Navigating shame to negotiate sexual agency in British born South Asian women: A grounded theory study

Abstract

Sexual health relates to perceptions and experiences of sexual-based relationships and needs. It is viewed as a fundamental component of overall health. Positive sexual health is dependent upon various determinants which include communication,
education and access to services. However, there are a number of barriers to positive sexual health due to its taboo nature. The sexual health needs of young people is a public health priority, in particular those from ethnic minority backgrounds. In the UK, the largest ethnic minority group is South Asian. Individuals from South Asian communities are socialised into the beliefs and norms of their culture through a process of enculturation. British born, South Asian women will also experience different levels of acculturation as they are influenced by the wider social context and cultures of the society they live in. Acculturation can influence their choices and beliefs where sexual health matters are concerned. Many South Asian religions emphasise the forbidden nature of pre-marital sexual relationships and may limit information about positive sexual health. However, within the British culture, young people generally have more permissible standards and beliefs surrounding sexual health. This may be particularly problematic for some British born, South Asian women who may be influenced by both the South Asian and British culture. Currently there is a lack of understanding into how young people navigate sexual health in these circumstances. My study aimed to explore the perceptions, awareness and experiences of sexual health among British born, South Asian women, aged 18-25 years: it was not limited to a particular South Asian group. I undertook a constructivist grounded theory study with purposive, snowball and theoretical sampling methods used within two recruitment phases. Both phases recruited females who were residing in the North West of England. Data collection methods involved focus groups and interviews and a total of 16 participants were recruited. Techniques of initial coding, focused coding, constant comparisons and theoretical sorting were used to analyse the data. Three main categories of ‘being influenced by religion, culture and the community’, ‘maintaining the secret relationship and acculturation’ and ‘accessing sexual health services, advice and awareness’ were identified. An overarching theory of ‘navigating shame to negotiate sexual agency’ was constructed – this theoretical interpretation draws on theories of shame and sexual agency depicted through a three stage interconnected model: ‘the grounding context of shame’, ‘connectedness with others’, and ‘finding their way’. Overall these findings highlight how women position themselves on a continuum where shame and sexual agency are concerned. This model provides a theoretical framework which identifies how some women may remain close to their encultured religious and cultural values and may be influenced heavily by shame. Whereas others adopt more Western values through acculturation in engaging in sex-based relationships. This model offers a
unique theoretical interpretation which can be used by health professionals and young women to understand their position in relation to sexual health and to enhance knowledge of the issues faced. Implications for policy, practice and research are
detailed.