Journal articles on the topic 'Institutionalised Stigma'

This article focusses on systemic and institutionalised racism against Indigenous people as a contemporary feature of the Australian social and penal landscape, and its implications for justice. There has been ongoing concern with institutional racism within the criminal justice system, however, this article concentrates on the intersection between institutional racism in non-criminal justice settings and their compounding effect on criminalization. Despite legal prohibitions on racial discrimination, various forms of institutional racism continue unabated. Indeed, part of the argument is that broader political changes particularly associated with the influence of neoliberalism on social policy have exacerbated the problem of institutional racism and redefined and reinforced the link between welfare and criminalization. Indeed, social welfare has come to be informed by the same values and philosophies as criminal justice: deterrence, surveillance, stigma and graduated sanctions or punishments. How might we understand these broader shifts in the public policy environment, to what extent do they reflect and reproduce institutional racism, and how do they bleed into increased criminalization? I endeavour to answer this question through the consideration of two specific sites of social welfare policy – child protection and social housing – and to consider how systemic and institutional forms of racism play out in daily life for Indigenous people and how they interact with criminal justice.

Transgender populations are heavily burdened by HIV and other sexually transmissible infections (STIs). However, data on co-infection with HIV and STIs among transgender people are limited. A systematic review was conducted of peer-reviewed articles and conference abstracts between January 2010 and November 2015 that focussed on HIV and STI infections among transgender populations globally. The literature was synthesised and opportunities for improving health research were commented on. Few studies reported HIV–STI co-infection (n = 4), while the majority of studies reported HIV and STI infections separately (n = 23). Most studies were conducted outside of the USA (n = 19), and all but one of these studies reported data on transgender women only. Among USA-based studies (n = 8), several reported data on both transgender men and transgender women (n = 3), whereas other studies reported exclusively on transgender men (n = 1) or transgender women (n = 4). Understanding HIV and STIs among transgender people requires research that simultaneously considers multilevel drivers of vulnerabilities. More data are needed on how the interaction of individual determinants, including biological risks of transmission, programmatic determinants such as service-delivery models and policy-level determinants including institutionalised stigma in healthcare settings, influence the HIV- and STI-related outcomes of transgender populations. Leveraging the knowledge of transgender-specific determinants of HIV and STIs should guide the content and approaches to future HIV and STI prevention and treatment efforts.

Neuropsychiatric symptoms in dementia are associated with greater caregiver burden and desire to institutionalize, though previous work largely examines the cumulative effects of many behavioral symptoms. Sexual disinhibition could be particularly stressful due to stigma attached to these behaviors. Links between care recipient sexual disinhibition, caregiver burden, and caregiver desire to institutionalize were examined by analyzing cross-sectional data from 730 family caregivers recruited online. Caregiver burden, caregiver desire to institutionalize, and neuropsychiatric symptoms, including sexual disinhibition, were assessed via caregiver report. Burden (P < .001) and desire to institutionalize ( P = .008) were greater among caregivers who endorsed sexual disinhibition. Sexual disinhibition uniquely predicted desire to institutionalize after accounting for presence ( P = .02) and severity ( P = .03) of other neuropsychiatric symptoms. A similar pattern was seen for burden (presence P < .04; severity P = .06), and follow-up analyses revealed caregiver burden mediated the relationship between care recipient sexual disinhibition and caregiver desire to institutionalize (presence bias-corrected 95% confidence intervals [BCa95% CI] [0.003, 0.08], severity BCa95% CI [0.007, 0.06]). Sexual disinhibition appears to be a particularly difficult neuropsychiatric symptom for the family caregiver, contributing to desire to institutionalize via caregiver burden.

AbstractReducing public stigma could improve patients’ access to care, recovery and social integration. The aim of the study was to evaluate a mass media intervention, which aimed to reduce the mental health, related stigma among the general population in Catalonia (Spain). We conducted a cross-sectional population-based survey of a representative sample of the Catalan non-institutionalized adult population (n = 1019). We assessed campaign awareness, attitudes to people with mental illness (CAMI) and intended behaviour (RIBS). To evaluate the association between campaign awareness and stigma, multivariable regression models were used. Over 20% of respondents recognized the campaign when prompted, and 11% when unprompted. Campaign aware individuals had better attitudes on the benevolence subscale of the CAMI than unaware individuals (P = 0.009). No significant differences in authoritarianism and support for community mental health care attitudes subscales were observed. The campaign aware group had better intended behaviour than the unaware group (P < 0.01). The OBERTAMENT anti-stigma campaign had a positive impact to improve the attitudes and intended behaviour towards people with mental illness of the Catalan population. The impact on stigma was limited to attitudes related to benevolence. A wider range of anti-stigma messages could produce a stronger impact on attitudes and intended behaviour.

Background: A key objective of government and social marketers is to remove the institutionalized stigma of mental illness, increasing mental health service uptake. While research has evaluated past campaigns based on changes in attitudes and beliefs, very little research has examined the communication messages used in social marketing campaigns. Focus of the Article: This impact evaluation research identifies the institutionalized cultural-moral norms incorporated into New Zealand’s Like Minds mental health advertisements and examines how attitudes and beliefs changed over time in response to these norms. Importance to the Social Marketing Field: This research offers a new approach to social marketing evaluation and demonstrates the importance of consistent incorporation of cultural-moral institutional norms in social marketing campaigns. Method: Using macro-social marketing theory, thematic analysis is used to identify the cultural-moral institutional norms in the Like Minds campaign advertisements over a 10-year period (2002–2012). Results: The Like Minds campaign was found to have multiple cultural-moral institutional norms, such as Mental illness as a villain, Personal responsibility, and Inherent human dignity, as well as utilizing two different institutionalization processes of Socialization and Identity Formation. However, these norms were inconsistently and sometimes contradictorily presented and as a result, not all changes in mental health stigma beliefs and attitudes show long term change. Rates for service uptake also had mixed results during the campaign duration, though overall an increase in uptake was found. Recommendations for Research and Practice: The research highlights the importance of understanding the underlying institutionalized cultural-moral norms presented in communications and aligning those with the overall objectives of a social marketing campaign. Limitations: Like Minds campaign phases 2 to 5 are analyzed, phase 1 was inaccessible for analysis and advertisements after 2012 are not analyzed.

Menstruation is shrouded in stigma and shame—that is the common refrain in burgeoning initiatives on menstrual health and hygiene. Public policies alone cannot undo stigma and enact social change, but they do interact with social norms. They can reflect and adopt stigmatizing attitudes and, as a result, institutionalize, formalize, and legitimize stigma; or they can actively challenge and denounce it and mitigate existing discrimination. Against this background, we explored whether and how policies on menstrual health and hygiene address menstrual stigma and advance menstrual literacy based on an analysis of 34 policy documents and 85 in-depth interviews with policy-makers and advocates in four countries: India, Kenya, Senegal, and the United States. We found that policies recognized menstrual stigma and set out to break the silence surrounding menstruation and advance menstrual education, but they did not contribute to dismantling menstrual stigma. Policy-makers seemed constrained by the very stigma they sought to tackle, resulting in hesitancy and missed opportunities. Policies raised awareness of menstruation, often with great noise, but they simultaneously called for hiding and concealing any actual, visible signs of menstruation and its embodied messiness. Educational initiatives mostly promoted bodily management and control, rather than agency and autonomy. As a result, policies might have succeeded in breaking the silence around menstruation, but stigma cannot be broken as easily. We first need to recognize its (invisible) power and its impacts in all spheres of life in order to actively challenge, dismantle, and redefine it.

Transgender people are one of the most stigmatized social groups. They are experiencing institutional stigma and stigma on individual psychological level through different medical and legal procedures specific to their group. Though gender confirmation surgeries have been performed in Serbia for more than three decades, research on experiences and ways in which transgender people give meaning to the process is lacking. This topic became even more prominent due to significant changes in the area of depychopathologization of gender diversity and individualization of the medical gender confirmation process. This paper presents the experiences of transgender people in Serbia throughout the medical gender confirmation process and analyses the ways in which transgender people experience the process and give meaning to it, aiming to draw attention to certain problematic practices still present in the local institutional context. We used semi-structured interviews to collect data. Our approach is qualitative, based on interpretative phenomenological analysis. The sample consists of 12 transgender people age 23 to 48 (8 trans men and 4 trans women). Results indicate the great psychological and practical significance of the medical transition, and diversity in their needs when it comes to surgical interventions, implicating the importance of the easier access to the treatment and the individualization of treatment.

BackgroundHealth professionals including psychiatrists were reported to have stigmatising opinions on psychiatric patients. Their views may be affected by clinical, social and cultural factors.ObjectiveThis study explored the views of Chinese psychiatrists on stigmatisation of psychiatric patients.MethodsFocus group discussions with psychiatrists were conducted in Hong Kong. Their views towards stigmatisation of psychiatric patients and strategies to reduce stigmatisation were discussed.FindingsThe psychiatrists perceived the clinical needs to classify the patients according to the diagnoses and they did not see it as stigmatisation. They believed that some mental illnesses are characterised with violence or deviance, and were not completely curable. Instead of trying to eliminate stigma, they managed in ways that took social expectations into consideration. They might offer a relative vague diagnostic label to save the ‘face’ of the patients and secure greater acceptance for the illness from the public. They tended to accept family members to make decisions on behalf of the patients. Reconciling public interest and patients’ autonomy, they encouraged stable psychotic patients to live in the community but agreed to institutionalise those patients with violent behaviours.ConclusionWhile the psychiatrists argued that the diagnosis was not a form of stigma, they were sensitive enough and framed responses to patients in ways to minimise stigma. They tended to believe that stigma was inevitable given the nature of some psychotic disorders. Disguising the stigma appeared to be the common approach to deal with stigma in a Chinese context.Clinical ImplicationsThe psychiatrists, especially those practicing in a Chinese context, may consider a wider perspective of community mental health rehabilitation which is not limited to social stability but also social life.

Background: Mental health has not had the same public profile as physical health. This has contributed to the stigma associated with mental illness and to its treatments. Research investigating how the traditions and values amongst those with an Arab heritage contribute to stigmatizing beliefs, attitudes or actions in the provision of mental healthcare has not been widely reported. Aim: To systematically review the literature and summarize the findings of studies reporting stigmatizing beliefs, actions and attitudes toward treatment of people with mental illness in the Arab population. Methods: PubMed, Ovid, Psycharticles and Embase were used to identify original studies of non-institutionalized Arab adults or children reporting findings relevant to stigma toward mental illness. A manual search of the bibliography of all selected original studies was also undertaken. Independent data extraction was performed by two reviewers, who then met to compare data and reach consensus. Findings were classified as stigmatizing beliefs, actions or attitudes toward mental health treatments. Results: A total of 33 articles were retrieved for full review. Those utilizing qualitative methodology provided insight into the many ways mental illness is viewed and defined among those with an Arab heritage. Among the studies using quantitative methodology, most compared stigmatizing beliefs, attitudes toward mental health treatments or stigmatizing actions among different Arab populations, some also investigated correlations between characteristics of the Arab population tested with stigmatizing beliefs, actions and attitudes toward mental health treatments. Findings from studies undertaken in Qatar reported greater stigmatizing beliefs, actions or attitudes toward mental health treatments among Qatari versus non-Qatari Arabs. Conclusion: A large diversity in the stigmatizing beliefs, actions and attitudes toward treatment of mental illness within the Arab population were identified. The influence of cultural variations on stigma should be explored further and used to tailor anti-stigma interventions in this population.

This paper reviews briefly the history of mental health depopulation in Canada over the past 30 years. The term “deinstitutionalization” is often used but is unsatisfactory. Using an exploratory, qualitative, methodological approach, data were collected on the problems encountered by a disproportionate, stratified random sample of 139 formerly institutionalized patients living in various geographical locales in Eastern Canada. Adopting a symbolic interactionist theoretical approach, this study, in an effort to fill a neglect in the literature, attempted to discover what the everyday world(s) of Canadian ex-mental patients was really like. Problems encountered related to stigma, poor housing, lack of back living skills, poverty, unemployment and aftercare. Quotations from patients are provided to illustrate such themes. The findings are discussed.

The purpose of the study was to establish psychological challenges facing orphaned children and caregivers residing in six institutionalized institutions located at Ubungo District in Dar es Salaam. The study involved 67 participants who were selected through purposive sampling technique. They included twelve caregivers, six Directors, one Social Welfare Officer and 48 children. The study applied the descriptive research design. Data were collected using in-depth interviews and non- participant observation. Data were sorted and coded based on themes and presented according to the research questions through the thematic approach. Results indicated that orphan children were faced with stigma, discrimination, bullying, physical punishment, anxiety, poor attachment and isolation. To some extent, the challenges were caused by grief and lack of counseling knowledge and skills from the caregivers. Additionally, care givers had limited freedom to punish/discipline children with misbehaviors. Therefore, the study recommends counseling training for caregivers in order to minimize children psychological complexities and misbehaviors as well as furnishing of life skills training for orphans

The purpose of the study was to establish psychological challenges facing orphaned children and caregivers residing in six institutionalized institutions located at Ubungo District in Dar es Salaam. The study involved 67 participants who were selected through purposive sampling technique. They included twelve caregivers, six Directors, one Social Welfare Officer and 48 children. The study applied the descriptive research design. Data were collected using in-depth interviews and non- participant observation. Data were sorted and coded based on themes and presented according to the research questions through the thematic approach. Results indicated that orphan children were faced with stigma, discrimination, bullying, physical punishment, anxiety, poor attachment and isolation. To some extent, the challenges were caused by grief and lack of counseling knowledge and skills from the caregivers. Additionally, care givers had limited freedom to punish/discipline children with misbehaviors. Therefore, the study recommends counseling training for caregivers in order to minimize children psychological complexities and misbehaviors as well as furnishing of life skills training for orphans

O trabalho é parte de nossa pesquisa de doutorado, trata-se de uma análise sobre a presença da enfermidade lepra, desde a Antiguidade até a Idade Média. O objetivo é identificar como o medo milenar do contágio, fortalecido pelos estigmas, acarretou um impacto profundo na vida das várias sociedades humanas do Oriente e do Ocidente. Pretende-se, ainda, demonstrar que as interpretações dadas a essa doença por religiões de matrizes, judaica e cristã tornaram-se institucionalizadas, gerando fortes representações negativas e preconceituosas que lhes são atribuídas. Para lançar luz à história da lepra e para tornar compreensível o medo e as interpretações preconceituosas lançadas aos indivíduos acometidos por ela, o aporte é buscado nas ciências econômicas, especificamente, no institucionalismo histórico, abordagem que tem como premissa básica a ênfase sobre a influência das instituições sobre o comportamento das sociedades, além de considerar a contingência histórica de toda e qualquer instituição (NORTH, 1990; 1991; 1994; 2000.) e (HODGSON, 1998; 2001; 2004; 2006; 2009). Leprosy in the East and West: from Antiquity to the Middle Ages The work is part of our doctoral research, it is an analysis of the presence of leprosy disease, from antiquity to the Middle Ages. The goal is to identify how the millennial fear of contagion, strengthened by the stigmas, led a profound impact on life of the various human societies of the east and the west. It is also intended to demonstrate that the interpretations given to this disease by matrix religions, Jewish and Christian have become institutionalized, generating strong negative and prejudiced representations attributed to them. To shed light on the history of leprosy and to make understandable the fear and interpretations prejudices released to individuals affected by it, the contribution is sought in the economic sciences, specifically, in historical institutionalism, approach that has as basic premise emphasis on the influence of institutions about the behavior of societies, in addition to considering the historical contingency of any and all institutions (NORTH, 1990; 1991; 1994; 2000)and (HODGSON, 1998; 2001; 2004; 2006; 2009).

Deng's truth-from-facts willingness to discard outmoded dogmas and his black-cats/white-cats readiness to tinker with China's basic economic institutions had led him boldly to venture where no Chinese leader - no leader anywhere in the communist world - had previously dared to go. Early on, Deng decoupled the engine of market competition (good) from the stigma of capitalist exploitation (bad) and threw open China's doors to the outside world, setting in motion a process of accelerated socio-economic development and modernization. . . . Rapid but uneven economic growth, accompanied by a deep erosion of traditional ideological norms and social controls, produced a situation high in raw entrepreneurial energy but low in institutionalized immunity to a wide variety of potential systemic disorders, ranging from rising regional inequality and uncontrolled rural emigration to a nationwide epidemic of crime, corruption, and popular cynicism. All this arguably rendered China more volatile politically than at any time since the late 1940s.'

Abstract In order to achieve fundamental results in punishing corruption crime, we should adhere to the legal anti-corruption pattern, advance with the Rule of Law, and make anti-corruption standardized and institutionalized. The bottom line is that we should reform and improve the criminal procedure for corruption crime in China. Problems in the current procedure for corruption crime mainly include: the presumption rules for corruption crime have not been established, the absence of stigma witness exemption system, the witness protection system, the investigation jurisdiction are not perfect, the supervision of investigation is weak, the lack of absentee trial system for corrupt crime, the non-institutionalization of off-site trial, technical investigation measures may be abused, and difficulties in person sought for corruption and asset recovery. To reform and improve the procedure for corruption crime in China, it is suggested that special procedures for corruption crime be set up as appropriate, relevant contents of the United Nations Convention against Corruption (UNCAC) should be reasonably absorbed, and efforts should be made to promote the institutionalization of the reform achievements in criminal procedure of corruption crime.

