ABSTRACT
Mexican migration to the United States has been attributed to the poverty and economic polarization in Mexico. Although the dismantling of the peasant economy persists as a factor in demographic displacement, there have been recent changes in the causes that provoke the migration of Mexicans. Family violence, for example, appears as an important motivator in pushing women into the migratory flow, especially in rural areas of the country where women's sexual and reproductive rights appear to be less respected. Homophobia is another point of reference which, along with hate crimes, generates a new category of migration to the United States. Although violence is beginning to be recognized and viewed sociologically as a factor in migratory displacement, it is a phenomenon that has been little explored in Mexico until now. This article proposes to analyze sexual violence and discrimination as motivators of an emerging migratory phenomenon among transgender and transsexual groups within the Mexican population. The article is based on a qualitative study which explored the universes of sense and meaning through the stories of four Mexican women, three transgender and one transsexual, infected with HIV-AIDS in Mexico and who are currently seeking political asylum in San Diego, California. The fieldwork was done between August and September 2003 in San Diego County. Interviews and ethnographic observations were carried out in three geographic regions in the city where neighborhoods of transgender and transsexual migrants of Mexican origin were detected, as well as Non-Governmental Organizations (NGOs) that provide medical and psychological care to undocumented migrants of Latin American origin who live with HIV/AIDS: Northern Region: Carlsbad and Rancho Bernardo; Central Region: North Hill Park and Balboa Park; Southern Region: San Ysidro and Imperial Beach. The article provides anthropological data regarding the contexts, practices and magnitude of rejection and violence that the subjects suffered in Mexico. Four settings are emphasized: family life, interaction in the streets, the relationship with police and the relationship with health services related to caring for HIV/AIDS. To support the analysis it was considered advisable to resort, on the one hand, to phenomenology as a methodological approach to daily life and, on the other hand, to semiotics, where culture is understood as the expression of symbolic forms and objectivizations of sense and meaning that exist in the context of asymmetrical social relationships. This theoretical framework allowed us to postulate that sexual violence is a structural process based on asymmetrical power relationships and that it implies social norms and ideologies of male hegemony that contribute to the social acceptance of violent practices against transgender and transsexual men, which can make them go unnoticed in the community. For the interviewees, migration became a resort for asserting their right to health care, and even a means to preserve their lives. In Mexico, their presence in public places would frequently provoke attacks, scorn and mockery, which could lead to physical and emotional wounds. Civil society is not the only source of violence against transsexual and transgender individuals. Some police organizations systematically persecute them and submit them to violence. The harassment of homosexuals is routine practice among police officers. Their physical appearance is interpreted as a moral misdemeanor. Under this argument, they can become the victims of a complex range of abuses and humiliations that include blackmail or extortion and can lead to physical assault and sexual violence. This last type of aggression is one of the most dangerous because it implies a homosexual conduct on the part of the aggressor. Because there is a risk that his victim might press charges, the violence exercised against the transgender individual by the aggressor may be aggravated, which initiates a cycle of territorial mobility linked to exile because of the fear of being killed. Violence against transsexuals is reinforced by Mexican laws and bureaucratic procedures, which only recognize two genders and thus make it more complicated for transsexuals to prove their legal right to initiate proceedings or a lawsuit. These legal-bureaucratic loopholes help make the aggressor's impunity acceptable and his violations socially invisible. The stories make it possible to understand that in Mexico transphobia is a specific form of sexual violence which, linked to the social construction of male dominance, exists out of social fear of homosexuality as the foundation that legitimizes discrimination, hate, persecution and aggression against transgender and transsexual individuals. One aspect that seems to intensify these forms of violence is the appearance of sexually transmitted viral infections. In fact, the history of infectious diseases shows that homosexuals, sexual workers and migrants appear over and over again in the collective imagination as those responsible for the origin of epidemics. In today's epidemiological context, transgender is seen as a scapegoat for HIV/ AIDS. In Mexico, this situation appears to reinforce the preconceptions of social hatred against transgender persons who are HIV positive, who may end up living with the social stigma of those who believe that the infection is fitting punishment. The evidence suggests that, when transgender individuals are HIV carriers, discrimination against them is worse. The prejudice of medical personnel and the financial inability of health institutions to treat HIV/AIDS lead to precarious care and, occasionally, denial of access to antiretroviral medications. Ethnography suggests that violence against transsexuals is not eliminated when they immigrate to the United States. They experience less aggression than in Mexico, but in the United States they suffer racial and job discrimination. The benefit resides in that, despite their undocumented status, they have free access to antiretroviral drugs and to psychological care offered by the NGOs in San Diego that assist persons infected with HIV/AIDS. The discrimination and sexual violence described by those interviewed amount to a triple stigmatization (because they are itinerant populations, because they are transgender and because they live with HIV). This is a system of stigmatization that not only affects their quality of life by excluding them from jobs and the legal system, but also because it keeps them from being recognized as subjects with rights to health care, especially with regard to access to antiretroviral drugs and medical care related to control of HIV/AIDS, decisive factors which trigger the decision to migrate. This paper suggests the development of a model aimed at making medical practitioners and, in general, health systems personnel more aware of the diversity of sexual practices and identities and emphasizes the right to sexual and mental health care for individuals who live with HIV, regardless of their sexual preference or gender. It is fundamental to develop policies that will prevent the stigmatization and discrimination of persons with HIV and that will recognize the right to health care among populations that have been stigmatized historically.
