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Both men and women generally view sex among Tarahumaras as natural and healthy, but private, as is the physical expression of affection. Thus the flaunting of one's sexuality in dress, speech, or behavior, especially in women, is considered immodest and usually inappropriate except in overt joking. Sexual activity with non-Tarahumara is generally considered to be dangerous and polluting, with high risks of contracting venereal diseases, HIV, or other illnesses. Sexual urges are considered to be strong, and thus it is often assumed that men and women alone together will give in to them. For most Tarahumara, marriage consists of starting a sexual and domestic relationship with a partner, and it is expected that couples go through a "try-out" period of living together before any official ceremony is performed, though the official ceremony is not needed for them to be considered "married." If they find that they do not get along, they may separate and look for another mate. Thus teenage sex is expected for both genders, while they look for long-term partners, though sexual promiscuity is frowned upon for both men and women. Extramarital sex at any stage in life is considered to be bad behavior for both genders (though perhaps more condemned, and less common, among women) and is a considerable preoccupation and cause of jealousy and fighting (whether the infidelity is real or imagined) among insecure couples. Physical modesty is encouraged for both men and women, primarily in the avoidance of showing the pubic area and buttocks, and to a certain extent women's hair, which is properly covered with a kerchief. Women's breasts are not particularly sexual and are often exposed in breast-feeding. Physical affection is rarely shown in public, though flagrant transgressions of modesty occur during joking and play at tesgüinadas. Both men and women may lift skirts, loincloths, grab their own or other's genitals, make lewd and suggestive jokes, and simulate intercourse in public, generally breaking the rules that apply when sober. Usually this sexual play occurs between individuals linked in joking relationships, and is also used, in more subtle ways, in everyday life. Ramoelma—joking play—is expected between children and their classificatory grandparents (which includes great-aunts and great-uncles), and their aunts and uncles, and between in-laws, especially brothers-in-law and sisters-in-law. Sexual joking occurs equally between relatives of the same sex or opposite sex, and includes young children and babies. Aside from this sanctioned joking, children and adolescents, especially females, are not encouraged to express their sexuality in public, and adults primarily only do so while drinking. In general, Tarahumara extend the same respect for individual choice to men and women who "switch gender." It is considered natural, if unusual, for certain men or women to identify with the other gender in dress, behavior, and sexual desires. They may be somewhat marginalized, but their difference is respected if it does no harm to others in the community. Prejudices and homophobia may be increasing as more Tarahumara work outside their communities and interact with mainstream Mexican ideas about gender and sexuality.

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