Professional service firms in Western Europe have a reputation for putting huge pressures on their junior employees, resulting in very long work hours, and as a consequence health risks. This study explores moral leadership as a possible response to the stigma of such dirty leadership. We conducted semi-structured interviews with 12 consultant managers and with each one of their juniors, and found that managers put several pressures on their juniors; these pressures bring high levels of stress, lowered wellbeing and burnout. Society considers such a pressuring leadership style morally dirty. To counteract the experience of being seen as morally dirty, we found that consultant managers were normalizing such criticisms as commonly assumed in dirty work literature. However, they also employed several moral leadership tactics to counteract the negative consequences criticized in society. However, in addition to the well-known individual-level tactics, consultant managers and their juniors also reported moral leadership support at the organizational level, like institutionalized performance talks after every project, trainings, specific criteria for hiring juniors, and policies to recognize and compliment high performance. Still, we cannot conclude these moral leadership approaches are moral by definition. They can be used in an instrumental way as well, to further push performance.

Abstract Objective: to analyze the dimensions assigned to long term care facilities for the elderly (LTCFs) by managers and health professionals. Method: a descriptive-exploratory study with a qualitative approach was conducted in the metropolitan area of Belo Horizonte, through ten focus groups with 51 managers and health professionals. Analysis was based on the content of the interviews. Results: considering the most common themes, three empirical categories emerged that explained the consensuses and contradictions present in the empirical material: a) the LTCF and the perpetuation of the asylum space; b) the LTCF as a space for health treatment c) a home: convergences and contradictions in the LTCF. Initially, findings relating to the political definition of the LTCF directly linked to social organs are evidenced. In the second category, LTCFs are described negatively, perpetuating the stigma of the term "asylum" which still reverberates in their daily lives. As a treatment space, LTCFs are considered health facilities due to the services offered and the presence of health professionals on a daily basis. In the third analysis, they are recognized as a home, based on current legislation that describes the LTCF as a collective, residential area. Conclusion: it is important to discuss the different attributes given to the LTCF to create resolutive actions in the care of the institutionalized elderly. The importance of thinking about the rights to health of the elderly and the need to understand how they inhabit this space is also emphasized.

AbstractObjectiveWe aimed to examine the food-seeking experiences of homeless emerging adults (age 18–24 years) in a US urban context.DesignThe study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking.SettingBuffalo, a mid-sized city in the Northeastern USA.SubjectsA sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18–24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters.ResultsParticipants’ food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends’ or relatives’ homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent’s application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs.ConclusionsGiven endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.

ABSTRACTBackground:In dementia, cognitive and psychological disorders might interfere with maintaining social interactions. We have little information about the nature of these interactions of people with dementia in nursing homes. The aim of this study is to investigate social interactions between people with dementia and to validate an observation grid of them.Methods:Fifty-six institutionalized people with dementia took part in this study. Residents had not met beforehand and were divided into groups of four to six. Social behaviors were videotaped and analyzed by two independent raters with an observation grid measuring frequency of occurrence. The ethogram was the conceptual tool that became the Social Observation Behaviors Residents Index (SOBRI).Results:Two-thousand-six-hundred-seventy instances of behavior were collected. Behaviors directed at others represented 50.90% and self-centered behaviors 47.83%. No negative behaviors were observed. Principal Component Analysis (PCA) was used to validate the SOBRI and showed two components of social behaviors that explained about 30.56% of the total variance: social interactions with other residents (18.36%) and with care staff (12.20%). The grid showed a good internal consistency with a Cronbach's α of 0.90 for the first component and 0.85 for the second one.Conclusions:The SOBRI presents robust psychometric validity. This pilot study indicates that people with dementia spontaneously interact with other residents. These results contradict the stigma of non-communication and the stereotypes about dementia. More studies and validations are needed to contribute to the knowledge of social interactions in dementia.

Abstract COVID highlights the importance of accurate estimates of the risk of elder abuse to guide prevention. Reliability of data is problematic; reports have issues with consistency of definitions, time periods, and stigma. This paper demonstrates the use of US Census data to estimate risk of elder abuse by mapping generational incongruities between care-givers and care-receivers that invite dissonance (Cohen, 2011). Using the 2014-2018 Nebraska Public Use Microdata and 5-year American Community Survey, this research identifies and profiles personal care aides/nursing aides for institutionalized persons (65+). Data reveal generation gaps in age, education, and race between care-receivers and care-givers that are geographically comparable in the three most populous counties (the Big-3), but different for the 90 rural counties. In Nebraska’s Big-3 Counties the difference in education between care-givers (ages 25+) and care-receivers (65+) is considerable; 42.9% of Big-3 care-givers have some college, while 43.6% of care-receivers have only high school. Intergenerational differences in education are greater in Nebraska’s 90 rural counties than in the Big-3; 41.2% of rural care-givers have some college; 46.1% of rural care-receivers have only high school. Racial intergenerational differences are greater in Big-3 than in rural counties; 90.3% of care-receivers and only 62.3% of care-givers are non-Hispanic White. For rural Nebraskans, intergenerational differences in race are smaller, 97.2% of care-receivers and 79.4% of care-givers are non-Hispanic White. This type of analysis can be used to identify geographic settings where elder abuse is most likely to happen and guide the development of preventive measures that mitigate elder abuse.

Officially, the poverty line in Russia is tied to the subsistence minimum but from the sociological point of view, its linkage to the subsistence minimum is arbitrary. The subject of the research is social boundaries, social space of poverty. The purpose of the research was to formulate the principles of an approach to overcoming poverty as a social phenomenon. The paper attempts to outline the social space of poverty as an attribute (stigma) by which a person is placed in a specific exclusion space that forms the specific ethos of poverty and the poor man’s habitus preventing any attempts to climb out of poverty. Belonging to this space institutionalizes the poor as a “kind of people”, which is reflected in specific mechanisms of referencing and self-referencing of poverty expressed in the life-purpose deficits. “Combating poverty” implies the creation of participation institutions through which relations and processes of social differentiation, social participation and reference are withdrawn from the dictate of economic factors. It is concluded that the poverty alleviation program should take into account the social limology of poverty and include the development of participation practices and institutions that exclude the stigmatization of poverty and the transformation of the poor into the “kind of people”. Such institutions should provide the poor with ample opportunities to participate in the formation of elites (professional, intellectual, and political). It is particularly important that children, teenagers and young people have access to such practices and institutions because each generation produces and reproduces the “social topology” in which poverty forms a specific “exclusion space”.

System-involvement resulting from anti-trafficking interventions and the criminalization of sex work and migration results in negative health impacts on sex workers, migrants, and people with trafficking experiences. Due to their stigmatized status, sex workers and people with trafficking experiences often struggle to access affordable, unbiased, and supportive health care. This paper will use thematic analysis of qualitative data from in-depth interviews and ethnographic fieldwork with 50 migrant sex workers and trafficked persons, as well as 20 key informants from legal and social services, in New York and Los Angeles. It will highlight the work of trans-specific and sex worker–led initiatives that are internally addressing gaps in health care and the negative health consequences that result from sexual humanitarian anti-trafficking interventions that include policing, arrest, court-involvement, court-mandated social services, incarceration, and immigration detention. Our analysis focuses on the impact of criminalization on sex workers and their experiences with sexual humanitarian efforts intended to protect and control them. We argue that these grassroots community-based efforts are a survival-oriented reaction to the harms of criminalization and a response to vulnerabilities left unattended by mainstream sexual humanitarian approaches to protection and service provision that frame sex work itself as the problem. Peer-to-peer interventions such as these create solidarity and resiliency within marginalized communities, which act as protective buffers against institutionalized systemic violence and the resulting negative health outcomes. Our results suggest that broader public health support and funding for community-led health initiatives are needed to reduce barriers to health care resulting from stigma, criminalization, and ineffective anti-trafficking and humanitarian efforts. We conclude that the decriminalization of sex work and the reform of institutional practices in the US are urgently needed to reduce the overall negative health outcomes of system-involvement.

Conquanto são tecidas as categorias educação e saúde,buscou-se neste estudo responder a inquietação dapesquisa, a saber: quais as razões para a recusa departilha do diagnóstico de Doença Falciforme (DF) entrejovens escolares em espaços institucionalizados deSalvador-BA? Para tanto, esta investigação, de naturezaqualitativa fundou-se metodologicamente no paradigmacrítico, consolidado no materialismo histórico dialético.Caracterizou-se como exploratória e descritiva e, paraa coleta de informações foram aplicados formuláriosa 48 jovens com doenças falciformes em idade entre15 e 29 anos, que constituíram o universo populacionalda pesquisa. Na segunda etapa da pesquisa, foramrealizadas entrevistas em profundidade objetivandoelucidar aspectos que emergiram da análise das respostasaos formulários. Os resultados indiciaram que os jovensescolares optam por não partilhar o diagnóstico daDF por três razões: o consenso quanto à invisibilidade;frustrações anteriores por ocasião da elucidação dadiagnose; e, medo do preconceito, da rotulação e doestigma. Conclui-se que medidas devem ser tomadas paraa potencialização do conhecimento sobre a patologia, pormeio de políticas de formação e mecanismos de escutaintermitente.ABSTRACTAs the categories education and health are woven, this study sought to answer the researchconcern, wich are: what are the reasons for refusal to share the diagnosis of sickle cell disease(SCD) among young students in institutionalized spaces in Salvador-BA? Therefore, thisqualitative research was methodologically based on the critical paradigm, consolidated indialectical historical materialism. It was characterized as exploratory and descriptive and, forcollecting information, forms were applied to 48 young people with sickle cell disease agedbetween 15 and 29 years, which constituted the population of the research. In the second stageof the research, in-depth interviews were conducted to clarify aspects that emerged from theanalysis of the responses to the forms. The results indicated that young students choose not toshare the diagnosis of SCD for three reasons: consensus on invisibility; previous frustrations atdiagnosis elucidation; and fear of prejudice, labeling and stigma. It is concluded that measuresshould be taken to enhance the knowledge about the pathology, through policies of trainingand intermittent listening mechanisms.

Contextualização: O artigo analisa a prática profissional terapêutica ocupacional em um Serviço de Acolhimento Institucional Infantojuvenil, em uma cidade no interior de São Paulo. Processo de intervenção: Compreendendo a raça como um marcador social de estereótipos e estigmas na vivência cotidiana dos corpos negros e a racialização das infâncias institucionalizadas, analisamos as experiências infantojuvenis nos processos de institucionalização. Análise crítica da prática: A partir de uma perspectiva decolonial e crítica da Terapia Ocupacional e de uma proposta contra hegemônica de atuação, discutimos a respeito de ações interventivas para valorização e reconhecimento da identidade cultural negra dentro do serviço, como uma possibilidade de prática afrorreferenciada e antirracista na/para Terapia Ocupacional.Palavras-chave: terapia Ocupacional. Prática Profissional. Criança Acolhida. Popoluação Negra AbstractContextualization: This article analyzes the professional practice of occupational therapist in an Institutional Childcare Service in a city of São Paulo state, in Brazil. Intervention / Follow-up process: We analyze children's experiences in institutionalization processes understanding race as a social marker. Critical analysis of the practice: The racialization of institutionalized childhoods causes stereotypes and stigmas in the day life experience of black kids. From a decolonial and critical perspective of Occupational Therapy and a counter-hegemonic proposal of action, we discuss interventional actions for valuing and recognizing black cultural identity within the service as a possibility of afro-referenced and anti-racist practice in/for Occupational Therapy.Keywords: Occupational Therapy. Professional Practice. Foster Child. Black People ResumenContextualización: El artículo analiza la práctica profesional terapéutica ocupacional en un Servicio de Acogida Institucional Infantil en una ciudad del interior de estado de São Paulo, en Brasil. Intervención / Proceso de seguimiento: Entendiendo la raza como un marcador social de estereotipos y estigmas en la vida cotidiana de los cuerpos negros y la racialización de la niñez institucionalizada, analizamos las experiencias de los niños en los procesos de institucionalización. Análisis crítico de la práctica: Desde una perspectiva decolonial y crítica de la Terapia Ocupacional y una propuesta de acción contrahegemónica, discutimos las acciones intervencionistas para la valoración y reconocimiento de la identidad cultural negra dentro del servicio como una posibilidad de práctica afro-referenciada y antirracista en/para la Terapia Ocupacional.Palabras clave: Terapia Ocupacional. Práctica Profesional. Ninõ acogido. Población Negra

AbstractJUVENILE DELINQUENCY AND SOCIAL REACTIONThe object of this research is to define the process of social reaction to juvenile delinquency, as well as the criteria used by the agencies of social control in deciding what factors brand the adolescent a delinquent. Starting with self-reported delinquency, we follow its course within the system of social regulations practised by the public, the police and the courts.The data concern self-reported delinquency (measured by the questionnaire of Nye and Short on self-reported delinquency), delinquency officially known to the police, and the decisions taken by the police and judges with regard to delinquent acts. These data were gathered in five districts in Montreal, representing five social strata.The analysis of the stigma of delinquency showed that there is more chance of working-class subjects entering the juvenile justice system, above all where acquisitive and rebellious delinquency is concerned, especially in relation to the community, the family and sex. Among the middle and upper classes the stigma of delinquency is attached more to aggression and rebellion connected with automobiles and vandalism.As to the origins of social reaction ¦— the way in which an adolescent is admitted to the juvenile justice system .— the citizen reports offences against his person and property, while the police record offences against public order and morals.At the police level, the adolescent is returned to his home if it is a question of rebellion committed by a group between the ages of 12 and 15, whereas he is taken to court if his offence, reported by the citizen, is repeated and of a more serious nature. In the case of those taken to court, the adolescent is detained if he is a recidivist, and receives a summons if it is his first offence.The judges favor special measures in the case of rebelliousness, and no action at all (postponement sine die) in the case of aggression or theft by adolescents of the working class. A recidivist will be institutionalized for a serious infraction and treated within the community in the case of a less serious offence. Re-education in the community is given if the adolescent has been detained, and a fine if he has received a summons.The results clearly show that the characteristics of the delinquent acts are more important than the socioeconomic milieu in determining whatdecisions are taken. However, the socioeconomic milieu does influence admission into the juvenile justice system, as well as judicial reaction. Working-class subjects are given less attention than those from the middle and upper classes, postponement sine die is more often used in the working-class milieu, and fines, re-education within the community and institu-tionalization are more often applied to subjects of the middle and upper classes. Moreover, the margin of discretionary powers in decision making is, on the whole, rather narrow, which means that in the majority of cases, decisions can be explained by no other factors than the characteristics of the delinquent acts. This discretionary margin in decision making is narrow, both at the police and judicial levels, when a choice between particular measures must be made ; on the other hand, there is some leeway, since the judge must choose between postponement sine die and a particular measure. Finally, the course of the offence within the juvenile justice system reinforces the previous decisions through a process of amplification, which, as a consequence, penalizes working-class subjects to some extent.In short, delinquency is an adolescent phenomenon in general, but only a minority of infractions enter and continue to circulate within the juvenile justice system. The criteria for decision making are indeed socio-economic, but more often relate to the past history of the delinquent and the nature of his offence.

Abstract In Europe psychiatric wards tend to be highly institutionalised settings, often lacking essential psychosocially-supportive elements which promote health, wellbeing and social interaction of patients and staff. This happens in the name of increased safety and anti-ligature standards or as a result of neglect and stigma often resulting from reduced opportunities of patients to actively participate in the decision making of their lives, the conditions of hospitalisation and the quality of their environments. Research on healthcare environments shows a profound impact of the built environment on therapeutic outcomes. While many recommendations derived from these studies, such as views to nature or single bedrooms, are difficult to implement in existing facilities, everyday objects potentially pose a powerful yet easily implementable resource for increasing therapeutic effects of the built environment. In this presentation we are going to briefly describe the hierarchies of psychiatric care affordances, as they derive from the SCP model –S stands for Safety and security, C for competence and P for personalisation and choice– that is a model especially developed for interpreting and evaluating psychiatric environments in relation to these principles. Then we are going to explore further the idea of personalisation and choice, its relationship with the psychosocial model of psychiatric rehabilitation and bring some implemented, practical examples of how this has been implemented in psychiatric settings across Europe and beyond. The aspects of co-design will be highlighted, as a key element of achieving personalisation and valorisation. This will help the audience come, who can be either from healthcare, policy or management backgrounds on the same page with members of the audience who come from a built environment background with concepts of institutionalisation vs ecopsychosocial concepts in relation to the built environment of the psychiatric wards.

Children with disabilities (CWDs) are one of the most marginalised and excluded groups in the society. Facing daily discrimination in the form of negative attitudes, lack of adequate policies and legislation, they are effectively barred from realising their rights to healthcare, education and even survival. It has been estimated that exposure towards all forms of violence against CWDs is four-time greater than that of children without disabilities. Bangladesh has an estimated 7–10 million CWDs (out of a total of 72 million children, World Health Organisation Report). Most of the time, these children are treated as a burden to their families or the community and thus become subject to violence. There are very few specialised institutions with residential facility to take care of them. So, they are institutionalised in general residential institutions at a significantly higher rate than other children. But both the special and general residential institutions have lack of skilled human resources and knowledge of the special situation and needs of CWDs. Peer groups of the CWDs are also less sensitised, which result in further stigma and discrimination of CWDs. A 2010 study was done by the Ministry of Women and children Affairs. The findings from interviews with adolescents’ aged 13–16 in 12 locations of Dhaka City revealed their extreme vulnerability. In 2010, a study by Bangladesh Protibondhi Foundation that conducted a survey supported by the Save the Children Sweden–Denmark found that 51.4% of CWDs are either at risk of sexual abuse (12.5%) or have been sexually abused (38.9%).The government of Bangladesh has taken a number of legislative and policy steps that indicate commitment to advancing the rights of persons with disabilities. In terms of international instruments, Department of Social Services under Ministry of Social Welfare operates various types of institutions for the children and also CWDs. The study will adopt qualitative and quantitative methods to collect information from both primary and secondary sources and also assess the situation of government non-government organisations/religious institutions where CWDs have residential facilities in order to understand which factors contribute to increased vulnerability of these children.

