The link between masculinity and health is often framed as strictly negative, where normative notions of gender are said to proliferate sexual transmitted diseases and intimate partner violence. But, in Uganda, historically health crises have decreased with few changes in masculinity, and masculine sexual privilege remaining largely intact. Robert Wyrod draws on research to argue that health can, in fact, be a potent catalyst for addressing complex gender power dynamics.
This post is part of a series exploring the effects, presentation and evolution of masculinity in contemporary African society.
From the #MeToo movement to the rise of Trump, the notion of toxic masculinity has become a key theme in global gender politics. As part of this attention to male privilege and power, efforts to challenge and change problematic aspects of manhood have proliferated. This includes in Africa where changing men and masculinity has become a focus of community-based organisations, international NGOs and development agencies. Across the continent, there is new critical attention to problematic ideas of manhood and how they could be altered.
An important facet of these dynamics is understanding the role that health can play. The link between masculinity and health is often framed as strictly negative for both men and women. Being a man in most societies means denying you may be sick or even vulnerable to illness. Toxic masculinity also drives men’s violence in intimate relationships, which has a host of dire health consequences for men’s partners. Yet, what is often overlooked is how health crises may catalyse progressive transformation in notions of masculinity.
AIDS is a particularly interesting case. The global AIDS pandemic has produced dramatic forms of activism, from the AIDS Coalition to Unleash Power to the Treatment Action Campaign in South Africa. These groups have forced both governments and pharmaceutical companies to provide life-saving treatment for AIDS patients. And because HIV is sexually transmitted, it has drawn attention to how power and inequality shape sexual relationships and safe sex. Given the severity of the AIDS epidemic in much of sub-Saharan Africa, what are the implications for changing notions of masculinity on the continent?
This question was at the centre of my own research on AIDS and masculinity in Uganda. I was drawn to Uganda because it is seen as a global AIDS success story, with dramatic declines in HIV prevalence in the 1990s. Uganda also has one of the most vibrant women’s movements on the continent. So, was Uganda’s AIDS success linked to deeper transformations of masculinity?
Over the course of a decade, I examined this issue in one modest urban community, called Bwaise, in the capital Kampala. Through my fieldwork in Bwaise, I found changes in masculinity were more limited than I expected. In fact, I found that masculine sexual privilege remained largely intact in the face of AIDS. This privilege included both men’s ability to control the terms of sex and men’s perceived privilege of having multiple sexual partners. In my book, AIDS and Masculinity in the African City, I focus on three key issues that explain this surprising persistence of masculine privilege in the face of a continuing AIDS epidemic in Uganda today.
First and perhaps foremost was the role that work played in the masculinity-sexuality nexus. Like many urban African contexts, Kampala is a city where work remains precarious, informal and poorly paid for the vast majority of residents. This chronic underemployment has recently been coupled to dramatically rising economic inequality. For most men, whose primary goal is to embody the male ideal of the family economic provider, these two factors make being a successful man elusive. In my fieldwork, I found that men who failed at becoming economic providers would sometimes compensate by having multiple sexual partnerships, shoring up their ego through girlfriends and mistresses. At the other end of the spectrum, economically successful men in Bwaise would sometimes also have multiple partners as a way to exhibit their economic success. Thus, for both poor and better-off men the nature of work functioned to buttress masculine sexual privilege.
A second factor was the limited role of women’s rights. Although Uganda’s women’s movement is decades old, I found that sexuality was not a focus of right’s activism. Instead, women’s role in politics and public life was more prominent. In the more contentious realm of sexual politics women activists faced much opposition, with rare successes such as reforming laws on domestic violence. Overall, therefore, rights were not something that provided much leverage for women when negotiating power dynamics in their sexual relationships. Thus, women’s rights activism provided limited challenges to men’s sexual privileges.
Finally, I found that AIDS prevention programs themselves did little to address complex gender power dynamics. Programs were largely focused on changing an individual’s sexual behaviour. In addition, the US government’s massive PEPFAR programme paved the way for highly puritanical prevention efforts focused on abstinence and ‘being faithful’. These programmes ignored gender issues and heightened secrecy around sexual relationships – yet another way masculine sexual privilege went unchallenged.
The lesson learned from my fieldwork is that health can be a potent catalyst for shifting normative notions of masculinity in more progressive directions. I did indeed find inspiring examples of this in Uganda, where I became an honorary member of a vibrant HIV-positive men’s support group. These men from the community were using the AIDS crisis to begin talking about the HIV-masculinity link. However, that does not happen automatically. Individuals, activists and community leaders need to be proactive in exploiting the opportunity health crises provide.
I also volunteered with an NGO, Raising Voices, doing ground-breaking work that linked HIV prevention with intimate-partner violence prevention. Their program, SASA!, showed dramatic progressive shifts in men’s attitudes and behaviours, including reducing sexual partnerships. SASA!’s success was due to its focus on involving a wide range of community members, from families to religious leaders to the police force. Critically, the program also encouraged community members themselves to think critically about conventional ideas of manhood and womanhood and how such ideas were linked to violence and HIV transmission.
These efforts reveal the potential of explicitly linking health issues to gender activism. They show how communities themselves can rethink what it means to be a man, fostering harmonious intimate relationships and a healthier society.
Top photo by Olu Famule on Unsplash.