Sexuality and gender within Afghanistan's bacha bereesh population

Purpose: Limited evidence exists on bacha bazi, Afghanistan's steadily revived practice involving transgenerational same-sex relationships, despite its frequent association with violence towards young males, known as bacha bereesh. This paper aims to fill this critical gap. Design/methodology/approach: The author conducted an integrative literature review using qualitative and quantitative secondary data. An ecological framework for violence was applied to the findings. Findings: The findings offer a comprehensive overview of bacha bazi in its modern form, including the unique health needs, sexual practices, and gender identities and orientations of bacha bereesh. The author reveals how Afghan masculine identities and male-male sexual activity occur in relation to power structures and notions of honor. Numerous risk factors increasing bacha bereesh vulnerability for violence and socio-legal barriers constraining access to crucial services are also discussed. Research limitations/implications: Afghanistan's shame-based culture limits accurate data collection by obscuring the practice and stigmatizing bacha bereesh who serve in feminized roles. Practical implications: The research highlights the inadequacies of applying Western gender-binary frameworks to bacha bazi. It contributes to our understanding of sexuality, gender, masculinity, and male-directed sexual violence within Afghan culture. These insights will help us better address the health needs of this underserved population. Originality/value: The lack of evidence addressing these topics highlights our paper's originality, while the literature firmly linking violence to poor physical and psychological health outcomes emphasizes the importance of its contribution