In this article, I argue that the medical conceptualization of gender identity in the United States has entered a “new regime of truth.” Drawing from a mixed-methods analysis of medical journals, I illuminate a shift in the locus of gender identity from external genitalia and pathologization of families to genes and brain structure and individualized self-conception. The sexed body itself has also undergone a transformation: Sex no longer resides solely in genitalia but has traveled to more visible parts of the body, implicating racialized aesthetic ideals in its new formulation. The re-imagining of gender identity as genetically and neurologically inscribed and the expanding locus of sex correspond to an inversion of the relationship between gender identity and the sexed body as well as shifts in medical jurisdiction. Whereas psychiatrists in the 1960s, ’70s, and ’80s understood gender as stemming from genital sex, the less popular idea that gender identity precedes the sexed body has gained traction in recent decades. If gender identity once derived from the sexed body, the sexed body must now be brought into alignment with gender identity. The increasing legitimacy of self-defined gender identity, the expanding definition of racialized sex, and the inversion of the sex–gender identity relationship elevates the role of surgeons in producing racialized and sexed bodies.
In recent decades, scholars of world cultural diffusion have begun to examine the structure of the world society itself, finding evidence of regionalization within the network of international nongovernmental organizations (INGOs). There is little research, however, on how the structure of world society shapes processes of transnational diffusion. In this paper, I propose that the regionalization of world society, measured through INGO membership composition, structures the transnational diffusion of cultural norms like LGBT associations. Analyzing an original, comprehensive dataset of 3,141 domestic, voluntary LGBT associations founded between 1979 and 2009, I find that countries embedded in anti-LGBT regions are more resistant to the diffusion of domestic LGBT associations. I further find that the negative effect of embeddedness in anti-LGBT regions on domestic LGBT association founding is weakened by dependence on Western foreign aid. The findings highlight the importance of examining the composition of INGOs as well as attending to the role of regional culture in studies of transnational diffusion.
Prior research demonstrates the importance of domestic associations joining transnational advocacy networks to create social change. Few studies, however, investigate how dynamic political opportunities influence the structure of crossnational networks. To address this gap, we analyze an original dataset of 3,103 domestic lesbian, gay, bisexual, and transgender (LGBT) associations in Europe connected through joint membership in 46 LGBT international nongovernmental organizations from 2010 to 2020. Results from network and multilevel analyses reveal a relatively unstable network that is centrally comprised of associations located in adverse political contexts. More specifically, advocacy associations located in adverse political contexts, but recently joining the European Union, are more likely to occupy central positions in the network. Although the structure of the network suggests LGBT organizations are countering traditional, hegemonic lines of stratification, the instability of central position undermines widely held assumptions about the relationship between power and centrality within these networks.
In At Risk, Vijayakumar offers an insightful, ethnographically rich account of how AIDS funding changed the landscape of sex worker activism and related state bureaucracy in India. At Risk contributes to a growing field of scholarship on AIDS and citizenship in India, including Chaitanya Lakkimsetti's Legalizing Sex (NYU Press, 2020), various work by Aniruddha Dutta and their collaborators, to name a few. Like this recent work, Vijayakumar brings a postcolonial perspective and also attends to the multiple levels in which the politics of sex work plays out. Scale matters in Vijayakumar's account, whether it is within particular organizations, the provincial state (Karnataka), the federal government, or global institutions like the World Health Organization. Drawing from a variety of data sources, primarily ethnographic fieldwork but also reports from federal and state governments in India and international organizations, and international and Indian medical journal articles, Vijayakumar deftly moves across different data and dimensions of what she calls the "global AIDS field," highlighting the contradictory ways that domestic struggles among different activist and state organizations reshape national AIDS policy.In the first part of the book, Vijayakumar provides an overview of the colonial history of policies regulating sexuality and AIDS, including the arrival of AIDS to India in the mid-1980s and how the country came to be seen as "at risk" for becoming the next AIDS epicenter at the turn of the 21st century, following the crisis in Africa. The crisis never happened, but the construction of India as "at risk" brought international attention and funding to the country for over a decade. This had several unintended consequences. The remainder of the book shows how activists took advantage of temporary political openings in the state that this aused, and came to see themselves and their futures in new ways.Vijayakumar's rich ethnographic detail shines through in the middle of the book, where she examines how sex worker organizations negotiated the influx of AIDS money. International funders did not simply dominate subnational organizations. Instead, Vijayakumar finds, these organizations were able to contest policies regulating sex work and AIDS because they had access to the constituencies that international donors wanted to reach. The principal-agent mismatch provided unexpected political opportunities for sex worker activists, including more recognition from the state and an expansion in paid non-governmental organization (NGO) jobs, the latter of which enabled activists to access class mobility in part through learning and adopting new bodily practices. Vijayakumar brings ethnographic richness her account, highlighting how NGO actors strategically use their position as brokers. In chapter 3, for instance, her opening narrative details a "training" session in which the attendees have more insight than the trainer.Because Vijayakumar attended the session, she captures the nuances of the interaction: the trainee...
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