Masculinities, body and health: An essay based on narrative

The aim of this article is to establish a mirror/dialogue between different perspectives in order to think and contribute to the transformation of the relationship between the construction of masculinity, risk, illness and health, seeking to point towards a salutogenic experience, that is, of care and the promotion of health. It seeks to spark a conversation between the social perspective, the cultural perspective and experience, between quantitative contributions and qualitative experiences. We based our analysis on different sources such as the report Masculinities and Health in the Region of the Americas [1]1 — Pan American Health Organization, Masculinities and Health in the Region of the Americas (Washington DC, 2019). and the Literature, Memory and Identity Workshops, as well as relevant literary sources.

Masculinities and health

Well into the 21st century, it has become increasingly evident that what we know as masculinity is not only quite diverse (leading us to speak of masculinities) but that, on the biological differentiation of the sexes, a series of notions is constructed in each society and time about what men are and should be, often opposed to what is expected of women. Many of these notions become mandates, such as being a provider, being competitive, having the “privilege” of using violence, being heterosexual, and denying human aspects of emotionality.

The list of references that demonstrate that many of these mandates pose a risk to the health of women, children, and men themselves keeps growing. Based on a study for the Pan American Health Organization [2]2 — Ibídem. we can conclude that, without a doubt, men continue to occupy a privileged place in most societies and contexts, but that this brings with it significant health costs (for women and men themselves), beginning with a life expectancy in the Americas of around 5 years less than women (similar to Europe). As the only statistical example, we share this analysis based on the mortality of men during their life cycle.

Men continue to occupy a privileged place in most societies and contexts, but that this brings with it significant health costs for women and men themselves

On an epidemiological level we can find clear references of the way in which hegemonic masculinity generates enormous costs to men’s health. Analysis of the main causes of mortality of men during the course of their lives [3]3 — Ibídem. clearly show four sets of health problems: those that have to do with violent deaths (homicides, road and work accidents, drowning, and suicide as a marker of the lack of ability to ask for help in the face of subjective discomfort) [4]4 — Suggested reading in this regard is “El otro yo” [The Alter Ego], by Mario Benedetti, included in La muerte y otras sorpresas [Death and Other Surprises] (1968), which allows us to observe the difficult relationship men have with emotions that are considered non-masculine. , deaths associated with substance abuse (alcohol, other drugs, and half of cirrhosis cases), and HIV/AIDS, which continues to be related to the lack of care in the field of sexuality. This leads to one in five men not reaching the age of 50. Furthermore, we have the presence of men in the deaths of women by homicide and in a large proportion of fatal accidents. The fourth set of causes has to do with chronic degenerative diseases: diabetes, heart problems and strokes. Thus, health stands out as a critical area for analysing hegemonic or dominant masculinity, and for developing transformative solutions.

The construction of gender identity

In the field of health we also have different perspectives or paradigms: subdisciplines such as pathology give a detailed account of the biological damage caused by illness, while medicine focuses primarily on healing and preventing further damage to individual bodies. Public health is concerned with collective processes both in terms of curing and prevention, and collective health denounces the structural social and economic factors that underlie the illness and death of different social groups. But what disciplines bear witness to suffering? To the subjective experience of getting ill, dying or being healthy? Possibly psychology, in its most humanistic or psychoanalytical variants, as well as the sociology of emotion, among others. But there is also philosophy and art, which in the first or third person guide us to this fundamental experience. And it is from this perspective that we want to raise awareness about the health/illness/care process in men, by delving into literature—which excites us, makes us think and allows us to look at ourselves in the mirror of various characters and “experience ourselves” through the stories of others—and autobiographical writing.

Regarding the body, Virginia Woolf writes:

All day, all night the body intervenes; blunts or sharpens, colours or discolours, turns to wax in the warmth of June, hardens to tallow in the murk of February. The creature within can only gaze through the pane—smudged or rosy; it cannot separate off from the body like the sheath of a knife or the pod of a pea for a single instant; it must go through the whole unending procession of changes, heat and cold, comfort and discomfort, hunger and satisfaction, health and illness, until there comes the inevitable catastrophe; the body smashes itself to smithereens, and the soul (it is said) escapes. But of all this daily drama of the body there is no record.
Virginia Woolf, On Being Ill (London: Hogarth Press, 1930).

