Sexuality, HIV/AIDS, and Civil Society in China


A Review of Inside the Circle: Sexuality, HIV/AIDS, and Civil Society in Post-Socialist Northwest China, by Casey J. Miller.

Although gays and lesbians in the United States can marry with their same-sex partners legally nationwide since June 26, 2015, their counterparts in China are still seeking legal recognition and social awareness. A number of gay/lesbian grassroots organizations have emerged in recent years in China in response to the increased will of self-awareness, greater respect to the diversity in society, and the numerous harm reduction projects of HIV/AIDS intervention funded by international donor agencies as well as the Chinese government.

Through 17 months fieldwork in urban northwest China on this emerging gay and lesbian community and serving as a volunteer in a local grassroots gay NGO, Tong’ai, Miller offers timely and excellent insight into how the experience of (homo)sexuality and the development of the gay/lesbian community are shaped by cultural understanding of gender, stigma attached to sexually transmitted diseases, daily joyful or painful experiences of love and loss, broader social anxieties about uncertainties in post-socialist China, and global harm reduction funding opportunities/challenges, as well as the desire to be a good and moral citizen of the PRC. In particular, Miller suggests that despite the political and legal challenges and social marginalization they are facing, gays and lesbians in northwest China are creating a social space in which they are trying to know more about themselves; looking for love, intimacy, friendship, and a sense of belonging; seeking ways to reconcile still-influential traditional values regarding marriage and family; and finally hoping to make a difference in the way that they were understood by wider Chinese society and contribute to the development of “civil society.”

In the first chapter, Miller provides a brief but enlightened historical background of gender and (homo)sexuality in China for his later ethnographic analysis. The historical background not only provides a big picture of how expressions of sexuality were changing over time in China, but also shows how sexuality is always shaped by broader social and power relations such as kinship, social class, and relations with the state and even foreign countries. Miller pays special attention to the connection of anxieties over issues of national strength, morality, and modernity, with state regulation of what constitutes “proper” expression of gender and sexuality.

Miller reaches back to premodern times when sexuality, sex roles and identity had not been linked to same-sex relations, but were largely determined by one’s broader social relationships and relative social status. Although Chinese dichotomy systems, such as yin/yang or wen/wu, are often simply regarded as signifying the femininity/masculinity division, they are actually not to separate genders, but instead to value the importance of their dynamic interactive balance. The dynamic equilibrium between yin and yang is considered essential for not only the individual body or an individual’s health, but also for all social relations, and viewed as the nature of the universe. Sexuality is also defined by national identity, especially during the encounter with non-Han Chinese rulers (e.g., the “fragile scholar” male character during the Yuan dynasty, when China was ruled by the Mongols) and foreign imperialist invaders. In late Qing and Republican China, Western thought about gender combined with Confucian views of the harmonious conjugal family unit as the basis of a stable social order, resulting in a rigid male/female sexual binary and the repulsion of any forms of sexuality outside of male-female marriage. As a result, homosexuality began to be pathologicalized not only into an individual disease, but also an ailment of the Chinese race, connecting the political failure of the nation to the very intimate sex behavior of Chinese people. Despite the contribution of Confucianism and Western scientific knowledge to casting homosexuality as deviant, after 1949 both are blamed as the origin of this “bad habit” as either capitalist corruption or feudal crime. In Mao’s era, the body and its desires were criticized as dangerous bourgeois individualism and selfishness, and individual sexuality was strictly regulated by the socialist state for the purpose of nation-building. Homosexuality became a form of mental illness requiring treatments like “hate therapy” or even electric shock. Although the later opening up (post-1978) continues the entanglement of discussions of sexuality and gender with modernity and state-building, it created a space which is often interpreted as a “sexual revolution” and provided opportunities enabling the emergence of gay and lesbian identities. However, many scholars show that the liberating discourse about sex may reproduce the state’s disciplinary power by actively promoting the monogamous heterosexual unit, and thus repress gays and lesbians whose sexuality does not align with the state’s agendas.

