Submissions on the North Health Discussion Document 'The Health of Men'
By Mark Rowley
These more detailed submissions are in addition to those I made orally at the public meeting in Auckland on 9 February 1996, at which meeting I also gave to John Fraser of North Health a copy of an 800 word article written for the national newspaper The Australian concerning the Draft National Men's Health Policy of January 1996. My comments in that article can be taken as applying equally to the North Health Document.
While it is unfortunate that health care in New Zealand became seriously reactive to minority lobby groups in the last twenty years as emerging gender and race ideologies converged with a shrinking health dollar (instead of tending to remain universally proactive), it must be belatedly acknowledged by men that this politicization of health resources is unlikely to ever reverse.
Given that, the initiative by North Health in releasing The Health of Men is to be commended, even as we recognise that the traditional "women and children first" ethos is still dominant in society among all sectors and will dilute efforts by men's health activists to secure a just share of limited resources. Paradoxically, this gallant "toughing it out" is correctly identified by North Health as being precisely part of the problem behind the appalling comparative health statistics of men.
My main concern with the document is two-fold: first, the way in which the concept of traditional masculinity has been put forward to explain the statistics along with associated proposals on how this masculinity must be changed; second, the poor recognition of realistic structural and practical ways in which men's health can be immediately improved.
Since the authors of the longer document (on which the final draft discussion document is largely based) found their singularly most helpful resource to be Men in Difficult Times (1981) by Robert Lewis (ed), it was instructive on acquiring this interesting but sadly out-of-date book to find in the Lewis introduction a consecration and apology to his wife for "...[taking] away some of her personhood by taking away her name." (p.xv)
A further warning of where the document authors are coming from is found in a chapter in Lewis, "The Social Construction of Masculine Anxiety".
"Anxiety, let alone masculine anxiety, is an elusive concept in its causation and expression. I will use masculine anxiety as a theoretical construct to explain a defensive reaction in attitude and action to threats to the perceived integrity of sex-role norms and to the individual's felt ability to meet these normative demands. The anxiety expresses itself in the increased saliency of gender in social life and in a compensatory emphasis on the assertive and aggressive side of the male role. The man "protesteth too much" is the commonsense recognition of what behavioural scientists term defensive masculinity or compensatory masculinity. Salience refers to an increased concern over what is proper male and female behaviour and the tendency to see sex-role differentiation at stake in a wide range of issues ..." (p.88)
Now I am protesting at what North Health is proposing to do with traditional masculinity but I doubt if it is possible to protest too much, so important and complex is this area. And I certainly won't be silenced by intellectually dishonest authors of a psycho-analytical bent such as quoted in Lewis above who set up a hypothesis in such a way as its falsification is not only made impossible but personal slurs about manhood can then be made about its critics. I feel a little how the Jews and Slavs might have felt had they been able to remonstrate directly with Hitler only to be told that in protesting they were merely suffering from racial and ethnic anxiety.
The Lewis book comes from a period in the history in the Men's Movement when its members were of a feminist persuasion, apologetic and guilty about being men, and where such research as was being done on masculinity was broadly behavioural and in heavy denial about any possible biological influences upon behaviour. To air even the possibility of such influences was, and still is, the very height of political incorrectness. It was also more than a little tinged by postmodernism and by the constructivism starting to make an impact in the social sciences from the likes of Focault and Derrida. All this shows in many of the chapters contributed to this book. I found it singularly objectionable and unhelpful.
I agree that it is probable that a certain proportion of the ill health suffered by males is the result of specifically male behaviour, as discussed in the document. Where I part company with the authors can be summarised in the following points:
- There is just too much recent scientific evidence, and Moir and Jessel's Brainsex is only one source for this, albeit an excellent one, for anyone to seriously suggest that males can be significantly changed across the broad range of behaviours discussed in the North Health document. (Another excellent source, reviewing hundreds of studies is: The New Sexual Revolution by Robert Pool) Males do differ from females in aggression, toughing it out, competitiveness, expression of emotion, the relative importance of relationships and risk taking. The evidence is very clear that male and female hormones acting upon emerging male and female brain structures, in the foetus at various stages, through early childhood and again strongly at puberty set much of what we term sex-role behaviour.
