Dr Chase Ledin explains how taking a creative approach with community members has informed his research. Background and inspiration In ‘The Quest for Sexual Health’ (2022), sociologist Steven Epstein maps the different meanings and stories we tell about sexual health in society, revealing and probing insights into the politics, practices and values that surround individual and group perceptions of sex (as an act and way of life). He also, quite usefully, enters into conversation with the “private desires and public dreams” that constitutes sex as an organisational principle (Epstein 1994) and the impulse to think (rather compulsively) about the unending practice(s) of sex as a health behaviour (Epstein & Mamo 2017). In this way, Epstein opens up conversations about the social processes and imaginaries that inform how and why sexual health is constructed, classified, evidenced, and experienced in society. After completing a PhD project in 2022, looking at imagined social futures ‘after AIDS’, Epstein’s positioning of private desires and public dreams inspired me to explore how and why we imagine sexual health in Scotland. I wondered if and whether creative health promotion in communities might enable and enrich collaborative and equitable exploration of both near present and far future societal conditions and practices for engaging in sex. I thus staged a series of creative workshops where community members could experiment and play with imagined and potential futures of sexual health in Scotland. This blog post details some of the experiences and findings from these workshops. Social imaginaries At the core of my creative workshops was an exploration of what Science and Technology Studies (STS) scholars have called ‘social imaginaries’. As Charles Taylor writes, a social imaginary is ‘not a set of ideas; rather it is what enables, through making sense of, the practices of a society’, which is ‘carried in images, stories and legends […] shared by large groups of people, if not the whole society’. For Taylor, a social imaginary is a shared practice that allows us to make sense of ‘how we all fit together in carrying out common practice[s]”. Similarly, Stephen Hughes has defined social imaginaries as ‘an analytic device deployed by social scientists to capture [how] social groups collectively imagine their relationship with [larger social processes]’. Hughes considers these imaginaries as an ‘assemblage of discourses, representations, institutions, and social practices that constitutes such a collective vision’. Working with and through social imaginaries, to better understand how and why sexual health is assembled collectively through stories and shared experiences, I sought to create space for people in my communities to explore their own ‘collectively imagined relationship’ and vision for the future. Specifically, I curated a workshop space that prioritised group discussion about present conditions and practices of sexual health and enabled participants to explore their ideas through health zine-making (Lupton 2022). As I illustrate below, using social imaginaries of imagined and potential futures enabled participants to laugh, groan, tear up, gesture, sit thoughtfully, fidget, react, and respond in a space where they could individually and collectively conjure shared commitments for sexual health and wellbeing. Imagining sexual health workshops From June 2023 to November 2024, I ran more than 10 zine workshops exploring aspects of sexual health in Scotland, including engaging with doctors in clinical spaces, digital life and dating apps, mental health, and envisioning changes to policy and infrastructure. As one participant explored, issues related to uneven political visions and bureaucratic stopgaps informed how they thought about and constructed the current generation of leaders and the potential future. Zine 1 - Text reads 'stop holding our future, H bionow stage. There is a CRISIS. This generation of leaders have zero vision.' image CC BY-NC-ND 4.0 © Chase Ledin. Another participant reflected upon their reproductive health experiences and what they thought it means to be a ‘perfect patient’. For them, there were obvious difficulties in living up to both self-expectations and social prescriptions from clinicians. They expressed the desire to be ‘vulnerable’ and discussed what it might mean to re-think how healthcare services might be re-orientated to encourage vulnerability in clinical settings. Zine 2 - Text reads 'Being a perfect patient can be difficult. I just want to be vulnerable'. Image CC BY-NC-ND 4.0 © Chase Ledin. One participant considered the national context of sexual health in Scotland. In their zine, they cast Scotland in a vast blue ocean – surrounded by a series of questions about geographical location, testing capacities and limitations, language and