Afterword
Raewyn Connell
University of Sydney, Sydney NSW
PP: 534 - 535
Article Text
The fine collection of studies in this special issue of Health Sociology Review provide a solid proof of how far the field has advanced, since the days when it was a novel idea that the 'male sex role' might have something to do with health.
It is now widely accepted that more powerful forces than role norms go into the making of masculinities and the shaping of men's health outcomes. These forces include economic structures, the corporate pursuit of profit, institutional arrangements, sexual desire, discursive power, racial inequalities, and violence - all of which can be seen in these studies.
It is also widely accepted that when we are speaking of masculinities, we do not address just one standard situation that can be understood by telling one standard story. Rather, we are talking about a complex array of situations, which have to be decoded patiently. Issues about masculinity, embodiment and health are differently shaped for different groups of boys and adult men.
The papers in this special issue provide strong evidence of this complexity. They treat health issues in the lives of fathers, boys in primary school, young and middle-aged gay men, and other groups. In each of these groups there is a range of situations and responses. If we were to go beyond the regions studied here, we would find even greater diversity, documented in the valuable research on masculinity that has come from India, South Africa, and Chile, to name only three sites of major research programmes. But the task of social science is not only to recognise complexity and document the wealth of social experience and response. It is also to analyse complexity, to understand situations, and to look for patterns - patterns that connect the experiences of different groups.
This group of studies is illuminating because we do see patterns that run through different situations. One of these is the continuing importance of gay/straight divisions in the gender orders of the affluent English-speaking countries represented here. This means not only division, but social domination. It is crucial that this is not just a matter of identity difference. It is a matter of the active construction of social hierarchy and exclusion. This is a presence in the lives of men who desire sexual relations with other men, whether calling themselves 'gay' or not. We see it in the concealment of such relations by many men who fear the stigma, exclusion, or violence that might follow disclosure - a mechanism all too familiar in the history of the HIV pandemic.
We also find the pattern in the lives of straight men, in the form of practices intended to separate themselves from, and make themselves superior to, gay men - including the joking and bullying documented here. They overlap with other practices designed to separate straight men from, and make themselves superior to, women and femininity; at the same time constructing hierarchies of worth among men. The pervasiveness of these mechanisms is revealed in the talk of boys, at surprisingly young ages. They are embedded in the organisational culture of competitive sports and in media discourses around sports, deeply compromising the health effectiveness of our culture's major system of physical education.
The marking of divisions between gay and straight is an important mechanism, in the gender orders discussed here, for the construction of hegemonic masculinity. But it is by no means the only one, for this is an endless process that works across many social terrains.
The research in this special issue demonstrates that what is hegemonic is not fixed. It is actively constructed, through practices that are often uncertain and stressful, and are not guaranteed to work. Claims to respect made from a position of weakness or marginality may involve toxic behaviour, both towards others and to oneself, such as gun violence and unprotected intercourse.
Yet claims and strategies from a position of power may also have health effects. We see this in the conduct of the owners and managers of tobacco corporations, gun manufacturers and alcohol merchants - not to mention the generals and presidents involved in devastating the health of entire populations in invasions, sieges and civil wars. The study of masculinity and health must include the larger health effects of masculinity practices in centres of privilege and authority.
Gender is an embodied social structure, in which the reproductive distinctions between male and female bodies are brought into history - are made socially effective, with effects that extend through time and form new social realities, constantly returning upon bodies. Gendered health outcomes are produced in this continuing formative process of social embodiment. They are not to be understood by any model of biological determinism nor by any model of the autonomy of discourse.
In the light of this principle, we need to reflect on research methods. The commonest method in this field is the qualitative interview study, often understood as grounded theory. Audio-recorded interviews with a small sample from a group of interest are transcribed, and then processed through a qualitative analysis programme. Such programmes essentially index themes across a set of interviews, and the resulting paper or (sometimes) book presents, through summary and quotation, the spectrum of statements on selected themes.
This has been a productive research paradigm, exploring diversity and, at its best, allowing subtle analysis of shared discourse. Yet it has limits, including difficulty in treating processes of embodiment (as distinct from discourses about the body). The research field needs a rich mixture of methods including life-history analysis, institutional ethnography and large-scale surveys. The media case study, survey, and small-scale focus-group methods in this special issue are important in moving towards this mixture.
Research in this field can have effects on practice - but has to be accessible to practitioners. The authors and editors of this special issue have taken the trouble to make the research clear and accessible. We are in their debt for this, as well as for the new research findings.
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