Interview: Sexuality in Vietnam - Khuat Thu Hong

People would ask me why I was studying sexuality. ‘It’s a dirty topic. Aren’t there other topics for you to study?’ they would say. 
But the more I engaged with it, the more important I found it to be.

How did you begin working on sexuality?

I started working on sexuality in the late 1980s. I had been working on population and family planning and realised that sexuality was important to address. In Vietnam, at that time, it was quite fashionable to study fertility, contraceptive use and maternal mortality but no one dared to pick up the topic of sexuality. So this was the only topic left that was unknown and unstudied. 

It was an appropriate topic for me to take on because of my academic background in Psychology. I started with little things like writing about the need to rethink sexuality and sexual behaviour in terms of family planning. It was not easy, in fact it was quite difficult because at that time in Vietnam there were no studies or books about sexuality. Most Vietnamese people knew very little about it. There was a lot of depression, unhappiness and other complex negative things surrounding sexuality – I wanted people to know more.

People would ask me why I was studying sexuality. ‘It’s a dirty topic. Aren’t there other topics for you to study?’ they would say. But the more I engaged with it, the more important I found it to be. I gathered material, did translations of short articles from English to Vietnamese, and so on. Then I completed my dissertation on marriage and the family and after I received a Ph.D in Sociology I worked as a research fellow with the Population Council. 

With a small grant from the Rockefeller Foundation I wrote a paper on sexuality in Vietnam that people liked very much. This was very encouraging for me because it validated my choice and told me that I was moving in the right direction. 

I think I was very lucky because from the mid 1990s the Ford Foundation provided intensive support for capacity building in Vietnam to study sexuality, particularly for research and for advocacy on sexuality and sexual rights. Since then, I have been continuously getting support from the Ford Foundation to continue working on sexuality. We are still at a learning stage but people appreciate that and we know that more people will join us in this work.

Why do you think sexuality is important?

Sexuality is important not just because of health reasons or in order to prevent HIV, it is much more than that – personality, culture, and even political things are included. 

People believe that in Vietnam we don’t like to talk about sex, that it’s not nice to talk about sex, that in some way we are ‘pure’ if we don’t talk about it. There’s a belief that things like pre-marital sex, HIV, etc are brought from somewhere else and are a bad cultural influence. In this we share the same concerns, we are the same as people from India, China and other countries in this region who prefer to believe that problems come from outside the country. Talking of other countries, we have the same desires and feelings as people in other countries though we express them differently of course. If we know more about sexuality, we can calm down, we can understand ourselves better and we can learn how to deal with so-called ‘problems’.

Given that you have been working in the field for a fairly long time, have you seen any changes in Vietnam regarding sexuality?

In the last ten to 15 years people have become more open. For instance, no one asks me anymore why I work on sexuality; they actually say that the work we do is important and useful. Media people come to ask our opinions on various matters – premarital sex, divorce, same sex relations. We have become a source of information that people appreciate. Even the more ‘conservative’ parts of society like parents, teachers, etc want us to help them build up their knowledge and skills. We can do little but more people are asking questions and are aware about the issues. We lack the skills and knowledge to cater to everyone’s needs so we need more people with us so that we can reach out even more.

Tell us more about how ISDS, the organisation that you work with, came about.

We began as the Centre for Social Development Studies (CSDS) in May 2002. At that time civil society in Vietnam was just emerging. Because it was still so new and weak, not all donors really trusted civil society. But we got a lot of support from some of them – the Ford Foundation, USAID, UN agencies – they helped us grow and I really appreciate them for that. 

We changed the name to ISDS – Institute for Social Development Studies – at the end of 2003. Why? Because in Vietnam, the term Centre has implications of being a place where you provide a range of different services including commercial services; the term Institute better defines our mandate and main activities. 

What sort of work does ISDS undertake?

Our main areas of work are research, training, advocacy and consultancy in Gender and Sexuality, Health, and Social Development. ISDS primarily undertakes research on social issues. We have worked on various issues – HIV/AIDS, children, migration, land rights, and so on. 

