A Haven in Havana
Dr. Mariela Castro Espín, the daughter of Cuban President Raúl Castro and the niece of Fidel Castro, heads up CENESEX, the Cuban National Center for Sexual Education, carrying on the legacy of her beloved mother, Vilma Espín, while building a safer, brighter future for her country’s LGBT Community
by Sean Black, with Chael Needle
Photographed Exclusively for A&U by Sean Black
We were free, always, to ask questions of our parents,” emphatically states Mariela Castro, through a translator, about conversations between her parents and their children when she was growing up. “We did it frequently,” she adds. “My parents always taught us that the absence of the protection of the rights of all people was a tragedy that should be resolved.” “All people,” she learned, included individuals who are LGBT and those who are living with HIV as well. As a child, she was shocked to hear of a man who had been disowned by his father because of his sexual orientation and subsequently ended his young life in a suicide, she shares. One might surmise that her impetus for her active role in politics and equality was in part forged by these domestic dialogues and early experiences.
And it might also explain why CENESEX (the Cuban National Center for Sexual Education), part of Cuba’s National Ministry of Health, has become a home base (emphasis on “home”) for many in the LGBT community in Havana and even beyond.
Several walking blocks southwest of Cuba’s famed El Malecón, a four to five mile seafront promenade cradling Central Havana’s coastline sits a cozy fortress in the charming Vedado neighborhood known as CENESEX. Although a quainter stronghold than the city’s monumental Castillo de los Tres Reyes del Morro (El Morro), a sixteenth-century fort begun in 1589 that impressively rendered Havana as the safest port in the Americas during the heyday of pirates and imperial invaders, CENESEX is nonetheless an organization and notable landmark, dedicated to Cuba’s comprehensive sexual health programming with a major focus on the LGBT population. CENESEX is led by Mariela Castro, the fifty-three-year-old mother of three, an academic and rising political figure of her own accord; she is an internationally heralded advocate and expert specializing in the rights of transgender individuals. She holds a PhD in the social sciences with a specialization in Transgender Studies.
Over the course of two days, A&U was invited to this safe haven, along with friends and delegates, mostly gay men of color. Acting as a photojournalist, I was honored to be asked to travel with the Black AIDS Institute delegation spearheaded by Phill Wilson, BAI’s founder, President and CEO, and this issue’s guest editor (see Wilson’s “Building Communidad”).
CENESEX, meticulously maintained, is flanked by once-elegant stately mansions in various states of disrepair, still quite opulent despite their crumbling facades and weathered windows agape and swagged in lace and brightly colored fabric. Neighboring structures with air-drying linens and clothing strung ledge-to-ledge imbue old-world charm over Cuba’s transitioning socio-economics, the balconies punctuated by the occasional, friendly onlooker with smart device in hand.
Arriving early on the first day, under the care of our trusty En Lista drivers, we pass freely through a wrought-iron gate following a tidy path up to a gracious satin-white wrap-around porch, sun-drenched seating areas abounding with lush foliage and manicured botanicals. Interior and exterior walls are awash in fresh coats of soft yellow paint that blend aptly with an ambience that’s calm and soothing amid the non-frenzied buzz of people of all ages, genders and sexualities working the grounds. Gardeners, office staff, security and cooks alike tend to tasks efficiently and dutifully yet never forgoing the passing chance to offer warm smiles and glimpses of kind eyes, all meant to acknowledge and affirm visitors.

“Everyone’s work at CENESEX is important,” proudly notes Ariel Causa Menéndez, an enthusiastic, bright young man and head of CENESEX’s International Relations Group, during our welcome orientation. It’s an idea that spills over to his love of American football. When I learned his favorite team was the Patriots, I singled out Tom Brady knowing how sports fans love their heroes, but he demurred in an aside, shifting the spotlight from the quarterback to the team. Point taken. It’s a team effort, like CENESEX.
That explains why Ariel, who is straight, so easily embraces his role as an LGBT ally. And that helps explain why Mariela Castro, who is also straight, is so confident and comfortable in her role as an LGBT ally, too. Cuba’s mission is the emancipation of all human beings; advocating across identities is par for the course in the nation’s people-centered approach to organizing life, work, and play.
Still, I wanted to know Castro’s specific reasons for her commitment to the LGBT community, and by extension, HIV/AIDS work. Mariela explained, with Ariel acting as translator throughout our interview, that she focused on this community because essentially LGBT rights up until recently were not included in the Cuban political agenda. Although her mother had always been worried about and cared for these matters up till the time she became seriously ill, it was Mariela who, when she became the director of CENESEX, made it her mission to incorporate the human rights of the LGBT community into the country’s larger social-political dialogue, as the Cuban Revolution was built on the principles of justice. She resolutely says about the fight for LGBT inclusion, “It was due, and would be just, based on these principles.”