- It would be tedious and impracticable in a submission of this type to quote all the evidence marshalled by Moir and Jessel and it is strongly recommended that be Brainsex be read before further pronouncements be made by North Health or anybody else on changing masculinity for purported health reasons. It is not just another chapter in the endless nature/nurture debate - it is a solid body of evidence still awaiting serious challenge, much less refutation. The best that feminists and constructivists can offer by way of a scientific or non-scientific explanation for male behaviour of the type described is that of "traditional male stereotype" or "traditional construction of masculinity". An essential part of the feminists' task of tearing down the "oppressive male patriarchy" is in radically restructuring traditional masculinity. It would be politically and ethically most unwise for North Health to wittingly or unwittingly buy into a fight on this issue. A quick paddle in the Internet will show the rapid emergence of many radical men's groups who would be spoiling for a fight on issues such as this.
- Men at large have not been consulted on this proposal to radically restructure masculinity, assuming for a moment that masculinity could be changed. Various programmes have been and are being tried in Australia and New Zealand schools, generally without proper parental and community consultation, in areas as diverse as bullying, sexism, non-competitiveness, anger management, sexual harassment, emotional expressiveness and encouragement of males into non-traditional areas, and I have yet to hear of any research which shows there is lasting, widespread or beneficial change in these areas, and I work as a counsellor and health educator in a school. These behaviours continue regardless. The question must be asked, if you can't change these behaviours in boys in a relatively controlled environment, what hope is there of changing them in men, consenting or not? And there would probably be more than a few women who would like to be consulted before society, with North Health in the vanguard, consigned traditional masculinity to oblivion. Part of the problem, it may be argued, is that the vast majority of teachers in primary school are women, and that the vast majority of health educators and counsellors in secondary schools are also women. Perhaps any small change that might occur in young males will not happen until a sufficient number of male role models are employed in schools. This would no doubt be strongly, and perversely, resisted by gender feminists.
- Men at large are blamed for their bad health in this document. This contrasts sharply with the way homosexuals, Maori men, and women (in North Health's The Health of Women) are dealt with. In conventional PC discourse these groups are all victims, oppressed and exploited by the dominant group, men. Therefore, there is relatively little discussion of how to find out what men want and need and of improving the delivery of better health care services to men. There is, by contrast, a heavy emphasis on saying what is wrong with men. There are enough people out there doing a pretty fair job of attacking men without North Health joining in - people in the print and electronic media and authors like Andrea Dworkin, Catherine MacKinnon, Marilyn French, Anne Schaef Wilson, Naomi Wolf, Olga Silverstein, Rosalind Miles and Christine Forsey, to name just a few of the better known ones. Discussions of the health problems facing gays and prostitutes, for example, focus on finding out the health needs of the members of these groups, providing them, with particular emphasis on safer sex education, assistance with STD's and clinics. Nowhere is it suggested that these people need to restructure their sexuality, their femininity or masculinity. It is not even suggested that they simply cease their sex behaviour. Of course, that behaviour is seen as impossible to stop - and yet North Health asks that all men stop being competitive and tough. Sen-sational call!
- The North Health documents make gratuitous and factually wrong swipes at men in the area of domestic violence. I can make extensive evidence available if requested showing the incidence of male and female domestic violence is near parity, while the whole issue of male injuries from domestic violence is not even hinted at in the men's document. This non-reporting of such incidents and injuries by men would be a very fruitful area of investigation for North Health to embark on, if it weren't so politically suicidal.
- There are some very practical reasons why women's health is generally better than men's, and they need to be stated, since they will also help explain why men's health statistics will never catch up with women's. Men don't menstruate, conceive or lactate. Women do. Men are generally not responsible for the health needs of infants and young children, nor for the family's food and eating habits. Women are. This automatically gives most women a much higher body and health awareness than most men. In addition, to invoke a dreaded social construct, women place a higher value on looking young and staying slim than men, who are less concerned with their body image. Healthy looking skin, nails, eyes and hair can all be achieved by attention to diet, sleep, relaxation and personal hygiene. Men are not noted for attention to these things.
- The document does not really address the health effects of unemployment and redundancy, especially among the unskilled, nor the effects upon men of the disintegration of the traditional nuclear family (only 13.5% are now such at last census count, defined as parents legally married with at least one child and where the father is the breadwinner and the mother the homemaker). Nor does it take into account the huge stress on separated and divorced non-custodial fathers, the heavy and often unjust child support payments ordered by courts, the now well-documented false child-abuse allegations and a wide range of laws that are progressively disadvantaging men and loading great stress on them thereby.
As mentioned above, men need to be consulted fully on their health needs and then the services provided to meet those needs. Merely requiring men to change their masculinity and getting schools to attempt to do it is a cynical cop-out costing North Health virtually nothing and likely to achieve even less.