PurposeIn this study, two mother-scholars describe their lived experiences working in higher education in the USA while parenting children with disabilities. They situate their narratives within the context of institutionalized motherhood, courtesy stigma and the career plateau experienced by many working mothers of children with disabilities.Design/methodology/approachWithin this collaborative autoethnography, the authors employ autoethnographic narrative and poetic inquiry.FindingsThe authors reveal unique work-life tensions that they have experienced as mothers, teachers and scholars, reflecting on the experiences that led them to become advocates for people and families with disabilities.Practical implicationsThe authors aim to reduce stigma and to disrupt the career plateau by offering suggestions to help coworkers and supervisors be more supportive of working parents of children with disabilities.Originality/valueThe authors enumerate the advantages of collaborative autoethnography in uncovering how stigma against mothers of children with disabilities is manifested within an academic community.

There has been strong advocacy for educators to extensively examine pedagogical assumptions to design more inclusive and accessible classes. However, our assumptions about inclusivity and the interplay of privilege and students’ “common sense” have received little attention. As such, a common sense gap exists, where faculty may regard certain content or information as familiar to all students without considering the more profound effects of institutionalized privileges on the educational experiences of students without privileged backgrounds. Adopting a critical lens to examine foundational assumptions about common sense has meaningful implications for the ideal of higher education as a credible pathway to social mobility for all. This paper illustrates how the creation and dissemination of “common sense” are bounded by social class and socialization processes. We consider how blind spots about “common sense” in management learning and education shape the experience of less privileged students, which then helps create and perpetuate stigma and inequality in workplaces and society. Furthermore, we integrate the literature on stigma and higher education to confer suggestions for educators and institutions on how to destigmatize education and effectively design and deliver inclusive classroom experiences.

Pakistan finds itself at a crossroads, struggling between legitimizing the identity of trans gender and non-conforming (TGNC) persons and the multivariate forces that hold back this progression. This can be observed when one seeks out census data on the khawajasira population – a respectful Urdu term for TGNC persons.1 Officially this number stands at 10,422,2 but various organizations advocating for TGNC rights state this number to be around 300,000 to 500,000.3 So while progressive changes, such as the Transgender Person (Protection of Rights) Act of 2018,4 have led to Pakistan recognizing khawajasira as a third gender, they are grossly underreported on the national census. This gives us an insight into the problems faced when it comes to their recognition into Pakistani society, often stemming from the stigma of their own social networks. This stigma illustrates the intersectional nexus of discrimination reflected in religion and politics, resulting in disapproval, marginalization, and social banishment.5 Religion is instrumentalized by predominantly religious and other non-state actors who condemn khawajsira identity and culture, which further propagates the status quo.6 As a result, much of Pakistan’s TGNC populations live on the margins of society, with an overwhelming majority experiencing institutionalized discrimination and physical attacks.5 The odds of subsequent engagement in high-risk behaviors such as survival sex, drug use, and even suicide increase dramatically.5 Due to this marginalization, TGNC persons defer their healthcare needs until absolutely necessary thus undermining their outcomes from illnesses that are otherwise preventable.7 Specific reasons include prejudice by healthcare professionals, inexperience with TGNC healthcare, and the lack of legislation protecting TGNC rights.

Abstract Background An increasing number of people living with HIV (PLWH) have had chronic noncommunicable diseases (NCDs) over the last 5 years. However, robust evidence regarding the perception and challenges of having NCDs among PLWH is limited. Therefore, this study aimed to synthesize qualitative evidence regarding the experiences of PLWH with NCDs. Methods We used a meta-aggregation approach to synthesize qualitative studies. Peer-reviewed and gray literature published in English and Chinese from 1996 to November 2020 was searched using electronic databases. Two reviewers independently appraised the methodological quality and extracted data from the included studies. The Joanna Briggs Institute (JBI) meta-aggregation approach was used to synthesize the findings. Results In total, 10,594 studies were identified in the initial database search. Fourteen eligible studies were included in the meta-synthesis. Among these studies, nine synthesized findings regarding the following topics were identified: fragmented healthcare systems, care continuity, manifestations of multiple conditions, financial hardship, stigma and discrimination, polypharmacy burden and adherence, reciprocal relationships between HIV and NCDs, and coping strategies. Conclusions In recent years, attempts have been made to institutionalize NCD preventive and control services in HIV long-term care. However, considering the growing problem of HIV and NCD comorbidity globally, integrated primary health care systems are needed to address the problems of PLWH with NCDs. Healthcare professionals should help PLWH develop strategies to better monitor their polypharmacy burden and adherence, stigma and discrimination, financial hardship, and manifestations of multiple conditions to achieve high levels of care continuity.

Introduction: There are large differences in the development of mental health systems of the West and the countries of the former Eastern Bloc. The latter is characterized by a more biological approach to mental health and reliance on psychiatric hospitals. In 2018, Uzbekistan authorities showed interest in reforming mental health care of the country. The policy report provides an overview of progress towards the provision of community mental health (CMH) care across Eastern Europe and recommendations for this transition within Uzbekistan.Methods: A literature search on mental health care in Uzbekistan was conducted to understand its strengths and weaknesses. Progress towards the provision of CMH care across Eastern Europe was assessed using data on the number of psychiatric beds and availability of mental health services in community settings reported within the published literature. Countries identified as making the greatest progress towards CMH care were reviewed in detail to better understand the process of reform assets and barriers.Results: Mental health care in Uzbekistan is highly institutionalized, underfunded and understaffed. Social care services are poorly developed. However, current leadership has kindled the promise of mental health reform. Georgia, Lithuania and Poland have made the most progress in terms of CMH care availability. However, due to various obstacles such as dual financial burden, high stigma and lack of political will, their programs lack social integration and/or uniform availability and underfunding along with scarcity of mental health specialists are common. On the other hand, research and evaluation, involvement of service users into service planning and cooperation with donors facilitated reform implementation.Conclusion: Uzbekistan may develop into a modern mental health system and avoid the setbacks encountered by other countries in the region, through careful financial planning, stigma reduction, improving mental health literacy, human resources strategic development and civil society engagement.

AbstractBackgroundFew studies have assessed the epidemiology of hallucinogenic substance use among racial and ethnic groups of varying age cohorts. Use of psychedelic substances may differ among people of color (POC), due to factors such as stigma and discriminatory drug enforcement practices against POC. The lack of inclusion of POC in psychedelic research further underscores the importance of identifying differences in use among racial/ethnic groups and age cohorts.MethodsData from the 2018 National Survey on Drug Use and Health (NSDUH) was used for this analysis (N = 56,313, unweighted), representative of the non-institutionalized U.S. population. Proportions of lifetime hallucinogen use by race/ethnicity were compared. Proportions of past year rates of use were compared to examine differences by race/ethnicity and age cohort.ResultsApproximately 15.9% of the U.S. population over 12 had used a hallucinogen at some point in their lifetime and 2.0% had used in the past year. Lifetime hallucinogen use was most prevalent among non-Hispanic White and multi-racial individuals, while Black/African Americans reported the lowest rates of use. White and multi-racial groups also reported the highest proportions of past year use among 12–34 year olds, and White individuals reported the highest proportions among 35–49 year olds. Hispanic individuals reported higher proportions of use among the 12–17 cohort, but lower proportions among the 26–49 year old cohorts. Black/African Americans reported the lowest rates of past year use among the 12–25 year old cohorts. 50+ and older cohorts reported the lowest rates of hallucinogen use in the past year.LimitationsData is cross-sectional and self-reported. “Race” is a social construction is subject to change over time, and NSDUH ethnoracial categories are limited. Institutionalized populations are not included in the study.ConclusionsSignificant differences in hallucinogen use among ethnoracial groups by substance and age cohorts were observed. Findings from this work may inform education, interventions, and therapeutic psychedelic research.

AbstractSocial accountability is often put forward as a strategy to promote health rights, but we lack a programmatic evidence base on if, when, and how social accountability strategies can be used to promote access to quality Sexual and Reproductive Health (SRH) care for stigmatized populations and/or stigmatized issues. In this Commentary, we discuss the potential advantages and disadvantages of social accountability strategies in promoting the availability of a full range of SRH services for excluded and historically oppressed populations. We accomplish this by describing four programs that sought to promote access to quality SRH care for stigmatized populations and/or stigmatized services. Program implementers faced similar challenges, including stigma and harmful gender norms among providers and communities, and lack of clear guidance, authority, and knowledge of Sexual and Reproductive Health and Rights (SRHR) entitlements at local level. To overcome these challenges, the programs employed several strategies, including linking their strategies to legal accountability, budgetary expenditures, or other institutionalized processes; taking steps to ensure inclusion, including through consultation with excluded or stigmatized groups throughout the program design and implementation process; specific outreach and support to integrating marginalized groups into program activities; and the creation of separate spaces to ensure confidentiality and safety. The program experiences described here suggest some general principles for ensuring that social accountability efforts are inclusive both in terms of populations and issues addressed. Further empirical research can test and further flesh out these principles, and deepen our understanding of context.

Abstract Background In the face of health-system constraints, local policymakers and decision-makers face difficult choices about how to implement, expand and institutionalize antiretroviral therapy (ART) services. This scoping review aimed to describe the barriers and facilitators to the implementation and scale up of differentiated service delivery (DSD) models for HIV treatment in Africa. Methods PubMed, Web of Science, Embase, Scopus, CINAHL, Global Health, Google, and Google Scholar databases were searched. There was no start date thereby all references up until May 12, 2021, were included in this review. We included studies reported in the English language focusing on stable adult people living with human immune deficiency virus (HIV) on ART and the healthcare providers in Africa. Studies related to children, adolescents, pregnant and lactating women, and key populations (people who inject drugs, men having sex with men, transgender persons, sex workers, and prisoners), and studies about effectiveness, cost, cost-effectiveness, and pre or post-exposure prophylaxis were excluded. A descriptive analysis was done. Results Fifty-seven articles fulfilled our eligibility criteria. Several factors influencing DSD implementation and scale-up emerged. There is variability in the reported factors across DSD models and studies, with the same element serving as a facilitator in one context but a barrier in another. Perceived reduction in costs of visit for patients, reduction in staff workload and overburdening of health facilities, and improved or maintained patients’ adherence and retention were reported facilitators for implementing DSD models. Patients’ fear of stigma and discrimination, patients’ and providers’ low literacy levels on the DSD model, ARV drug stock-outs, and supply chain inconsistencies were major barriers affecting DSD model implementation. Stigma, lack of model adoption from providers, and a lack of resources were reported as a bottleneck for the DSD model scale up. Leadership and governance were reported as both a facilitator and a barrier to scaling up the DSD model. Conclusions This review has important implications for policy, practice, and research as it increases understanding of the factors that influence DSD model implementation and scale up. Large-scale studies based on implementation and scale up theories, models, and frameworks focusing on each DSD model in each healthcare setting are needed.

ObjectivesResearch about decision-making capacity has been growing in the last decades. That relates to more concerns regarding patients’ autonomy, and an increase in diseases that can negatively impact capacity. This research aims to: explore perceptions, legal aspects, and assessment procedures related to healthcare decision-making capacity in older adults with cognitive impairment; and study the first version of a new assessment instrument of this capacity.MethodNine focus groups were conducted, including healthcare, law and justice, nursing home professionals, institutionalized older adults, and dwelling older adults. Focus group discussions followed semi-structured interview scripts, specifically developed for each group. After group discussions, the assessment instrument was presented, and participants were asked to evaluate each item relevance and comprehensibility. Qualitative coding of the transcriptions was performed with resource to MAXQDA, using direct content analysis.ResultsSix primary themes emerged from the qualitative analysis: Decision-making capacity features; Abilities implied in decision-making; Factors influencing decision-making; Obstacles to decision-making; Legal aspects; and Assessment procedures.DiscussionResults corroborate previous theoretical formulations of capacity. Generally, research results have implications for clinical and assessment practices, as well as preventive strategies that can improve older adult’s decision-making capacity. Assessment procedures of capacity should include a thorough protocol for the assessment of cognition, functionality, depressive symptoms, and decision-making abilities. In this respect, the need for an assessment tool that can provide valid information during evaluation processes is highlighted. Concerning the strategies to promote decision-making capacity, these rely on improving older adult’s health literacy and healthcare providers communication skills, as well as conduct actions to reduce stigma toward people with dementia.

Intimate partner violence (IPV) impacts career development and negatively influences employment prospects, education attainment, and financial earnings; yet there is a gap in research exploring the experiences of employment-seeking from the perspectives of survivors. An intersectional and social ecological perspective provides an important framework and highlights the multiple intersecting barriers of IPV and employment ranging from mental health concerns such as trauma, anxiety and depression to lack of shelter and childcare, limited access to employment services, and other forms of discrimination. This article responds to this gap in research and provides findings from a constructivist grounded theory study of 16 employment-seeking survivors of IPV. To theorize and understand IPV and employment utilizing an intersectional and social ecological framework, the following research question were addressed: (a) What are the contextual barriers or facilitators that shape the employment-seeking process of survivors of IPV? (b) How do the experiences of discrimination shape the employment-seeking experience of survivors of IPV? (c) What employment services were helpful or unhelpful during the employment-seeking process? Two main themes emerged from analysis: (a) Multilevel barriers to employment and (b) Employment barriers/facilitators to employment-seeking. Findings indicate that survivors of IPV face multiple barriers to employment at the intrapersonal (e.g., depression, anxiety, trauma, low self-esteem), interpersonal (e.g., ties to an abusive partner, responsibilities related to childcare), community (lack of social support, few employment opportunities, poverty), and structural/institutionalized levels (e.g., racism, sexism, transphobia). Implications from these findings illustrate that employment-seeking is shaped by structural inequities, intersecting stigma, individual level barriers, and social identities, as well as experience of abuse, which is an important contribution to IPV research. This study provides insight into the complexities of employment-seeking and helps improve knowledge on the social ecological and intersecting barriers of employment from the perspectives of survivors.

Abstract The world's population is aging rapidly. Globally, the population of older people will nearly double in the next 30 years, from 12% to 22%. Unfortunately, many elderly people are often vulnerable to the development of mental health problems. Besides the development of mental disorders (such as depression) or neurological disorders (such as cognitive impairment), they often experience several health ailments and loss of functionality, which negatively impacts their mental health and wellbeing. The WHO points out that mental health problems among this group of people are under-identified by healthcare professionals and by older people and their relatives themselves, and that stigma surrounding these conditions makes people often reluctant to seek help. Therefore, more scientific research and debate is needed on mental health of older persons, especially from a public health perspective. By bringing together researchers on this domain from different countries and background, this workshop aims to contribute to the scientific insight in this topic and finally to the improvement of the mental health and wellbeing of this growing group of people. In this workshop, research findings on the prevalence of (undetected) mental health problems and the impact of organizational, social and physical conditions on these problems, among older persons, both institutionalized and not, will be presented and discussed by five researchers from different European countries. Dr. Sunwoo Lee (Czech Republic) will talk about the demographic, psychosocial, and health-related risk factors for suicidal ideation among older adults in 12 European countries. Dr. Patricia De Vriendt (Belgium) will give a presentation on the unnoticed mild cognitive problems in nursing homes in Flanders. Dr. Henriette van der Roest (the Netherlands) will show the relationship between organizational adaptions in Dutch nursing homes and cognitive improvement and quality of life among older persons with dementia. Dr. Jutta Lindert (Germany) will focus on the impact of social stress and strain on the episodic memory and executive functioning of the “Midlife in the United States (MIDUS) cohort. And finally Dr. Mauro Carta (Italy) will illustrate the positive effect of moderate physical activity on cognitive functioning and general wellbeing of older people. Key messages Mental health problems among the growing group of older people are prevalent and of different kind. More scientific insight is needed on the prevalence and determinants of these problems, in order to provide timely and adequate support and prevention.