For example, we have looked at gender and land issues, at women’s access to land. Though we have quite a progressive Land Law in Vietnam our Customary Laws are stronger and women do not easily get access and ownership of land. Sexuality and related topics are also a focal area of research for us – we have done research on various aspects of sexuality including MSM issues, condoms, stigma and discrimination related to HIV, drug use, and so on.

What did you find through your study on condoms?

We conducted this research with men and women, sex workers and their clients, MSM, rural-to-urban migrants, drug users, and people living with HIV/AIDS. We found that most people seem to dislike the condom because they are concerned about sexual pleasure. This is very much a gender issue. Men don’t like it, they feel it affects their male power. Women, to please their male partners, also don’t like it. Many women say that they would like to use a condom because it keeps them clean and safe but they don’t dare to suggest it. 

We found that many couples do not discuss sexual matters at all. Men may use a condom with sexworkers or girlfriends but not with the wife. Even if the wife suspects she cannot say anything. If young women suggest condom use they are perceived as being ‘knowledgeable’ and ‘experienced’, instead of being ‘innocent’ and ‘naïve’ as they are expected to be. There are very high rates of unwanted pregnancies and teen abortions. 

You mentioned a study with men who have sex with men. What was that about? 

Same sex relations are regarded as a ‘social evil’ in Vietnam, along with prostitution, drug use, gambling, and alcoholism which are regarded as the other ‘social evils’. So there is a lot of prejudice and discrimination. In 2004, ISDS conducted a qualitative study with men who have sex with men in Hanoi. This research was undertaken to provide a better understanding that MSM are not a homogenous group, but that regardless of the subgroups that they may belong to they suffer a lot because of stigma and discrimination due to poor understanding from the people around them. We wanted to provide a more comprehensive picture of their lives, work, and sexuality. They are members of all social groups –from blue-collar workers to police officers to high ranking government officials – but they are all vulnerable because of stigma and discrimination. They have lots of misconceptions about various sexual health issues such as having sex with men is safer than doing so with women, a good looking and clean man has no HIV or STDs, etc. We also found that health providers have no experience working with this group.

In your view, who are the people most affected by stigma and discrimination?

From our research in collaboration with the International Center for Research on Women (ICRW) we found that stigma and discrimination of HIV positive people is very severe, especially in the family and health care settings. Sex workers and drug users are most stigmatised. We did a study on the sub-culture of drug users, mostly Injecting Drug Users (IDUs). Heroin is the most popular drug that young people use. There are lots of myths about drugs – that drugs enhance sexual power, if you inject once there is no addiction, drugs will make you smarter, give you a long life, better health. More and more young women are injecting drugs. Sex work and drugs are closely linked. Young women engage in sex to keep the habit. Sex workers’ lovers/boyfriends/pimps force them to remain in the trade. It is very painful to see these women who have lost everything except the drug, and yet they can’t quit. But on the positive side, the government now has a new policy of harm reduction and is providing methadone substitute for drug treatment and is also conducting needle exchange programmes. 

What’s in the pipeline regarding sexuality research that you are involved with?

ISDS has just completed a study on the social construction of sexuality in Vietnam. We have interviewed 300 people from different parts of the country between the ages of 15 – 65 years of different genders, rural/urban locations, and occupations. Through this qualitative research we are looking at the history of sexual life of different people, their sexual practices, knowledge, beliefs, concepts about sexuality and how these change over time. The report should be out by the end of this year.

We are also hoping to conduct a study on marriage, migration and trafficking. 

Marriage, migration and trafficking? Please tell us more.