Raising men's awareness of their poor health and of their health needs is a vital, urgent, realistic and achievable goal. I believe men can be successfully educated into better health practices, without this crazy dream of socially re-engineering and emasculating men.
Simple though not cheap, but certainly effective structural changes for working men would include employer provision of more nursing and medical services, perhaps with government incentives, and for self-employed men, free medical treatment so that a salesman or a contractor could take time off work to visit a medical facility without facing a double monetary penalty.
While I agree aggression is basically a male phenomenon, that other males are the main victims, and testosterone is the major factor in this aggression, it is clear that the degree and incidence of aggression in a society is a function of learned and socio-cultural factors. There is now an increasing amount of evidence as reported by authors as diverse as Miedzian and Blankenhorn that boys brought up without sufficient fathering will resort to the popular media, peers and gangs for their model of masculinity. It goes without saying that this will be a false and exaggerated masculinity. Whatever North Health can do in this arena will be repaid many times over in better men's health.
The document 'The Health of Women' should be more of a guide for North Health in the next draft of the men's policy. Questionnaires, surveys, meetings, as for women. Let me paraphrase several lines from p.2 of the women's document:
"Men are entitled to health services where they will be treated with dignity, as whole persons in their own right, not merely in terms of their role as fathers or their protector/provider attributes...
"We aim to help men make informed choices about their health by purchasing accurate and easily understood information services outlining the many health options facing men today. We believe it is important that men are satisfied with both the range of services available and the way in which those services are delivered."
I am aware that discussion and provision of women's health services is some years ahead of men's, but there is no good reason why the two paragraphs above could not also have been in the men's document. But, being cynical, I can see why they were not. If North Health can give me an honest answer as to why statements like these are not routinely included in men's health papers I would be most appreciative.
I can, finally, put my position no better than how Moir and Jessel evaluated the importance of the biological research evidence: (pp.128-129)
"Raging at men's innate maleness is as useful as raging against the weather, or the existence of the Himalayas ... Yet some women believe that the only salvation lies in relandscaping our entire social and sexual planet... [The differences] lie in the brain, its structure, priorities and strategies. These in turn inform our hopes, ambitions, skills and abilities. They are at the core of our being. Reducing the differences simply to those of reproduction is a denial not only of the scientific truth, but of the very essence of our humanity, be it male or female.
The problem is that it is the apostles of sexual sameness who set the agenda; they would enact the laws and ban the sexist books in a vain attempt to divert children from their natural sexual identities. But the idea that we are all born with a clean slate of a mind, a tabula rasa ready for society to print its message upon, is a totalitarian's dream. And if, after all, we are what we are because of our biology, is it not as monstrous and hopeless a task to eliminate our differences as it was to create a master race? There is a disturbing whiff of sexual fascism in the premises and prescriptions of those who advocate sexual neutrality."
Arndt, Bettina (1995) Taking Sides: Men, Women and the Shifting Social Agenda Random House Australia (p.222)
Blankenhorn, David (1995) Fatherless America Basic Books/Harper-Collins. NY.
Dworkin, Andrea (1988) Letters From a War Zone Secker & Warburg
" " (1983) Right Wing Women The Women's Press UK.
Forsey, Christine (1994) Hands Off West Education Centre, Vic.
" " (1990) The Making of Men - Guidelines for Working With Boys to Counter the Male Sex-role West Education Centre, Victoria
French, Marilyn (1992) The War Against Women Simon & Schuster
Lewis, Robert A (Ed) (1985) Men in Difficult Times; Masculinity Today and Tomorrow Prentice Hall NJ.
MacKinnon, Catherine (1993) Only Words Harvard University Pr.
Miedzian, Myriam (1991) Boys Will be Boys - Breaking the Link between Masculinity and Violence Doubleday
Miles, Rosalind (1991) Love, Sex, Death and the Making of the Male Simon & Schuster
Moir, Anne & Jessel, David (1989) Brainsex Mandarin UK
Pool, Robert (1993) The New Sexual Revolution Hodder & Stoughton, London
Raphael, Beverley, & Martinek, Nada Men and Mental Health in: Proceedings from the National Men's Health Conference, Melbourne, August 1995 Commonwealth Department of Human Services and Health
Schaef, Anne Wilson (1981) Women's Reality Harper & Row
Silverstein, Olga (1994) The Courage to Raise Good Men Viking
Wolf, Naomi (1990) The Beauty Myth Vintage UK
" " (1993) Fire With Fire Vintage UK