“I’m fat–and it’s okay! It doesn’t mean I’m stupid, or ugly, or lazy, or selfish. I’m fat!” so proclaims Joy Nash in her YouTube video, A Fat Rant. “Fat! It’s three little letters–what are you afraid of?!” This is the question I pose to my class on day one of Fat Studies. Sadly, many college students do fear fat, and negative attitudes toward fat people are quite prevalent in this population (Ambwani et al. 366). As I teach it, Fat Studies is cross-listed between Psychology and Gender Studies. However, most students who enrol have majors in Psychology or other behavioural health science fields in which weight bias is particularly pronounced (Watkins and Concepcion 159). Upon finding stronger bias among third- versus first-year Physical Education students, O’Brien, Hunter, and Banks (308) speculated that the weight-centric curriculum that typifies this field actively engenders anti-fat attitudes. Based on their exploration of textbook content, McHugh and Kasardo (621) contend that Psychology too is complicit in propagating weight bias by espousing weight-centric messages throughout the curriculum. Such messages include the concepts that higher body weight invariably leads to poor health, weight control is simply a matter of individual choice, and dieting is an effective means of losing weight and improving health (Tylka et al.). These weight-centric tenets are, however, highly contested. For instance, there exists a body of research so vast that it has its own name, the “obesity paradox” literature. This literature (McAuley and Blair 773) entails studies that show that “obese” persons with chronic disease have relatively better survival rates and that a substantial portion of “overweight” and “obese” individuals have levels of metabolic health similar to or better than “normal” weight individuals (e.g., Flegal et al. 71). Finally, the “obesity paradox” literature includes studies showing that cardiovascular fitness is a far better predictor of mortality than weight. In other words, individuals may be both fit and fat, or conversely, unfit and thin (Barry et al. 382). In addition, Tylka et al. review literature attesting to the complex causes of weight status that extend beyond individual behaviour, ranging from genetic predispositions to sociocultural factors beyond personal control. Lastly, reviews of research on dieting interventions show that these are overwhelmingly ineffective in producing lasting weight loss or actual improvements in health and may in fact lead to disordered eating and other unanticipated adverse consequences (e.g., Bacon and Aphramor; Mann et al. 220; Salas e79; Tylka et al.).The newfound, interdisciplinary field of scholarship known as Fat Studies aims to debunk weight-centric misconceptions by elucidating findings that counter these mainstream suppositions. Health At Every Size® (HAES), a weight-neutral approach to holistic well-being, is an important facet of Fat Studies. The HAES paradigm advocates intuitive eating and pleasurable physical activity for health rather than restrictive dieting and regimented exercise for weight loss. HAES further encourages body acceptance of self and others regardless of size. Empirical evidence shows that HAES-based interventions improve physical and psychological health without harmful side-effects or high dropout rates associated with weight loss interventions (Bacon and Aphramor; Clifford et al. “Impact of Non-Diet Approaches” 143). HAES, like the broader field of Fat Studies, seeks to eradicate weight-based discrimination, positioning weight bias as a social justice issue that intersects with oppression based on other areas of difference such as gender, race, and social class. Much like Queer Studies, Fat Studies seeks to reclaim the word, fat, thus stripping it of its pejorative connotations. As Nash asserts in her video, “Fat is a descriptive physical characteristic. It’s not an insult, or an obscenity, or a death sentence!” As an academic discipline, Fat Studies is expanding its visibility and reach. The Fat Studies Reader, the primary source of reading for my course, provides a comprehensive overview of the field (Rothblum and Solovay 1). This interdisciplinary anthology addresses fat history and activism, fat as social inequality, fat in healthcare, and fat in popular culture. Ward (937) reviews this and other recently-released fat-friendly texts. The field features its own journal, Fat Studies: An Interdisciplinary Journal of Body Weight and Society, which publishes original research, overview articles, and reviews of assorted media. Both the Popular Culture Association and National Women’s Studies Association have special interest groups devoted to Fat Studies, and the American Psychological Association’s Division on the Psychology of Women has recently formed a task force on sizism (Bergen and Carrizales 22). Furthermore, Fat Studies conferences have been held in Australia and New Zealand, and the third annual Weight Stigma Conference will occur in Iceland, September 2015. Although the latter conference is not necessarily limited to those who align themselves with Fat Studies, keynote speakers include Ragen Chastain, a well-known member of the fat acceptance movement largely via her blog, Dances with Fat. The theme of this year’s conference, “Institutionalised Weightism: How to Challenge Oppressive Systems,” is consistent with Fat Studies precepts:This year’s theme focuses on the larger social hierarchies that favour thinness and reject fatness within western culture and how these systems have dictated the framing of fatness within the media, medicine, academia and our own identities. What can be done to oppose systemised oppression? What can be learned from the fight for social justice and equality within other arenas? Can research and activism be united to challenge prevailing ideas about fat bodies?Concomitantly, Fat Studies courses have begun to appear on college campuses. Watkins, Farrell, and Doyle-Hugmeyer (180) identified and described four Fat Studies and two HAES courses that were being taught in the U.S. and abroad as of 2012. Since then, a Fat Studies course has been taught online at West Virginia University and another will soon be offered at Washington State University. Additionally, a new HAES class has been taught at Saint Mary’s College of California during the last two academic years. Cameron (“Toward a Fat Pedagogy” 28) describes ways in which nearly 30 instructors from five different countries have incorporated fat studies pedagogy into university courses across an array of academic areas. This growing trend is manifested in The Fat Pedagogy Reader (Russell and Cameron) due out later this year. In this article, I describe content and pedagogical strategies that I use in my Fat Studies course. I then share students’ qualitative reactions, drawing upon excerpts from written assignments. During the term reported here, the class was comprised of 17 undergraduate and 5 graduate students. Undergraduate majors included 47% in Psychology, 24% in Women Studies, 24% in various other College of Liberal Arts fields, and 6% in the College of Public Health. Graduate majors included 40% in the College of Public Health and 60% in the College of Education. Following submission of final grades, students provided consent via email allowing written responses on assignments to be anonymously incorporated into research reports. Assignments drawn upon for this report include weekly reading reactions to specific journal articles in which students were to summarise the main points, identify and discuss a specific quote or passage that stood out to them, and consider and discuss applicability of the information in the article. This report also utilises responses to a final assignment in which students were to articulate take-home lessons from the course.Despite the catalogue description, many students enter Fat Studies with a misunderstanding of what the course entails. Some admitted that they thought the course was about reducing obesity and the presumed health risks associated with this alleged pathological condition (Watkins). Others understood, but were somewhat dubious, at least at the outset, “Before I began this class, I admit that I was skeptical of what Fat Studies meant.” Another student experienced “a severe cognitive dissonance” between the Fat Studies curriculum and that of a previous behavioural health class:My professor spent the entire quarter spouting off statistics, such as the next generation of children will be the first generation to have a lower life expectancy than their parents and the ever increasing obesity rates that are putting such a tax on our health care system, and I took her words to heart. I was scared for myself and for the populations I would soon be working with. I was worried that I was destined to a chronic disease and bothered that my BMI was two points above ‘normal.’ I believed everything my professor alluded to on the danger of obesity because it was things I had heard in the media and was led to believe all my life.Yet another related, “At first, I will be honest, it was hard for me to accept a lot of this information, but throughout the term every class changed my mind about my view of fat people.” A few students have voiced even greater initial resistance. During a past term, one student lamented that the material represented an attack on her intended behavioural health profession. Cameron (“Learning to Teach Everybody”) describes comparable reactions among students in her Critical Obesity course taught within a behavioural health science unit. Ward (937) attests that, even in Gender Studies, fat is the topic that creates the most controversy. Similarly, she describes students’ immense discomfort when asked to entertain perspectives that challenge deeply engrained ideas inculcated by our culture’s “obesity epidemic.” Discomfort, however, is not necessarily antithetical to learning. In prompting students to unlearn “the biomedically-informed truth of obesity, namely that fat people are unfit, unhealthy, and in need of ‘saving’ through expert interventions,” Moola at al. recommend equipping them with an “ethics of discomfort” (217). No easy task, “It requires courage to ask our students to forgo the security of prescriptive health messaging in favour of confusion and uncertainty” (221). I encourage students to entertain conflicting perspectives by assigning empirically-based articles emanating from peer-reviewed journals in their own disciplines that challenge mainstream discourses on obesity (e.g., Aphramor; Bombak e60; Tomiyama, Ahlstrom, and Mann 861). Students whose training is steeped in the scientific method seem to appreciate having quantitative data at their disposal to convince themselves–and their peers and professors–that widely held weight-centric beliefs and practices may not be valid. One student remarked, “Since I have taken this course, I feel like I am prepared to discuss the fallacy of the weight-health relationship,” citing specific articles that would aid in the effort. Likewise, Cameron’s (“Learning to Teach Everybody”) students reported a need to read research reports in order to begin questioning long-held beliefs.In addition, I assign readings that provide students with the opportunity to hear the voices of fat people themselves, a cornerstone of Fat Studies. Besides chapters in The Fat Studies Reader authored by scholars and activists who identify as fat, I assign qualitative articles (e.g., Lewis et al.) and narrative reports (e.g., Pause 42) in which fat people describe their experiences with weight and weight bias. Additionally, I provide positive images of fat people via films and websites (Clifford et al. HAES®; Watkins; Watkins and Doyle-Hugmeyer 177) in order to counteract the preponderance of negative, dehumanising portrayals in popular media (e.g., Ata and Thompson 41). In response, a student stated:One of the biggest things I took away from this term was the confidence I found in fat women through films and stories. They had more confidence than I have seen in any tiny girl and owned the body they were given.I introduce “normal” weight allies as well, most especially Linda Bacon whose treatise on thin privilege tends to set the stage for viewing weight bias as a form of oppression (Bacon). One student observed, “It was a relief to be able to read and talk about weight oppression in a classroom setting for once.” Another appreciated that “The class did a great job at analysing fat as oppression and not like a secondhand oppression as I have seen in my past classes.” Typically, fat students were already aware of weight-based privilege and oppression, often painfully so. Thinner students, however, were often astonished by this concept, several describing Bacon’s article as “eye-opening.” In reaction, many vowed to act as allies:This class has really opened my eyes and prepared me to be an ally to fat people. It will be difficult for some time while I try to get others to understand my point of view on fat people but I believe once there are enough allies, people’s minds will really start changing and it will benefit everyone for the better.Pedagogically, I choose to share my own experiences as they relate to course content and encourage students, at least in their written assignments, to do the same. Other instructors refrain from this practice for fear of reinforcing traditional discourses or eliciting detrimental reactions from students (Watkins, Farrell, and Doyle-Hugmeyer 191). Nevertheless, this tack seems to work well in my course, with many students opting to disclose their relevant circumstances during classroom discussions: Throughout the term I very much valued and appreciated when classmates would share their experiences. I love listening and hearing to others experiences and I think that is a great way to understand the material and learn from one another.It really helped to read different articles and hear classmates discuss and share stories that I was able to relate to. The idea of hearing people talk about issues that I thought I was the only one who dealt with was so refreshing and enlightening.The structure of this class allowed me to learn how this information is applicable to my life and made it deeper than just memorising information.Thus far, across three terms, no student has described iatrogenic effects from this process. In fact, most attribute positive transformations to the class. These include enhanced body acceptance of self and others: This class decreased my fat phobia towards others and gave me a better understanding about the intersectionality of one’s weight. For example, I now feel that I no longer view my family in a fat phobic way and I also feel responsible for educating my brother and helping him develop a strong self-esteem regardless of his size.I never thought this class would change my life, almost save my life. Through studies shown in class and real life people following their dreams, it made my mind completely change about how I view my body and myself.I can only hope that in the future, I will be more forgiving, tolerant, and above all accepting of myself, much less others. Regardless of a person’s shape and size, we are all beautiful, and while I’m just beginning to understand this, it can only get better from here.Students also reported becoming more savvy consumers of weight-centric media messages as well as realigning their eating and exercise behaviour in accordance with HAES: I find myself disgusted at the television now, especially with the amount of diet ads, fitness club ads, and exercise equipment ads all aimed at making a ‘better you.’ I now know that I would never be better off with a SlimFast shake, P90X, or a Total Gym. I would be better off eating when I’m hungry, working out because it is fun, and still eating Thin Mints when I want to. Prior to this class, I would work out rigorously, running seven miles a day. Now I realise why at times I dreaded to work out, it was simply a mathematical system to burn the energy that I had acquired earlier in the day. Instead what I realise I should do is something I enjoy, that way I will never get tired of whatever I am doing. While I do enjoy running, other activities would bring more joy while engaging in a healthy lifestyle like hiking or mountain biking.I will never go on another diet. I will stop choosing exercises I don’t love to do. I will not weigh myself every single day hoping for the number on the scale to change.A reduction in self-weighing was perhaps the most frequent behaviour change that students expressed. This is particularly valuable in that frequent self-weighing is associated with disordered eating and unhealthy weight control behaviours (Neumark-Sztainer et al. 811):I have realised that the number on the scale is simply a number on the scale. That number does not define who you are. I have stopped weighing myself every morning. I put the scale in the storage closet so I don’t have to look at it. I even encouraged my roommate to stop weighing herself too. What has been most beneficial for me to take away from this class is the notion that the number on the scale has so much less to do with fitness levels than most people understand. Coming from a numbers obsessed person like myself, this class has actually gotten me to leave the scales behind. I used to weigh myself every single day and my self-confidence reflected whether I was up or down in weight from the day before. It seems so silly to me now. From this class, I take away a new outlook on body diversity. I will evaluate who I am for what I do and not represent myself with a number. I’m going to have my cake this time, and actually eat it too!Finally, students described ways in which they might carry the concepts from Fat Studies into their future professions: I want to go to law school. This model is something I will work toward in the fight for social justice.As a teacher and teacher of teachers, I plan to incorporate discussions on size diversity and how this should be addressed within the field of adapted physical education.I do not know how I would have gone forward if I had never taken this class. I probably would have continued to use weight loss as an effective measure of success for both nutrition and physical activity interventions. I will never be able to think about the obesity prevention movement in the same way.Since I am working toward being a clinical psychologist, I don’t want to have a client who is pursuing weight loss and then blindly believe that they need to lose weight. I’d rather be of the mindset that every person is unique, and that there are other markers of health at every size.Jones and Hughes-Decatur (59) call for increased scholarship illustrating and evaluating critical body pedagogies so that teachers might provide students with tools to critique dominant discourses, helping them forge healthy relationships with their own bodies in the process. As such, this paper describes elements of a Fat Studies class that other instructors may choose to adopt. It additionally presents qualitative data suggesting that students came to think about fat and fat people in new and divergent ways. Qualitative responses also suggest that students developed better body image and more adaptive eating and exercise behaviours throughout the term. Although no students have yet described lasting adverse effects from the class, one stated that she would have preferred less of a focus on health and more of a focus on issues such as fat fashion. Indeed, some Fat Studies scholars (e.g., Lee) advocate separating discussions of weight bias from discussions of health status to avoid stigmatising fat people who do experience health problems. While concerns about fostering healthism within the fat acceptance movement are valid, as a behavioural health professional with an audience of students training in these fields, I have chosen to devote three weeks of our ten week term to this subject matter. Depending on their academic background, others who teach Fat Studies may choose to emphasise different aspects such as media representations or historical connotations of fat.Nevertheless, the preponderance of positive comments evidenced throughout students’ assignments may certainly be a function of social desirability. Although I explicitly invite critique, and in fact assign readings (e.g., Welsh 33) and present media that question HAES and Fat Studies concepts, students may still feel obliged to articulate acceptance of and transformations consistent with the principles of these movements. As a more objective assessment of student outcomes, I am currently conducting a quantitative evaluation, in which I remain blind to students’ identities, of this year’s Fat Studies course compared to other upper division/graduate Psychology courses, examining potential changes in weight bias, body image and dieting behaviour, adherence to appearance-related media messages, and obligatory exercise behaviour. I postulate results akin to those of Humphrey, Clifford, and Neyman Morris (143) who found reductions in weight bias, improved body image, and improved eating behaviour among college students as a function of their HAES course. As Fat Studies pedagogy proliferates, instructors are called upon to share their teaching strategies, document the effects, and communicate these results within and outside of academic spheres.ReferencesAmbwani, Suman, Katherine M. Thomas, Christopher J. Hopwood, Sara A. Moss, and Carlos M. Grilo. “Obesity Stigmatization as the Status Quo: Structural Considerations and Prevalence among Young Adults in the U.S.” Eating Behaviors 15.3 (2014): 366-370. Aphramor, Lucy. “Validity of Claims Made in Weight Management Research: A Narrative Review of Dietetic Articles.” Nutrition Journal 9 (2010): n. pag. 15 May 2015 ‹http://www.nutritionj.com/content/9/1/30›.Ata, Rheanna M., and J. Kevin Thompson. “Weight Bias in the Media: A Review of Recent Research.” Obesity Facts 3.1 (2010): 41-46.Bacon, Linda. “Reflections on Fat Acceptance: Lessons Learned from Thin Privilege.” 2009. 23 Apr. 2015 ‹http://www.lindabacon.org/Bacon_ThinPrivilege080109.pdf›.Bacon, Linda, and Lucy Aphramor. “Weight Science: Evaluating the Evidence for a Paradigm Shift.” Nutrition Journal 10 (2011). 23 Apr. 2015 ‹http://www.nutritionj.com/content/10/1/9›.Barry, Vaughn W., Meghan Baruth, Michael W. Beets, J. Larry Durstine, Jihong Liu, and Steven N. Blair. “Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis.” Progress in Cardiovascular Diseases 56.4 (2014): 382-390.Bergen, Martha, and Sonia Carrizales. “New Task Force Focused on Size.” The Feminist Psychologist 42.1 (2015): 22.Bombak, Andrea. “Obesity, Health at Every Size, and Public Health Policy.” American Journal of Public Health 104.2 (2014): e60-e67.Cameron, Erin. “Learning to Teach Everybody: Exploring the Emergence of an ‘Obesity” Pedagogy’.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press.Cameron, Erin. “Toward a Fat Pedagogy: A Study of Pedagogical Approaches Aimed at Challenging Obesity Discourses in Post-Secondary Education.” Fat Studies 4.1 (2015): 28-45.Chastain, Ragen. Dances with Fat. 15 May 2015 ‹https://danceswithfat.wordpress.com/blog/›.Clifford, Dawn, Amy Ozier, Joanna Bundros, Jeffrey Moore, Anna Kreiser, and Michele Neyman Morris. “Impact of Non-Diet Approaches on Attitudes, Behaviors, and Health Outcomes: A Systematic Review.” Journal of Nutrition Education and Behavior 47.2 (2015): 143-155.Clifford, Dawn, Patti Lou Watkins, and Rebecca Y. Concepcion. “HAES® University: Bringing a Weight Neutral Message to Campus.” Association for Size Diversity and Health, 2015. 23 Apr. 2015 ‹https://www.sizediversityandhealth.org/content.asp?id=258›.Fat Studies: An Interdisciplinary Journal of Body Weight and Society. 23 Apr. 2015 ‹http://www.tandfonline.com/toc/ufts20/current#.VShpqdhFDBC›.Flegal, Katherine M., Brian K. Kit, Heather Orpana, and Barry L. Graubard. “Association of All-Cause Mortality with Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-Analysis.” Journal of the American Medical Association 309.1 (2013): 71-82.Humphrey, Lauren, Dawn Clifford, and Michelle Neyman Morris. “Health At Every Size College Course Reduces Dieting Behaviors and Improves Intuitive Eating, Body Esteem, and Anti-Fat Attitudes.” Journal of Nutrition Education and Behavior, in press.Jones, Stephanie, and Hilary Hughes-Decatur. “Speaking of Bodies in Justice-Oriented Feminist Teacher Education.” Journal of Teacher Education 63.1 (2012): 51-61.Lee, Jenny. Embodying Stereotypes: Memoir, Fat and Health. Fat Studies: Reflective Intersections, July 2012, Wellington, NZ. Unpublished conference paper.Lewis, Sophie, Samantha L. Thomas, Jim Hyde, David Castle, R. Warwick Blood, and Paul A. Komesaroff. “’I Don't Eat a Hamburger and Large Chips Every Day!’ A Qualitative Study of the Impact of Public Health Messages about Obesity on Obese Adults.” BMC Public Health 10.309 (2010). 23 Apr 2015 ‹http://www.biomedcentral.com/1471-2458/10/309›.Mann, Traci, A. Janet Tomiyama, Erika Westling, Ann-Marie Lew, Barbara Samuels, and Jason Chatman. “Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer.” American Psychologist 62.3 (2007): 220-233.McAuley, Paul A., and Steven N. Blair. “Obesity Paradoxes.” Journal of Sports Sciences 29.8 (2011): 773-782. McHugh, Maureen C., and Ashley E. Kasardo. “Anti-Fat Prejudice: The Role of Psychology in Explication, Education and Eradication.” Sex Roles 66.9-10 (2012): 617-627.Moola, Fiona J., Moss E. Norman, LeAnne Petherick, and Shaelyn Strachan. “Teaching across the Lines of Fault in Psychology and Sociology: Health, Obesity and Physical Activity in the Canadian Context.” Sociology of Sport Journal 31.2 (2014): 202-227.Nash, Joy. “A Fat Rant.” YouTube, 17 Mar. 2007. 23 Apr. 2015 ‹https://www.youtube.com/watch?v=yUTJQIBI1oA›.Neumark-Sztainer, Dianne, Patricia van den Berg, Peter J. Hannan, and Mary Story. “Self-Weighing in Adolescents: Helpful or Harmful? Longitudinal Associations with Body Weight Changes and Disordered Eating.” Journal of Adolescent Health 39.6 (2006): 811–818.O’Brien, K.S., J.A. Hunter, and M. Banks. “Implicit Anti-Fat Bias in Physical Educators: Physical Attributes, Ideology, and Socialization.” International Journal of Obesity 31.2 (2007): 308-314.Pause, Cat. “Live to Tell: Coming Out as Fat.” Somatechnics 2.1 (2012): 42-56.Rothblum, Esther, and Sondra Solovay, eds. The Fat Studies Reader. New York: New York University Press, 2009.Russell, Connie, and Erin Cameron, eds. The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. New York: Peter Lang Publishing, in press. Salas, Ximena Ramos. “The Ineffectiveness and Unintended Consequences of the Public Health War on Obesity.” Canadian Journal of Public Health 106.2 (2015): e79-e81. Tomiyama, A. Janet, Britt Ahlstrom, and Traci Mann. “Long-Term Effects of Dieting: Is Weight Loss Related to Health?” Social and Personality Psychology Compass 7.12 (2013): 861-877.Tylka, Tracy L., Rachel A. Annunziato, Deb Burgard, Sigrun Daníelsdóttir, Ellen Shuman, Chad Davis, and Rachel M. Calogero. “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.” Journal of Obesity (2014). 23 Apr. 2015 ‹http://www.hindawi.com/journals/jobe/2014/983495/›.Ward, Anna E. “The Future of Fat.” American Quarterly 65.4 (2013): 937-947.Watkins, Patti Lou. “Inclusion of Fat Studies in a Difference, Power, and Discrimination Curriculum.” The Fat Pedagogy Reader: Challenging Weight-Based Oppression in Education. Eds. Erin Cameron and Connie Russell. New York: Peter Lang Publishing, in press. Watkins, Patti Lou, and Rebecca Y. Concepcion. “Teaching HAES to Health Care Students and Professionals.” Wellness Not Weight: Motivational Interviewing and a Non-Diet Approach. Ed. Ellen Glovsky. San Diego: Cognella Academic Publishing, 2014: 159-169. Watkins, Patti Lou, and Andrea Doyle-Hugmeyer. “Teaching about Eating Disorders from a Fat Studies Perspective. Transformations 23.2 (2013): 147-158. Watkins, Patti Lou, Amy E. Farrell, and Andrea Doyle Hugmeyer. “Teaching Fat Studies: From Conception to Reception. Fat Studies 1.2 (2012): 180-194. Welsh, Taila L. “Healthism and the Bodies of Women: Pleasure and Discipline in the War against Obesity.” Journal of Feminist Scholarship 1 (2011): 33-48. Weight Stigma Conference. 23 Apr. 2015 ‹http://stigmaconference.com/›.