She first began working with the trans community because its members came to her, and from those interactions, discovered that part of the LGBT community remained outside of the revolutionary project. The fight for rights, thus, has been a mixing of outsider grass-roots and insider government politics in a way not known in the United States. It sounds very complicated—individuals who were not recognized by the establishment now are suddenly embraced by the establishment and must work with the government. I should note that, historically, the trans liberation movement in Cuba preceded and in effect paved the way for the country’s LGBT movement. While trans activists have always been a part of the United States’ LGBT movement, on the front lines of California’s Compton’s Cafeteria Riot and Dewey’s Lunch Counter Riot, and New York City’s Stonewall Riots, all during the 1960s, they have often been overshadowed and in many ways marginalized by white gay male activists and how our history of LGBT equality and that of AIDS activism has been told.
When she started working on LGBT issues, she was fortunate to have the support of the Communist Party, she says. However her father has been quieter on this stance. “He has always, nevertheless, encouraged my siblings and me to fight for our own beliefs and causes. I am forever grateful to my father for his advice,” she shares.
CENESEX, as its mission statement conveys, encourages these types of “open, knowledgeable dialogues,” perhaps echoing Mariela’s early upbringing. As an institution devoted to education and research in the field of human sexuality, CENESEX “promotes scientific research” and “fosters the exchange of experiences.” CENESEX’s intersectoral approach to human rights and sexual education can be traced back to early efforts of the Cuban Revolution that were later formalized through a collaboration of the Federation of Cuban Women (FMC), the Ministry of Public Health, and different sectors of the state and civil society in the early seventies. The National Work Group on Sexual Education (GNTS), created by the FMC, which for many years was directed by Mariela’s mother, Vilma Espín, took up the charge of training and educating professionals and the general public. GNTES became its own legal entity in 1977, working with the Commission for the Attention of Rights Equality for Women, Family, Childhood and Youth to establish a firmer scientific basis supporting sexual education; support the expertise of therapists and sexual educators; and provide specialized care to transsexual people, among other actions. CENESEX along with serving as the governmental advisory institution in all issues related to sexual health was founded in 1989 to continue the work of GNTES with a gender-centric approach. A recent example of its gender-based services is counseling and identifying Cuban transgender individuals who might want to consider sex-reassignment surgery; the procedure is now state-sponsored under Cuba’s universal healthcare system after the government lifted the ban on the procedure in 2007.

CENESEX’s various activities also now include post-graduate education; education for physicians, sociologists, psychologists, specialists and activists, among others; substantial research and teaching initiatives; various publishing activities (of note is the organization’s quarterly publication, Sexologia y Sociedad); and international partnerships for training and social networking for the equality and advancements in all areas of sexual health. Its programming includes a maternity and paternity campaign, which runs between Valentine’s Day and Father’s Day and is committed to ensuring gender equality; a campaign about AIDS awareness on World AIDS Day held December 1; and other campaigns targeted to educating about women’s rights, domestic violence, and violence against children. The legal department works in tandem, and oversees and investigates complaints in all areas in regards to discrimination and abuse. Visually reinforcing this stance, the walls of CENESEX’s atrium serve as gallery space reflecting the Center’s bold campaigns, networks, and outreach initiatives. Significant work by internationally prominent artists, such as Italian photographic artist Giuseppe Klain, whose exhibition “I Miserabili” was on display during my visits, is showcased. Klain’s powerful work aligned with Cuba’s stance on the protection of women and their rights. Past exhibitions have included work by Los Angeles-based artist Byron Motley and images from his book Embracing Cuba. These efforts reflect the spark of the Cuban Revolution more than fifty-five years ago.
But socialism is open to revision—that’s also why CENESEX has evolved to include educational components around community-tailored sexuality education and prevention and promotion of sexual health; HIV/AIDS awareness; and advocacy for individuals who are lesbian, gay, bisexual, and transgender, among others. Presently, CENESEX offers direct support to five social community networks, including Youth Network for Health and Sexual Rights, Transgender People Network (TransCuba), Network of Lesbian and Bisexual Women, Humanity for Diversity (HxD) and the Network of Lawyers for Sexual Rights.