conversations, uneven access to basic services, and some suggestions for what we might need to ‘map’ onto the national sexual health imaginary. Zine three - text reads 'why is Scotland so scared about talking about sex. Maybe sexual health services in the UK would be better if they worked collectively. Do you only get access to postal STI kit services if you live in the central belt? Strangely distanced in access to essential services. Sorry STI kit are 'unavailable' in your area. Maybe people in Scotland would have better sexual health if they have better "access". Trans youth deserve to have access to essential gender affirming care in Scotland. Individuals of Scotland deserve better. Freedom to know about your body and its health. Develop: Inclusive sexual health education, person centred care & services, a Scottish RSE curriculum, national STI testing in Scotland, Consistant supply of STI tests, contraception...'. Image CC BY-NC-ND 4.0 © Chase Ledin Finally, another participant experimented with the zine form to make a DIY flip-book that presents and answers basic questions about sexual and reproductive health, including how to put on a condom, where to get tested, contraception options, and where to find ‘good’ sex education. Whilst focussed on present conditions, this participant considered the role of the creative arts in pushing visual health promotion strategies beyond traditional channels of communication – and using edgy, un-censored imagery and text to encourage critical and open conversation about sexual health to improve conditions for the future Zine 4. Text includes 'egg, advanotal, must ovulate, don't ovulate, Egg is not the god of sticky tape + apples, Delicious + tempting, Rotten, too many people took a bite, just a core, core = seeds=eggs, god is a man goddammit, you are sticky tape with no stick, testing testing'. Image CC BY-NC-ND 4.0 © Chase Ledin ConclusionDelivering these workshops and engaging with community members using the zine form allowed us to collaboratively explore how and why we imagine sexual health in society depends upon the context, practices, actions, and experiences that assemble a diverse – and sometimes conflicting – notion of health and wellbeing through the act of sex. Many participants imagined the social and political contexts of sex that intimately shaped their own practices. Others considered the role of leaders, communication outlets, and health specialists in devising and delivering effective education to both shape and improve sexual health and wellbeing. Still others mentioned here, both in conversation and through zine exploration, considered why sex itself might be useful as a tenuous and collective relationship across the group and people in their communities. They considered sexual health to stem from emotional and psychological health, experienced and amplified by inter-personal relationships, and experienced and shared across communities and national contexts.Reflecting upon these discussions and images, I have learned that sexual health is a negotiated practice with differing priorities depending upon the individual, group or community. Whilst there are shared principles that are upheld by public health and global health organisations like the NHS and the World Health Organisation (WHO), individuals within communities play a central role in negotiating and practicing shared forms of sexual health on their own terms and in practice with others. Using social imaginaries to explore and understand how these negotiations and practices are experienced has been helpful to illuminate how and why we make sense of sexual health as a social practice and why sexual health and wellbeing is an unfolding experience rather than a fixed concept or condition in society.Funding DisclosureThis research was funded by the Wellcome Trust [Grant number 209519/Z/17/Z] as part of a postdoctoral project within the Centre for Biomedicine, Self and Society (Jan 2023 to Jan 2024).ReferencesEpstein, S. 1994. A Queer Encounter: Sociology and the Study of Sexuality (external link to jstor.org). Sociological Theory 12(2): 188-202.Epstein, S., & Mamo, L. 2017. The proliferation of sexual health: Diverse social problems and the legitimation of sexuality(external link to doi.org). Social Science & Medicine 188: 176-190.Epstein, S. 2022. The Quest for Sexual Health. Chicago: University of Chicago Press.Hughes, S. 2024. Hearts and minds: The technopolitical role of affect in sociotechnical imaginaries(external link to doi.org). Social Studies of Science 54(6): 907-930.Lupton, D. 2022. “Health zines: Hand-made and heart-felt,” (external link to taylorfrancis.com) in: Friedman & Jones (eds.) Routledge Handbook of Health and Media, 65-76. London: Routledge. Related informationDr Chase LedinWhat are your WISHes for women’s health? This article was published on 2025-02-19