Introduction The decline of marriage in the West has been extensively researched over the last three decades (Carmichael and Whittaker; de Vaus; Coontz; Beck-Gernshein). Indeed, it was fears that the institution would be further eroded by the legalisation of same sex unions internationally that provided the impetus for the Australian government to amend the Marriage Act (1961). These amendments in 2004 sought to strengthen marriage by explicitly defining, for the first time, marriage as a legal partnership between one man and one woman. The subsequent heated debates over the discriminatory nature of this definition have been illuminating, particularly in the way they have highlighted the ongoing social significance of marriage, even at a time it is seen to be in decline. Demographic research about partnering practices (Carmichael and Whittaker; Simons; Parker; Penman) indicates that contemporary marriages are more temporary, fragile and uncertain than in previous generations. Modern marriages are now less about a permanent and “inescapable” union between a dominant man and a submissive female for the purposes of authorised sex, legal progeny and financial security, and more about a commitment between two social equals for the mutual exchange of affection and companionship (Croome). Less research is available, however, about how couples themselves reconcile the inherited constructions of romantic love as selfless and unending, with trends that clearly indicate that romantic love is not forever, ideal or exclusive. Civil marriage ceremonies provide one source of data about representations of love. Civil unions constituted almost 70 per cent of all marriages in Australia in 2010, according to the Australian Bureau of Statistics. The civil marriage ceremony has both a legal and symbolic role. It is a legal contract insofar as it prescribes a legal arrangement with certain rights and responsibilities between two consenting adults and outlines an expectation that marriage is voluntarily entered into for life. The ceremony is also a public ritual that requires couples to take what are usually private feelings for each other and turn them into a public performance as a way of legitimating their relationship. Consistent with the conventions of performance, couples generally customise the rest of the ceremony by telling the story of their courtship, and in so doing they often draw upon the language and imagery of the Western Romantic tradition to convey the personal meaning and social significance of their decision. This paper explores how couples construct the idea of love in their relationship, first by examining the western history of romantic love and then by looking at how this discourse is invoked by Australians in the course of developing civil marriage ceremonies in collaboration with the author. A History of Romantic Love There are many definitions of romantic love, but all share similar elements including an intense emotional and physical attraction, an idealisation of each other, and a desire for an enduring and unending commitment that can overcome all obstacles (Gottschall and Nordlund; Janowiak and Fischer). Romantic love has historically been associated with heightened passions and intense almost irrational or adolescent feelings. Charles Lindholm’s list of clichés that accompany the idea of romantic love include: “love is blind, love overwhelms, a life without love is not worth living, marriage should be for love alone and anything less is worthless and a sham” (5). These elements, which invoke love as sacred, unending and unique, perpetuate past cultural associations of the term. Romantic love was first documented in Ancient Rome where intense feelings were seen as highly suspect and a threat to the stability of the family, which was the primary economic, social and political unit. Roman historian Plutarch viewed romantic love based upon strong personal attraction as disruptive to the family, and he expressed a fear that romantic love would become the norm for Romans (Lantz 352). During the Middle Ages romantic love emerged as courtly love and, once again, the conventions that shaped its expression grew out of an effort to control excessive emotions and sublimate sexual desire, which were seen as threats to social stability. Courtly love, according to Marilyn Yalom, was seen as an “irresistible and inexhaustible passion; a fatal love that overcomes suffering and even death” (66). Feudal social structures had grounded marriage in property, while the Catholic Church had declared marriage a sacrament and a ceremony through which God’s grace could be obtained. In this context courtly love emerged as a way of dealing with the conflict between the individual and family choices over the martial partner. Courtly love is about a pure ideal of love in which the knight serves his unattainable lady, and, by carrying out feats in her honour, reaches spiritual perfection. The focus on the aesthetic ideal was a way to fulfil male and female emotional needs outside of marriage, while avoiding adultery. Romantic love re-appeared again in the mid-eighteenth century, but this time it was associated with marriage. Intellectuals and writers led the trend normalising romantic love in marriage as a reaction to the Enlightenment’s valorisation of reason, science and materialism over emotion. Romantics objected to the pragmatism and functionality induced by industrialisation, which they felt destroyed the idea of the mysterious and transcendental nature of love, which could operate as a form of secular salvation. Love could not be bought or sold, argued the Romantics, “it is mysterious, true and deep, spontaneous and compelling” (Lindholm 5). Romantic love also emerged as an expression of the personal autonomy and individualisation that accompanied the rise of industrial society. As Lanz suggests, romantic love was part of the critical reflexivity of the Enlightenment and a growing belief that individuals could find self actualisation through the expression and expansion of their “emotional and intellectual capacities in union with another” (354). Thus it was romantic love, which privileges the feelings and wishes of an individual in mate selection, that came to be seen as a bid for freedom by the offspring of the growing middle classes coerced into marriage for financial or property reasons. Throughout the 19th century romantic love was seen as a solution to the dehumanising forces of industrialisation and urbanisation. The growth of the competitive workplace—which required men to operate in a restrained and rational manner—saw an increase in the search for emotional support and intimacy within the domestic domain. It has been argued that “love was the central preoccupation of middle class men from the 1830s until the end of the 19th century” (Stearns and Knapp 771). However, the idealisation of the aesthetic and purity of love impacted marriage relations by casting the wife as pure and marital sex as a duty. As a result, husbands pursued sexual and romantic relationships outside marriage. It should be noted that even though love became cemented as the basis for marriage in the 19th century, romantic love was still viewed suspiciously by religious groups who saw strong affection between couples as an erosion of the fundamental role of the husband in disciplining his wife. During the late 19th and early 20th centuries romantic love was further impacted by urbanisation and migration, which undermined the emotional support provided by extended families. According to Stephanie Coontz, it was the growing independence and mobility of couples that saw romantic love in marriage consolidated as the place in which an individual’s emotional and social needs could be fully satisfied. Coontz says that the idea that women could only be fulfilled through marriage, and that men needed women to organise their social life, reached its heights in the 1950s (25-30). Changes occurred to the structure of marriage in the 1960s when control over fertility meant that sex was available outside of marriage. Education, equality and feminism also saw women reject marriage as their only option for fulfilment. Changes to Family Law Acts in western jurisdictions in the 1970s provided for no-fault divorce, and as divorce lost its stigma it became acceptable for women to leave failing marriages. These social shifts removed institutional controls on marriage and uncoupled the original sexual, emotional and financial benefits packaged into marriage. The resulting individualisation of personal lifestyle choices for men and women disrupted romantic conventions, and according to James Dowd romantic love came to be seen as an “investment” in the “future” that must be “approached carefully and rationally” (552). It therefore became increasingly difficult to sustain the idea of love as a powerful, mysterious and divine force beyond reason. Methodology In seeking to understand how contemporary partnering practices are reconstituting romantic love, I draw upon anecdotal data gathered over a nine-year period from my experiences as a marriage celebrant. In the course of personalising marriage ceremonies, I pose a series of questions designed to assist couples to explain the significance of their relationship. I generally ask brides and grooms why they love their fiancé, why they want to legalise their relationship, what they most treasure about their partner, and how their lives have been changed by their relationship. These questions help couples to reflexively interrogate their own relationship, and by talking about their commitment in concrete terms, they produce the images and descriptions that can be used to describe for guests the internal motivations and sentiments that have led to their decision to marry. I have had couples, when prompted to explain how they know the other person loves them say, in effect: “I know that he loves me because he brings me a cup of coffee every morning” or “I know that she loves me because she takes care of me so well.” These responses are grounded in a realism that helps to convey a sense of sincerity and authenticity about the relationship to the couple’s guests. This realism also helps to address the cynicism about the plausibility of enduring love. The brides and grooms in this sample of 300 couples were a socially, culturally and economically diverse group, and they provided a wide variety of responses ranging from deeply nuanced insights into the nature of their relationship, to admissions that their feelings were so private and deeply felt that words were insufficient to convey their significance. Reoccurring themes, however, emerged across the cases, and it is evident that even as marriage partnerships may be entered into for a variety of reasons, romantic love remains the mechanism by which couples talk of their feelings for each other. Australian Love and Marriage Australians' attitudes to romantic love and marriage have, understandably, been shaped by western understandings of romantic love. It is evident, however, that the demands of late modern capitalist society, with its increased literacy, economic independence and sexual equality between men and women, have produced marriage as a negotiable contract between social equals. For some, like Carol Pateman, this sense of equality within marriage may be illusory. Nonetheless, the drive for individual self-fulfilment by both the bride and groom produces a raft of challenges to traditional ideas of marriage as couples struggle to find a balance between independence and intimacy; between family and career; and between pursuing personal goals and the goals of their partners. This shift in the nature of marriage has implications for the “quest for undying romantic love,” which according to Anthony Giddens has been replaced by other forms of relationship, "each entered into for its own sake, for what can be derived by each person from a sustained association with another; and which is continued only in so far as it is thought by both parties to deliver enough satisfactions for each individual to stay within it” (qtd. in Lindholm 6). The impact of these social changes on the nature of romantic love in marriage is evident in how couples talk about their relationship in the course of preparing a ceremony. Many couples describe the person they are marrying as their best friend, and friendship is central to their commitment. This description supports research by V.K. Oppenheimer which indicates that many contemporary couples have a more “egalitarian collaborative approach to marriage” (qtd. in Carmichael and Whittaker 25). It is also standard for couples to note in ceremonies that they make each other happy and contented, with many commenting upon how their partners have helped to bring focus and perspective to their work-oriented lives. These comments tend to invoke marriage as a refuge from the isolation, competition, and dehumanising elements of workplaces. Since emotional support is central to the marriage contract, it is not surprising that care for each other is another reoccurring theme in ceremonies. Many brides and grooms not only explicitly say they are well taken care of by their partner, but also express admiration for their partner’s treatment of their families and friends. This behaviour appears to be seen as an indicator of the individual’s capacity for support and commitment to family values. Many couples admire partner’s kindness, generosity and level of personal self-sacrifice in maintaining the relationship. It is also not uncommon for brides and grooms to say they have been changed by their love: become kinder, more considerate and more tolerant. Honesty, communication skills and persistence are also attributes that are valued. Brides and grooms who have strong communication skills are also praised. This may refer to interpersonal competency and the willingness to acquire the skills necessary to negotiate the endless compromises in contemporary marriage now that individualisation has undermined established rules, rituals and roles. Persistence and the ability not to be discouraged by setbacks is also a reoccurring theme, and this connects with the idea that marriage is work. Many couples promise to grow together in their marriage and to both take responsibility for the health of their relationship. This promise implies awareness that marriage is not the fantasy of happily ever after produced in romantic popular culture, but rather an arrangement that requires hard work and conscious commitment, particularly in building a union amidst many competing options and distractions. Many couples talk about their relationship in terms of companionship and shared interests, values and goals. It is also not uncommon for couples to say that they admire their partner for supporting them to achieve their life goals or for exposing them to a wider array of lifestyle choices and options like travel or study. These examples of interdependence appear to make explicit that couples still see marriage as a vehicle for personal freedom and self-realisation. The death of love is also alluded to in marriage ceremonies. Couples talk of failed past relationships, but these are produced positively as a mechanism that enables the couple to know that they have now found an enduring relationship. It is also evident that for many couples the decision to marry is seen as the formalisation of a preexisting commitment rather than the gateway to a new life. This is consistent with figures that show that 72 per cent of Australian couples chose to cohabit before marriage (Simons 48), and that cohabitation has become the “normative pathway to marriage” (Penman 26). References to children also feature in marriage ceremonies, and for the couples I have worked with marriage is generally seen as the pre-requisite for children. Couples also often talk about “being ready” for marriage. This seems to refer to being financially prepared. Robyn Parker citing the research of K. Edin concludes that for many modern couples “rushing into marriage before being ‘set’ is irresponsible—marrying well (in the sense of being well prepared) is the way to avoid divorce” (qtd. in Parker 81). From this overview of reoccurring themes in the production of Australian ceremonies it is clear that romantic love continues to be associated with marriage. However, couples describe a more grounded and companionable attachment. These more practical and personalised sentiments serve to meet both the public expectation that romantic love is a precondition for marriage, while also avoiding the production of romantic love in the ceremony as an empty cliché. Grounded descriptions of love reveal that attraction does not have to be overwhelming and unconquerable. Indeed, couples who have lived together and are intimately acquainted with each other’s habits and disposition, appear to be most comfortable expressing their commitment to each other in more temperate, but no less deeply felt, terms. Conclusion This paper has considered how brides and grooms constitute romantic love within the shifting partnering practices of contemporary Australia. It is evident “in the midst of significant social and economic change and at a time when individual rights and freedom of choice are important cultural values” marriage remains socially significant (Simons 50). This significance is partially conveyed through the language of romantic love, which, while freighted with an array of cultural and historical associations, remains the lingua franca of marriage, perhaps because as Roberto Unger observes, romantic love is “the most influential mode of moral vision in our culture” (qtd. in Lindholm 5). It is thus possible to conclude, that while marriage may be declining and becoming more fragile and impermanent, the institution remains important to couples in contemporary Australia. Moreover, the language and imagery of romantic love, which publicly conveys this importance, remains the primary mode of expressing care, affection and hope for a partnership, even though the changed partnering practices of late modern capitalist society have exposed the utopian quality of romantic love and produced a cynicism about the viability of its longevity. It is evident in the marriage ceremonies prepared by the author that while the language of romantic love has come to signify a broader range of more practical associations consistent with the individualised nature of modern marriage and demystification of romantic love, it also remains the best way to express what Dowd and Pallotta describe as a fundamental human “yearning for communion with and acceptance by another human being” (571). References Beck, U., and E. Beck-Gernsheim, Individualisation: Institutionalised Individualism and Its Social and Political Consequences. London: Sage, 2002. Beigel, Hugo G. “Romantic Love.” American Sociological Review 16.3 (1951): 326–34. Carmichael, Gordon A, and Andrea Whittaker. “Forming Relationships in Australia: Qualitative Insights into a Process Important to Human Well Being.” Journal of Population Research 24.1 (2007): 23–49. Coontz, Stephanie. Marriage, A History: How Love Conquered Marriage. New York: Viking, 2005. Croome, Rodney. “Love and Commitment, To Equality.” The Drum Opinion, Australian Broadcasting Corporation (ABC) News. 8 June 2011. 14 Aug. 2012 < http://www.abc.net.au/unleashed/2749898.html >. de Vaus, D.L. Qu, and R. Weston. “Family Trends: Changing Patterns of Partnering.” Family Matters 64 (2003): 10–15. Dowd, James T, and Nicole R. Pallotta. “The End of Romance: The Demystification of Love in the Postmodern Age.” Sociological Perspectives 43.4 (2000): 549–80. Gottschall, Jonathan, and Marcus Nordlund. “Romantic Love: A Literary Universal?” Philosophy and Literature 30 (2006): 450–70. Jankowiak, William, and Ted Fischer, “A Cross-Cultural Perspective on Romantic Love,” Ethnology 31 (1992): 149–55. Lantz, Herman R. “Romantic Love in the Pre-Modern Period: A Sociological Commentary.” Journal of Social History 15.3 (1982): 349–70. Lindholm, Charles. “Romantic Love and Anthropology.” Etnofoor 19:1 Romantic Love (2006): 5–21. Parker, Robyn. “Perspectives on the Future of Marriage.” Australian Institute of Family Studies 72 Summer (2005): 78–82.Pateman, Carole. “Women and Consent.” Political Theory (1980): 149–68. Penman, Robyn. “Current Approaches to Marriage and Relationship Research in the United States and Australia.” Family Matters 70 Autumn (2005): 26–35. Simons, Michelle. “(Re)-forming Marriage in Australia?” Australian Institute of Family Matters 73 (2006): 46–51.Stearns, Peter N, and Mark Knapp. “Men and Romantic Love: Pinpointing a 20th-Century Change.” Journal of Social History 26.4 (1993): 769–95. Yalom, Marilyn. A History of the Wife. New York: Harper Collins, 2001.

