SOCIAL RESPONSIBILITIES ASSOCIATED WITH MASCULINITY
Research conducted in western contexts revealed that reluctance to seek health help resulting in their poor health service utilisation and poor health outcomes tended to be associated with men’s adherence to hegemonic masculinity (Buckley & Ó Tuama, 2010; Chaturvedi et al., 1997; Galdas et al., 2007; García-Calvente et al., 2012; Hennessy & Mannix-Mc Namara, 2014; Jeffries, 2012).
For example, in the case of men’s experience of chest pain, it was found that Caucasian males in both studies conducted by Chaturvedi et al (1997) and Galdas et al (2007) delayed seeking immediate care from healthcare services. This delay was not due to failure to recognise symptoms, but it was the consequences of their attempt to enact a particular form of masculine identity, whereby responding to symptoms was perceived to equate to a sign of weakness and vulnerability, which was incompatible with ideals of hegemonic masculinity. McVittie & Willock (2006) posited that this masculine concept is associated with power and with stoicism in the face of adversity. Hence, seeking help is regarded as incompatible with hegemonic masculinity and it is viewed as weak and unmasculine (C. McVittie, Cavers, & Hepworth, 2005). This was exactly what
these two studies by Chaturvedi et al (1997) and Galdas et al (2007) confirmed.
Similarly, it has been reported that Irish men view health help seeking as a female trait and not associated with masculinity as it demonstrates a lack of self-reliance (Buckley & Ó Tuama, 2010; Hennessy & Mannix-Mc Namara, 2014). Jeffries (2012) found that white British men also subscribed to this view. This was also the case with Spanish men. In an interview-based study aiming to compare health, vulnerability and ways of coping with illness between Spanish men and women, the researchers found that Spanish men tend to overrate how healthy they are and to hide their problems by projecting the image of being a ‘tough guy’ (García- Calvente et al., 2012). Taken together the perception of better health and less vulnerability to illness creates a negative influence on these men’s health help seeking intentions and utilisation of healthcare services.
It can be argued that this behaviour and perception of masculine ideals are learnt and acquired. According to a recent WHO report boys and young men are often socialised to be self-reliant, independent, devoid of emotion and expected not to concern themselves with their physical health or seek assistance during times of need (Barker, 2000). Somewhat in contrast to these studies,
being able to fulfil masculine norms and discharge the social responsibilities associated with manhood, particularly towards their family was found to be a priority for Asian men and meeting family responsibilities are often considered as attributes to their masculinity. This sentiment was shared by Asian men in two separate studies undertaken by Ng, Tan & Low (2008) and Fazli Khalaf, Low, Ghorbani & Khoei (2013). Asian men in the studies identified that being the breadwinner and head of their family is important for them as a man. They stressed that this ability to perform could potentially be compromised by ill-health. Hence, they would visit their doctor in the event of experiencing ill-health symptoms so as not to risk the compromise to their ability and capacity to discharge roles and actions associated with or enhancing of their masculinity.
In 2007, Galdas, Cheater and Marshall, found that in comparison to the White British men, South Asian men showed a greater willingness to seek medical help (Galdas et al., 2007). They found that the South Asian men considered seeking help as important and acceptable particularly in the case of experience of chest pain so as to avoid unwanted complications. Chiming with studies referred to above, South Asian men in this study drew attention to the importance of male responsibility for the family and regarded health help seeking as a means of avoiding compromising their ability to discharge this responsibility. This study also found that for the South
Asian man, discharging responsibility for the family and maintaining their own health are important masculine attributes. This all contributes to greater willingness to seek medical help. Interestingly, this is the opposite of the white men amongst whom the ability to tolerate pain and discomfort was valued as a masculine attribute. Not adhering to this by, for example, visiting their GP as a first port of call would be regarded as weak and un-masculine.
Findings such as those reported above could offer a possible explanation for the higher rates of attendance to GPs amongst the Asian male community in London when compared to their white peers (Gillam, Jarman, White, & Law, 1989). In a retrospective survey of the various ethnicities that consulted GPs in London between 1971 and 1981, it was found that, in comparison to other ethnic groups, Asian men had a much higher consultation rate (Gillam et al., 1989).
However it can be argued that this does not mean that employment and ability to earn and support the family are not important to White men. It is equally important but they did not prioritise it as much as South Asian men. It can be argued that changes in the social and economic environment drive these men to rework how they consider the ways that masculinity is bound up with men being the sole breadwinner of the family (Cleaver, 2002).
THEME 2: THE INTERSECTION OF AGE AND MASCULINITY