Marriage, migration and trafficking are all connected. What is happening is that a lot of Vietnamese young women are marrying Taiwanese and South Korean men and leaving the country and we do not really understand the situation. There are almost 100,000 Vietnamese brides in Taiwan. How this operates is that brokers advertise and hold recruitment campaigns for brides. This is popular especially in the South, like in Ho Chi Minh City where there are bride/wife markets. The girls apply, they submit a photo, and are called on a particular day. All the girls sit in a large room in lines, men come and inspect them, and then some are short-listed. So a man will inspect around 100 girls and then select ten out of the 100 girls and finally choose one. Of course it’s illegal but they do it in hiding. The broker takes a lot of money from both sides but the man gets to select his wife. After the wedding she may join him and go to Taiwan or South Korea. There is also evidence of trafficking within this process. We will collaborate with colleagues in Taiwan and South Korea to get better insights into these issues.

What do you hope to achieve through all this fascinating research that ISDS does?

In the past I focused on academic work but now I see that advocacy and applied research are also important. Beautiful books and research reports have their value but most of them remain on the shelves and we also need to contribute to positive social change, while we keep science moving. So now we also work with the media and with women’s unions to integrate the issue of sexuality in their work. We also work with many different government agencies – Health, Education, Training, and also with Communist party agencies. They find it useful to work with us because they learn different ways of seeing and understanding the issue, they see different angles and learn different skills of analysing the situation, and the use of participatory methods. 

We use our research findings for advocacy purposes. After the research study, we often do a large dissemination among the NGO community, government and donors. We also do public education through the media, through TV programmes, newspaper interviews on social issues, and so on, so that people learn more about these issues and are able to better debate them.

Let me give you a current example. The Ministry of Health is drafting a policy on sex reassignment surgery based on the government’s request. So now the media asks for my opinion on this. I share the findings from our study that many transgendered people have to go abroad for surgery and spend so much money. Why can’t it be done here in Vietnam? I hope that once this policy is passed legal procedures will follow and transsexuals can then also get a legal identity in keeping with their gender. So these are the ways in which our research can influence policy and can make a change in people’s thinking and their lives.

Do you feel that the current dialogue on sexuality in Vietnam has its origins in movements in the ‘West’?

The events of over 30 years ago may have stimulated some of the discussions on LGBT issues in our region, but not the dialogue on sexuality in general. The current dialogue is because of concerns about HIV. 

In terms of our growth, we don’t repeat what happened in the West – it is not a linear movement – the context is different, the issues are different. We are not ‘behind’ them – our context makes things happen. The scale, the scope of the dialogue are quite different from what happened in the West a few decades ago. In the West, it was about individualism and life-style; here it is more about cultural and political issues as well as rights on a larger scale. 

Is there a ‘sexuality movement’ in Vietnam?

We do not have a history or tradition of ‘movements’ in Vietnam but in recent years there have been debates on various issues like should prostitution be legal or illegal. There is an Ordinance on Prostitution that raised many debates when it was drafted a few years ago – the conservative side won, so prostitution is currently illegal.

A movement, if any, to do with sexuality began because of HIV. For instance, HIV gave a reason to start an open discussion about sexuality education or to form a network of MSM on issues affecting them. It is still growing and I think it is too early to call it a movement. Now it is going beyond HIV and safer sex and is more about rights, identity, and freedom. The more they get together, the more they talk, the more they learn. Earlier people had no idea about lesbians, but now they are beginning to talk about them also. The media debates issues more now whereas earlier they regarded same sex relations as a social evil and left it at that. Now they have changed and have more complex debates – some say it is bad, others say it is not bad and at least they are debating it more openly. The discussions are not just health related but related to freedom and lifestyle and the discourse is evolving.

Khuat Thu Hong is the Co-Director of the Institute for Social Development Studies (ISDS), Hanoi, Vietnam. She has been a gender specialist with the United Nations Development Program (UNDP). She has worked extensively on gender issues and HIV/AIDS, and focuses on social aspects and sexual behaviours of sex workers and their clients related to HIV/AIDS. She has also worked and written a number of papers on reproductive and sexual health of adolescents and young people to influence policy and programs in Vietnam. Hong is also a member of the Resource Centre’s Advisory Committee. For more information about ISDS, please visit