Introduction Gore Vidal, the famous writer and literary critic, was recently buried next to his long-term partner, Howard Austen. The couple, who met in the 1950s, had lived together happily for decades. They were in many ways the kind of same-sex couple frequently valorised in contemporary gay marriage campaigns. Vidal and Austen, however, could not serve as emblematic figures for this campaign, and not only because the two men had no interest in marriage. Vidal, who reportedly had over a hundred lovers, both male and female, once attributed the longevity of their relationship to its platonic nature; both men continued to sleep with other people, and they reportedly stopped having sex with each other after they moved in together (Vidal, Palimpsest, 131–32). A relationship that decoupled monogamy, romance, companionship, and sexuality, and reconnected them in a way that challenged the accepted truths of institutionalised marriage, stands as an implicit questioning of the way in which gay marriage campaigns construct the possibilities for life, love, and sex. It is this questioning that we draw out in this article. In his writing, Vidal also offers a perspective that challenges the assumptions and certainties of contemporary politics around gay marriage. In 1981, he wrote “Some Jews and the Gays” in response to an article entitled “The Boys on the Beach” by conservative Jewish writer Midge Decter. Vidal’s riposte to Decter’s depiction of the snide superiority of the “boys” who disturbed her beachside family holidays highlighted the lack of solidarity conservative members of the Jewish community displayed towards another persecuted minority. From Vidal’s perspective, this was because Decter could not conceive of gay identity as anything other than pathological: Since homosexualists choose to be the way they are out of idle hatefulness, it has been a mistake to allow them to come out of the closet to the extent that they have, but now that they are out (which most are not), they will have no choice but to face up to their essential hatefulness and abnormality and so be driven to kill themselves with promiscuity, drugs, S-M, and suicide. (Vidal, Some Gays) In response, Vidal made a strong case for solidarity between Jews, African-Americans, and what he termed “homosexualists” (or “same-sexers”). More importantly for our argument, he also contested Decter’s depiction of the typical homosexual: To begin to get at the truth about homosexualists, one must realise that the majority of those millions of Americans who prefer same-sex to other-sex are obliged, sometimes willingly and happily but often not, to marry and have children and to conform to the guidelines set down by the heterosexual dictatorship. (Vidal, Some Gays) According to Vidal, Decter’s article applied only to a relatively privileged section of homosexualists who were able to be “self-ghettoized”, and who, despite Decter’s paranoid fantasies, lived lives perfectly “indifferent to the world of the other-sexers.” In the thirty years since the publication of “Some Jews and the Gays” much has clearly changed. It is unlikely that even a conservative publication would publish an article that depicts all homosexualists as marked by idle hatefulness. However, Decter’s self-hating homosexualist continues to haunt contemporary debates about same-sex marriage, albeit in sublimated form. Critiques of gay marriage campaigns, which are becoming increasingly difficult to ignore, often focus on the politics of inclusion and exclusion, whether on the terrain of gender (non)conformity (Spade), or the campaigns’ implicit and racialised assumption of a white, middle-class homosexual couple as the subject of their efforts (Riggs; Farrow). While our article is indebted to these critiques, our argument is focused more specifically on the unintended effect of the Australian debate about same-sex marriage, namely the (re)creation of the married couple’s other in the form of the adolescent, promiscuous, and unhappy homosexual. It is here that we find the source of our title, also chosen in tribute to Vidal, who in his life and writing disrupts this dichotomy. We argue that the construction of the respectable white middle-class same-sexer who sits at the centre of gay marriage discourse relies on a contemporary manifestation of the self-hating homosexualist – the sexually irresponsible queer constructed in contrast to the responsible gay. The first half of this article traces this construction. In the second section, we argue that this process cannot be divorced from the ways that advocates of same-sex marriage depict the institution of marriage. While critics such as Judith Butler have attempted to separate arguments against homophobic discrimination from the need to advocate for marriage, we argue that the two are intrinsically linked in marriage equality campaigns. These campaigns seek to erase both the explicit critique of marriage found in Vidal’s article and the implicit possibility of living otherwise found in his life. Instead of a heterosexual dictatorship that can be successfully avoided, marriage is proclaimed to be not only benign but the only institution capable of saving self-hating queers from misery by turning them into respectable gay married couples. This is, therefore, not an article about today’s Midge Decters, but about how contemporary same-sex marriage supporters rely on a characterisation of those of us who would or could not choose to marry as, to return to Vidal (Some Jews), “somehow evil or inadequate or dangerous.” As queer people who continue to question both the desirability and inevitability of marriage, we are ultimately concerned with thinking through the political consequences of the same-sex marriage campaign’s obsessive focus on normative sexuality and on the supposedly restorative function of the institution of marriage itself. Hateful Queers and Patient Gays Contemporary supporters of gay marriage, like Vidal so many years earlier, do often oppose conservative attempts to label homosexualists as inherently pathological. Tim Wright, the former convenor of “Equal Love,” one of Australia’s primary same-sex marriage campaign groups, directly addressing this in an opinion piece for Melbourne’s The Age newspaper, writes, “Every so often, we hear them in the media calling homosexuals promiscuous or sick.” Disputing this characterisation, Wright supplants it with an image of patient lesbians and gay men “standing at the altar.” Unlike Vidal, however, Wright implicitly accepts the link between promiscuity and pathology. For Wright, homosexuals are not sick precisely because, and only to the extent that they accept, a forlorn chastity, waiting for their respectable monogamous sexuality to be sanctified through matrimony. A shared moral framework based upon conservative norms is a notable feature of same-sex marriage debates. Former Rainbow Labor convenor Ryan Heath articulates this most clearly in his 2010 Griffith Review article, excerpts of which also appeared in the metropolitan Fairfax newspapers. In this article, Heath argues that marriage equality would provide a much-needed dose of responsibility to “balance” the rights that Australia has accorded to homosexuals. For Heath, Australia’s gay and lesbian communities have been given sexual freedoms by an indulgent adult (heterosexual) society, but are not sufficiently mature to develop the social responsibilities that go with them: “Like teenagers getting their hands on booze and cars and freedom from parental surveillance for the first time, Australia’s gay and lesbian communities have enthusiastically taken up their new rights.” For Heath, the immaturity of the (adult) gay community, with its lack of married role models, results in profound effects for same-sex attracted youth: Consider what the absence of role models, development paths, and stability might do to those who cannot marry. Is there no connection between this and the disproportionate numbers of suicides and risky and addictive behaviours found in gay communities? It is this immaturity, rather than the more typically blamed homophobic prejudice, bullying or persecution, that is for Heath the cause of the social problems that disproportionately affect same-sex attracted adolescents. Heath continues, asking why, after journalist Jonathan Rauch, any parent would want to “condemn their child to…‘a partnerless life in a sexual underworld’.” His appeal to well-meaning parental desires for the security and happiness of children echoes countless insidious commentaries about the tragedy of homosexual existence, such as Decter’s above. These same commentaries continue to be used to justify exclusionary and even violent reactions by families and communities when children reveal their (non-heterosexual) sexualities. As for so many social conservatives, for Heath it is inconceivable to view a partnerless life as anything other than tragedy. Like Wright, he is also convinced that if one must be partnerless it is far better to be forlornly chaste than to participate in an “underworld” focused primarily on promiscuous sex. The opinions of those condemned to this purgatorial realm, either through compulsion or their own immaturity, are of little interest to Heath. When he states that “No families and couples I have interviewed in my research on the topic want this insecure existence,” we are to understand that it is only the desires of these responsible adults that matter. In this way, Heath explicitly invokes the image of what Mariana Valverde has called the “respectable same-sex couple”, homosexualists who are socially acceptable because being “same-sex” is the only thing that differentiates them from the white, middle-class norm that continues to sit at the heart of Australian politics. Heath goes on to describe marriage as the best “social safety net”, adopting the fiscal rhetoric of conservatives such as former federal leader of the Liberal party, Malcolm Turnbull. Turnbull argued in 2012’s annual Michael Kirby lecture (a lecture organised by Southern Cross University’s School of Law and Justice in tribute to the retired gay High Court justice) that same-sex marriage would save the state money, as other relationship recognition such as the 2008 Rudd reforms have. In one of the few passages widely reported from his speech he states: “There will plainly be less demand for social services, medical expenses, hospital care if people, especially older people, like Michael [Kirby] and [partner] Johan, live together as opposed to being in lonely isolation consoled only by their respective cats.” Same-sex marriage is not simply a fight for equality but a fight to rescue homosexualists from the immiserated and emotionally impoverished lives that they, through their lack of maturity, have constructed for themselves, and which, after a brief sojourn in the sexual underworld, can only end in a lonely feline-focused existence funded by the responsible citizens that constitute the bulk of society. We are told by gay marriage advocates that the acceptance of proper adult relationships and responsibilities will not only cure the self-hatred of same-sexers, but simultaneously end the hatred expressed through homophobia and bullying. In the most recent Victorian state election, for example, the Greens ran an online Q&A session about their policies and positions in which they wrote the following in response to a question on relationship recognition: “It would create a more harmonious, less discriminatory society, more tolerant of diversity. It would also probably reduce bullying against same-sex attracted teenagers and lower the suicide rate.” This common position has been carefully unpicked by Rob Cover, who argues that while there may be benefits for the health of some adults in recognition of same-sex marriage, there is absolutely no evidence of a connection between this and youth suicide. He writes: “We are yet to have evidence that there are any direct benefits for younger persons who are struggling to cope with being bullied, humiliated, shamed and cannot (yet) envisage a liveable life and a happy future—let alone a marriage ceremony.” While same-sex marriage advocates consider themselves to be speaking for these same-sex attracted youth, offering them a happy future in the form of a wedding, Cover reminds us that these are not the same thing. As we have shown here, this is not a process of simple exclusion, but an erasure of the possibility of a life outside of heteronormative or “respectable”, coupledom. The “respectable same-sex couple”, like its respectable heterosexual counterpart, not only denies the possibility of full participation in adult society to those without partners but also refuses the lived experience of the many people like Vidal and Austen who do not accept the absolute equation of domesticity, responsibility, and sexual monogamy that the institution of marriage represents. A Good Institution? The connection between marriage and the mythical end of homophobia is not about evidence, as Cover rightly points out. Instead it is based on an ideological construction of marriage as an inherently valuable institution. Alongside this characterisation of marriage as a magical solution to homophobia and other social ills, comes the branding of other models of living, loving and having sex as inherently inferior and potentially harmful. In this, the rhetoric of conservatives and same-sex marriage advocates becomes disturbingly similar. Margaret Andrews, the wife of former Howard minister Kevin and a prominent (straight) marriage advocate, featured in the news a couple of years ago after making a public homophobic outburst directed at (queer) writer Benjamin Law. In response, Andrews outlined what for her were the clearly evident benefits of marriage: “For centuries, marriage has provided order, stability, and nurture for both adults and children. Indeed, the status of our marriages influences our well-being at least as much as the state of our finances.” Despite being on the apparent opposite of the debate, Amanda Villis and Danielle Hewitt from Doctors for Marriage Equality agree with Andrews about health benefits, including, significantly, those linked to sexual behaviour: It is also well known that people in long term monogamous relationships engage in far less risky sexual behaviour and therefore have significantly lower rates of sexually transmitted infections. Therefore legalisation of same sex marriage can lead to a reduction in the rates of sexually transmitted disease by decreasing stigma and discrimination and also promoting long term, monogamous relationships as an option for LGBTI persons. Here same-sex marriage is of benefit precisely because it eradicates the social risks of contagion and disease attributed to risky and promiscuous queers. To the extent that queers continue to suffer it can be attributed to the moral deficiency of their current lifestyle. This results in the need to “promote” marriage and marriage-like relationships. However, this need for promotion denies that marriage itself could be subject to discussion or debate and constructs it as both permanent and inevitable. Any discussion which might question the valuation of marriage is forestalled through the rhetoric of choice, as in the following example from a contributor to the “Equal Love” website: We understand that not everyone will want to get married, but there is no denying that marriage is a fundamental institution in Australian society. The right to be married should therefore be available to all those who choose to pursue it. It is a right that we chose to exercise. (Cole) This seemingly innocuous language of choice performs a number of functions. The first is that it seeks to disallow political debates about marriage by simply reducing critiques of the institution to a decision not to partake in it. In a process mirroring the construction of queers as inherently immature and adolescent, as discussed in the previous section, this move brands political critiques of marriage as historical remnants of an immature radicalism that has been trumped by liberal maturity. The contribution of Alyena Mohummadally and Catherine Roberts to Speak Now highlights this clearly. In this piece, Roberts is described as having used “radical feminism” as a teenage attempt to fill a “void” left by the lack of religion in her life. The teenage Roberts considered marriage “a patriarchal institution to be dismantled” (134). However, ten years later, now happily living with her partner, Roberts finds that “the very institutions she once riled against were those she now sought to be a part of” (137). Roberts’ marriage conversion, explained through a desire for recognition from Mohummadally’s Muslim family, is presented as simply a logical part of growing up, leaving behind the teenage commitment to radical politics along with the teenage attraction to “bars and nightclubs.” Not coincidentally, “life and love” taught Roberts to leave both of these things behind (134). The second consequence of arguments based on choice is that the possibility of any other terrain of choice is erased. This rhetoric thus gives marriage a false permanence and stability, failing to recognise that social institutions are vulnerable to change, and potentially to crisis. Beyond the same-sex marriage debates, the last fifty years have demonstrated the vulnerability of marriage to social change. Rising divorce rates, increasing acceptance of de facto relationships and the social recognition of domestic violence and rape within marriage have altered marriage inescapably, and forced questions about its inevitability (see: Stacey). This fact is recognised by conservatives, such as gay marriage opponent Patrick Parkinson who stated in a recent opinion piece in the Sydney Morning Herald that a “heartening aspect” of the “otherwise divisive” debate around gay marriage is that it has marked a “turnaround” in support for marriage, particularly among feminists, gays and other progressives. Malcolm Turnbull also explains his transition to support for same-sex marriage rights on the basis of this very premise: “I am very firmly of the view that families are the foundation of our society and that we would be a stronger society if more people were married, and by that I mean formally, legally married, and fewer were divorced.” He continued, “Are not the gays who seek the right to marry, to formalise their commitment to each other, holding up a mirror to the heterosexuals who are marrying less frequently and divorcing more often?” As Parkinson and Turnbull note, the decision to prioritise marriage is a decision to not only accept the fundamental nature of marriage as a social institution but to further universalise it as a social norm against the historical trends away from such normalisation. This is also acknowledged by campaign group Australian Marriage Equality who suggests that people like Parkinson and Turnbull who are “concerned about the preservation of marriage may do best to focus on ways to increase its appeal amongst the current population, rather than direct their energies towards the exclusion of a select group of individuals from its privileges.” Rather than challenging conservatism then, the gay marriage campaign aligns itself with Turnbull and Parkinson against the possibility of living otherwise embodied in the shadowy figure of the sexually irresponsible queer. The connection between ideological support for marriage and the construction of the “respectable homosexual couple” is made explicit by Heath in the essay quoted earlier. It is, he says, part of “the pattern of Western liberal history” to include “in an institution good people who make a good case to join.” The struggle for gay marriage, he argues, is linked to that of “workers to own property, Indigenous Australians to be citizens, women to vote.” By including these examples, Heath implicitly highlights the assimilationist dimension of this campaign, a dimension which has been importantly emphasised by Damien Riggs. Heath’s formulation denies the possibility of Indigenous sovereignty beyond assimilationist incorporation into the Australian state, just as it denies the possibility of a life of satisfying love and sex beyond marriage. More generally, Heath fails to acknowledge that none of these histories have disrupted the fundamental power dynamics at play: the benefits of property ownership accrue disproportionately to the rich, those of citizenship to white Australians, and political power remains primarily in the hands of men. Despite the protestations of gay marriage advocates there is no reason to believe that access to marriage would end homophobia while racism, class-based exploitation, and institutional sexism continue. This too, is part of the pattern of Western liberal history. Conclusion Our intention here is not to produce an anti-marriage manifesto—there are many excellent ones out there (see: Conrad)—but rather to note that gay marriage campaigns are not as historically innocuous as they present themselves to be. We are concerned that the rush to enter fully into institutions that, while changed, remain synonymous with normative (hetero)sexuality, has two unintended but nonetheless concerning consequences. Gay marriage advocates risk not only the discarding of a vision in which people may choose to not worship at the altar of the nuclear family, they also reanimate a new version of Decter’s self-hating gay. Political blogger Tim Dunlop encapsulates the political logic of gay marriage campaigns when he says, rather optimistically, that barring homosexualists from marriage “is the last socially acceptable way of saying you are not like us, you do not count, you matter less.” An alternative view proffered here is that saying yes to gay marriage risks abandoning a project that says we do not wish to be like you, not because we matter less, but because we see the possibility of different lives, and we refuse to accept a normative political logic that brands those lives as inferior. In casting this critique as adolescent, as something that a mature community should have grown out of, the same-sex marriage campaign rejects what we see as the most important social contributions that “same-sexers” have made. Where we think Vidal was mistaken back in 1981 was in his assertion that we “same-sexers” have been simply indifferent to the world of the “other-sexers.” We have also turned a critical eye upon “heterosexualist” existence, offering important critiques of a so-called adult or responsible life. It is this history that queer writer Sara Ahmed reminds us of, when she celebrates the angry queer at the family dinner table who refuses to simply succumb to a coercive demand to be happy and pleasant. A similar refusal can be found in queer critiques of the “dead citizenship” of heterosexuality, described by José Esteban Muñoz as: a modality of citizenship that is predicated on negation of liveness or presentness on behalf of a routinized investment in futurity. This narrative of futurity is most familiar to those who live outside of it. It is the story of the [sic] nation's all-consuming investment in the nuclear family, and its particular obsession with the children, an investment that instantly translates into the (monological) future. (399) In the clamour to fully assert their membership in the world of adult citizenship, same-sex marriage advocates negate the potential liveness and presentness of queer experience, opting instead for the routinised futurity that Muñoz warns against. Imagining ourselves as forlorn figures, standing with tear-stained cheeks and quivering lips at the altar, waiting for normative relationships and responsible citizenship is not the only option. Like Vidal and Austen, with whom we began, queers are already living, loving, and fucking, in and above our sexual underworlds, imagining that just possibly there may be other ways to live, both in the present and in constructing different futures. References Ahmed, Sara. The Promise of Happiness. Durham: Duke UP, 2010. Andrews, Margaret. “A Health Check on Marriage.” The Punch, 13 Aug. 2010. 24 Sept. 2012 ‹http://www.thepunch.com.au/articles/a-health-check-on-marriage/›. Butler, Judith. “Is Kinship Always Already Heterosexual?” differences: A Feminist Journal of Cultural Studies 13.1 (2002): 14–44. Cole, Jules. “Marriage Equality Upholds the rights of all Australians.” Equal Love website, 24 Sept. 2012 ‹http://www.equallove.info/node/83›. Conrad, Ryan, ed. Against Equality: queer critiques of gay marriage. Lewiston: Against Equality Publishing Collective, 2010. Cover, Rob. “Is same-sex marriage an adequate responst to queer youth suicide?”Online Opinion: Australia’s e-journal of social and political debate, 22 Aug. 2012. 24 Sept. 2012 ‹http://www.onlineopinion.com.au/view.asp?article=14017›. Dunlop, Tim. “There is no excuse.” ABC The Drum Unleashed, 8 Apr. 2010. 24 Sept. 2012 ‹http://www.abc.net.au/unleashed/34402.html›. Farrow, Kenyon, “Why is gay marriage anti-black?” Against Equality: queer critiques of gay marriage. Ed. Ryan Conrad. Lewiston: Against Equality Publishing Collective, 2010. 21–33. Frequently Asked Questions, Australian Marriage Equality, 24 Sept. 2012 ‹http://www.australianmarriageequality.com/faqs.htm›. Grattan, Michelle. “Turnbull’s Gay Marriage Swipe.” The Age. 7 July 2012. 24 Sept. 2012 ‹http://www.smh.com.au/opinion/political-news/turnbulls-gay-marriage-swipe-20120706-21mou.html›. Heath, Ryan. “Love in a Cold Climate.” Griffith Review. 29 (2010). 24 Sept. 2012 ‹http://www.griffithreview.com/edition-29-prosper-or-perish/251-essay/949.html›. Mohummadally, Alyena and Catherine Roberts. “When Worlds, Happily, Collide.” Speak Now: Australian Perspectives on Same-Sex Marriage. Ed. Victor Marsh. Thornbury: Clouds of Magellan, 2012, 134–139. Muñoz, José Esteban. “Citizens and Superheroes.” American Quarterly. 52.2 (2000): 397–404. Parkinson, Patrick. “About Time We All Cared More About Marriage.” Sydney Morning Herald, 24 Aug. 2012. 24 Sept. 2012 ‹http://www.smh.com.au/opinion/politics/about-time-we-all-cared-more-about-marriage-20120823-24p2g.html›. Rauch, Jonathan. Gay Marriage: Why It Is Good for Gays, Good for Straights, and Good for America. New York: Holt Paperbacks, 2004. Riggs, Damien. “The Racial Politics of Marriage Claims.” Speak Now: Australian Perspectives on Gay Marriage. Ed. Victor Marsh. Thornbury: Clouds of Magellan, 2012. 191–201. Stacey, Judith. Brave New Families: Stories of Domestic Upheaval in Late Twentieth-Century America. Berkeley and Los Angeles: U of California P, 1998. Spade, Dean. Normal Life: Administrative Violence, Critical Trans Politics and the Limits of Law. Cambridge, MA: South End Press, 2011. Turnbull, Malcolm. “Reflections on Gay Marriage: Michael Kirby Lecture 2012.” 24 Sept. 2012 ‹http://www.malcolmturnbull.com.au/media/speeches/reflections-on-the-gay-marriage-issue-michael-kirby-lecture-2012/›. Valverde, Mariana. “A New Entity in the History of Sexuality: The Respectable Same-Sex Couple.” Feminist Studies. 32.1 (2006): 155–162. Vidal, Gore. “Some Jews and the Gays.” The Nation. 14 Nov. 1981. 24 Sept. 2012 ‹http://www.thenation.com/article/169197/some-jews-gays›. —. Palimpsest: A Memoir. New York and London: Random House, 1995. Villis, Amanda, and Danielle Hewitt. “Why Legalising Same Sex Marriage Will Benefit Health.”17 Aug. 2012. 24 Sept. 2012 ‹http://www.onlineopinion.com.au/view.asp?article=14004›. Wright, Tim. “Same-Sex Couples Still Waiting at the Altar For a Basic Right.” The Age. 31 July 2009. 12 Sept. 2012 ‹http://www.theage.com.au/opinion/samesex-couples-still-waiting-at-the-altar-for-a-basic-right-20090730-e2xk.html›.