Woolf wrote this in 1925, soon after Thomas Mann published The Magic Mountain (1924). Much later, Solzhenitsyn adopted a similar perspective in Cancer Ward (1960).

In literature, there are a multiplicity of texts that describe the types of behaviours that affect people’s physical, mental and social health and well-being

Regarding the power of writing, writer Juan José Millás, in his book El mundo [The World], mentions:

My father boasted about having been the first to manufacture an electric scalpel in Spain, although he probably stole the idea from a foreign publication. I remember seeing him bent over the table in the workshop, making cuts in a beef fillet, amazed by the precision and neatness of the cut. I will never forget the moment when he turned to me, feeling a little scared while watching him, to pronounce that foundational phrase: “Look, Juanjo, it cauterises the wound at the same time it produces it.” When I write by hand, on a notebook, as I am doing now, I think I look a bit like my father in the act of testing the electric scalpel, seeing as writing opens and cauterizes wounds simultaneously.
Juan José Millás, El mundo (Ciudad de Mexico: Planeta, 2008).

Now, what differences have been found between women and men in relation to their health? How does the gender mandate affect men’s health, specifically? In the first place, we find that possess a greater willingness to remember, write and share their experiences, which is the process we propose as a way to generate greater awareness of where and how gender identity manifests itself. This is demonstrated in the number of men who attend the workshops (40% compared to 60% women), and in the fact that only 20% of them stay until the end. Another fundamental difference is that the abilities to access emotions are more developed in women; they allow themselves to express them more openly. It is more difficult for men to break the resistance to access, delve into, write about and share their emotions, as well as to identify the ways in which the established power discourses shape them. Restraining emotions and feelings is normalised. However, the ability to express emotions becomes possible for almost all of the men who complete the workshop.

What can be observed regarding the behaviour manifested in men’s writings that deal with the risk of suffering traumatic events due to the “mandates of patriarchal masculinity” is expressed, above all, in the exercising of physical violence as a way to “resolve” conflicts, as well as containing emotions that make them seem “weak” or “fragile”, which in many cases can cause the development of insecurities, complexes, fears and anger. Also in the way they relate to their peers, competing and degrading each other with nicknames based on their physical appearance (corpulence), skin colour, economic, social and cultural stratum, and in a degrading, misogynistic and homophobic manner if they display “effeminate” behaviours. And, furthermore, in the internalisation of their relationships with figures of authority, structure and masculine role models, as occurs with uncles, grandfathers and fathers. In literature, there are a multiplicity of texts that describe the types of behaviours that affect people’s physical, mental and social health and well-being. We focus on a few in order to identify them and reflect on how they are experienced, and how they affect people in different ways. We use stories and fragments of texts by authors such as Juan Villoro, Javier Marías, José Agustín, Javier Cercas and Enrique Serna, among other literary texts from the perspectives of both men and women, as an exercise in the appropriation of writing.

We shall cite an example that, although it contains colloquial language particular to Mexico, can be understood within the context and allows participants to observe and identify normalised violent behaviours. They are fragments from the final section of the story “Mañana lloraré” [I Will Cry Tomorrow] by Héctor Aguilar Camín (following a fight that two twins provoke to defend their sister’s “shyness”, which is also an act of violence against her and the bodies of women in a state of “defencelessness” and possession/objectification):

“What a way to beat each other up, boys!” said the police officer once inside and installed in Doña Raquel Casares’ living room. “It reminds me of the good old days, beating people up all over town, La Romita, La Candelaria, Martínez de la Torre, Atencingo.”
. . . Alatriste walked in front and stared incredulously at his own hands . . . He went up to the first floor and surveyed the mess in the hall again: Gamiochipi with his hands clenched over his head, Morales’ disfigured face, Changoleón’s choking, Geme Tico’s sweating from the pain of the fracture that was beginning to liquefy the clumps of blood in his hair again, the horrifying left side of Geme Taco’s face, El Cuero’s broken nose, the purple line down Colington’s face. And the agent giving a speech among them, exhuming their dead.
. . . He went into the bathroom and poured cold water on his hands for a long time, until they were numb. Something began to flip inside him. “I’m not going to cry,” he repeated out loud. “At least I’m not going to cry today.”
He stared at his feelingless hands, those unfamiliar and alien hands, numb from the water that ran transparent over them, then raised his eyes and looked in the mirror at the face of a guy he did not know either.
“What a joke,” said the guy in the mirror, trying to crack a smile.
“What a joke,” Alatriste replied, trying to crack his own.
But they both cried like pigs…
Aguilar Camín, Héctor (1989). “Mañana lloraré”. In Lo fugitivo permanece, 21 cuentos mexicanos. Selected and presented by Carlos Monsiváis. Mexico City: Ministry of Public Education.