“Socialism has been a bad word not just in the U.S., but elsewhere in the world because of political interests that have tried to demonize it, make it bad,” says Manuel Vázquez Seijido, Chief Legal Advisor at CENESEX, during one of our CENESEX meetings, with Ariel Causa acting as translator. Indeed, socialism has cropped up in recent years in the United States’ healthcare arena. Opponents of President Obama’s Affordable Care and Patient Protection Act have long labeled his approach as “socialist,” meaning to scare up an antiquated Cold War ideology that pitted Americans against Soviets and to highlight more recently claimed “failures” of Canada and various European countries’ systems to provide gold-standard care. And now Presidential candidate Bernie Sanders is taking heat for his stances as a democratic socialist, including universal access to healthcare.
He continues about defining socialism in this context of demonization, “However, our experience [involves] not just constructed socialism but learning how to construct socialism because it is not something we have already figured out as a whole.” In other words, it is not a static concept or practice, frozen in time as many in the rest of the world would have it.
“It doesn’t mean that we are perfect; it doesn’t mean we have done each and everything right—we have discovered along the way that we have made mistakes; they are mistakes we hadn’t discovered and we are working on solving those that we know [about] and we are perfecting the work we are doing. However the key value of socialism, the most important thing, is to put the human being in the center of the spotlight.
“Hence, in order to put the human being in the center of the spotlight his or her [inherent] rights must be placed in the center of whatever project you build, in a process of liberation that will secure the right to enjoy freely these very rights.”
Manuel and Ariel pause to compare the terms “liberation” and “emancipation” in translation. “I know you are a harsh public,” half-jokingly mentions Ariel.
Continuing, Manuel adds, “Socialism has been an important strategy for the Cuban Government and Cuban people to develop a response that addresses people with these kinds of limitations—people living with HIV, including those seropositive within the LGBT community.
“There are two key principles of our healthcare system in its development and implementation, which are universality, which means everyone has the right to receive attention, and the entire intervention must be delivered for free. So the state takes part and assumes the responsibilities of preventing people from getting infected, working on prevention as a key way to avoid people getting infected and if the person gets infected guaranteeing that that person will have the kind of respect and dignity that anyone deserves including medical attention to people living with HIV. That is an example of how socialism helps people living with HIV.”

Manuel asks, “Do you happen to know that Cuba was declared—we are very proud of this—[to have eradicated] the vertical transmission of the disease?”
Just last year, news of this breakthrough on the AIDS front came around the time that the United States began its first steps in lifting its embargo on Cuba. In June 2015, Cuba received validation from the World Health Organization that the country’s efforts to reduce mother-to-child transmission of HIV and syphilis was a stellar success—the nation became the first in the world to eliminate new infections by this mode of transmission. According to WHO, the success stems from an integration of maternal and child health programs with HIV/STI programs, as well as abundant and equal access to free universal healthcare, in this case, tailored to reproductive and sexual health. This success is mirrored in other aspects of HIV education, testing, treatment, and support, which benefits from an approach that threads together governmental institutions and agencies, the media, and health and education organizations under Cuban Ministry of Public Health’s National Strategic Plan for Sexually-Transmitted Infections–HIV/AIDS as implemented by the National STI–HIV/AIDS Prevention Center. Cuba boasts the lowest rate of HIV infection and the highest level of HIV/AIDS treatment among all Caribbean nations. According to 2014 estimates from UNAIDS, the prevalence rate of HIV among adults aged fifteen to forty-nine is 0.3 percent. By comparison, Haiti is at 1.9 percent for the same population; Jamaica at 1.6.
One of the most impactful and longest campaigns for public wellbeing was HIV messaging targeting young people and MSM. Notes Manuel: “The Campaign takes physical expression in many many ways; education materials, brochures, flyers, magazines, our magazine. We generate trainings here with the activists in order for them to deliver the campaign guidelines and spread it all through the country.”
Condom distribution is widespread, through public campaigns and purchasing them at pharmacies and cafeterias, and the like. Because of governmental subsidizing, condoms can be purchased for five cents for three condoms. Access to condoms is almost universal. “In Cuba the government puts a very large part of its budget to the attention of HIV issues,” says Manuel.
I ask if Cuban researchers are working toward a cure. “Of course [but] because of the blockade, it is hard for us to gain access to supplies for medicines and supplies for the treatment so in many cases we’ve had to produce them ourselves, which means also that we have had to redirect [the expertise of] our specialists that would be otherwise researching for a cure and reassign resources in order to create our own versions of antiretroviral medicines in order to come up with the needs we had at the moment,” explains Manuel. The CENESEX representatives also say if Cuban researchers find a cure, they would share it freely with the world.
