Immediate, Likely and Meaningful: A
framework for understanding and responding
to the sexual health risk-taking behaviours of
young men.
Dr Mark Limmer
Lancaster University
m.limmer@lancaster.ac.uk
1st November 2012
International conference on Challenges for Health and Healthcare in Europe
Aalborg University
Background
Hegemonic Masculinity
“the configuration of gender practice ....which
guarantees (or is taken to guarantee) the dominant
position of men and the subordination of women”
(Connell, 1995 p77)
Gender Practice implies performance and requires and audience –
“other men” (Kimmel, 1994)
Relational – Difference from, and superiority over, women. Often
manifest through sex (Holland et al, 1998)
Meanings of sex for young men
Multiple meanings that vary over time and space:
Pleasure and status (McDowell, 2003; Wight, 1998)
An embodiment of masculinities - note impact of
pornography on aesthetic and expectation (Segal,
1997; Holland et al, 1998)
Explicitly heterosexual (Richardson, 2010)
Closely linked to homophobia – homosexuality equated
with femininity and ‘lesser’ masculinities (Kimmel, 1994)
Masculinities linked to exclusion and deprivation
Young working class masculinities – “Fighting, fucking
and football” (Mac An Ghaill, 1994)
Rejection of education, embracing risk taking, violence
and homophobia (McDowell, 2003)
Exclusion and deprivation linked to sexual ill-health
(Wellings et al, 2001)
The study from which these data were drawn...
The impact of masculinities and social exclusion on
young men’s sexual risk taking
Sample:
46 young men aged 15-17
22 defined as socially excluded
24 defined as socially included
All defined themselves as white british
Methodology
5 focus Groups (3 with SE young men, 2 with SI young
men)
46 individual semi-structured interviews
Focus group incorporated a live drama element and a
structured exercise
Thematic analysis
Sex
Masculinities
Exclusion
Results 1: Definitions of masculinities and the
importance of sex
1. Aspirations
“Job, house, nice house, nice car, promotion prospects and stuff like
that. I always want to be moving up with what I’m doing. I always
want to have goals until I reach right to the top and everything is
done, everything is alright and I can just settle down with a wife and
stuff. Just be happy with myself.” (Terry, aged 15)
While the aspiration was universal the belief that it would transpire
and the strategies for achieving it were far stronger in the socially
included cohort
2. Relational
- Not female
- Not gay
3. As attributes
Different young men were able to draw on different
attributes. For socially included young men these
included academic achievement, status in school,
sporting achievement, acceptance by social
institutions and sense of maturity.
For the socially excluded young men the attributes
they could draw on were more limited, essentially
sex, fighting and the active rejection of the above.
4. As a performance with an audience
For included young men a range of audiences
For excluded young men, mainly peers
“Someone who is trusting, someone who is understanding, someone you can
talk to about stuff, someone who watches your back all the time and helps
you, someone who cares about you as much as you care about them –
because it’s your mate, isn’t it” (Keith, aged 15)
The socially excluded young men articulated
masculinities built on a very narrow base, essentially
on the residue that pertains to all men by dint of the
social construction of their gender and it is performed
under the metaphorical gaze of a very narrow
audience – most of whom are equally marginalised.
In the hierarchy of men these young men are
relatively powerless and isolated. Avoiding rejection
from the peer group, from the only affirmation of
their masculinities, provides a powerful driving force
behind the young men’s attitudes and behaviours.
Results 2: Approved sexual masculinities
1. Expertise and leadership
- Mechanistic
- Lack of communication (Leader and led)
Knowledge sources varied:
Socially Included young men a range including school and family
Socially Excluded young men mainly peers and pornography
“Honest to god boys, you learn off your yer mates, yer learn off yer mates,
boys. You can’t just discover it; it can’t just come in to yer head, can it? Yer
learn off yer mates” (Alex, aged 16)
Sexual expertise valued as it leads to further opportunities
“If you bang a bird an’ their lovin’ it, they go round and tell their mates that
you’re mint an’ that, do they not – an’ they come back, an’ they come back for
more” (Darren, aged 16)
2. Voracious – not rejecting a sexual opportunity
Closely tied to the fear of being labelled gay
Relates not just to sex with a partner but masturbation, talk and
pornography
But....
3. Sex with the right partner
“If the girl is minging you get bothered for it, don’t you? But if they are
nice everyone is buzzing, everyone thinks ‘well, he’s a man, he’s done
that with her.” (Terry, aged 15)
Results 3: Universal belief in a “dirty/clean” dichotomy
relating to young women
(cf: Hyde et al, 2009; Waldby et al, 1993)
Label based on: Sexual history “shagged around a bit”
Quantity of sexual partners
Too assertive or experimental
Dress
Attractiveness
Personal hygiene
Most commonly used as a short-hand for a greater likelihood to pass
on a sexually transmitted infection – which were believed to be visible
“You can tell because if they have got scabs and everything, not all the
time you can’t but most of the time you can. Some of the diseases are
inside but some of them are not some of them are on the outside. Most
of the diseases are on the outside not on the inside. It comes out like
green stuff and things like that and it is hanging.” (Gary, aged 17)
Linked to poverty and place – especially by the socially included young
men for whom poverty and place were key markers of their own
masculinities status.
“You’ll not [find clean girls] round 'ere where everyone's been fucked
up an' that, corrupted an' that. You want to go out of the area - fresh
people. Fresh meat an' that.” (Alex, aged 16)
Labels were applied by young men and reinforced by peers – they
could also be taken away or changed to suit the needs of the group
and enable them to maintain control over the nature and value of the
sexual encounter.