In chapters 2 and 3, Miller situates his analysis in the literature on sexuality and starts to analyze his own ethnographic data collected from the emerging “the circle” (quanzi), which is not only an “imagined community” as in Benedict Anderson’s notion, but also needed to come into contact with others. By carefully examining the generational differences (divided according to China’s common practice of reckoning generations by the decade of birth: born after 1960, 1970, 1980, and 1990), Miller describes the experiences of self-awareness of being gay and stories of “joining the circle” from different generations of men To explore the meaning of being gays/lesbians in China and to understand the local sex/gender system, Miller documents how people inside the “circle” draw, perceive, navigate, and move beyond a set of binary oppositions of sex roles and gender norms (e.g., 0/1 for men and T(tomboy)/P(wife) for women). Miller also analyzes the terms used among people inside the circle to refer to themselves and others, documenting their meanings, using contexts, popularity, and patterns of changes. For examples, these terms range from borrowed words like gay and lala, to a more clinic term tongxinglian, to tongzhi, which is used as a resistance strategy focusing more on social harmony than sexuality, to local dialect huo. Chapter 2 offers a fascinating discussion of the complexity, richness, and contradictory nature of experiences of gender and sexuality in post-socialist China.

Miller continues his analysis on gender and sexuality in chapter 3, but pays particular attention to the intimate lives of gay men and their experiences and understandings of love and affection. Miller examines how gay men reconcile their romantic lives with social expectations of getting married, and with the filial obligation to continue the family line especially when they are the only children (under the one-child policy). Family is often people’s primary concern and filial piety is considered the most important norm of being a person in China. Thus, different from coming out in the West, which is regarded as a self-acceptance ritual or an important political duty, Chinese gay men often consider coming out a highly personal decision mainly about how to tell one’s parents. Miller points out that the lack of social and legal recognition results in the general short-term relationship and a belief of the intrinsically impermanent love between two men. Miller argues that this pessimistic perception is also due to their understanding and experience of the inevitable transition from sexual love/passionate love (jiqing) to familial affection/companionate love (qinqing). According to Miller’s informants, this is not only limited to the gay community but applicable to all Chinese people in a uncertain era of social changes. These pressures and the hopeless romantic love, as Miller observed, on the one hand, forced some gay men to marry straight women (sometimes they married lesbians in what is called a “show marriage”) to compromise social expectation and their parents’ need. On the other hand, this drove some gay men to desire marriage and children for a stable and committed relationship. Miller argues that this kind of desire also reflects anxiety about old-age care, which is a wider social unease in current Chinese society. In the last part of this chapter, Miller shows another strategy of local gay men to gain a sense of belonging: family-like though unstable gay kinship. Miller situates his analysis in the shift of kinship studies from “what kinship does” (how kinship structures economic and political relations) to “what kinship is” (how it is perceived and practiced, emphasizing the divergent means of connection/disconnection). Miller extends the work of “what kinship is” by examining the practices, norms, and rituals of gay kinship in northwest China. Gay men in northwest China with good relationships form a social network called “gay family” (jiazu), to seek a sense of belonging, to temporarily escape from factors constraining their everyday lives outside the circle such as gender and age, and to create a supplementary space where they could enact family relationships as gay men without challenging the hegemonic notions of kinship and value of being a filial son and a moral Chinese.

