Abstract
As dating apps in general (and Tinder in particular) have become increasingly normalized in Australia (and elsewhere) it has become common for popular commentary to associate app use with increased rates of sexually transmitted infections (STIs) – particularly chlamydia (see Callander, 2017; Stephens, 2017). This association is contradicted, however, by longitudinal studies indicating that Australian young people have not increased the number of casual partners they report in surveys post-2011, and reported rates of condom-use have remained steady for many years (Purtill, 2016).
Apps are not the only digital technologies to be associated with sexual risks. As smartphone ownership has become more widespread among young people, adult anxieties regarding young people's sexual expression have crystallized around digital practices. Public concern regarding commercial media's ‘sexualization’ of young people seems to have shifted to focus on young people's everyday practices of mediated intimacy, ranging from the use of social networking services for flirtation and chat to more controversial practices such as the exchange and circulation of explicit pictures and texts, both commercial and user-generated (Livingstone and Mason, 2015).
Despite multiple peer-reviewed studies that suggest that young people seek out explicit material (including pornography) to supplement (or replace) insufficiencies in formal sexuality education, changes to sexuality education policies and curricula are slow and highly contested. (Ollis et al., 2012). The adoption of an evidence-based approach to health promotion and sex and relationships education that respectfully engages with young people's digital practices is slower still (Albury and Byron, 2015). And yet, such an approach is not without precedent. As policy makers and governance bodies globally begin to grapple with the challenges of what children's and young people's rights in the digital age, it seems appropriate to consider what a ‘rights-based approach’ to young people's digital sexual cultures might look like (Livingstone and Third, 2017).
I was fortunate to be part of a particular conjunctural moment in Sydney from the 1990s to the early 2000s – participating in dance-party culture, attending HIV Social Research conferences, reading Foucault, studying queer theory with David Halperin at the University of New South Wales – and building a loose working relationship with the National Association of People with HIV/AIDS that lasted nearly 20 years. Although I would not have articulated it this way at that time, I was immersed in the affective tensions within HIV research and education in the 1990s and the ‘post-crisis’ moment in the early 2000s. This was a highly charged and often agonistic space for queer and feminist scholarship – where social and cultural researchers were seen to lean too far towards critical theory, community educators struck back with frustration and anger at the lack of a translational framework that might inform evidence-based strategies for their everyday work of health promotion and pedagogy (see Duffin, 1998). 1
From 1997 onwards I began co-hosting events for people living with and affected by HIV – primarily as a support person for Tobin Saunders aka drag queen Vanessa Wagner. As Race (2009) observes, this was a period in which drug treatments were saving lives, but this often occurred at the cost of a user's well-being. Early treatment regimes were onerous, and often associated with a range of side effects ‘including diarrhea, nausea, high blood pressure, liver damage, insomnia, fatigue, hallucinations, depression, memory problems, and other irreversible and unknown dangers’ (Race, 2009: 56).
As a ‘naughty nurse’ sidekick for Vanessa Wagner at her Wheel of Misfortune roadshow (which used camp comedy to explore the question of what it meant to ‘live well on treatments’), I became part of a queer health promotion movement that Race has dubbed ‘counterpublic health’: ‘the cultivation of viable ethics and modes of embodiment that contend not only with the challenges of HIV infection, but also the mass mediation and medico-moralisation of pleasure and health’ (2009: 110). Significantly, our performances did not focus on ‘compliance’ with medical regimes. Instead, at these events (and at the formal NSW Health Department forums I participated in from 2004 to 2014) I was a witness to the wit, intellectual rigour and reflexive humility of bureaucrats, social and biomedical researchers and clinicians who worked closely with affected communities to develop protocols and processes for treatment and education that openly acknowledged the partial and imperfect nature of the tools they had at hand.
