Real men don't: Unintentional constructions of gender in public health interventions

Among public health interventionists, there is growing recognition that addressing health issues influenced by male gender norms (e.g., intimate partner violence, sexual violence, sexual transmission of HIV, tobacco use, etc.) require consideration of the ways that men and boys perform certain risky behaviors in order to be perceived as more masculine. Most large-scale international public health organizations are now advocating for ‘gender transformative' interventions that work with men to change gender roles and thus to promote more gender-equitable relationships between men and women. We argue that promoting ‘gender-transformative' approaches is important but too broad; we should be promoting a specific type of gender transformative approaches that challenge gender norms. Gender-transformative interventions can be subdivided into two categories: (1) gender-redefining: these seek to redefine what it means to be a man (e.g., ‘real men don't need to be violent') and (2) gender-challenging: these seek to challenge the existence of, or strict adherence to, norms of masculinity (e.g., ‘how does violence make a man more masculine?'). While both approaches would address certain negative aspects of masculinity, gender-redefining approaches can inadvertently reinforce the notion that men must behave in specific socially prescribed ways to be perceived as masculine. Gender-challenging interventions, on the other hand, weaken strict norms of masculine behavior and therefore could have a positive effect on multiple masculine-related behaviors. The term ‘gender-transformative' is insufficiently nuanced and public health interventionists should adopt approaches that challenge male gender norms, rather than just redefine them, to ameliorate the negative effects of masculinity on health.