Today, while access to HIV-related and LGBT-centered care is not a barrier, engagement in care is still stymied. The primary cause? Arguably, it’s stigma and discrimination. Cuba’s early response to the first wave of the epidemic may have inadvertently propelled this stigma. Although President Fidel Castro responded to the epidemic much earlier and more robustly than President Ronald Reagan, the creation of sanitariums for people living with (or, at that time, sometimes dying of) AIDS mandated the quarantining of positive individuals by governmental policy and arguably supported the notion that individuals living with HIV/AIDS were an Other to be kept outside of society. Now fourteen AIDS Sanitariums remain and since 1994 they have been voluntary. But also, in general, Cuba, like the rest of the world, has not been immune to heteronormativity, homophobia and transphobia, longstanding drivers of stigma and discrimination in patriarchal cultures.
One of the ways CENESEX works hard to end this stigma and discrimination is through the transformative power of art. Ariel, on behalf of CENESEX, echoes A&U’s mission that art is an effective cultural tool in disseminating critical information effecting change within societies especially when targeted successfully to those at risk for HIV infection.
“We use art as a key strategy of delivering HIV prevention messaging in our campaign posters, designed by our Communications Department and placed in public spaces.”
Continuing he adds, “We also organize prevention events in nightclubs and in other social hubs of the LGBT community, and use venues that have major social impact against homophobia.” For example, this May, CENESEX is planning a slate of activities against homophobia and transphobia in Havana and Matanzas, including a lecture by Mariela, activist panels, photo exhibits by Paolo Titolo (husband of Dr. Castro Espín) and Byron Motley, parades against homophobia and transphobia, diversity celebrations, and anti-stigma galas, among other events.
Included in this messaging are coveted “Calendar Boy” calendars raffled at clubs and events, one of which Mariela presented to me along with a warm hug upon my arrival.
Additionally, at the gracious, impromptu invitation and arrangement of Manuel, I was welcomed the night before my return to the U.S. to Cuba’s colorful and extravagant nightclub, Las Vegas, featuring the famed performer Imperio, who made a point to give a shout-out to A&U magazine as a special guest.
“We do what we call ‘prevention from the stage’ through transformista artists who deliver messages of prevention while doing their performances,” shared Manuel.
Cuba’s gay nightlife venues encourage light-hearted exchanges between transformistas and the audience about safer sex at performance intermissions along with interspersed animation videos depicting scenarios for sexually active, gay individuals. The graphics reinforce plausible situations, which hopefully appeal and make impressions on the crowd’s energized spectators. Several transformistas and a troupe of scintillating dancers turned out brilliant performances in legendary Cuban form under superb artistic direction going late into the early hours of the following morning.
At the conclusion of our meetings, on day two of our interviews following a balcony photo shoot that nicely captured a sunny backlighting as warm as her demeanor, Mariela Castro acknowledges the importance of CENESEX’s work and reemphasizes her further commitment to its future and to those who find resources, shelter and safety under its roof.
In closing, she made clear her message to A&U: “I am well aware of the ethical-philosophical contradictions that ‘move’ in the [socio-political] matters we have discussed,” clarifies Castro, a student of Socialist-Marxist thought. She affirms however that Marxism is a coherent and progressive alternative to capitalism, a system from which the Cuban Revolution sought to liberate the Cuban people. “On this basis, the Revolution must uphold its historic, social responsibility to eliminate segregation, discrimination and social exclusion.”
She continues, “The revolution succeeded in dismantling many of the mechanisms of domination but lacked clarity on this issue of LGBT equality, as did most other countries in the world, but if we want to strengthen socialism [and our mission] we have to address it head on. By changing global consciousness and educating entire populations we shall surely succeed; no doubt.”
Special thanks to Dr. Mariela Castro Espín, Ariel, Manuel, Miguel and the entire staff of CENESEX (www.cenesex.org), Phill Wilson for including A&U and the travelers of his historic delegation and most especially the many new friends who made my trip remarkable and unforgettable including Andy Sanchez, my guide at the drop of a hat, David our chauffeur, Anita y Ariel, Omar, Restaurante Torresson, Orly, Orlando Sr., Idada, Rubén, Miguel, Arturo, Nicholas, Sulema, Vivianna, Barbara, Jorge, and many other remarkable individuals who opened their doors, their minds and their hearts to me. Muchas gracias!
Sean Black interviewed Niecy Nash for the February 2016 cover story.
Chael Needle is Managing Editor of A&U.