In chapters 4 and 5, Miller turns his focus to grassroots gay and lesbian activism, NGOs, and civil/uncivil society, bringing studies on civil society and state-society relations into conversation with those on sexuality. In chapter 4, Miller’s investigation of one gay (tong’ai) and one lesbian (UNITE) community-based organization (CBO) in northwest China reveals how China’s social and economic reforms and the global HIV/AIDS crisis, as well as numerous harm reduction projects, create opportunities for many gays and lesbians to come together for common goals not only fighting HIV/AIDS but working together to gain greater social awareness and acceptance of homosexuality. Miller views these communities as examples of “a unique and often overlooked form of civil society in China that, while not entirely free of the power and influence of the state, is nonetheless pursuing its own projects and is never entirely subject to state domination and control” (p. 197). Literature on civil society is debating whether civil society is coterminous with the state, or in opposition with the state, or actually enables the domination of the individual from a ruling class by the state. Also, scholars are arguing if the concept of civil society can be applied to a Chinese society in which state and society are largely overlapping, as if there is a clean separation between civil society organizations and the state. Miller goes beyond these debates to view gay and lesbian community as a site on which dynamic interaction between state and society occur, and thus adopts a new approach to civil society that examines the ways in which “different forms of power and hegemony-including state power and hegemony-are maintained, resisted, and transformed in various ways by non-state actors” (p. 205). To do so, Miller analyzes the historical development of these organizations, members’ understanding and motivation of being volunteers, their interaction with the government and the state, especially through the connection of HIV/AIDS-related harm reduction projects. Although these projects often focus on HIV/AIDS prevention, volunteers from local NGOs value these projects as a way of achieving larger social and political goals, such as increasing support for homosexuality in China and the strengthening of China’s civil society. Miller compares local lesbian NGOs with their gay male counterparts and then points out that the major difference between gay and lesbian organizations is that HIV/AIDS was not regarded as an issue that affected lesbians. As a result, lesbian organizations do not have many opportunities for obtaining funding and political support. But at the same time, Miller argues that lesbians are more free to pay attention to political and cultural agendas, which are also the original goals of gay NGOs. Miller’s observation on both gay and lesbian community contributes to the inadequate and often neglected study of women in the field of gay, lesbian, or queer anthropology.

The final chapter continues to explore emerging civil society, but focuses critically on the conflicts, distrust, division, disillusionment, and other “uncivil” aspects of that civil society, especially when these local organizations encounter and contract with large international donor agencies like the Gates Foundation and the Global Fund. Although the “civil society argument” often links these voluntary associations to democracy, some scholars argue that “uncivil society” characterized by self-interest, conflict, or anti-democratic actions also renders the nature of this kind of association as similar to terrorist organizations. Miller goes beyond this debate, which clearly distinguishes uncivil society from civil society, to argue that “we would be better served by adopting a broader notion of (un)civil society that includes all CSOs (civil society organizations) whose internal or external relations are marked by varying degrees of hostility, discord, antagonism, strife, fraud, authoritarianism, or competition” (p. 272). Instead of making a simple good/bad judgment, Miller tries to reveal the causes and consequences of incivility in the emerging gay and lesbian community. Miller discusses several reasons for the incivility, such as the international NGO’s lack of respect for local organizations and the local situation, keen and improper competition among civil society groups, charismatic authority in local grassroots NGOs, and resulting conflicts and bureaucratization. Miller argues that these are partially the results of the promotion of a neoliberal public health model in which both the Chinese government and international donor agencies promoted NGOs to prioritize HIV testing and treatment, and encouraged NGOs to compete with one another in order to secure contracts and funds. The focus is on HIV/AIDS because both the Chinese government and foreign donor agencies consider fighting a disease as safer than touching upon the more controversial and politically sensitive issues of sexual identity and gay and lesbian rights in China. As a result, many organizations’ attention on social and political goals has been distracted. Indeed, the narrow focus on HIV/AIDS and the more professionalized work style are challenging local grassroots NGOs’ most valuable capital: their social connections with the local gay and lesbian community. As Miller shows, Tong’ai was becoming increasingly alienated from their very local target community. This chapter offers a critical analysis of the relationship between grassroots gay men’s group, the state, and international funding agencies, and provides a rich ethnographic analysis on the emerging civil society in which the “civil” and the “uncivil” aspects are impossible to draw and their interaction is essential for the development of the civil society. This chapter also engenders reflection on the risk of public health intervention on what is called “at-risk populations.”

This dissertation is an important contribution to queer anthropology, anthropology of sexuality, study of civil society, and of China, as well as to study of public health intervention practices and of those people who are still living in the margins of power and society.

Chao-xiong Zhang
Department of Anthropology
Washington University in St. Louis

Primary Sources

Participant observation
Semi-structured interviews

Dissertation information

Brandeis University. 2013. 373pp. Primary Adviser: Sarah Lamb.

Image: Photo by Author.

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