Abstract
In China, an emerging social issue involves a subset of rural women who, because of family and culture, become inadvertently matched up with and married to closeted men who have sex with men (MSM). These women-referred to as Tongqi-often discover they are in a loveless marriage, but any effort to change their situation results in intense backlash, discrimination, and stigma from families, village communities, and even government and healthcare institutions. This study explores the experiences of Tongqi, examining the influence of social interaction, community relationships, and macrostructural factors that coalesce to create an environment of chronic enacted stigma. In-depth interviews were conducted with 59 rural Tongqi, 11 of whom contracted human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) from their spouses. The findings reveal the significant role of extended kinship networks and macrostructural elements, such as hukou (household registration) and government officers, as well as village-level lineage structures. Informant data highlights how lineage relationships, interwoven with gender practices, contribute to the enacted stigma impacting the physical and psychological health of Tongqi. Tongqi report psychological effects such as an array of symptoms reflecting post-traumatic stress, chronic depression, and attempted suicide. Tongqi also report adverse physical health concerns involving reproductive health, unwanted pregnancies, sexually transmitted infections (STIs), and pregnancy complications. These findings helped produce possible policy recommendations to address the most pressing issues faced by Tongqi.