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This is the second in a series of six articles on the importance of theories and values in health research
Series editor: Priscilla Alderson
How do theories help us to grasp various truths about men's and women's responses to illness? How do theories of masculinity illuminate the reactions of young men who have lost a sexual organ and face a life threatening disease? Why are men sometimes treated differently from women in life threatening situations? 1 This paper shows how theories that underlie research influence the ways in which we perceive phenomena and how we deal with them. It questions assumptions about the concept of masculinity in medicine and how these assumptions affect men. Alternative ways of seeing may widen our perceptions, but at the same time they present us with more difficulties.
Summary points
In the positivist view, membership of the male sex is signified by the male anatomy
In the social constructivist view, male gender is practised in social interactions and is signified by beliefs and behaviour, like being hard and strong. Each society assumes that "given" attributes are fixed,although they vary across cultures and between individuals
Postmodernism will not work with rules -the fixed categories of sex and gender disintegrate altogether and are replaced by "floating signifier
Floating signifiers give no credence to "a sexual identity": "masculine" or "feminine" characteristics stereotypically assigned to sex or gender are no longer defined
The ways in which practitioners and researchers perceive masculinities can affect health care and research
The biological concept of sexa positivist approach
In the biological approach, sexual anatomy equates with sexual destiny. Anatomy is proof of being a man. Being a man takes on a universal status, generalisable and immutable. Aggression, reason, a need for control, competitiveness, and emotional reticence are thought to be "natural" attributes for a man 2 contradiction or ambiguity is anathema to him.
Men are consistently reported to live shorter lives, but women have higher rates of physical and mental morbidity. 3 Numerous surveys report that health behaviour practised by men adversely affects their health outcomes in terms of, for example, the underuse of medical and psychotherapeutic services. 3 4 Their rigidly stoical stance contributes to some physical and mental disorders that are disproportionately experienced by men. 4...