In Caribbean Pleasure Industry, medical anthropologist Mark Padilla presents a comprehensive and nuanced ethnography of male sex workers in the Dominican Republic's gay tourist trade. Padilla's emphasis on male sex workers whose clients are primarily homosexual tourists reconfigures a longstanding heterocentric bias in scholarship on Caribbean sex tourism. His focus on bugarrones and skanky pankies – male sex workers who have sex with gay men while maintaining their heterosexual identities – also intervenes into debates within Latin American sexuality studies about whether men who take an ‘active’ or penetrative role in homoerotic encounters strengthen or diminish their masculine status. Padilla argues that bugarrones and skanky pankies do maintain their hetero-masculine privilege, but only by hiding their work with gay tourists and enacting traditional notions of male prowess and power.

At once an analyst and an advocate, Padilla positions his work as ‘critical medical anthropology’ and sets out to use ethnography to improve upon HIV and AIDS prevention efforts in the Dominican Republic. He demonstrates how public health models have rendered heterosexually identified male sex workers invisible. Rather than critique health agencies from afar, however, Padilla teams with Amigos Siempre Amigos, a Dominican HIV and AIDS prevention organisation, to collect a rich set of data about male sex workers that includes written surveys, semi-structured interviews, focus group results, and participant observations gathered over the course of two years in Santo Domingo and Boca Chica. Padilla draws on this evidence to critique HIV prevention models that conflate male bisexual behaviour with homosexuality and to suggest how agencies might better account for the complex identities and safer-sex practices of male sex workers in gay enclaves.

In addition to the practical applications of Padilla's work, the author crafts a valuable analytical framework that he terms ‘the political economy of sexuality’. Padilla shows how the Dominican governmental and economic restructuring that began in the 1970s emphasised modernisation efforts, international tourism, and the privatisation of state-owned sugar mills. These shifts inspired economic vulnerabilities among Dominican men that led to the market-based sexual practices of bugarrones and skanky pankies. As he links macroeconomic structural changes to the rise of the practices and identities of male sex workers, Padilla contributes to a growing body of anthropological studies of globalisation and sexuality. In a particularly insightful moment, Padilla argues that the bugarrón identity is not a traditional category that has been transformed by global flows, but rather is ‘already incorporated into global systems of consumption’ (emphasis in original; p. 103). The author questions the emic purity of the bugarrón category, and, in doing so, joins with analysts who have recently challenged the binary construction of ‘the local’ and ‘the global’ inherent in models of ‘gay globalization’, or the idea that Western gay identities are colonising Third World sexual practices.

Throughout Caribbean Pleasure Industry, Padilla presents poignant examples of how bugarrones and skanky pankies are victimised by normative systems of gender and sexuality, the tourist industry, police corruption and abuse, and gay institutions in the Dominican Republic. At times, however, his emphasis on the marginality of bugarrones and skanky pankies leads Padilla to disregard how male sex workers naturalise inequalities between themselves and gay Dominican men. The exclusion of the perspectives of gay Dominican men enables Padilla to defend male sex workers' social transgressions – lying, cheating, stealing and degrading homosexuals – as forms of ‘resistance’ without considering how gay Dominicans might challenge this view (p. 40). For instance, in his first chapter, Padilla describes discrimination against male sex workers in a detailed anecdote about a gay club in Santo Domingo that unjustly banned bugarrones and skanky pankies. Yet, drawing on Padilla's interviews with male sex workers, one could see how gay Dominican men might contend that male sex workers exploited vulnerable queer enclaves for profit and simultaneously perpetuated homophobia against gay patrons. Padilla explains the absence of gay Dominicans' interpretations in the text when he reminds readers that bugarrones and skanky pankies targeted gay foreign tourists, who could become long-term clients known as ‘Western Union daddies’. But without the critiques from homosexual Dominican men, the contentious ties that bound male sex workers and gay enclaves in Santo Domingo and Boca Chica can at times become opaque.

Padilla's treatment of sex tourism and male sexual practices offers an invaluable comparative perspective for an emergent body of scholarship dedicated to understanding bugarrón identities and same-sex prostitution in the Cuban tourist trade. Caribbean Pleasure Industry also hints at a number of new research avenues beyond the scope of this present work. For instance, how do relationships between Dominican diasporic tourists and sex workers complicate Padilla's vision of the ‘neo-colonial inequalities’ between sex workers and their gay clients? How have Dominican models of same-sex identity, such as the bugarrón, been exported to urban centres in the United States in ways that have transformed the seemingly stable notion of ‘Western male homosexuality’? In terms of transnational racialised desires, how might Caribbean colour hierarchies complicate the binary vision of ‘black’ Dominican male bodies and the ‘white’ gay tourists Padilla discusses?

Extremely well-crafted and accessible, Caribbean Pleasure Industry strikes a successful balance between ethnographic evidence and theoretical analysis. It will prove useful to a wide range of audiences that include scholars of Latin America and the Caribbean, medical anthropologists, public health specialists, and theorists of gender and sexuality. Mark Padilla raises the bar for studies of same-sex practices in Latin America, and his work will rightly serve as a critical new starting point for studies of Latin American masculinity and sex tourism in the Caribbean.