This chapter started with a critical examination of the sexual ideologies that prevail in the public sphere in Vietnam. These ideologies, we have shown, define heterosexual marriage as the cornerstone of social order, emphasising people’s duties to contribute to society through the sexual alliances they build. The family visions that these ideologies entail are strongly gender hierarchical, emphasising male assertiveness and female submissiveness and self-sacrifice. Next, a review of the sexual health consequences of this ideological restriction of sexuality to the marital sphere drew attention to the social exclusions that result: the denial of young people’s sexual practices; the silencing of sexual violence within and outside marriage; and the social marginalisation of individuals who must seek a livelihood in the sex industry. In conclusion, we shall point to some recent tendencies which suggest that this pattern of sexual exclusions is changing.

Since civil society organisations were allowed to operate in Vietnam in the early 1990s, numerous organisations advocating for the health and rights of sexual minority groups have emerged. This has helped to bring the interests of gay, lesbian, and transgender people on to the political agenda (see Newton in this volume), while also increasing public attention to issues such as the sexual rights of people with disabilities, young people’s needs for sex education, the sexual health and rights consequences of violence against women, and the unintended social impact of social evils rhetoric. As a consequence of civil society pressures for reform, several important legal changes have taken place over the past years. Marital rape has, as mentioned above, been outlawed. The National Assembly recently decided that sex workers shall no longer be sent to rehabilitation camps for re-education and disease treatment, and a new Labour Law issued by the National Assembly and coming into effect in July 2013 forbids workplace sexual harassment. Sex work remains illegal in Vietnam, but during recent National Assembly debates, several delegates advocated decriminalisation (Tuoi Tre News 2011). In order for such social initiatives and legal amendments to achieve full social effect, however, entrenched cultural notions of masculinity and femininity, and of family life and societal welfare must be addressed. As Khuat Thu Hong, Le Bach Du’o’ng, and Nguyen Ngoc Huong observe, persistent moral ideologies often threaten to undermine attempts at sexual reform. Taking sex education for youth as an example, they describe how government efforts to include sexual health in Vietnamese school curricula confront huge challenges, as ‘the general discourse and society still reject sex in adolescence and sex before marriage for the large part, treating it as unhealthy and a violation of morality’ (Khuat et al. 2009: 363). These authors therefore encourage their compatriots to talk more openly about sex:

Now that Vietnamese society has joined the global world and is moving fast toward modernization, social institutions, especially the scientific community, must examine sexuality from a politics-free viewpoint so that society can cope properly with issues like sexually transmitted diseases, HIV/AIDS, sexual assault and abuse, teenage pregnancy, or family planning (2009: 366).

It can, of course, be debated whether such a politics-free viewpoint on sexuality exists. As the evidence presented in this chapter indicates, national politics reach far into day-to-day sexual lives; in Vietnam as elsewhere, political agendas shape intimate human relations and sexual health conditions in consequential ways.