Anthropological Quarterly 77.1 (2004) 203-206
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This is a book that was missing in the literature on gender in Latin America. It is also an original contribution to the anthropology of health and disease in the region. In the study of gender and sexuality in Brazil, women's experiences and perspectives have remained notably unexplored and the author sets out to correct this lack.
Jessica Gregg's analysis of working class women's discourse and practice is shaped by an ethnographic study of a low-income neighborhood in Recife, Northeast Brazil, referred to as the "Ilha." Here she lived for most of her 18 months of fieldwork, conducted between 1993 and 1996. In this poverty-stricken slum, she argues, sexually active women use their sexuality as an economic resource, and to do this they confront one of two options in their relations with men: They can choose 'security' and obtain respect by "marrying," that is, living with a man in a monogamous relationship, even if for only for a brief period; or they can opt for "liberty," remaining single and maintaining affairs with one or more men. She further argues that these two possible strategies reflect the hegemonic cultural model of female gender and sexuality, which emerges from a male perspective. This constructs Brazilian women as hyper-sensual, a dangerous condition that renders them in need of male control, given the high value attached [End Page 203] to virginity and (female) fidelity. Gregg shows that while women pragmatically reinterpret this model, in their struggle for survival, they do not effectively challenge it in their practice. The lived experience of engaging in sexual relations with men and of reconstructing these relations in talk with other women is fraught with contradiction, nevertheless. For the author shows that women act as if the only escape from the dilemmas of unequal and extremely strained gender relations in a marriage, is to choose to become a disreputable woman, exchanging one form of unsatisfactory arrangement for another.
Her ethnography convincingly sustains this argument and Gregg writes of the experiences of her friends from the Ilha with eloquence and affection. She quotes from her conversations with women generously and to good effect, both giving them a say (however edited) and giving us, the readers, a degree of proximity to her subjects. She has a knack for using case studies to good effect and for integrating description and discussion of episodes that she observed in the Ilha or in Recife felicitously in the course of each chapter. Perhaps the structure of the book, which returns repeatedly in different chapters to themes of liberty and security, leads to some repetition. But this does not impinge on the value of the ethnography itself.
Once this basic ethnography of sexuality and gender is established, she turns to the theme of cervical cancer. Women in Northeast Brazil and in Recife suffer from the world's highest incidence of this disease, which is linked to the sexual transmission of HPV (human papillomavirus). Gregg, who was training to be a medical doctor during the period she researched the book, spent two days a week in a state-run cancer clinic or in the public cancer hospital in Recife, working with doctors and locating women to interview. She could observe the cancer wards and out-patient services, conduct preliminary interviews and follow informants through treatment. She also collected data on cervical cancer statistics and also on prevention campaigns, notably those run by SOS Corpo, an important NGO (non-governmental organization) in Northeast Brazil working for reproductive rights.
The NGO, with support from the municipal authorities and international foundations and UNICE (United Nations Childrens Fund), ran a campaign that linked cancer to sexuality, adopting the slogan "If you have sex, do prevention" (Quem faz sexo, faz prevenção). In Brazil, the term prevenção is a very common form of reference to the pap smear. As a result of this and also of...