A Framework for understanding young men’s perception
of sexual risk
Less concerned with risks that emanate from their performance of
masculinities, more concerned about risks to their performance of
masculinities.
Immediate
Likely
For risk to have an
impact on behaviour
it must be perceived
as......
Meaningful
Immediate:
Must impact on something that is in their immediate
purview, not necessarily something that is happening
very soon, but impacting on something that is of
concern to them at this particular point in time (cf the
impact of alcohol).
Likely:
Must be perceived as likely to happen. What is
considered likely is dependent on the perceived
credibility of the message and the messenger.
Meaningful:
The consequence of the risk must be something that is
meaningful, something that the young man is bothered
about at this point in time.
Case Study 1 – Gary (aged 17)
Gary had sex for the first time when he was 14, did not use condoms then or
subsequently, he was unemployed at the time of the interview and estranged
from his family. Gary was aware of the risks of STIs and conception but was more
concerned that he was seen by his peers to be sexually active and to have sex
with the ‘right’ young woman. He saw his reputation with his peers as largely
reliant on his sexual behaviours and the most immediate risk for him was their
negative judgement. Gary did not see infection as being a likely consequence of
his activities because he only had sex with “quite nice girls” and anyway his
experience of sex without condoms had created the belief that infections would
not happen to him.
I have never wore a johnny in my life. I will be honest I have never and never
caught nothing in my life. I have been with about 14 [girls] or something it is not
that much but it is in my eyes (Gary, aged 17)
Neither conception nor infection constituted meaningful risks to Gary, the
former could be denied - “It’s not mine. I shoot blanks me”- and the latter
dismissed. His only meaningful sexual risk at this point in time related to the
judgement of his peers.
Case Study 2: Josh (aged 17)
Josh had sex for the first time when he was 16 and used condoms on this and
subsequent occasions. At the time of interview he was completing his ‘A’ levels
with a view to continuing his studies at University.
Josh was very aware of the risk of pregnancy which he perceived would have an
immediate impact on his ability to go away to university and would damage his
relationship with his parents. He had no immediate concerns about his sexual
performance and when asked what his key message to other young men would
be, replied “Don’t worry if it’s crap, use a condom and make sure it’s what you
both want”. Josh identified conception as a likely risk, a message that had been
picked up and reinforced through his sex education at school. The consequences
of pregnancy were more meaningful to him than any concerns about what his
peers might think – “your friends are not going to bother if you are crap in bed”.
As aspects of Gary and Josh’s lives, circumstances
and aspirations change, so too will their personal
definition of risk which is understood as fluid and
contextual, in stark contrast to the fixed, stolidity
of risk as expressed in terms of the concrete
outcomes of infection and conception beloved by
policy makers
Some implications for policy and practice
Need to understand young men’s sexual health risk-taking as rooted in
masculinities. Addressing masculinities rather than what emanates from them
should be the priority.
Current policy preoccupation with infection and conception as the risks has
little or no resonance with many young men. Interventions need to be rooted
in young men’s own perception of risk.
Credibility gap between what young men are told and the reality as they
experience it. A need for a more honest and nuanced dialogue.
Alcohol has a significant impact on risk decision making – alcohol needs to be
addressed as a root cause of wider risk taking as well as a risk in its own right
For many young men their peers are the most accessible and credible sources
of information and values – utilising peers as a health promotion resource
needs further exploration – but....
References
Connell, R (1995) Masculinities Polity, Cambridge
Holland, J; Ramazanoglu, C; Sharpe, S; Thomson, R (1998) The male in the head; young people, heterosexuality and power London;
Tufnell Press
Hyde, A, Drennan, J; Howlett, E; Brady, D (2009) Young Men’s Vulnerability in Constituting Hegemonic Masculinity in Sexual
Relations American Journal of Men’s Health 3:3 pp 238-251
Kimmel, M (1994) Masculinity as homophobia: Fear, shame and silence in the construction of gender identity. In Whitehead, S;
Barrett, F (eds) The Masculinity Reader Blackwell: Oxford
Mac An Ghaill, M (1994) The Making of Men Buckingham, OUP
McDowell, L (2003) Redundant Masculinities? Employment Change and White Working Class Youth. Blackwell Publishing: Oxford
Richardson, D (2010) Youth Masculinities: Compelling male heterosexuality British Journal of Sociology 61:4 pp737-756
Segal, L (1997) The Belly of the Beast: Sex as Male Domination? In Whitehead, S and Barrett, F (eds) The Masculinities Reader
Polity, Cambridge
Waldby, C; Kippax, S; Crawford, J (1993) Cordon Sanitaire: ‘Clean’ and ‘unclean’ women in the AIDS discourse of young
heterosexual men. In Aggleton, P (ed) Facing the second decade. Social aspects of AIDS Oxford, England
Wellings, K; Nanchahal, K; MacDowell, W; McManus, S; Erens, B; Mercer, C; Johnson, A; Copas, A; Korovessis, C; Fenton, K, Field, J
(2001) Sexual behaviour in Britain: Early heterosexual experience The Lancet 358 pp 1843- 1850
Wight, D (1994) Boys’ thoughts and talk about sex in a working-class locality of Glasgow. Sociological Review 42 pp 703-737
Thanks for listening!
Dr Mark Limmer
Lecturer in Public Health
Division of Health Research
Furness, Rm C03
Lancaster University
Lancaster LA1 4YG
+44 1524 593015
m.limmer@lancaster.ac.uk