourses, which frame what counts as sexual – what is permitted, and what is forbidden (Foucault 1978b). Foucault also produced work related to the intersection of sex and education in his ‘great strategic unities’ Sexuality revolves around a set of opposing and condensed power relations, that at certain moments merge in these strategic unities. These strategic unities were: (1) the hysterization of the woman’s body, (2) the socialization of procreative behavior, (3) the psychiatrization of ‘perverse’ pleasure, and (4) the pedagogization of children’s sex (Foucault 1978b).

The inclusion of sex in school curricula allows for the diffusion of specific discourses on sex, as schools are instrumental in reinforcing the dominant values of culture in certain groups (Meyer 2010). School systems are classic examples of exertion of power through discipline, as described in Discipline & Punish (Foucault 1978a). For Foucault, a key aspect of the operationalization of power is discipline. Discipline is a form of power, where individuals are

instruments for the exercise of power. Individuals are not enforcers of power, they are embedded in the structure of discipline and power. Disciplinary power depends on three elements: hierarchical observation, normalizing judgement, and the examination (Foucault 1978a), all of which are present within school systems.

In reaction to this clear oppression and power imbalance in the school system, critical pedagogy stemmed from critical theory. Critical theory in the field of education goes beyond the traditional critiques of social class and oppression, but analyzes “how social forces work against them in overt and covert ways to maintain the power structures that privilege the dominant group” (Meyer 2010, 12). Education as a contribution to hegemony is also central to critical theories. The role of education from this point of view is to perpetuate power structures without force, by transmitting messages through the school system. These ideas paved the way for the formalization

of critical pedagogy as a theoretical approach (Meyer 2010). Paolo Freire’s work, The pedagogy

of the oppressed (1993), engaged in educational praxis, with an approach to teaching that focused on the empowerment of oppressed groups – specifically indigenous groups in Brazil. Other theories of multicultural education also call for critically reexamining power structures in education (Meyer 2010). Within critical pedagogy, two forms of education are described: banking and liberating, of which the latter creates opportunities for marginalized groups to actively participate and be invested in the design of their own educational practices, thus enhancing self- awareness and understanding (Martos 2016). I suggest critical pedagogy as an approach both to evaluate and to design and develop interventions for sexual education that are beneficial to individual students, and also their wider network and community. The use of critical pedagogy is particularly useful for the recommendation of feasible, adequate, and appropriate sexual education programs, considering the population at hand.

As a final point, models of biocommunicability and biomedicalization are also used as a resource to analyze the discourses that circulate regarding sex and sexuality, how these are framed according to different sources and audiences, and how sex has become medicalized. Biocommunicability is the study of how “knowledge about the [biomedical] phenomenon emerges and circulates” (Briggs and Hallin 2016, 8), while biomedicalization is the process of internal shifts in biomedicine that change the power of physicians and integrates the field of medicine and social sciences (Briggs 2011).