This way of “experiencing” masculinity is usually generated during primary socialisation and later during adolescence, when experiencing the body is central. Regarding the body in men, for example, Juan José Millás, in La vida a ratos, tells us:

The risk of suffering traumatic events due to the “mandates of patriarchal masculinity” is expressed, above all, in the exercising of physical violence as a way to “resolve” conflicts, as well as containing emotions that make them seem “weak” or “fragile”

Monday. The question is: do I have a body or am I my body? As a young man, you have a body which you drive wildly, as befits the derangement typical of those years. You make it go at a hundred and eighty miles an hour, push its revs beyond the limit, and it almost always responds.
During that period, the affinity between you and your body is not very high: the same as you have with a toy or a car. Your toy can break, your car can get old, but you’re still there, going for it and smashing it like a man. It could be said that you don’t believe in death. But as the years go by, mysteriously, one becomes one’s body.
One day you get out of bed, walk towards the mirror, look at yourself, and the revelation suddenly hits you: I am my body, I am this, I am my container and content, all at the same time. If a text, literary or otherwise, could speak to itself, it would reach the same conclusion: my content is my form. Thus, it is said, after a certain age the body ceases to be the vehicle of the self to become the self of the vehicle. A frightening revelation.
Juan José Millás, La vida a ratos (Mexico City: Alfaguara, 2019).

Millás confirms what studies of masculinity teach us: men grow up with a perception of invulnerability, which puts them at risk when they feel vulnerable; to find oneself in a not very masculine place is synonymous with weakness, which makes it difficult to ask for help. This vulnerability can, but not always, be accepted as life progresses, even though the experience of being “patient” may continue to be difficult and contradictory, especially when a small or large quota of power is held. Let us look at Roman emperor Hadrian, masterfully interpreted by Marguerite Yourcenar:

I took off my cloak and tunic and lay down on a couch. I spare you details which would be as disagreeable to you as to me, the description of the body of a man who is growing old, and is about to die of a dropsical heart . . . It is difficult to remain an emperor in the presence of a physician, and difficult even to keep one’s essential quality as man. The professional eye saw in me only a mass of humours, a sorry mixture of blood and lymph . . . But no one can go beyond prescribed limits: my swollen limbs no longer sustain me through the long Roman ceremonies; I fight for breath; and I am now sixty… I have nevertheless reached the age where life, for every man, is accepted defeat.
Marguerite Yourcenar, Memoirs of Hadrian, translated by Grace Frick in collaboration with the author (London: Secker & Warburg, 1955).

Then the novel narrates parts of his life he has renounced: hunting, riding a horse, eating too much, the voluptuousness of love, and “of all the joys which are slowly abandoning me, sleep is one of the most precious, though one of the most common, too.”

Men in the face of illness and mourning

The issue of care in both health and illness is an issue that has become feminised as a result of the sexual division of labour. This also occurs in the care of men, especially when they are children, adolescents or older adults. A young man is suddenly confronted with caring for his father. Mario Sánchez Carbajal realises this when referring to the umpteenth time his father, who could barely take care of himself and hardly allowed others to take care of him, was admitted to hospital. Together with his mother, they must find a way to reorganise their lives to support his father’s hospital care… “and thus we would try to build our life around that of my father, around a wild and brittle sun; a glass sun that did not possess the words to name us, but that had us tethered, circling around it, like those wild horses that to be tamed are forced to run thousands of laps around a man who is not even half the animal’s size.” [5]5 — Sánchez Carbajal, Mario (2017). Bilis negra. Mexico City: INBA.