La migración mexicana a Estados Unidos se ha interpretado como un proceso demográfico que existe en respuesta al empobrecimiento y a la polarización económica en México. Aunque la desarticulación económica y el abandono de las regiones rurales de México persisten como factores de expulsión de población, la migración de mexicanos muestra cambios recientes en las causas que la originan. La violencia familiar, por ejemplo, aparece como un detonante importante de la incorporación de la mujer en los flujos migratorios, particularmente es el caso de zonas rurales del país. La homofobia es otro referente que, relacionado a los crímenes de odio, parece generar un nuevo orden de migración hacia Estados Unidos. No obstante que la violencia empieza a ser reconocida y vista sociológicamente como un factor de expulsión migratoria, en México es un fenómeno que hasta ahora se ha explorado poco. En este trabajo se analizan la violencia sexual y la discriminación como detonantes de un fenómeno migratorio emergente entre grupos de población homosexual. Se trata de un estudio cualitativo de tipo fenomenológico con el que se exploraron los universos de sentido y significado por medio de las historias de vida de migrantes transgénero y transexuales que viven con VIH en San Diego. El trabajo de campo se realizó en agosto de 2003 en condados de San Diego, California, en Estados Unidos. Se realizaron entrevistas y observaciones etnográficas en tres regiones geográficas de la ciudad donde se detectó la presencia de vecindarios de migrantes transgénero y transexuales de origen latinoamericano. En este artículo se describen precisamente las historias de personas transgénero y transexuales que se infectaron de VIH-sida en México. Para estas personas, la migración se convirtió en un recurso para atender su derecho a la salud e incluso para conservar la vida. El objetivo de este artículo es dar cuenta de las formas de agresión física y de discriminación que llevaron a los entrevistados a solicitar asilo político en San Diego, California. Las narraciones permiten comprender que en México la transfobia es una forma de violencia sexual que, ligada a la construcción social de la masculinidad dominante, existe a partir del miedo social a la homosexualidad como el basamento que legitima la discriminación, la persecución y la agresión de personas transgénero y transexuales. Un aspecto que parece recrudecer estas formas de violencia es la aparición de infecciones sexualmente transmisibles de tipo viral. De hecho, la historia de las enfermedades infecciosas muestra que homosexuales, trabajadoras sexuales y migrantes son figuras que aparecen de manera recurrente en el imaginario colectivo como responsables del origen de las epidemias. En el contexto global actual destaca la construcción del transgénero como víctima propiciatoria del VIH/sida. En México, esta coyuntura parece reforzar los esquemas de odio social en contra de las personas homosexuales que son VIH positivas, quienes pueden llegar a vivir con el estigma social de quien cree que la infección es un castigo meritorio. La discriminación y la violencia sexual que describen las informantes tiene que ver con la triple estigmatización (por ser poblaciones móviles, por ser transgénero y además por vivir con VIH). Se trata de un sistema de estigmatización que no sólo afecta la calidad de vida al excluirles laboral y jurídicamente, sino que impide reconocerles como sujetos de derecho a la salud, especialmente en materia de acceso a medicamentos antirretrovirales y de atención médica relativa al control del VIH/sida. Es necesario desarrollar un modelo de sensibilización dirigido a personal médico y, en general, de los sistemas de salud sobre la diversidad de prácticas e identidades sexuales y hacer énfasis en los derechos a la salud sexual y mental de las personas que viven con VIH, sin importar su preferencia sexual y de género.