Like Race, I learned to value this approach, which questioned hierarchies of evidence in which ‘the randomized controlled trial’ was the gold standard for shaping health promotion practice, and instead looked to ‘questions of history and cultural value [and] to embodied and engaged practices of interpretation and response’ (2009: 110). Many of my projects since have sought to address ‘wicked problems’ of sexuality, gender and media via the critical lenses I saw applied to gay men's sexual health in these spaces. Yet young people are treated very differently by contemporary public health policy and practice.
All young people – even those who do not identify as same-sex attracted and/or gender diverse – are framed as ‘priority populations’ within Australian sexual health policy. For example, the Sydney Local Health District's Sexual Health Strategy specifically names young people, while stating that the New South Wales government ‘recognises the important human rights issues associated with sexual health, in particular, the need to actively engage affected groups and priority populations in developing, monitoring and evaluating sexual health policies, plans and programs’ (2013: 3).
Yet while many NSW organizations invite young people to join advisory groups and contribute to participatory co-design processes for specific campaigns or resources, they are not central to planning decisions, and do not have a say in how government and non-government organizations allocate their resources. On one hand, it could be argued that young people lack the experience to take an active role in this kind of policy conversation. On the other, it seems that contemporary Australian policy-makers and service providers targeting young people have learned very little from the successful (if agonistic) collaboration that characterized the community-led HIV response. Significantly, young people's intimate networks and digital practices are often implicitly or explicitly devalued and dismissed by Australian sex education and health promotion practice (Byron, 2015).
There is a substantial body of research in the fields of media and communications and internet studies that addresses mediated sexualities, and a burgeoning sub-field that specifically investigates young people's practices (see Smith and Attwood with McNair, 2017). Much of this work is qualitative, drawing on ethnographic methods that have been described variously by terms like ‘thick data’ (Wang, 2013) and ‘deep hanging out’ (boyd, 2015). These studies attempt to both understand the value digital media practices have for young people, and map the terrains of the mediated cultures (and sub-cultures) they inhabit. Yet this literature does not always count as ‘evidence’ in spaces where assessments of individual ‘knowledge, attitudes and behaviours’ are framed as the privileged objects of qualitative inquiry (Dowsett, 2007: 428).
It is unsurprising, then, that educators and health promotion service providers express discomfort and disconnection from young people's digital practices. In research I conducted with educators and health professionals in 2015, participants identified ‘sexting’ and ‘online porn’ as significant issues for their professional practice, but expressed frustration at a range of institutional and individual barriers that prevented them from adopting ‘best-practice’ approaches in their workplaces (Albury and Byron, 2015). These barriers stem (in part) from a lack of theoretical and practical pre-service training for health and education professionals. Beyond that, however, there is an absence of genuinely multi-disciplinary collaboration in the space where digital cultures and sexual cultures intersect and overlap. Further, most research into young people's mediated sexual cultures (including my own) does not position young people as active co-researchers – partly due to the legal and ethical restrictions that must be overcome (see Lumby et al., in press).
Acknowledging these (not inconsiderable) hurdles, I am still drawn to the question of what ‘counterpublic sexual health’ might mean for young people. Researchers working at the intersection of sexuality, media, health promotion and education – such as Robards et al. (2017) and Byron and Hunt (2017) – point to social media platforms such as Tumblr as spaces where young people undertake peer-to-peer practices of intimacy, knowledge exchange and community-formation, that side-steps the ‘medico-moralisation of pleasure and health’ as it is deployed in many formal education and policy settings (Race, 2009: 110). Young people's sexual health and well-being may not be ‘in crisis’, but it is a priority for government and non-government organizations.
Given the considerable ongoing investment in this space, how might researchers, educators, health service providers and policy makers develop a capacity to recognize and engage with young people's sexual and cultural practices, including the production and circulation of sexually explicit texts? What might a ‘rights-based’ or ‘strengths-based’ framework look like in this space? Finally, what might ‘embodied and engaged practices of interpretation and response’ look like in the field of young people's sexual health? (Race, 2009:110). That is, how might young people participate in sexual health practice as experts, partners, policy-makers and/or researchers, rather than simply as clients, research subjects or ‘target populations’ – and what impact might this have on the next 20 years of sexual health research and practice?