Introduction I am a transmigrant who has moved back and forth between the West and the Rest. I was born and raised in a Muslim family in a predominantly Muslim country, Bangladesh, but I spent several years of my childhood in Pakistan. After my marriage, I lived in the United States for a year and a half, the Middle East for 5 years, Australia for three years, back to the Middle East for another 5 years, then, finally, in Australia for the last 12 years. I speak Bengali (my mother tongue), Urdu (which I learnt in Pakistan), a bit of Arabic (learnt in the Middle East); but English has always been my medium of instruction. So where is home? Is it my place of origin, the Muslim umma, or my land of settlement? Or is it my ‘root’ or my ‘route’ (Blunt and Dowling)? Blunt and Dowling (199) observe that the lives of transmigrants are often interpreted in terms of their ‘roots’ and ‘routes’, which are two frameworks for thinking about home, homeland and diaspora. Whereas ‘roots’ might imply an original homeland from which people have scattered, and to which they might seek to return, ‘routes’ focuses on mobile, multiple and transcultural geographies of home. However, both ‘roots’ and ‘routes’ are attached to emotion and identity, and both invoke a sense of place, belonging or alienation that is intrinsically tied to a sense of self (Blunt and Dowling 196-219). In this paper, I equate home with my root (place of birth) and route (transnational homing) within the context of the ‘diaspora and belonging’. First I define the diaspora and possible criteria of belonging. Next I describe my transnational homing within the framework of diaspora and belonging. Finally, I consider how Australia can be a ‘home’ for me and other Muslim Australians. The Diaspora and Belonging Blunt and Dowling (199) define diaspora as “scattering of people over space and transnational connections between people and the places”. Cohen emphasised the ethno-cultural aspects of the diaspora setting; that is, how migrants identify and position themselves in other nations in terms of their (different) ethnic and cultural orientation. Hall argues that the diasporic subjects form a cultural identity through transformation and difference. Speaking of the Hindu diaspora in the UK and Caribbean, Vertovec (21-23) contends that the migrants’ contact with their original ‘home’ or diaspora depends on four factors: migration processes and factors of settlement, cultural composition, structural and political power, and community development. With regard to the first factor, migration processes and factors of settlement, Vertovec explains that if the migrants are political or economic refugees, or on a temporary visa, they are likely to live in a ‘myth of return’. In the cultural composition context, Vertovec argues that religion, language, region of origin, caste, and degree of cultural homogenisation are factors in which migrants are bound to their homeland. Concerning the social structure and political power issue, Vertovec suggests that the extent and nature of racial and ethnic pluralism or social stigma, class composition, degree of institutionalised racism, involvement in party politics (or active citizenship) determine migrants’ connection to their new or old home. Finally, community development, including membership in organisations (political, union, religious, cultural, leisure), leadership qualities, and ethnic convergence or conflict (trends towards intra-communal or inter-ethnic/inter-religious co-operation) would also affect the migrants’ sense of belonging. Using these scholarly ideas as triggers, I will examine my home and belonging over the last few decades. My Home In an initial stage of my transmigrant history, my home was my root (place of birth, Dhaka, Bangladesh). Subsequently, my routes (settlement in different countries) reshaped my homes. In all respects, the ethno-cultural factors have played a big part in my definition of ‘home’. But on some occasions my ethnic identification has been overridden by my religious identification and vice versa. By ethnic identity, I mean my language (mother tongue) and my connection to my people (Bangladeshi). By my religious identity, I mean my Muslim religion, and my spiritual connection to the umma, a Muslim nation transcending all boundaries. Umma refers to the Muslim identity and unity within a larger Muslim group across national boundaries. The only thing the members of the umma have in common is their Islamic belief (Spencer and Wollman 169-170). In my childhood my father, a banker, was relocated to Karachi, Pakistan (then West Pakistan). Although I lived in Pakistan for much of my childhood, I have never considered it to be my home, even though it is predominantly a Muslim country. In this case, my home was my root (Bangladesh) where my grandparents and extended family lived. Every year I used to visit my grandparents who resided in a small town in Bangladesh (then East Pakistan). Thus my connection with my home was sustained through my extended family, ethnic traditions, language (Bengali/Bangla), and the occasional visits to the landscape of Bangladesh. Smith (9-11) notes that people build their connection or identity to their homeland through their historic land, common historical memories, myths, symbols and traditions. Though Pakistan and Bangladesh had common histories, their traditions of language, dress and ethnic culture were very different. For example, the celebration of the Bengali New Year (Pohela Baishakh), folk dance, folk music and folk tales, drama, poetry, lyrics of poets Rabindranath Tagore (Rabindra Sangeet) and Nazrul Islam (Nazrul Geeti) are distinct in the cultural heritage of Bangladesh. Special musical instruments such as the banshi (a bamboo flute), dhol (drums), ektara (a single-stringed instrument) and dotara (a four-stringed instrument) are unique to Bangladeshi culture. The Bangladeshi cuisine (rice and freshwater fish) is also different from Pakistan where people mainly eat flat round bread (roti) and meat (gosh). However, my bonding factor to Bangladesh was my relatives, particularly my grandparents as they made me feel one of ‘us’. Their affection for me was irreplaceable. The train journey from Dhaka (capital city) to their town, Noakhali, was captivating. The hustle and bustle at the train station and the lush green paddy fields along the train journey reminded me that this was my ‘home’. Though I spoke the official language (Urdu) in Pakistan and had a few Pakistani friends in Karachi, they could never replace my feelings for my friends, extended relatives and cousins who lived in Bangladesh. I could not relate to the landscape or dry weather of Pakistan. More importantly, some Pakistani women (our neighbours) were critical of my mother’s traditional dress (saree), and described it as revealing because it showed a bit of her back. They took pride in their traditional dress (shalwar, kameez, dopatta), which they considered to be more covered and ‘Islamic’. So, because of our traditional dress (saree) and perhaps other differences, we were regarded as the ‘Other’. In 1970 my father was relocated back to Dhaka, Bangladesh, and I was glad to go home. It should be noted that both Pakistan and Bangladesh were separated from India in 1947 – first as one nation; then, in 1971, Bangladesh became independent from Pakistan. The conflict between Bangladesh (then East Pakistan) and Pakistan (then West Pakistan) originated for economic and political reasons. At this time I was a high school student and witnessed acts of genocide committed by the Pakistani regime against the Bangladeshis (March-December 1971). My memories of these acts are vivid and still very painful. After my marriage, I moved from Bangladesh to the United States. In this instance, my new route (Austin, Texas, USA), as it happened, did not become my home. Here the ethno-cultural and Islamic cultural factors took precedence. I spoke the English language, made some American friends, and studied history at the University of Texas. I appreciated the warm friendship extended to me in the US, but experienced a degree of culture shock. I did not appreciate the pub life, alcohol consumption, and what I perceived to be the lack of family bonds (children moving out at the age of 18, families only meeting occasionally on birthdays and Christmas). Furthermore, I could not relate to de facto relationships and acceptance of sex before marriage. However, to me ‘home’ meant a family orientation and living in close contact with family. Besides the cultural divide, my husband and I were living in the US on student visas and, as Vertovec (21-23) noted, temporary visa status can deter people from their sense of belonging to the host country. In retrospect I can see that we lived in the ‘myth of return’. However, our next move for a better life was not to our root (Bangladesh), but another route to the Muslim world of Dhahran in Saudi Arabia. My husband moved to Dhahran not because it was a Muslim world but because it gave him better economic opportunities. However, I thought this new destination would become my home – the home that was coined by Anderson as the imagined nation, or my Muslim umma. Anderson argues that the imagined communities are “to be distinguished, not by their falsity/genuineness, but by the style in which they are imagined” (6; Wood 61). Hall (122) asserts: identity is actually formed through unconscious processes over time, rather than being innate in consciousness at birth. There is always something ‘imaginary’ or fantasized about its unity. It always remains incomplete, is always ‘in process’, always ‘being formed’. As discussed above, when I had returned home to Bangladesh from Pakistan – both Muslim countries – my primary connection to my home country was my ethnic identity, language and traditions. My ethnic identity overshadowed the religious identity. But when I moved to Saudi Arabia, where my ethnic identity differed from that of the mainstream Arabs and Bedouin/nomadic Arabs, my connection to this new land was through my Islamic cultural and religious identity. Admittedly, this connection to the umma was more psychological than physical, but I was now in close proximity to Mecca, and to my home of Dhaka, Bangladesh. Mecca is an important city in Saudi Arabia for Muslims because it is the holy city of Islam, the home to the Ka’aba (the religious centre of Islam), and the birthplace of Prophet Muhammad [Peace Be Upon Him]. It is also the destination of the Hajj, one of the five pillars of Islamic faith. Therefore, Mecca is home to significant events in Islamic history, as well as being an important present day centre for the Islamic faith. We lived in Dhahran, Saudi Arabia for 5 years. Though it was a 2.5 hours flight away, I treasured Mecca’s proximity and regarded Dhahran as my second and spiritual home. Saudi Arabia had a restricted lifestyle for women, but I liked it because it was a Muslim country that gave me the opportunity to perform umrah Hajj (pilgrimage). However, Saudi Arabia did not allow citizenship to expatriates. Saudi Arabia’s government was keen to protect the status quo and did not want to compromise its cultural values or standard of living by allowing foreigners to become a permanent part of society. In exceptional circumstances only, the King granted citizenship to a foreigner for outstanding service to the state over a number of years. Children of foreigners born in Saudi Arabia did not have rights of local citizenship; they automatically assumed the nationality of their parents. If it was available, Saudi citizenship would assure expatriates a secure and permanent living in Saudi Arabia; as it was, there was a fear among the non-Saudis that they would have to leave the country once their job contract expired. Under the circumstances, though my spiritual connection to Mecca was strong, my husband was convinced that Saudi Arabia did not provide any job security. So, in 1987 when Australia offered migration to highly skilled people, my husband decided to migrate to Australia for a better and more secure economic life. I agreed to his decision, but quite reluctantly because we were again moving to a non-Muslim part of the world, which would be culturally different and far away from my original homeland (Bangladesh). In Australia, we lived first in Brisbane, then Adelaide, and after three years we took our Australian citizenship. At that stage I loved the Barossa Valley and Victor Harbour in South Australia, and the Gold Coast and Sunshine Coast in Queensland, but did not feel at home in Australia. We bought a house in Adelaide and I was a full time home-maker but was always apprehensive that my children (two boys) would lose their culture in this non-Muslim world. In 1990 we once again moved back to the Muslim world, this time to Muscat, Sultanate of Oman. My connection to this route was again spiritual. I valued the fact that we would live in a Muslim country and our children would be brought up in a Muslim environment. But my husband’s move was purely financial as he got a lucrative job offer in Muscat. We had another son in Oman. We enjoyed the luxurious lifestyle provided by my husband’s workplace and the service provided by the housemaid. I loved the beaches and freedom to drive my car, and I appreciated the friendly Omani people. I also enjoyed our frequent trips (4 hours flight) to my root, Dhaka, Bangladesh. So our children were raised within our ethnic and Islamic culture, remained close to my root (family in Dhaka), though they attended a British school in Muscat. But by the time I started considering Oman to be my second home, we had to leave once again for a place that could provide us with a more secure future. Oman was like Saudi Arabia; it employed expatriates only on a contract basis, and did not give them citizenship (not even fellow Muslims). So after 5 years it was time to move back to Australia. It was with great reluctance that I moved with my husband to Brisbane in 1995 because once again we were to face a different cultural context. As mentioned earlier, we lived in Brisbane in the late 1980s; I liked the weather, the landscape, but did not consider it home for cultural reasons. Our boys started attending expensive private schools and we bought a house in a prestigious Western suburb in Brisbane. Soon after arriving I started my tertiary education at the University of Queensland, and finished an MA in Historical Studies in Indian History in 1998. Still Australia was not my home. I kept thinking that we would return to my previous routes or the ‘imagined’ homeland somewhere in the Middle East, in close proximity to my root (Bangladesh), where we could remain economically secure in a Muslim country. But gradually I began to feel that Australia was becoming my ‘home’. I had gradually become involved in professional and community activities (with university colleagues, the Bangladeshi community and Muslim women’s organisations), and in retrospect I could see that this was an early stage of my ‘self-actualisation’ (Maslow). Through