ABSTRACT
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Summary In the past, the epidemic of Acquired Immune Deficiency Syndrome (AIDS) was not conceived originally as a public health problem, and was attributed instead to individuals enacting social roles related to lifestyles considered as transgressions from hegemonic sexuality (heterosexual, reproductive and monogamous). The epidemiological analysis was upheld by clinical notions which reinforced the stigma of population groups historically discriminated, such as homosexuals and the Afro-American population. The study of the epidemic based on the concept of risk gave rice to the category of groups at risk, so that the phenomenon was explained from a moral point of view, as it also became apparent that the deaths associated with AIDS were a consequence of sexual preferences. This then impeded the analysis of the epidemic from the standpoint of the structural components of public health. Once it was possible to isolate and identify the Human Immune Deficiency virus (HIV) as the causal agent of AIDS, the epidemiology ceased referring to risk groups and incorporated the notion of risk practices. Even though, in the beginning potential infection with HIV by means of bodily fluids, such as blood, semen, and uterine cervical fluid was recognized, the clinical discourse still reinforced the stigmatization of infected people. The only innovation was the invention of the sexual worker as a new likely victim of the epidemic. At this moment, epidemiology recognizes the importance of speaking about contexts of risk instead of groups or practices at risk. Notwithstanding, the global dynamics of the epidemic tends to reinforce the idea that migrants are a new group at risk. This implies going backwards in the conceptual thinking of HIV/ AIDS because it suggests that migrants are a new hazard for public health, just like homosexuals and commercial sex workers. The mobile populations play a role in the transmission of HIV, especially in regions where international borders are shared between countries with unequal economies. For this, it is necessary to consider that the infections of HIV exist in cultural, political, and economical contexts. In this kind of regions, the epidemic can not be analyzed thinking of migrants as the responsible actors in the prevalence growth. The human traffic and the sexual aggressions, for example, are social phenomena linked to the structural conditions of the geographical stations of the mobile populations. In addition, it is necessary to consider that the worldwide dynamics of poverty and migration are produced as a result of disintegration of rural economies (disasters, wars, structural poverty). The relation between migration and poverty can be focused as that of contexts of sexual violence and discrimination. This point of view allows for the exploration of the conditions of HIV/STD infection among persons whose dignity is less respected. The relationship between international clandestine migration and HIV/AIDS has been studied scarcely. With the aim of proposing a different epistemological focus for this problem, in this article we reflect on the possibility of analyzing the notion of vulnerability placing it in a category which takes into account the historical, cultural, social and economic contexts. We propose to analyze vulnerability as a condition that may be transformed in space and time, and that is socially diverse because of this. From this, it follows that vulnerability is acquired in the process of interaction between migrants and the societies through which they move in transit. In this sense, vulnerability can be expressed as a way of being and living, linked to social roles and the course of the personal lives of the people who accompany migrants at the time of their territorial migration. Thus vulnerability is modified according to the historical and social conditions of their places of origin, the places they pass through, and the places of their destination, but also varies according to age, sex, education and social norms which direct sexual identity, as well as the reasons migrants have for displacing themselves. This perspective also permits us to observe that in ethnographic terms, vulnerability can be studied by taking into account the social capital of the clandestine migrant which, when translated into terms of their access to social networks in the places of origin, transit and destination, may either bring them nearer to or further away from situations of isolation, depression and sexual violence. The concept of vulnerability that we propose allows for the explanation of the ruralization of the HIV/AIDS epidemic as a phenomenon related to four socio-historic aspects: poverty, disintegration of agricultural zones, sexual violence and clandestine migration to the United States. We also suggest to include the fact that the HIV/AIDS epidemic occurs in contexts where the violation of human rights is associated with sexual aggression, which can also cause new HIV/STD. For this reason, the impact of poverty acquires a specific influence on this process presenting itself as the way of life of the migrant who transfers him-herself without documents and without authorization and who is especially fragile because he/she faces circumstances in which he/she has no social power. We thus consider that in order to understand in depth the phenomenon concerning the vulnerability of populations who move without legal papers, it is necessary to include both the life histories of the individuals and a study of the social context in which these take place, as a mean of analyzing their vulnerability. The objective of this essay consists in demonstrating the instrumental potential of the concept of vulnerability and its methodological implications for the study of international clandestine migration, as well as sexual aggressions as indicators of violation of human rights and infection with HIV/STD, respectively.