On the issue of care during illness, the experience of the pandemic has made gender inequality sharply visible and has contributed to reinforcing the problem in many ways, although when questioning it, certain segments of men have been able to assume it as a challenge to equality and care. Ivonne Laus clearly describes the effect of lockdown on the mental health of the segment of society that enjoys the luxury of being able to work from home by living in:

The women’s movement against inequality, injustice and violence has also laid bare that the patriarchal mandate has to do with a hierarchical society in which violence and inequality have been normalised

This unbearable alterity that the world is today, I suffer silence in my mouth, at the corner of these renounced lips that do not wet anything, that do not pronounce anything, that do not spit, that do not drink from anyone’s glass, at their tables, in their houses, in their streets. The abyss of the eyes, which slide unsuspectingly on the slope of the curve of disease. And, again, the murmur, that ringing in the ears, but grating, that deafens the afternoon, to the sound of the song of the deadly siren that sounds every day, unequivocally, at six o’clock.
Hands anaesthetised from not touching anything. Feet numb from feeling the weight of the walk between the bathroom, the bed, the kitchen, and the living room. The mind trapped within the 17 inches of the automatic brightness of the computer screen, a hermit-like life empowered to the extreme in defence of all humanity.
Ivonne Laus, In P. Collado; G. Nettel; Y. Weiss (coord.), Crónicas de la Pandemia (México: UNAM, 2020).

The pandemic confronted men with vulnerability and fear, with the need to take care of themselves to be able to take care of others, and with the challenge of managing both work and domestic malaises. It is not accidental that important leaders of various countries around the world refused to wear face masks to then fall ill with COVID. The pandemic also questions the idea of capitalist and neoliberal progress and its predatory relationship with nature—a patriarchal form of development. In the feminisation of care work, many women end up caring for both women and men throughout their whole lives, frequently functioning as “ambassadors” of male ailments in health services.

Concerning the care and knowledge of the different evolutionary stages of the body throughout life, the discourses of power and control that are internalised by men can generate a lower tolerance towards the bodily vulnerability that they, like any other living being, experience and, therefore, towards the vision of life as a process that includes death as a natural part of it. In this sense, there is a certain difficulty in identifying why the vision of hegemonic masculinity puts them at greater risk of rejecting a healthier quality of life, one that does not expose them to violent acts, and in the prevention and care of their health in the broadest sense, thus resulting in a quality of the process of life itself and, therefore, of death. Regarding the experience of mourning, it is important to allow oneself to feel the pain, sadness and fragility of the loss to elaborate the process of mourning (among other emotional manifestations). If these emotions and feelings are conceived as synonymous with weakness or being “feminine”, they will generate a complicated or non-elaborate mourning process, which will end up affecting their own health and that of those close to them.

In conclusion

The women’s movement in favour of profound changes in relation to gender inequality, injustice and violence has also laid bare the urgency of knowing and recognising that the patriarchal mandate has to do with a hierarchical society in which violence and inequality have been normalised, and that it also affects men (although not in the same way and proportion) [6]6 — We recognise that this text was developed in a very binary way, comparing men and women. Obviously, society is much more diverse and complex, and in this regard, literature will also be an extraordinary tool for raising awareness. . This movement encourages the creation of new ways of forming ourselves, of relating, of doing politics, of exercising justice, of creating collective networks with other types of values in one’s own gaze, and of listening to oneself and others. This text seeks to help show the ways in which hegemonic masculinity also affects men, and that the privileges that are still prevalent greatly affect both women and men. Based on self-care as a political category, men can analyse and rebuild their identity, overcome mandates and stereotypes to expand this care to others, as well as to the planet. Along this path, we have wanted to emphasise the power of literature and autobiographical writing by means of a programme that can act as a mirror, a sensitisation and awareness mechanism, as well as a space that enables dialogue between genders and generations.

References

1 —
Pan American Health Organization, Masculinities and Health in the Region of the Americas (Washington DC, 2019).

2 —
Ibídem.

3 —
Ibídem.

4 —
Suggested reading in this regard is “El otro yo” [The Alter Ego], by Mario Benedetti, included in La muerte y otras sorpresas [Death and Other Surprises] (1968), which allows us to observe the difficult relationship men have with emotions that are considered non-masculine.

5 —
Sánchez Carbajal, Mario (2017). Bilis negra. Mexico City: INBA.

6 —
We recognise that this text was developed in a very binary way, comparing men and women. Obviously, society is much more diverse and complex, and in this regard, literature will also be an extraordinary tool for raising awareness.