my involvement with diverse people, I felt emotionally connected with the concerns, hopes and dreams of my Muslim-Australian friends. Subsequently, I also felt connected with my mainstream Australian friends whose emotions and fears (9/11 incident, Bali bombing and 7/7 tragedy) were similar to mine. In late 1998 I started my PhD studies on the immigration history of Australia, with a particular focus on the historical settlement of Muslims in Australia. This entailed retrieving archival files and interviewing people, mostly Muslims and some mainstream Australians, and enquiring into relevant migration issues. I also became more active in community issues, and was not constrained by my circumstances. By circumstances, I mean that even though I belonged to a patriarchally structured Muslim family, where my husband was the main breadwinner, main decision-maker, my independence and research activities (entailing frequent interstate trips for data collection, and public speaking) were not frowned upon or forbidden (Khan 14-15); fortunately, my husband appreciated my passion for research and gave me his trust and support. This, along with the Muslim community’s support (interviews), and the wider community’s recognition (for example, the publication of my letters in Australian newspapers, interviews on radio and television) enabled me to develop my self-esteem and built up my bicultural identity as a Muslim in a predominantly Christian country and as a Bangladeshi-Australian. In 2005, for the sake of a better job opportunity, my husband moved to the UK, but this time I asserted that I would not move again. I felt that here in Australia (now in Perth) I had a job, an identity and a home. This time my husband was able to secure a good job back in Australia and was only away for a year. I no longer dream of finding a home in the Middle East. Through my bicultural identity here in Australia I feel connected to the wider community and to the Muslim umma. However, my attachment to the umma has become ambivalent. I feel proud of my Australian-Muslim identity but I am concerned about the jihadi ideology of militant Muslims. By jihadi ideology, I mean the extremist ideology of the al-Qaeda terrorist group (Farrar 2007). The Muslim umma now incorporates both moderate and radical Muslims. The radical Muslims (though only a tiny minority of 1.4 billion Muslims worldwide) pose a threat to their moderate counterparts as well as to non-Muslims. In the UK, some second- and third-generation Muslims identify themselves with the umma rather than their parents’ homelands or their country of birth (Husain). It should not be a matter of concern if these young Muslims adopt a ‘pure’ Muslim identity, providing at the same time they are loyal to their country of residence. But when they resort to terrorism with their ‘pure’ Muslim identity (e.g., the 7/7 London bombers) they defame my religion Islam, and undermine my spiritual connection to the umma. As a 1st generation immigrant, the defining criteria of my ‘homeliness’ in Australia are my ethno-cultural and religious identity (which includes my family), my active citizenship, and my community development/contribution through my research work – all of which allow me a sense of efficacy in my life. My ethnic and religious identities generally co-exist equally, but when I see some Muslims kill my fellow Australians (such as the Bali bombings in 2002 and 2005) my Australian identity takes precedence. I feel for the victims and condemn the perpetrators. On the other hand, when I see politics play a role over the human rights issues (e.g., the Tampa incident), my religious identity begs me to comment on it (see Kabir, Muslims in Australia 295-305). Problematising ‘Home’ for Muslim Australians In the European context, Grillo (863) and Werbner (904), and in the Australian context, Kabir (Muslims in Australia) and Poynting and Mason, have identified the diversity within Islam (national, ethnic, religious etc). Werbner (904) notes that in spite of the “wishful talk of the emergence of a ‘British Islam’, even today there are Pakistani, Bangladeshi and Arab mosques, as well as Turkish and Shia’a mosques”; thus British Muslims retain their separate identities. Similarly, in Australia, the existence of separate mosques for the Bangladeshi, Pakistani, Arab and Shia’a peoples indicates that Australian Muslims have also kept their ethnic identities discrete (Saeed 64-77). However, in times of crisis, such as the Salman Rushdie affair in 1989, and the 1990-1991 Gulf crises, both British and Australian Muslims were quick to unite and express their Islamic identity by way of resistance (Kabir, Muslims in Australia 160-162; Poynting and Mason 68-70). In both British and Australian contexts, I argue that a peaceful rally or resistance is indicative of active citizenship of Muslims as it reveals their sense of belonging (also Werbner 905). So when a transmigrant Muslim wants to make a peaceful demonstration, the Western world should be encouraged, not threatened – as long as the transmigrant’s allegiances lie also with the host country. In the European context, Grillo (868) writes: when I asked Mehmet if he was planning to stay in Germany he answered without hesitation: ‘Yes, of course’. And then, after a little break, he added ‘as long as we can live here as Muslims’. In this context, I support Mehmet’s desire to live as a Muslim in a non-Muslim world as long as this is peaceful. Paradoxically, living a Muslim life through ijtihad can be either socially progressive or destructive. The Canadian Muslim feminist Irshad Manji relies on ijtihad, but so does Osama bin Laden! Manji emphasises that ijtihad can be, on the one hand, the adaptation of Islam using independent reasoning, hybridity and the contesting of ‘traditional’ family values (c.f. Doogue and Kirkwood 275-276, 314); and, on the other, ijtihad can take the form of conservative, patriarchal and militant Islamic values. The al-Qaeda terrorist Osama bin Laden espouses the jihadi ideology of Sayyid Qutb (1906-1966), an Egyptian who early in his career might have been described as a Muslim modernist who believed that Islam and Western secular ideals could be reconciled. But he discarded that idea after going to the US in 1948-50; there he was treated as ‘different’ and that treatment turned him against the West. He came back to Egypt and embraced a much more rigid and militaristic form of Islam (Esposito 136). Other scholars, such as Cesari, have identified a third orientation – a ‘secularised Islam’, which stresses general beliefs in the values of Islam and an Islamic identity, without too much concern for practices. Grillo (871) observed Islam in the West emphasised diversity. He stressed that, “some [Muslims were] more quietest, some more secular, some more clamorous, some more negotiatory”, while some were exclusively characterised by Islamic identity, such as wearing the burqa (elaborate veils), hijabs (headscarves), beards by men and total abstinence from drinking alcohol. So Mehmet, cited above, could be living a Muslim life within the spectrum of these possibilities, ranging from an integrating mode to a strict, militant Muslim manner. In the UK context, Zubaida (96) contends that marginalised, culturally-impoverished youth are the people for whom radical, militant Islamism may have an appeal, though it must be noted that the 7/7 bombers belonged to affluent families (O’Sullivan 14; Husain). In Australia, Muslim Australians are facing three challenges. First, the Muslim unemployment rate: it was three times higher than the national total in 1996 and 2001 (Kabir, Muslims in Australia 266-278; Kabir, “What Does It Mean” 63). Second, some spiritual leaders have used extreme rhetoric to appeal to marginalised youth; in January 2007, the Australian-born imam of Lebanese background, Sheikh Feiz Mohammad, was alleged to have employed a DVD format to urge children to kill the enemies of Islam and to have praised martyrs with a violent interpretation of jihad (Chulov 2). Third, the proposed citizenship test has the potential to make new migrants’ – particularly Muslims’ – settlement in Australia stressful (Kabir, “What Does It Mean” 62-79); in May 2007, fuelled by perceptions that some migrants – especially Muslims – were not integrating quickly enough, the Howard government introduced a citizenship test bill that proposes to test applicants on their English language skills and knowledge of Australian history and ‘values’. I contend that being able to demonstrate knowledge of history and having English language skills is no guarantee that a migrant will be a good citizen. Through my transmigrant history, I have learnt that developing a bond with a new place takes time, acceptance and a gradual change of identity, which are less likely to happen when facing assimilationist constraints. I spoke English and studied history in the United States, but I did not consider it my home. I did not speak the Arabic language, and did not study Middle Eastern history while I was in the Middle East, but I felt connected to it for cultural and religious reasons. Through my knowledge of history and English language proficiency I did not make Australia my home when I first migrated to Australia. Australia became my home when I started interacting with other Australians, which was made possible by having the time at my disposal and by fortunate circumstances, which included a fairly high level of efficacy and affluence. If I had been rejected because of my lack of knowledge of ‘Australian values’, or had encountered discrimination in the job market, I would have been much less willing to embrace my host country and call it home. I believe a stringent citizenship test is more likely to alienate would-be citizens than to induce their adoption of values and loyalty to their new home. Conclusion Blunt (5) observes that current studies of home often investigate mobile geographies of dwelling and how it shapes one’s identity and belonging. Such geographies of home negotiate from the domestic to the global context, thus mobilising the home beyond a fixed, bounded and confining location. Similarly, in this paper I have discussed how my mobile geography, from the domestic (root) to global (route), has shaped my identity. Though I received a degree of culture shock in the United States, loved the Middle East, and was at first quite resistant to the idea of making Australia my second home, the confidence I acquired in residing in these ‘several homes’ were cumulative and eventually enabled me to regard Australia as my ‘home’. I loved the Middle East, but I did not pursue an active involvement with the Arab community because I was a busy mother. Also I lacked the communication skill (fluency in Arabic) with the local residents who lived outside the expatriates’ campus. I am no longer a cultural freak. I am no longer the same Bangladeshi woman who saw her ethnic and Islamic culture as superior to all other cultures. I have learnt to appreciate Australian values, such as tolerance, ‘a fair go’ and multiculturalism (see Kabir, “What Does It Mean” 62-79). My bicultural identity is my strength. With my ethnic and religious identity, I can relate to the concerns of the Muslim community and other Australian ethnic and religious minorities. And with my Australian identity I have developed ‘a voice’ to pursue active citizenship. Thus my biculturalism has enabled me to retain and merge my former home with my present and permanent home of Australia. References Anderson, Benedict. Imagined Communities: Reflections on the Origin and Spread of Nationalism. London, New York: Verso, 1983. Australian Bureau of Statistics: Census of Housing and Population, 1996 and 2001. Blunt, Alison. Domicile and Diaspora: Anglo-Indian Women and the Spatial Politics of Home. Oxford: Blackwell, 2005. Blunt, Alison, and Robyn Dowling. Home. London and New York: Routledge, 2006. Cesari, Jocelyne. “Muslim Minorities in Europe: The Silent Revolution.” In John L. Esposito and Burgat, eds., Modernising Islam: Religion in the Public Sphere in Europe and the Middle East. London: Hurst, 2003. 251-269. Chulov, Martin. “Treatment Has Sheik Wary of Returning Home.” Weekend Australian 6-7 Jan. 2007: 2. Cohen, Robin. Global Diasporas: An Introduction. Seattle: University of Washington, 1997. Doogue, Geraldine, and Peter Kirkwood. Tomorrow’s Islam: Uniting Old-Age Beliefs and a Modern World. Sydney: ABC Books, 2005. Esposito, John. The Islamic Threat: Myth or Reality? 3rd ed. New York, Oxford: Oxford UP, 1999. Farrar, Max. “When the Bombs Go Off: Rethinking and Managing Diversity Strategies in Leeds, UK.” International Journal of Diversity in Organisations, Communities and Nations 6.5 (2007): 63-68. Grillo, Ralph. “Islam and Transnationalism.” Journal of Ethnic and Migration Studies 30.5 (Sep. 2004): 861-878. Hall, Stuart. Polity Reader in Cultural Theory. Cambridge: Polity Press, 1994. Huntington, Samuel, P. The Clash of Civilisation and the Remaking of World Order. London: Touchstone, 1998. Husain, Ed. The Islamist: Why I Joined Radical Islam in Britain, What I Saw inside and Why I Left. London: Penguin, 2007. Kabir, Nahid. Muslims in Australia: Immigration, Race Relations and Cultural History. London: Kegan Paul, 2005. ———. “What Does It Mean to Be Un-Australian: Views of Australian Muslim Students in 2006.” People and Place 15.1 (2007): 62-79. Khan, Shahnaz. Aversion and Desire: Negotiating Muslim Female Identity in the Diaspora. Toronto: Women’s Press, 2002. Manji, Irshad. The Trouble with Islam Today. Canada:Vintage, 2005. Maslow, Abraham. Motivation and Personality. New York: Harper, 1954. O’Sullivan, J. “The Real British Disease.” Quadrant (Jan.-Feb. 2006): 14-20. Poynting, Scott, and Victoria Mason. “The Resistible Rise of Islamophobia: Anti-Muslim Racism in the UK and Australia before 11 September 2001.” Journal of Sociology 43.1 (2007): 61-86. Saeed, Abdallah. Islam in Australia. Sydney: Allen and Unwin, 2003. Smith, Anthony D. National Identity. Harmondsworth: Penguin, 1991. Spencer, Philip, and Howard Wollman. Nationalism: A Critical Introduction. London: Sage, 2002. Vertovec, Stevens. The Hindu Diaspora: Comparative Patterns. London: Routledge. 2000. Werbner, Pnina, “Theorising Complex Diasporas: Purity and Hybridity in the South Asian Public Sphere in Britain.” Journal of Ethnic and Migration Studies 30.5 (2004): 895-911. Wood, Dennis. “The Diaspora, Community and the Vagrant Space.” In Cynthia Vanden Driesen and Ralph Crane, eds., Diaspora: The Australasian Experience. New Delhi: Prestige, 2005. 59-64. Zubaida, Sami. “Islam in Europe: Unity or Diversity.” Critical Quarterly 45.1-2 (2003): 88-98. Citation reference for this article MLA Style Kabir, Nahid. "Why I Call Australia ‘Home’?: A Transmigrant’s Perspective." M/C Journal 10.4 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0708/15-kabir.php>. APA Style Kabir, N. (Aug. 2007) "Why I Call Australia ‘Home’?: A Transmigrant’s Perspective," M/C Journal, 10(4). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0708/15-kabir.php>.